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Alves SG, Pivatto F, Filippini FB, Dannenhauer GP, Seroiska G, Bischoff HM, Birk LFS, Terra DH, Sganzerla D, Miglioranza MH. Performance of the SHARPEN Score and the Charlson Comorbidity Index for In-Hospital and Post-Discharge Mortality Prediction in Infective Endocarditis. Arq Bras Cardiol 2024; 120:e20230441. [PMID: 38451614 PMCID: PMC11021123 DOI: 10.36660/abc.20230441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/03/2023] [Accepted: 10/18/2023] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Central Illustration : Performance of the SHARPEN Score and the Charlson Comorbidity Index for In-Hospital and Post-Discharge Mortality Prediction in Infective Endocarditis. BACKGROUND SHARPEN was the first dedicated score for in-hospital mortality prediction in infective endocarditis (IE) regardless of cardiac surgery. OBJECTIVES To analyze the ability of the SHARPEN score to predict in-hospital and post-discharge mortality and compare it with that of the Charlson comorbidity index (CCI). METHODS Retrospective cohort study including definite IE (Duke modified criteria) admissions from 2000 to 2016. The area under the ROC curve (AUC-ROC) was calculated to assess predictive ability. Kaplan-Meier curves and Cox regression was performed. P-value < 0.05 was considered statistically significant. RESULTS We studied 179 hospital admissions. In-hospital mortality was 22.3%; 68 (38.0%) had cardiac surgery. Median (interquartile range, IQR) SHARPEN and CCI scores were 9(7-11) and 3(2-6), respectively. SHARPEN had better in-hospital mortality prediction than CCI in non-operated patients (AUC-ROC 0.77 vs. 0.62, p = 0.003); there was no difference in overall (p = 0.26) and in operated patients (p = 0.41). SHARPEN > 10 at admission was associated with decreased in-hospital survival in the overall (HR 3.87; p < 0.001), in non-operated (HR 3.46; p = 0.006) and operated (HR 6.86; p < 0.001) patients. CCI > 3 at admission was associated with worse in-hospital survival in the overall (HR 3.0; p = 0.002), and in operated patients (HR 5.57; p = 0.005), but not in non-operated patients (HR 2.13; p = 0.119). Post-discharge survival was worse in patients with SHARPEN > 10 (HR 3.11; p < 0.001) and CCI > 3 (HR 2.63; p < 0.001) at admission; however, there was no difference in predictive ability between these groups. CONCLUSION SHARPEN was superior to CCI in predicting in-hospital mortality in non-operated patients. There was no difference between the scores regarding post-discharge mortality.
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Affiliation(s)
- Sofia Giusti Alves
- Hospital de Clínicas de Porto AlegrePorto AlegreRSBrasilHospital de Clínicas de Porto Alegre, Porto Alegre (HCPA), RS – Brasil
| | - Fernando Pivatto
- Hospital de Clínicas de Porto AlegrePorto AlegreRSBrasilHospital de Clínicas de Porto Alegre, Porto Alegre (HCPA), RS – Brasil
- Hospital Nossa Senhora da ConceiçãoPorto AlegreRSBrasilHospital Nossa Senhora da Conceição (HNSC), Porto Alegre, RS – Brasil
| | - Filippe Barcellos Filippini
- Instituto de Cardiologia de Santa CatarinaSão JoséSCBrasilInstituto de Cardiologia de Santa Catarina, São José, SC – Brasil
| | - Gustavo Paglioli Dannenhauer
- Instituto de Cardiologia de Santa CatarinaSão JoséSCBrasilInstituto de Cardiologia de Santa Catarina, São José, SC – Brasil
| | - Gabriel Seroiska
- Universidade Federal de Ciências da Saúde de Porto AlegrePorto AlegreRSBrasilUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS – Brasil
| | - Helena Marcon Bischoff
- Universidade Federal de Ciências da Saúde de Porto AlegrePorto AlegreRSBrasilUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS – Brasil
| | - Luiz Felipe Schmidt Birk
- Universidade Federal de Ciências da Saúde de Porto AlegrePorto AlegreRSBrasilUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS – Brasil
| | - Diego Henrique Terra
- Universidade Federal de Ciências da Saúde de Porto AlegrePorto AlegreRSBrasilUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS – Brasil
| | - Daniel Sganzerla
- Unimed Porto Alegre Cooperativa MédicaPorto AlegreRSBrasilUnimed Porto Alegre Cooperativa Médica, Porto Alegre, RS – Brasil
| | - Marcelo Haertel Miglioranza
- Universidade Federal de Ciências da Saúde de Porto AlegrePorto AlegreRSBrasilUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS – Brasil
- Unimed Porto Alegre Cooperativa MédicaPorto AlegreRSBrasilUnimed Porto Alegre Cooperativa Médica, Porto Alegre, RS – Brasil
- Instituto de Cardiologia do Rio Grande do SulLaboratório de Pesquisa e Inovação em Imagem CardiovascularPorto AlegreRSBrasilInstituto de Cardiologia do Rio Grande do Sul (ICFUC-RS) – Laboratório de Pesquisa e Inovação em Imagem Cardiovascular, Porto Alegre, RS – Brasil
- Hospital Mãe de DeusPorto AlegreRSBrasilHospital Mãe de Deus, Porto Alegre, RS – Brasil
