Survival Disparities of Diffuse Large B-Cell Lymphoma in a Community-Based Inner-City Cancer Center.

BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) comprises approximately 30% of all non-Hodgkin lymphomas. Multiple studies have demonstrated race-based disparities in survival among patients with DLBCL across all stages of disease, in the era both before and after rituximab. The etiology for the racial disparities in survival among patients with DLBCL is still unknown. Moreover, the Revised International Prognostic Index (R-IPI), a tool that predicts the DLBCL patients' outcome, has not yet been validated in African Americans (AA). PATIENTS AND METHODS: We conducted a cohort study of patients diagnosed with DLBCL from January 1, 2007, to December 31, 2017, from our tumor registry in a single community-based inner-city cancer center. We abstracted demographic, clinical, histopathologic, treatment, and R-IPI variables. A total of 181 patients (47.5%) with biopsy-proven DLBCL were included in the retrospective analysis. The median age was 65 years, 47% were men, 41% were AA, and 44% were white. RESULTS: The AA group had a younger median age, higher lactate dehydrogenase levels, higher frequency of B symptoms, and higher HIV infection than the non-AA group. The AA group had significantly decreased median overall survival than the non-AA group (15.7 months; 95% confidence interval, 10.3 to 23.9, vs. 93.6 months; 95% confidence interval, 61.5 to 142.6, respectively; P < .001). The survival disparities persisted after excluding patients with HIV and who did not receive chemotherapy. In addition, AA race predicts a reduced survival by univariate and multivariate analysis. CONCLUSION: AA with DLBCL may have a poorer prognosis than the non-AA population. Further studies should investigate the biology of DLBCL in the AA population.

Case Report: IgG multiple myeloma and chronic myeloid leukemia in a single patient.

A 58-year-old man presented with recurrence of chronic myeloid leukemia (CML) after complete molecular remission in the setting of non-compliance with imatinib. He was restarted on imatinib and was also noted to have IgG kappa monoclonal gammopathy of undetermined significance (MGUS). The patient re-achieved molecular remission after resumption of imatinib, but his MGUS progressed to smoldering myeloma and he was eventually diagnosed with multiple myeloma (MM) and initiated on treatment for MM with thalidomide, bortezomib and dexamethasone. He has responded well to treatment of the myeloma and continues concurrent maintenance imatinib treatment for CML and is being evaluated for bone marrow transplant. The association of two concurrent hematological malignancies, CML and MM, is very rare and has been infrequently reported in literature. The pathophysiology of this has not yet been fully understood. This case report reviews the various theories to explain this and discusses the potential challenges of simultaneous treatment of MM and CML.

Development of new cold antibodies in a patient with a history of warm autoimmune haemolytic anaemia.

A 31-year-old male presented to our facility with complaints of shortness of breath and left-sided chest pain. On record review, it was revealed that he had been seen in 2014 for an almost identical presentation and had been found to have haemolytic anaemia with warm autoantibodies. Following his acute treatment during that hospital admission, he was lost to follow-up. During his subsequent admission, 5 years later, he was found to have a systemic autoimmune disorder with a superimposed acute bacterial infection leading to a second case of haemolytic anaemia and at this time with both cold and warm antibodies present. While his diagnosis was initially difficult to make due to both derangements in expected laboratory values and the mixed pattern of the haemolytic anaemia, he was promptly treated with intravenous immune globulin and steroids and was able to make a full recovery.

Metastatic clear cell endometrial carcinoma: an unusual cause of a common clinical presentation.

A 60-year-old woman presented with melena for 2 weeks. She had undergone hysterectomy and bilateral salpingo-oophorectomy to treat clear cell endometrial carcinoma 10 months before the presentation. She was anaemic and tachycardic; abdominal CT scan revealed a large duodenal mass. Her gastrointestinal bleed was not amenable to endoscopic intervention, so she had emergent laparotomy, pancreaticoduodenectomy with duodenal mass excision. Histopathology confirmed that the duodenal mass was a metastatic deposit from her clear cell endometrial cancer. Postoperatively, she was frail and chose hospice care and she died 90 days postoperatively. Clear cell endometrial cancer is a rare subtype of endometrial cancer, that has a worse prognosis compared with the more common endometrioid subtype. The duodenum is a rare site for metastatic endometrial cancer, and we report this case to alert clinicians to the possibility of metastases to the small intestine in patients with clear cell endometrial cancer.