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Pinto SOSA, Pereira MA, Ribeiro Junior U, D'Albuquerque LAC, Ramos MFKP. PALLIATIVE GASTRECTOMY VERSUS GASTRIC BYPASS FOR SYMPTOMATIC CLINICAL STAGE IV GASTRIC CANCER: A PROPENSITY SCORE MATCHING ANALYSIS. Arq Bras Cir Dig 2024; 36:e1790. [PMID: 38324851 PMCID: PMC10841491 DOI: 10.1590/0102-672020230072e1790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 10/15/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Patients with clinical stage IV gastric cancer may require palliative procedures to manage complications such as obstruction. However, there is no consensus on whether performing palliative gastrectomy compared to gastric bypass brings benefits in terms of survival. AIMS To compare the overall survival of patients with distal obstructive gastric cancer undergoing palliative surgical treatment, using propensity score matching analysis. METHODS Patients who underwent palliative bypass surgery (gastrojejunostomy or partitioning) and resection between the years 2009 and 2023 were retrospectively selected. Initial and postoperative clinicopathological variables were collected. RESULTS 150 patients were initially included. The derived group (n=91) presented more locally invasive disease (p<0.01), greater degree of obstruction (p<0.01), and worse clinical status (p<0.01), while the resected ones (n= 59) presented more distant metastasis (p<0.01). After matching, 35 patients remained in each group. There was no difference in the incidence of postoperative complications, but the derived group had higher 90-day mortality (p<0.01). Overall survival was 16.9 and 4.5 months for the resected and derived groups, respectively (p<0.01). After multivariate analysis, hypoalbuminemia (hazard ratio - HR=2.02, 95% confidence interval - 95%CI 1.17-3.48; p=0.01), absence of adjuvant chemotherapy (HR=5.97; 95%CI 3.03-11.7; p<0.01), and gastric bypass (HR=3,28; 95%CI 1.8-5.95; p<0.01) were associated with worse survival. CONCLUSIONS Palliative gastrectomy was associated with greater survival and lower postoperative morbidity compared to gastric bypass. This may be due to better local control of the disease, with lower risks of complications and better effectiveness of chemotherapy.
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Affiliation(s)
| | - Marina Alessandra Pereira
- Universidade de Sao Paulo, Faculty of Medicina, Cancer Institute, Hospital de Clinicas, Department of Gastroenterology - São Paulo (SP), Brazil
| | - Ulysses Ribeiro Junior
- Universidade de Sao Paulo, Faculty of Medicina, Cancer Institute, Hospital de Clinicas, Department of Gastroenterology - São Paulo (SP), Brazil
| | - Luiz Augusto Carneiro D'Albuquerque
- Universidade de Sao Paulo, Faculty of Medicina, Cancer Institute, Hospital de Clinicas, Department of Gastroenterology - São Paulo (SP), Brazil
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Martins C, Silveira VNDC, da Silva FN, Dias JDJ, Branco MDRFC, dos Santos AM, de Oliveira BLCA. Clinical-epidemiological characteristics and survival of cases of severe acute respiratory syndrome (SARS) due to COVID-19, according to the COVID-19 vaccination schedule in Brazil, 2021-2022: a prospective study. Epidemiol Serv Saude 2023; 32:e2023128. [PMID: 38126542 PMCID: PMC10727126 DOI: 10.1590/s2237-96222023000400003.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 10/16/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To analyze the clinical and sociodemographic characteristics and survival of individuals with severe acute respiratory syndrome due to COVID-19 according to the COVID-19 vaccination schedule, Brazil, 2021-2022. METHODS This was a cohort study based on data from the Influenza Epidemiological Surveillance Information System; the Kaplan-Meier and Survival Tree methods were used to analyze survival. RESULTS Among the 559,866 hospitalized cases, a higher proportion of vaccinated individuals was found among female (15.0%), elderly people aged ≥ 80 (34.5%), people from the Southeast region (15.7%), those who did not undergo respiratory support (21.2%) and those who did progress to death (15.2%); the survival curve showed that risk of death for unvaccinated individuals was higher in all age groups (p-value < 0.001); elderly people aged ≥ 80, who did not undergo mechanical ventilation and who had a booster dose had lower risk when compared to their peers who had two doses or were unvaccinated (hazard ratio = 0.64; 95%CI 0.62;0.67). CONCLUSION Lowest risk of death was found in vaccinated individuals, especially those who had two doses or a booster dose as well. MAIN RESULTS Prevalence was found to be high among unvaccinated individuals. Risk of death was lower among those vaccinated with a booster dose, compared to those not vaccinated, in all age groups analyzed. IMPLICATIONS FOR SERVICES The number of hospitalizations of unvaccinated individuals with severe acute respiratory syndrome was high, which increases the demand for health services to care for these individuals. PERSPECTIVES It is necessary to promote widespread vaccination of the entire population of Brazil, in addition to the regular provision of booster doses for the different population groups.
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Affiliation(s)
- Carlos Martins
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís, MA, Brazil
| | | | - Fábio Nogueira da Silva
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís, MA, Brazil
| | - José de Jesus Dias
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís, MA, Brazil
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Gonçalves DS, dos Santos AMR, da Costa SCV, da Costa RS, Senna KMSE, Zimmermann IR. Overall survival and associated factors in women with metastatic breast cancer treated with trastuzumab at a public referral institution. Rev Bras Epidemiol 2023; 26:e230045. [PMID: 37878833 PMCID: PMC10642446 DOI: 10.1590/1980-549720230045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE To characterize associated factors and overall survival of women with metastatic breast cancer treated with trastuzumab after its incorporation into the SUS, and additionally to present the direct costs of this technology. METHODS This is a retrospective cohort, based on data from computerized medical records from one of the units of the National Cancer Institute (INCA), in Rio de Janeiro-RJ, Brazil. Women with HER-2 positive metastatic breast cancer undergoing trastuzumab treatment from September 2017 to August 2018 were included. Overall survival was estimated using the Kaplan-Meier method and compared between groups using the log-rank test. RESULTS 136 women were selected, whose median age at diagnosis was 51 years (range: 21-81 years). The median OS was 43.63 months (95%CI 33.92-53.34). It is observed that the median OS for the population already diagnosed with metastatic disease (stage IV) was significantly lower than for patients diagnosed in stages I-III (37.43 months vs. 48.6 months, p<0, 01). Women without previous use of trastuzumab had a higher median OS than patients pretreated with trastuzumab (45.16 months vs. 40.73 months, p<0.01). CONCLUSION Trastuzumab improves survival in HER-2 positive metastatic breast cancer. Brain and multiple metastases are associated with a worse prognosis. It is essential to avoid advanced staging and perform surgical treatment, with emphasis on radical mastectomy. The SUS must adopt policies and strategies for early diagnosis and guarantee access to trastuzumab, considering its high cost.
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Affiliation(s)
- Débora Silva Gonçalves
- Instituto Nacional de Cardiologia, Professional Master's Program in Health Technology Assessment – Rio de Janeiro (RJ), Brazil
| | - Arn Migowski Rocha dos Santos
- Instituto Nacional de Cardiologia, Professional Master's Program in Health Technology Assessment – Rio de Janeiro (RJ), Brazil
| | | | - Rodrigo Saar da Costa
- Instituto Nacional do Câncer José Alencar Gomes da Silva – Rio de Janeiro (RJ), Brazil
| | - Katia Marie Simões e Senna
- Instituto Nacional de Cardiologia, Professional Master's Program in Health Technology Assessment – Rio de Janeiro (RJ), Brazil
| | - Ivan Ricardo Zimmermann
- Universidade de Brasília, School of Health Sciences, Department of Collective Health – Brasília (DF), Brazil
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Kale PL, Fonseca SC. Intrauterine growth restriction, prematurity, and low birth weight: risk phenotypes of neonatal death, Rio de Janeiro State, Brazil. CAD SAUDE PUBLICA 2023; 39:e00231022. [PMID: 37377302 PMCID: PMC10547104 DOI: 10.1590/0102-311xpt231022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/27/2023] [Accepted: 03/23/2023] [Indexed: 06/29/2023] Open
Abstract
Intrauterine growth restriction and prematurity determine low birth weight. The combination of the three conditions results in different neonatal phenotypes that interfere with child survival. Neonatal prevalence, survival and mortality were estimated according to neonatal phenotypes in the cohort of live births in 2021 in the state of Rio de Janeiro, Brazil. In this study, live births of multiple pregnancies, with congenital anomalies and inconsistencies in the information of weight and gestational age were excluded. The Intergrowth curve was used to classify weight adequacy. Mortality (< 24 hours, 1-6 and 7-27 days) and survival (Kaplan-Meier) were estimated. In total, 6.8%, 5.5%, and 9.5% of the 174,399 live births were low birth weight, small for gestational age (SGA), and premature, respectively. Considering low birth weight live births, 39.7% were SGA and 70% were premature. The neonatal phenotypes were heterogeneous according to maternal, delivery, pregnancy, and newborn characteristics. The mortality rate per 1,000 live births was high for low birth weight premature newborns, both SGA (78.1) and AGA (adequate for gestational age: 61.1), at all specific ages. Reductions in the survival rate were observed when comparing non-low birth weight and AGA term live births. The estimated prevalence values were lower than those of other studies, partly due to the exclusion criteria adopted. The neonatal phenotypes identified children who were more vulnerable and at higher risk of death. Prematurity contributed more to mortality than SGA, and its prevention is necessary to reduce neonatal mortality in the state of Rio de Janeiro.