Access to internet, smartphone usage, and acceptability of mobile health technology among cancer patients.

PURPOSE: The use of mobile health (mHealth) technologies to augment patient care enables providers to communicate remotely with patients enhancing the quality of care and patient engagement. Few studies evaluated predictive factors of its acceptance and subsequent implementation, especially in medically underserved populations. METHODS: A cross-sectional study of 151 cancer patients was conducted at an academic medical center in the USA. A trained interviewer performed structured interviews regarding the barriers and facilitators of patients' current and desired use of mHealth technology for healthcare services. RESULTS: Of the 151 participants, 35.8% were male and ages ranged from 21 to 104 years. 73.5% of participants currently have daily access to internet, and 68.2% currently own a smartphone capable of displaying mobile applications. Among all participants, acceptability of a daily mHealth application was significantly higher in patients with a college-level degree (OR 2.78, CI95% 1.25-5.88) and lower in patients > 80 years of age (OR 0.05, CI95% 0.01-0.23). Differences in acceptability when adjusted for current smartphone use and daily access to internet were nonsignificant. Among smartphone users, the desire to increase cancer knowledge was associated with a higher likelihood of utilizing a mHealth application (OR 261.53, CI95% 10.13-6748.71). CONCLUSION: The study suggests that factors such as age, educational achievement, and access to internet are significant predictors of acceptability of a mHealth application among cancer patients. Healthcare organizations should consider these factors when launching patient engagement platforms.

Hemophagocytic Lymphohistiocytosis in an AIDS Patient with Kaposi Sarcoma: A Treatment Dilemma.

Hemophagocytic lymphohistiocytosis (HLH) is a result of an abnormal activation of immune cells (T lymphocytes, natural killer cells, and macrophages) resulting in cytokine overproduction and immune destruction of cells, eventually resulting in multiorgan failure. Genetic causes are responsible for primary hemophagocytosis, but malignancies, infections, and autoimmunity underlie most of the secondary cases. We present an unusual case of a patient with AIDS and disseminated Kaposi sarcoma who was commenced on highly active antiretroviral therapy (HAART) but developed HLH secondary to immune reconstitution inflammatory syndrome (IRIS). We report this case to highlight the difficulty in managing this patient given the complex interplay of immunosuppression due to AIDS, immune reconstitution following initiation of HAART, and immune overdrive manifesting as HLH.

Da anormalidade na saúde para a anormalidade na educação / From abnormality in health to abnormality in education / De la anormalidad en la salud a la anormalidad en la educación

Este texto tem como temática a relação entre políticas públicas e Psicologia da Saúde a partir da articulação entre formas de governo da população e modos de condução de condutas. Para tanto, problematiza o deslocamento de enunciados de normalidade e anormalidade do campo da saúde para o campo da educação, como estratégia para compreender uma ontologia do presente. O texto apoia-se em autores da Psicologia Social, mais especificamente do pós-estruturalismo, que são ferramentas conceituais para pensar em Psicologia da Saúde. A Psicologia da Saúde aqui é um plano forjado por distintas articulações teórico-conceituais que se ocupam de problematizar a saúde. Desse modo, torna-se uma superfície mediante a qual é possível considerar não o que é a saúde, mas os efeitos daquilo que produz, quando articulada a outros campos, como as políticas públicas e mais especificamente a Educação.