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Affiliation(s)
- Pauline Lorena Kale
- Instituto de Estudos de Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
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Marinho EMS, Santos JMM, Brito BDS, Andrade ADS, Lopes JM. Mechanical Valve Implants: What Are Their Long-Term Effects?Reply. Arq Bras Cardiol 2023; 120:e20220875. [PMID: 37466489 PMCID: PMC10364984 DOI: 10.36660/abc.20220875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 12/15/2022] [Accepted: 12/15/2022] [Indexed: 07/20/2023] Open
Affiliation(s)
- Eldys Myler Santos Marinho
- Universidade Federal do Vale do São FranciscoPetrolinaPEBrasilUniversidade Federal do Vale do São Francisco (UNIVASF) – Educação Física, Petrolina, PE – Brasil
| | - Júlio Martinez Martinez Santos
- Universidade Federal do Vale do São FranciscoPaulo AfonsoBABrasilUniversidade Federal do Vale do São Francisco (UNIVASF) – Medicina, Paulo Afonso, BA – Brasil
| | - Bruno da Silva Brito
- Universidade Federal da ParaíbaPrograma de Pós-graduação em NeurociênciaJoão PessoaPBBrasilUniversidade Federal da Paraíba - Programa de Pós-graduação em Neurociência, João Pessoa, PB – Brasil
| | - Achilles de Souza Andrade
- Universidade Federal da ParaíbaJoão PessoaPBBrasilUniversidade Federal da Paraíba – Medicina, João Pessoa, PB – Brasil
| | - Johnnatas Mikael Lopes
- Universidade Federal do Vale do São FranciscoPaulo AfonsoBABrasilUniversidade Federal do Vale do São Francisco (UNIVASF) – Medicina, Paulo Afonso, BA – Brasil
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Bruno TC, Bittencourt MS, Quidim AVL, Santos IS, Lotufo PA, Benseñor IM, Goulart AC. Prognosis Related to Reperfusion Therapy Post-Acute Coronary Syndrome in Secondary Care: Long-Term Survival Analysis in the ERICO Study. Arq Bras Cardiol 2023; 120:e20220849. [PMID: 37194831 PMCID: PMC10263393 DOI: 10.36660/abc.20220849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/15/2023] [Accepted: 02/15/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Relationship between reperfusion therapy post-acute coronary syndrome (ACS) and mortality in secondary care is not well-known. OBJECTIVES To evaluate the impact of three therapeutic strategies: (1) exclusive medical therapy, (2) percutaneous coronary intervention (PCI) and (3) coronary artery bypass grafting (CABG) on long-term survival of participants in the Strategy of Registry of Acute Coronary Syndrome (ERICO) study. METHODS Survival analyses for all-cause, cardiovascular (CVD) and coronary artery disease (CAD) mortality were performed according to three therapeutic strategies (exclusive medical therapy, PCI or CABG). Cox regression models were used to estimate the hazard ratio (HR) with respective 95% confidence interval (95%CI) from 180 days to four years of follow-up after ACS. Models are presented as crude, age-sex adjusted and further adjusted for previous CAD, ACS subtype, smoking, hypertension, dyslipidemia, left ventricular ejection fraction and according to the number of obstructed (≥ 50%) major coronary arteries. RESULTS Among 800 participants, the lowest crude survival rates were detected among individuals who underwent CABG (all-cause and CVD). CABG was correlated to CAD (HR: 2.19 [95% CI: 1.05-4.55]). However, this risk lost significance in the full model. PCI was associated to lower probability of fatal events during four-year follow-up: all-cause [multivariate HR: 0.42 (95% CI: 0.26-0.70)], CVD [HR: 0.39 (95% CI: 0.20-0.73)] and CAD [multivariate HR: 0.24 (95% CI: 0.09-0.63)] compared to those submitted to exclusive medical therapy. CONCLUSION In the ERICO study, PCI after ACS was associated to better prognosis, particularly CAD survival.
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Affiliation(s)
- Tatiana C. Bruno
- Centro de Pesquisa Clínica e EpidemiológicaHospital UniversitárioUniversidade de São PauloSão PauloSPBrasil Centro de Pesquisa Clínica e Epidemiológica – Hospital Universitário – Universidade de São Paulo , São Paulo , SP – Brasil
| | - Márcio S. Bittencourt
- Centro de Pesquisa Clínica e EpidemiológicaHospital UniversitárioUniversidade de São PauloSão PauloSPBrasil Centro de Pesquisa Clínica e Epidemiológica – Hospital Universitário – Universidade de São Paulo , São Paulo , SP – Brasil
| | - Alessandra V. L. Quidim
- Centro de Pesquisa Clínica e EpidemiológicaHospital UniversitárioUniversidade de São PauloSão PauloSPBrasil Centro de Pesquisa Clínica e Epidemiológica – Hospital Universitário – Universidade de São Paulo , São Paulo , SP – Brasil
| | - Itamar S. Santos
- Centro de Pesquisa Clínica e EpidemiológicaHospital UniversitárioUniversidade de São PauloSão PauloSPBrasil Centro de Pesquisa Clínica e Epidemiológica – Hospital Universitário – Universidade de São Paulo , São Paulo , SP – Brasil
- Universidade de São PauloFaculdade de MedicinaSão PauloSPBrasil Universidade de São Paulo , Faculdade de Medicina , São Paulo , SP – Brasil
| | - Paulo A. Lotufo
- Centro de Pesquisa Clínica e EpidemiológicaHospital UniversitárioUniversidade de São PauloSão PauloSPBrasil Centro de Pesquisa Clínica e Epidemiológica – Hospital Universitário – Universidade de São Paulo , São Paulo , SP – Brasil
- Universidade de São PauloFaculdade de MedicinaSão PauloSPBrasil Universidade de São Paulo , Faculdade de Medicina , São Paulo , SP – Brasil
| | - Isabela M. Benseñor
- Centro de Pesquisa Clínica e EpidemiológicaHospital UniversitárioUniversidade de São PauloSão PauloSPBrasil Centro de Pesquisa Clínica e Epidemiológica – Hospital Universitário – Universidade de São Paulo , São Paulo , SP – Brasil
- Universidade de São PauloFaculdade de MedicinaSão PauloSPBrasil Universidade de São Paulo , Faculdade de Medicina , São Paulo , SP – Brasil
| | - Alessandra C. Goulart
- Centro de Pesquisa Clínica e EpidemiológicaHospital UniversitárioUniversidade de São PauloSão PauloSPBrasil Centro de Pesquisa Clínica e Epidemiológica – Hospital Universitário – Universidade de São Paulo , São Paulo , SP – Brasil
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Tagliari F, Correia MG, Amorim GD, Colafranceschi AS, Pedroso JM, Rodrigues LF, Tagliari TR, Weksler C, Lamas C. Clinical Features and Survival Analysis of Patients after Mechanical Heart Valve Replacement, with an Emphasis on Prosthetic Valve Thrombosis. Arq Bras Cardiol 2022; 119:734-744. [PMID: 36453764 PMCID: PMC9750220 DOI: 10.36660/abc.20210544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 04/10/2022] [Accepted: 04/13/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Valvular heart diseases are highly prevalent in the world, and surgical valve replacement has improved patients' survival. OBJECTIVES To describe clinical and laboratory data of patients undergoing mechanical valve replacement, and to determine the incidence of prosthetic valve thrombosis (PVT). METHODS Retrospective cohort study with a follow-up of up to nine years. The study variables were collected from conventional and electronic medical charts. Statistical calculations were performed using the Jamovi software version 1.2.2.; a p<0.05 was considered statistically significant. Kaplan Meier curves were constructed, and Cox regression analysis was performed for analysis of factors related to mortality. RESULTS A total of 473 patients were included, mean age of 46.9 ±11.3 years. Rheumatic disease was the most common etiology. In a mean follow-up period of 4.43 years, mortality rate was 16.1%. Patients with aortic prosthesis showed higher survival than patients with double implant (mitral and aortic) (p=0.026). Of the factors adjusted for mortality, only functional class and chronic renal failure showed statistically significant association. The incidence of PVT was 0.24/100 patients/year, and the first event occurred more than 1000 days after the implant. Smoking and pannus formation were significantly associated with PVT. No differences were found in INR variability between patients with and without thrombosis by prosthetic position, but significant differences were found in INR before thrombosis as compared with patients without thrombosis (INR= 2.20 [1.80-2.20] vs. 2.80 [2.20-3.40]; p= 0.040). The incidence of stroke and bleeding was 4.4% and 5.2% respectively. CONCLUSIONS The study population was young, and rheumatic valve disease was common in this group. The prevalence of PVT was similar to that described in the literature, despite the low income and low educational level of our sample.
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Affiliation(s)
- Fábio Tagliari
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ – Brasil
| | - Marcelo Goulart Correia
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ – Brasil
| | - Guilherme Dalcol Amorim
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ – Brasil
| | | | - João Manoel Pedroso
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ – Brasil
| | - Luiz Fernando Rodrigues
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ – Brasil
- Universidade Federal do Estado do Rio de JaneiroRio de JaneiroRJBrasilUniversidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ – Brasil
| | - Thaisa Rodrigues Tagliari
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ – Brasil
| | - Clara Weksler
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ – Brasil
| | - Cristiane Lamas
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ – Brasil
- Universidade do Grande RioRio de JaneiroRJBrasilUniversidade do Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ – Brasil
- FiocruzInstituto Nacional de Infectologia Evandro ChagasRio de JaneiroRJBrasilInstituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro, RJ – Brasil
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Picarelli H, Yamaki VN, Solla DJF, Neville IS, Santos AGD, Freitas BSAGD, Diep C, Paiva WS, Teixeira MJ, Figueiredo EG. The preoperative neutrophil-to-lymphocyte ratio predictive value for survival in patients with brain metastasis. Arq Neuropsiquiatr 2022; 80:922-928. [PMID: 36261127 PMCID: PMC9770070 DOI: 10.1055/s-0042-1755324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte ratio (PLR), and red blood cell distribution width (RDW) have been previously studied as predictors of survival in different malignancies. OBJECTIVE The aim of this study was to evaluate the predictive value of these hematologic inflammatory biomarkers for patients with brain metastases (BM). METHODS We reviewed a consecutive cohort of patients at Instituto do Cancer do Estado de São Paulo (ICESP-FMUSP) from 2011 to 2016 with ≥ 1 BM treated primarily by surgical resection. The primary outcome was 1-year survival. We optimized the NLR, MLR, PLR, and RDW cutoff values, preserving robustness and avoiding overestimation of effect size. RESULTS A total of 200 patients (mean age 56.1 years; 55.0% female) met inclusion criteria. Gross-total resection was achieved in 89.0%. The median (quartiles) preoperative and postoperative KPS scores were 60 (50-80) and 80 (60-90), respectively. Preoperative NLR was significantly associated with survival (HR 2.66, 95% CI: 1.17-6.01, p = 0.019). A NLR cutoff value of 3.83 displayed the most significant survival curve split. CONCLUSIONS Preoperative NLR is an independent predictor of survival in newly diagnosed BM. We propose a cutoff value of 3.83 for preoperative NLR testing may be clinically useful as predictor of poor survival in this population. The wide accessibility of the NLR favors its inclusion in clinical decision-making processes for BM management.