This text investigates the relationship between public policies and Health Psychology based on the articulation between forms of government of the population and ways of conducting behaviors. To do so, it analyzes the drift of normality and abnormality statements from the field of health to the field of education, as a strategy to understand current ontology. The work is supported by authors of Social Psychology, more specifically from post-structuralism, which are conceptual tools for thinking about Health Psychology. Health Psychology is understood here is a plan forged by distinct theoretical conceptual articulations that are concerned with problematizing health. Thus, it becomes a surface through which it is possible to consider not what health is, but the effects that it produces when articulated to other fields, such as public policies and more specifically Education.

Este texto tiene como temática la relación entre políticas públicas y Psicología de la Salud a partir de la articulación entre formas de gobierno de la población y modos de conducir conductas. Para ello, problematiza el desplazamiento de enunciados de normalidad y anormalidad del campo de la salud hacia el campo de la educación, como estrategia para comprender una ontología del presente. El texto se apoya en autores de la Psicología Social, más específicamente del post estructuralismo, que son herramientas conceptuales para pensar en Psicología de la Salud. La Psicología de la Salud aquí es un plan forjado por distintas articulaciones teórico-conceptuales que se ocupan de problematizar la salud. De este modo, se convierte en una superficie mediante la cual es posible considerar no lo que es la salud, sino los efectos de lo que produce cuando se articula a otros campos, tales como las políticas públicas y, más específicamente, la Educación.

Trends and Outcomes of Venous Thromboembolism in Hospitalized Patients With Ovarian Cancer: Results From Nationwide Inpatient Sample Database 2003 to 2011.

OBJECTIVE: Venous thromboembolism (VTE) is a major cause of mortality and morbidity in hospitalized patients with malignancy. Nationwide Inpatient Sample database was analyzed to determine the trends in the rate of hospitalization and mortality from VTE in hospitalized ovarian cancer patients and assess its economic impact and resource utilization. METHOD: We queried the 2003 to 2011 Nationwide Inpatient Sample database from Healthcare Cost and Utilization project (Agency of Healthcare Research and Quality) to identify all adults (age ≥18 years) ovarian cancer. Patients hospitalized with VTE as one of the top 3 discharge diagnoses were also identified. Demographic characteristics and in-hospital outcomes of this population were compared with ovarian cancer patients without VTE. Binary logistic regression analysis was used to obtain adjusted odds ratios (ORs). RESULTS: A total of 34,249 (3.5%) of a total of 981,386 hospitalized ovarian cancer patients had an accompanying diagnosis of VTE. Mean age of the study population was 64 years. After adjusting for potential confounders, compared with those without VTE, ovarian cancer patients with VTE had significantly higher inpatient mortality (6.2% vs 4.3%; OR, 1.12 [confidence interval (CI), 1.06-1.17]; P < .001), longer length of stay (5 vs 4 days; OR, 1.40 [CI, 1.36-1.43]; P < .001), higher average cost of hospitalization (US $26,000 vs US $22,000; OR, 1.10 [CI, 1.07-1.13]; P < .001), and greater disability at discharge (OR, 1.34 [CI, 1.31-1.38]; P < .001). Although the annual number of VTE admissions in ovarian cancer patients increased, in-hospital mortality declined from 10.9% in 2003 to 5.3% in 2011. CONCLUSIONS: Venous thromboembolism in hospitalized patients with ovarian cancer is associated with higher inpatient mortality, length of stay, higher cost of hospitalization, and disability at discharge. The hospitalization rate has increased, but the inpatient mortality rate has declined over study period.

Role of Immune Checkpoint Inhibitors in Advanced or Recurrent Endometrial Cancer.

Currently, treatment options for patients with advanced or recurrent endometrial cancer remain limited. The current standard of care treatment for advanced endometrial carcinoma is a platinum doublet chemotherapy. Second-line treatment options overall are very limited. There is no optimal treatment option for patients who show disease progression with first-line therapy. Therefore, novel and more efficacious therapies for patients with advanced or recurrent disease are needed. Immune checkpoint inhibitors have demonstrated a very impressive safety profile and anti-tumor activity in patients with programmed death-ligand 1 (PD-L1) positive endometrial cancer who were pre-treated with chemotherapy. We have done a detailed review of the literature to emphasize the role of immune checkpoint inhibitors in the treatment of metastatic or recurrent endometrial cancer.