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Affiliation(s)
- Helder Picarelli
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, Divisão de Neurocirurgia, São Paulo SP, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto do Câncer de São Paulo, São Paulo SP, Brazil.
| | - Vitor Nagai Yamaki
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, Divisão de Neurocirurgia, São Paulo SP, Brazil.
| | - Davi Jorge Fontoura Solla
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, Divisão de Neurocirurgia, São Paulo SP, Brazil.
| | - Iuri Santana Neville
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, Divisão de Neurocirurgia, São Paulo SP, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto do Câncer de São Paulo, São Paulo SP, Brazil.
| | - Alexandra Gomes dos Santos
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, Divisão de Neurocirurgia, São Paulo SP, Brazil.,Address for correspondence Alexandra Gomes dos Santos
| | | | - Calvin Diep
- University of Toronto Medical School, Department of Anesthesiology and Pain Medicine, Toronto, Ontario, Canada.
| | - Wellingson Silva Paiva
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, Divisão de Neurocirurgia, São Paulo SP, Brazil.
| | - Manoel Jacobsen Teixeira
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, Divisão de Neurocirurgia, São Paulo SP, Brazil.
| | - Eberval Gadelha Figueiredo
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, Divisão de Neurocirurgia, São Paulo SP, Brazil.
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10
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da Cunha LDCBP, Guerios EE, da Cunha CLP, Carvalho LA, Lemos P, Sarmento-Leite R, Abizaid AA, Mangione JA, Oliveira AD, Siciliano A, Esteves V, de Brito FS. Relationship between Mitral Regurgitation and Transcatheter Aortic Valve Implantation: a Multi-Institutional Follow-up Study. Arq Bras Cardiol 2021; 116:1059-1069. [PMID: 34133587 PMCID: PMC8288547 DOI: 10.36660/abc.20190772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 05/23/2020] [Accepted: 06/16/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Mitral regurgitation (MR) is prevalent in patients undergoing transcatheter aortic valve implantation (TAVI). There are some controversies about the prognostic impact of MR in survival of TAVI patients. OBJECTIVE To examine the relationship between TAVI and MR in a patient population from the Brazilian TAVI Registry. METHODS Seven hundred and ninety-five patients from the Brazilian TAVI Registry were divided at baseline, discharge, and follow-up according to their MR grade as follows: absent/mild (AMMR) or moderate/severe (MSMR). They were subsequently regrouped according to their immediate and late changes in MR severity after TAVI as follows: no change, improved, or worsened MR. Predictors and prognostic impact on baseline as well as changes in MR severity were analyzed. Statistical significance was set at p < 0.05. RESULTS Baseline MSMR was present in 19.3% of patients and was a predictor of increased late mortality. Immediately after TAVI, 47.4 % of cases improved to AMMR, predicted by a higher Society of Thoracic Surgeons score and a higher grade of baseline aortic regurgitation. Upon follow-up, 9.2% of cases of AMMR worsened to MSMR, whereas 36.8% of cases of MSMR improved to AMMR. Lower baseline left ventricular ejection fraction (LVEF) and improvement in LVEF at follow-up were predictors of MR improvement. Progressive worsening of MR upon follow-up was an independent predictor of higher late mortality after TAVI (p = 0.005). CONCLUSIONS Baseline MSMR predicts late mortality after TAVI. Lower LVEF and improved LVEF at follow-up predict MR improvement after TAVI. Progressive worsening of MR severity at follow-up is an independent predictor of late mortality, which is a rare finding in the literature.
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Affiliation(s)
| | - Enio Eduardo Guerios
- Universidade Federal do ParanáHospital de ClínicasCuritibaPRBrasil Universidade Federal do Paraná - Hospital de Clínicas - UFPR, Curitiba , PR - Brasil
| | - Claudio Leinig Pereira da Cunha
- Universidade Federal do ParanáHospital de ClínicasCuritibaPRBrasil Universidade Federal do Paraná - Hospital de Clínicas - UFPR, Curitiba , PR - Brasil
| | - Luiz A. Carvalho
- Hospital Pró-CardíacoRio de JaneiroRJBrasil Hospital Pró-Cardíaco , Rio de Janeiro , RJ - Brasil
| | - Pedro Lemos
- Hospital Israelita Albert EinsteinSão PauloSPBrasil Hospital Israelita Albert Einstein , São Paulo , SP - Brasil
| | - Rogério Sarmento-Leite
- Instituto de CardiologiaPorto AlegreRSBrasil Instituto de Cardiologia , Porto Alegre , RS - Brasil
| | - Alexandre A. Abizaid
- Hospital Israelita Albert EinsteinSão PauloSPBrasil Hospital Israelita Albert Einstein , São Paulo , SP - Brasil
| | - José Antonio Mangione
- Hospital Beneficência Portuguesa de São PauloSão PauloSPBrasil Hospital Beneficência Portuguesa de São Paulo , São Paulo , SP - Brasil
| | | | - Alexandre Siciliano
- Hospital Israelita Albert EinsteinSão PauloSPBrasil Hospital Israelita Albert Einstein , São Paulo , SP - Brasil
| | - Vinicius Esteves
- Rede D’Or São LuizSão PauloSPBrasil Rede D’Or São Luiz , São Paulo , SP - Brasil
| | - Fábio Sândoli de Brito
- Universidade de São PauloInstituto do CoraçãoSão PauloSPBrasil Universidade de São Paulo Instituto do Coração , São Paulo , SP - Brasil
- Hospital Sírio-LibanêsSão PauloSPBrasil Hospital Sírio-Libanês , São Paulo , SP - Brasil
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11
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Moraes BA, Strada JKR, Gasparin VA, Espirito-Santo LCD, Gouveia HG, Gonçalves ADC. Breastfeeding in the first six months of life for babies seen by Lactation Consulting. Rev Lat Am Enfermagem 2021; 29:e3412. [PMID: 33852684 PMCID: PMC8040780 DOI: 10.1590/1518-8345.3538.3412] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 08/10/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to identify breastfeeding patterns, survival of exclusive breastfeeding and factors associated with its interruption, in the first six months of life of babies seen by Lactation Consulting. METHOD a prospective cohort, with 231 mother-babies in a Baby-Friendly Hospital. An initial questionnaire was applied after 24 hours of birth, after consulting, as well as a follow-up questionnaire, applied by telephone at 15, 30, 60, 120 and 180 days, with sociodemographic and obstetric variables, maternal habits, father's schooling, birth data and baby feeding. Survival Analysis was carried out. RESULTS at 180 days of age, exclusive breastfeeding was 12.7% and the probability was 19.6% in the analysis of the survival curve. The factors associated with its interruption were smoking during pregnancy (HR 1.66; CI 1.05 - 2.61), age ≥ 35 years old (HR 1.73; CI 1.03 - 2.90), difficulty in breastfeeding after hospital discharge (HR 2.09; CI 1.29 - 3.41), search for professional assistance (HR 2.45; CI 1.69 - 3.54) and use of a pacifier (HR 1.76; IC 1.21 - 2.58). CONCLUSION lactation consultancy contributed to the improvement of the exclusive breastfeeding rates, although there are opportunities for advances.
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Affiliation(s)
- Bruna Alibio Moraes
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | | | - Vanessa Aparecida Gasparin
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
- Universidade do Estado de Santa Catarina, Departamento de Enfermagem, Chapecó, SC, Brazil
| | | | - Helga Geremias Gouveia
- Universidade Federal do Rio Grande do Sul, Departamento de Enfermagem Materno Infantil, Porto Alegre, RS, Brazil
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12
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Nobre KEL, Pereira MA, Ramos MFKP, Ribeiro U, Zilberstein B, Cecconello I, Dias AR. RECURRENCE IN PN0 GASTRIC CANCER: RISK FACTORS IN THE OCCIDENT. Arq Bras Cir Dig 2021; 34:e1562. [PMID: 34008706 PMCID: PMC8121064 DOI: 10.1590/0102-672020210001e1562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/09/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Nearly 10% of node negative gastric cancer patients who underwent curative surgery have disease recurrence. Western data is extremely poor on this matter and identifying the risk factors that associate with relapse may allow new strategies to improve survival. AIM Verify the clinical and pathological characteristics that correlate with recurrence in node negative gastric cancer. METHODS All gastric cancer patients submitted to gastrectomy between 2009 and 2019 at our institution and pathologically classified as N0 were considered. Their data were available in a prospective database. Inclusion criteria were: gastric adenocarcinoma, node negative, gastrectomy with curative intent, R0 resection. Main outcomes studied were: disease-free survival and overall survival. RESULTS A total of 270 patients fulfilled the inclusion criteria. Mean age was 63-year-old and 155 were males. Subtotal gastrectomy and D2 lymphadenectomy were performed in 64% and 74.4%, respectively. Mean lymph node yield was 37.6. Early GC was present in 54.1% of the cases. Mean follow-up was 40.8 months and 19 (7%) patients relapsed. Disease-free survival and overall survival were 90.9% and 74.6%, respectively. Independent risk factors for worse disease-free survival were: total gastrectomy, lesion size ≥3.4 cm, higher pT status and <16 lymph nodes resected. CONCLUSION In western gastric cancer pN0 patients submitted to gastrectomy, lymph node count <16, pT3-4 status, tumor size ≥3.4 cm, total gastrectomy and presence of lymphatic invasion, are all risk factors for disease relapse.