Clinical outcomes of African American patients with advanced or metastatic non-small cell lung cancer on Nivolumab in a single community-based cancer center.

African Americans (AA) have the highest incidence and mortality rates with lung cancer. They are diagnosed at an earlier age with more advanced disease. Programmed cell death protein-1 inhibitor, Nivolumab, was approved as a second-line agent after failure of platinum-based therapy for advanced or metastatic non-small cell lung cancer (NSCLC). The original studies leading to the approval of Nivolumab had insufficient AA patients, thus there is still inadequate knowledge on treatment outcomes among AA patients. Our primary study endpoints were to determine the median overall survival, 1-year overall survival rate, median progression-free survival, and 1-year progression-free survival rate of patients with advanced or metastatic non-small cell lung cancer on Nivolumab. Our secondary study endpoints were to determine the overall tumor response rate, median time to response, median duration of response, and incidence of treatment-related adverse events of grade 3 or 4. In this retrospective study, we reviewed the charts of 38 patients, 29 of which were AA, with advanced or metastatic NSCLC who received Nivolumab from March 1, 2015 until November 30, 2017 from a single community-based cancer center and compared our results with historical data. Adenocarcinoma was the most common histology (71%) among all patients. Seven (18%) continued to use Nivolumab while 21 (55%) discontinued the treatment mainly due to progression of the disease. The median overall survival was 21.4 months (95% CI 13.5-27.4) and 17.6 months (95% CI 11.5-27.6) for all the patients and AA, respectively. Both have statistically significant difference (P < 0.001) compared to the historical studies of Borghaei et al. and Brahmer et al. At 1 year, the overall survival rate was 73% (95% CI 50-86) and 66% (95% CI 40-82) for all patients and AA, respectively. The median progression-free survival was also statistically significant (P < 0.001) between all the patients 6.3 months (95% CI 2.8-8), AA 6.0 months (95% CI 2.3-8.0), and the said historical studies. The 1-year progression-free survival rate was 23% (95% CI 10-39) and 28% (95% CI 12-47) for all patients and AA, respectively. Overall tumor response rate which includes complete and partial responses was 21% (95% CI 10-37) and 24% (95% CI 10-43) for all patients and AA, respectively. The median time to response was 3 and 2.8 months for all patients and AA, respectively. The median duration of response was 3.8 and 4.0 months for all patients and AA, respectively. Treatment-related adverse events of grade 3 or 4 were reported in 8 and 10% in all patients and AA, respectively, similar to the rates previously shown. AA patients with advanced or metastatic NSCLC on Nivolumab had increased overall survival and progression-free survival with similar grade 3 or 4 treatment-related adverse events. Providing adequate access to immunotherapy is indispensable to maximize survival benefit for AA patients.

Pressão arterial elevada em escolares de 7 a 10 anos da rede de ensino de um município rural do Espírito Santo / High blood pressure in 7 to 10 years old students from a rural municipality/ES

Resumo Objetivo Estimar a prevalência de níveis pressóricos elevados em escolares de 7 a 10 anos de um município rural do Espírito Santo entre os anos de 2009 e 2010; avaliar a associação da pressão arterial elevada com idade, sexo e estado nutricional. Método Estudo transversal, com amostra de 899 escolares de 7 a 10 anos residentes em um município rural do Espírito Santo. Os dados foram coletados por meio de questionários e as crianças foram submetidas a medidas antropométricas e de pressão arterial. Realizou-se dupla digitação, utilizou-se o programa SPSS 17.0. para análises estatísticas e o teste de hipótese qui-quadrado para determinar as associações. Resultados Dos 899 participantes, houve prevalência de 16,2% de pressão arterial elevada, sem diferença significativa por sexo (p = 0,343) e idade (p = 0,47). Crianças com excesso de peso apresentaram maior prevalência de pressão alta, assim como maior média de pressão arterial sistólica e diastólica. Encontraram-se diferenças significativas entre as médias de pressão arterial sistólica com relação ao sexo (p < 0,001) e idade (p = 0,016). Conclusão A prevalência média da pressão arterial elevada foi maior nos meninos, que apresentaram também maior prevalência na pressão arterial limítrofe. Apresentar excesso de peso contribuiu de forma significante para a elevação da pressão arterial.