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Affiliation(s)
| | | | | | - Ulysses Ribeiro
- Cancer Institute, Hospital das Clinicas, University of São Paulo, São Paulo, SP, Brazil
| | - Bruno Zilberstein
- Cancer Institute, Hospital das Clinicas, University of São Paulo, São Paulo, SP, Brazil
| | - Ivan Cecconello
- Cancer Institute, Hospital das Clinicas, University of São Paulo, São Paulo, SP, Brazil
| | - André Roncon Dias
- Cancer Institute, Hospital das Clinicas, University of São Paulo, São Paulo, SP, Brazil
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13
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Denardin D, Savaris FE, da Cunha AC, Betat RDS, Telles JAB, Targa LV, Weiss A, Zen PRG, Rosa RFM. Retrospective cohort of trisomy 18 (Edwards syndrome) in southern Brazil. SAO PAULO MED J 2015; 133:320-5. [PMID: 25388684 PMCID: PMC10876362 DOI: 10.1590/1516-3180.2013.79900715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 11/20/2013] [Accepted: 07/11/2014] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Trisomy 18 (T18), or Edwards syndrome, is a chromosomal disease characterized by a broad clinical picture and a poor prognosis. Our aim was to describe clinical, radiological and survival data of a cohort of patients prenatally diagnosed with T18. DESIGN AND SETTING Retrospective single cohort in the Fetal Medicine Service of Hospital Materno Infantil Presidente Vargas (HMIPV). METHODS All sequential patients with T18 registered at the Fetal Medicine Service of HMIPV between January 2005 and September 2013 were considered. We gathered their clinical, radiological and survival data and used the Kaplan-Meier test for survival analysis. RESULTS Ten patients were diagnosed with T18, of whom seven (70%) were female. The majority (90%) were referred due to malformations seen on ultrasound. The mean gestational age at the first evaluation was 25.5 weeks. At karyotyping, the defects were considered multiple in only four patients (40%). All the fetuses presented full trisomy of chromosome 18. The main abnormality observed was congenital heart disease (n = 7). Intrauterine death occurred in half of the patients (50%). All live patients (n = 5) were born through cesarean section presenting low weight and low Apgar scores. The median length of survival after birth was 18 days. CONCLUSIONS T18 is associated with a high risk of fetal and neonatal death. The majority of the patients present major malformations identified through ultrasound, such as congenital heart defects, which could help in identifying such cases prenatally.
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Affiliation(s)
- Daniela Denardin
- MD. Physician, Residency Program on Obstetrics and Gynecology, Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Fabíola Elizabete Savaris
- MD. Physician, Residency Program on Obstetrics and Gynecology, Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, Rio Grande do Sul, Brazil.
| | - André Campos da Cunha
- MD. Obstetrician, Fetal Medicine, Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Rosilene da Silveira Betat
- MD. Obstetrician, Fetal Medicine, Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Jorge Alberto Bianchi Telles
- MD. Fetologist, Fetal Medicine, Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Luciano Vieira Targa
- MD. Pediatric Radiologist, Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Aline Weiss
- MD. Neonatologist, Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Paulo Ricardo Gazzola Zen
- PhD. Adjunct Professor of Clinical Genetics and of the Postgraduate Program on Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Rafael Fabiano Machado Rosa
- PhD. Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA) and Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, Rio Grande do Sul, Brazil.
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14
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Tavares MBAC, Sousa RB, Silva TOE, Moreira LA, Silva LTTL, Tavares CBAC, Vieira SC. Prevalence of prognostic factors for cancer of the uterine cervix after radical hysterectomy. SAO PAULO MED J 2009; 127:145-9. [PMID: 19820876 PMCID: PMC10956892 DOI: 10.1590/s1516-31802009000300007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Revised: 07/14/2009] [Accepted: 06/08/2009] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Cancer of the uterine cervix is still very common in Brazil. It is important to evaluate factors that influence its prognosis. The aim here was to analyze the prevalence of prognostic anatomoclinical factors among patients with carcinoma of the uterine cervix undergoing radical hysterectomy. DESIGN AND SETTING Cross-sectional study on 301 patients with invasive carcinoma of the uterine cervix who underwent Level III Piver-Rutledge hysterectomy surgery at São Marcos Hospital. METHODS The following variables were analyzed: age, histological type, degree of differentiation, invasion of lymphatic, vascular and perineural space, lymph node metastasis, distance to nearest margin, tumor invasion depth, vaginal cuff size, largest diameter of the tumor, presence of necrosis and surgical margin involvement. Descriptive statistics, multiple regression analysis, Kaplan-Meier survival curves and the log-rank test were performed. A significance level of 5% was used. RESULTS The mean age was 48.27 years. The following were not important for the prognosis, in relation to survival analysis: degree of differentiation and tumor invasion depth; presence of lymphatic, blood and perineural invasions; distance to nearest margin; and vaginal cuff size. Tumor size (P < 0.036), presence of lymph node metastasis (P < 0.0004), necrosis (P < 0.05) and surgical margin involvement (P < 0.0015) presented impacts on survival. The overall survival with 98 months of follow-up was 88.35%. CONCLUSION The most prevalent prognostic factors were the presence of lymph node metastasis, tumor size and surgical margin involvement.
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Affiliation(s)
| | - Rodrigo Beserra Sousa
- Medical student, School of Medicine, Universidade Federal do Piauí (UFPI), Teresina, Piauí, Brazil.
| | - Thiago Oliveira e Silva
- Medical student, School of Medicine, Universidade Federal do Piauí (UFPI), Teresina, Piauí, Brazil.
| | | | | | - Carolina Buenos Aires Cabral Tavares
- MD. Gynecologist and Obstetrician, Maternidade-Escola Assis Chateaubriand (MEAC), Universidade Federal do Ceará (UFC), Fortaleza, Ceará, Brazil.
| | - Sabas Carlos Vieira
- MD, PhD. Oncological Surgeon and Professor, Universidade Federal do Piauí (UFPI), Teresina, Piauí, Brazil.
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