Abstract Objective To estimate the prevalence of high blood pressure levels among schoolchildren aged 7 to 10 years old in a rural municipality of the State of Espírito Santo between 2009 and 2010. The study aimed to evaluate the association of high blood pressure with age, sex and nutritional status. Method Cross-sectional study including 899 students, age of 7-10 years old, residing in a rural municipality of Espírito Santo. Data were collected through questionnaires, anthropometric and blood pressure levels measurements. We used double typing with the SPSS 17.0. Software for statistical analysis, and the chi-square hypothesis test to determine associations. Results We found prevalence of 16.2% of high blood pressure, no significant difference by sex (p=0.343) and age (p=0.47). Children who are overweight have higher prevalence of high blood pressure, as well as higher mean blood pressure. We did find significant differences between the mean systolic blood pressure and sex (p <0.001) and age (p = 0.016). Conclusion The prevalence of high blood pressure was higher in boys, who also had a higher prevalence in borderline hypertension. Overweight contributed significantly to the elevation of blood pressure.

Determinantes da pressão arterial elevada em crianças: um estudo caso-controle em área rural do Espírito Santo / Determinación de la presión arterial alta en niños: un estudio caso-control en zona rural del Espírito Santo / Determinants of high blood pressure in children: a case-control study in a rural area of the Espírito Santo State

Objective: this study aims to identify and analyze the predictor factors of the occurrence of High Blood Pressure (HBP) in children aged from 7 to 10 years old from a rural municipality in Espírito Santo State. Methods: The subjects were divided into two groups, as follows: cases (SBP or DBP ≥ P95) and controls (BP < P90). The subjects were paired by sex and age. The sampling has been built from subject random selection, where were evaluated 395 children, 79 cases and 316 controls. Results: The prevalence of overweight in the cases was 8.9% and 11.1% in controls; the sedentary lifestyle was present in 88.1% of the cases and 87.9% of the controls; the average screen time was 97.7 minutes and106.6 minutes per day in cases and controls, respectively. Conclusion: It has been observed the need to create public policies aimed at health promotion in order to vulnerable groups can be receiving assistance since childhood.

Objetivo: identificar e analisar os fatores preditores da ocorrência da pressão arterial elevada em crianças de 7 a 10 anos de um município rural no Espírito Santo. Métodos: Foram constituídos dois grupos de estudo: os casos (PAS ou PAD ≥ P95) e os controles (PA

Objetivo: identificar y analizar los factores predictivos de la aparición de la hipertensión arterial en niños de 7 a 10 años de un municipio rural en el Espírito Santo. Métodos: Se construyeron dos grupos: los casos (PAS o PAD ≥ 95) y controles (PA

Association between life events after diagnosis of breast cancer and metastasis. / Associação entre eventos de vida pós diagnóstico de câncer de mama e metástase.

The objective was to examine the association between life events post diagnosis of breast câncer and metastasis. Cross-sectional study with 300 women attending a reference hospital in oncology in the Espírito Santo. Was used the instrument Life Events Units-LEU/VAS to evaluate life events reported by women. Data were analyzed by using the nonparametric Wilcoxon and chi-square tests. It was performed odds ratio calculation for the variables associated with metastasis. It was found that 21% of the sample reported at least one life event post diagnosis. Of the 46 women who developed metastases, 20 reported one or more life events (p = 0.001). The odds ratio calculated shows that having life events post diagnosis increases by 2.59 (1,37 - 4,91; p = 0,003) times the chance of developing metastasis. When considering the time between diagnosis and the onset of metastasis there was a median of 18.0 months. The study shows a relationship between life events and metastasis, however emphasize the importance of a more complex analysis to better understand the impacts of these events on the onset and progression of breast cancer.

Objetivou-se examinar a associação entre os eventos de vida pós-diagnóstico de câncer de mama e o aparecimento de metástase. Estudo transversal realizado com 300 mulheres atendidas em um hospital de referência em oncologia no Espírito Santo. Utilizou-se o instrumento "Life Events Units- LEU/VAS", para avaliar os eventos de vida relatados pelas mulheres. Os dados foram analisados através dos testes não paramétrico de Wilcoxon e qui-quadrado. Foi realizado cálculo de "odds ratio" para as variáveis associadas à metástase. Identificou-se que 21% da amostra relatou pelo menos um evento de vida após o diagnóstico. Das 46 mulheres que evoluíram para metástase, 20 relataram um ou mais eventos de vida (p = 0,001). O "odds ratio" calculado aponta que ter eventos de vida pós-diagnóstico aumenta em 2,59 (1,37 ­ 4,91; p = 0,003) vezes a chance de desenvolver metástase. Quando considerado o tempo transcorrido entre o diagnóstico e o surgimento da metástase observou-se uma mediana de 18,0 meses. O estudo mostra uma relação entre eventos de vida e metástase, entretanto, ressalta-se a importância de uma análise mais complexa para compreender melhor os impactos causados por esses eventos no surgimento e na progressão do câncer de mama.

Associação entre eventos de vida pós diagnóstico de câncer de mama e metástase / Association between life events after diagnosis of breast cancer and metastasis

Resumo Objetivou-se examinar a associação entre os eventos de vida pós-diagnóstico de câncer de mama e o aparecimento de metástase. Estudo transversal realizado com 300 mulheres atendidas em um hospital de referência em oncologia no Espírito Santo. Utilizou-se o instrumento "Life Events Units- LEU/VAS", para avaliar os eventos de vida relatados pelas mulheres. Os dados foram analisados através dos testes não paramétrico de Wilcoxon e qui-quadrado. Foi realizado cálculo de "odds ratio" para as variáveis associadas à metástase. Identificou-se que 21% da amostra relatou pelo menos um evento de vida após o diagnóstico. Das 46 mulheres que evoluíram para metástase, 20 relataram um ou mais eventos de vida (p = 0,001). O "odds ratio" calculado aponta que ter eventos de vida pós-diagnóstico aumenta em 2,59 (1,37 - 4,91; p = 0,003) vezes a chance de desenvolver metástase. Quando considerado o tempo transcorrido entre o diagnóstico e o surgimento da metástase observou-se uma mediana de 18,0 meses. O estudo mostra uma relação entre eventos de vida e metástase, entretanto, ressalta-se a importância de uma análise mais complexa para compreender melhor os impactos causados por esses eventos no surgimento e na progressão do câncer de mama.

Abstract The objective was to examine the association between life events post diagnosis of breast câncer and metastasis. Cross-sectional study with 300 women attending a reference hospital in oncology in the Espírito Santo. Was used the instrument Life Events Units-LEU/VAS to evaluate life events reported by women. Data were analyzed by using the nonparametric Wilcoxon and chi-square tests. It was performed odds ratio calculation for the variables associated with metastasis. It was found that 21% of the sample reported at least one life event post diagnosis. Of the 46 women who developed metastases, 20 reported one or more life events (p = 0.001). The odds ratio calculated shows that having life events post diagnosis increases by 2.59 (1,37 - 4,91; p = 0,003) times the chance of developing metastasis. When considering the time between diagnosis and the onset of metastasis there was a median of 18.0 months. The study shows a relationship between life events and metastasis, however emphasize the importance of a more complex analysis to better understand the impacts of these events on the onset and progression of breast cancer.

Body, culture and meaning / Corpo, cultura e significado

INTRODUCTION: Human beings go through history in search of the plenitude and perfection of the human body. The actors have changed and the scene has changed, and likewise the sociocultural context, the tastes and interpretations, and the meaning have changed, yet the search for the ideal body remains OBJECTIVE: A critical-reflexive approach is proposed regarding the standard of the body throughout the historical trajectory, as well as its cultural representativeness and the meaning attributed to it METHODS: This is a critical-reflexive dissertation based on existing literature. We have used the: MEDLINE, LILACS, Scientific Electronic Library - SciELO and Bireme databases; as well as Google Scholar and grey literature. The preparation of the manuscript followed the norms of literature reviews, and nearly attained the qualitative approach RESULTS: One must consider the relationship that the media establishes with the body, impelling a relentless search for a standardized reflection in the mirror, seen as beauty; the culture of purchasing power regarding the female body, of discrimination, of violence, and of indifference. It reveals a discussion of aspects that are important and fundamental to understand the body in its totality, not only as an organic structure, but also as something complex and subjective that suffers constant influences from the environment to which it is exposed and from the time and society in which it is inserted CONCLUSION: It may be concluded that the body has always been in a prominent position in the civilizations of the numerous historical periods mankind has lived through, and regardless of when, there has always been a corporal stereotype to be followed, cultivated and worshiped, and the search for this conquest continues in current days

INTRODUÇÃO: O ser humano perpassa a história na procura da plenitude e da perfeição do corpo. Mudam-se os atores, muda-se o cenário, o contexto sociocultural, os gostos e interpretações, o significado, e permanece-se a busca pelo corpo ideal OBJETIVO: Propõe-se uma abordagem de caráter crítico-reflexiva sobre o padrão do corpo ao longo da trajetória histórica, assim como sua representatividade cultural e o significado a ele atribuído MÉTODO: Trata-se de uma dissertação crítico-reflexiva construída com base em literatura existente. Utilizou-se os bancos de dados: MEDLINE, LILACS, Scientific Eletronic Library - SciELO e Bireme; bem como o Google Acadêmico e literaturas cinzentas. A elaboração do manuscrito seguiu as normas da revisão de literatura, e aproximou-se da abordagem qualitativa RESULTADOS: Há de se considerar a relação que a mídia estabelece com o corpo, impulsionando uma busca incansável por um reflexo padronizado no espelho, encarado como beleza; A cultura do poder de compra sobre o corpo feminino, da discriminação, da violência, da indiferença. Revela-se uma discussão sobre aspectos fundamentais e importantes para se compreender o corpo na totalidade, não apenas como uma estrutura orgânica, mas como algo complexo e subjetivo que sofre constantes influências do ambiente ao qual é exposto, da época e da sociedade na qual está inserido CONCLUSÃO: Conclui-se que o corpo sempre esteve em uma posição de destaque nas civilizações dentre os inúmeros períodos históricos vividos, independente de qual momento, sempre houve um estereótipo corporal a ser seguido, cultuado e adorado, e a busca por essa conquista continua nos dias atuais

Prevalência de Hipertensão em Crianças de Escolas Públicas / Prevalence of Hypertension in Children from Public Schools

Fundamentos: Há uma discrepância entre protocolos utilizados para o diagnóstico da hipertensão infantil, sendo o mais indicado a aferição da pressão arterial em pelo menos três momentos distintos. Objetivo: Identificar a prevalência de hipertensão arterial em crianças, e realizar associação com a variável estado nutricional. Métodos: Trata-se de um estudo longitudinal, que incluiu todas as crianças de 7 a 10 anos matriculadas nas escolas públicas e que apresentaram autorização dos responsáveis, totalizando 722 crianças. Na primeira avaliação, a família da criança respondeu a um questionário, e a criança foi submetida às análises antropométrica e hemodinâmica. A pressão arterial foi aferida três vezes em três momentos distintos. Crianças que apresentaram pressão arterial elevada no primeiro momento foram reavaliadas em um segundo momento; aquelas que permaneceram com pressão arterial elevada foram reavaliadas em um terceiro momento. Resultados: A prevalência de pressão arterial elevada no primeiro momento foi de 8,1%, no segundo foi de 3,2% e no terceiro de 2,1%. O estado nutricional esteve associado de forma significante ao aumento das médias das pressões arteriais sistólica e diastólica, sendo maiores nas crianças com sobrepeso e obesidade. As crianças classificadas como obesas, em todos os momentos, foram as que apresentaram maior prevalência de pressão arterial elevada. Conclusão: Com aferições da pressão arterial de crianças em diferentes momentos foi possível a redução dos casos falsos-positivos para hipertensão arterial. O estado nutricional esteve diretamente relacionado ao aumento dos valores pressóricos. Realizar as medições em consultas rotineiras torna-se fundamental para o diagnóstico e a intervenção precoce

Background: There is a discrepancy between protocols used for the diagnosis of childhood hypertension, and the most recommended one is the measurement of blood pressure in at least three different moments. Objective: To identify the prevalence of hypertension in children, and to associate it with the nutritional status variable. Methods: This is a longitudinal study, which included all children aged 7 to 10 years enrolled in public schools and had the authorization of their parents/guardians, totaling 722 children. In the first evaluation, the child's family answered a questionnaire, and the child was submitted to anthropometric and hemodynamic evaluation. Blood pressure was measured three times at three different times. Children who had high blood pressure at the first moment were reassessed at a second time; those who persisted with high blood pressure were re-evaluated at a third moment. Results: The prevalence of high blood pressure at the first moment was 8.1%, being 3.2% in the second and 2.1% in the third. The nutritional status was significantly associated with the increase in systolic and diastolic blood pressures, being higher in overweight and obese children. The highest prevalence of high blood pressure was found in children classified as obese, at all moments.Conclusion: By performing blood pressure measurements of children at different moments, it was possible to reduce falsepositive cases for arterial hypertension. The nutritional status was directly associated with the increase in blood pressure values. Performing the measurements in routine consultations becomes essential for diagnosis and early intervention

Prognostic Significance of Dementia in Older Adults with Solid Tumors.

BACKGROUND: The public health burden of cancer and dementia in the geriatric population is well documented. There is limited data on how dementia predicts mortality among geriatric patients with solid tumors. The objective of this study is to determine the prognostic significance of dementia on survival in patients with solid tumors. METHODS: We performed a 5-year retrospective study on elderly subjects aged ≥60 years with and without dementia that were diagnosed with solid tumors. RESULTS: Among 3,460 patients with solid tumors, 132 (3.8%) patients were found to have dementia. The median age at diagnosis was 71 years. Kaplan-Meier curves demonstrated that patients with dementia had an inferior median survival compared to the nondemented group (30 vs. 56 months; log-rank p < 0.001). Cox proportional hazard regression modeling identified age >80 years, female gender, diabetes mellitus, congestive heart failure, atrial fibrillation, chronic obstructive pulmonary disease, chronic kidney disease, dementia, and radiation therapy as risk factors for decreased overall survival. CONCLUSIONS: We demonstrated that dementia is associated with shorter overall survival in elderly patients with solid tumors.

Erdheim-Chester disease, moving away from the orphan diseases: A case report.

With approximately 750 cases reported, Erdheim-Chester disease is an exceedingly rare histiocyte cell disorder. Affected sites typically include long bones, large vessels and central nervous system. However, cutaneous and pulmonary involvement can also occur. The diagnosis is ascertained by identification of foamy histiocytes positive for CD68, CD163, and factor XIIIa on immunoperoxidase staining. Recently published literature have described an association between Erdheim-Chester disease and BRAF V600E mutation. This finding prompted the investigation of therapeutic possibilities with BRAF inhibitors, successful agents against other BRAF mutation-positive diseases. Vemurafenib, a BRAF kinase inhibitor, has been shown to be effective in BRAF V600E mutation-positive malignancies, such as NSCLC and melanoma, as well as in several case reports of Erdheim-Chester disease. We report a case of Erdheim-Chester disease diagnosed at our institution, treated with vemurafenib.