Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 70
Filtrar
1.
Neurologia (Engl Ed) ; 36(6): 426-432, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34238525

RESUMO

INTRODUCTION: Understanding of Alzheimer disease (AD) is fundamental for early diagnosis and to reduce caregiver burden. The objective of this study is to evaluate the degree of understanding of AD among informal caregivers and different segments of the general population through the Alzheimer's Disease Knowledge Scale (ADKS). PATIENTS AND METHODS: We assessed the knowledge of caregivers in different follow-up periods (less than one year, between 1 and 5 years, and over 5 years since diagnosis) and individuals from the general population. ADKS scores were grouped into different items: life impact, risk factors, symptoms, diagnosis, treatment, disease progression, and caregiving. RESULTS: A total of 419 people (215 caregivers and 204 individuals from the general population) were included in the study. No significant differences were found between groups for overall ADKS score (19.1 vs 18.8, P = .9). There is a scarce knowledge of disease risk factors (49.3%) or the care needed (51.2%), while symptoms (78.6%) and course of the disease (77.2%) were the best understood aspects. Older caregiver age was correlated with worse ADKS scores overall and for life impact, symptoms, treatment, and disease progression (P < .05). Time since diagnosis improved caregivers' knowledge of AD symptoms (P = .00) and diagnosis (P = .05). CONCLUSION: Assessing the degree of understanding of AD is essential to the development of health education strategies both in the general population and among caregivers.


Assuntos
Doença de Alzheimer , Cuidadores , Doença de Alzheimer/diagnóstico , Progressão da Doença , Humanos
2.
Rev Col Bras Cir ; 48: e20202632, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33503139

RESUMO

The current Covid-19 pandemic has been the most discussed topic of the year, mostly about protection and ways to avoid dissemination of the virus. In the healthcare system, especially in the operating rooms, the viability of laparoscopic surgery was questioned, mostly because of the transmission through aerosol. This article tries to suggest a way to minimize risks of laparoscopic surgery, during this situation, by using electrostatic filters, a simple, effective and low cost alternative.


Assuntos
COVID-19/prevenção & controle , Dióxido de Carbono , Controle de Infecções/métodos , Laparoscopia , Pneumoperitônio , Humanos , Pandemias
3.
Rev. Col. Bras. Cir ; 48: e20202632, 2021. graf
Artigo em Inglês | LILACS | ID: biblio-1155371

RESUMO

ABSTRACT The current Covid-19 pandemic has been the most discussed topic of the year, mostly about protection and ways to avoid dissemination of the virus. In the healthcare system, especially in the operating rooms, the viability of laparoscopic surgery was questioned, mostly because of the transmission through aerosol. This article tries to suggest a way to minimize risks of laparoscopic surgery, during this situation, by using electrostatic filters, a simple, effective and low cost alternative.


RESUMO A atual pandemia do Covid-19 tem sido o assunto mais discutido do ano de 2020, principalmente no que se refere a proteção e as formas de limitar a disseminação do vírus. No cenário hospitalar, mais especificamente no centro cirúrgico, a viabilidade da cirurgia laparoscópica foi questionada, em relação a transmissibilidade do vírus por aerossol. Este artigo sugere uma forma de minimizar os riscos em cirurgias laparoscópicas durante esse cenário, com o uso de filtros eletrostáticos de ventilação mecânica. Uma alternativa simples, eficaz e de baixo custo.


Assuntos
Humanos , Pneumoperitônio , Dióxido de Carbono , Controle de Infecções/métodos , Laparoscopia , COVID-19/prevenção & controle , Pandemias
5.
Anim Reprod Sci ; 177: 97-104, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28063626

RESUMO

Several factors unrelated to the semen samples could be influencing in the sperm motility analysis. The aim of the present research was to study the effect of four chambers with different characteristics, namely; slide-coverslip, Spermtrack, ISAS D4C10, and ISAS D4C20 on the sperm motility. The filling procedure (drop or capillarity) and analysis time (0, 120 and 240s), depth of chamber (10 or 20µm) and field on motility variables were analysed by use of the CASA-mot system in goat sperm. Use of the drop-filling chambers resulted in greater values than capillarity-filling chambers for all sperm motility and kinetic variables, except for LIN (64.5% compared with 56.3% of motility for drop- and capillarity-filling chambers respectively, P<0.05). There were no significant differences in total sperm motility between different chamber depths, however, use of the 20µm-chambers resulted in greater sperm progressive motility rate, VSL and LIN, and less VCL and VAP than chambers with a lesser depth. There was less sperm motility and lesser values for kinetic variables as time that elapsed increased between sample loading and sperm evaluation. For sperm motility, use of droplet-loaded chambers resulted in similar values of MOT in all microscopic fields, but sperm motility assessed in capillarity-loaded chambers was less in the central fields than in the outermost microscopic fields. For goats, it is recommended that sperm motility be analysed using the CASA-mot system with a drop-loaded chamber within 2min after filling the chamber.


Assuntos
Cabras , Análise do Sêmen/instrumentação , Análise do Sêmen/métodos , Manejo de Espécimes/instrumentação , Motilidade dos Espermatozoides , Animais , Cinética , Masculino , Análise do Sêmen/veterinária , Manejo de Espécimes/métodos , Manejo de Espécimes/veterinária , Contagem de Espermatozoides/instrumentação , Contagem de Espermatozoides/métodos , Contagem de Espermatozoides/veterinária , Espermatozoides/citologia , Fatores de Tempo
6.
J Dairy Sci ; 99(12): 10102-10108, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27665139

RESUMO

Milk flow during the first minute of milking was analyzed using data from 1,132 Murciano-Granadina breed goats belonging to 17 herds. During the individual lactations, 2 test days were scheduled for recording several milk flow traits, total milk, milk composition (fat and protein percentages), and somatic cell count. Average lag time from teatcup attachment to arrival of milk at the milk claw (T0) was 4.9 s and at the milk meter (T1) was 15.8 s. Average milk flow after 30 s (MF0.5) was 0.29kg/30 s (0 to 1.1kg/30 s) and milk flow at 60 s or milking speed (MF1) was 0.67kg/min (0.1 to 2.1kg/min). Repeatabilities of T0, T1, MF0.5, and MF1 were 0.45, 0.58, 0.62, and 0.68, respectively. The MF1 showed high phenotypic correlation withT1(-0.63) and MF0.5 (0.90), medium values withT0(-0.42) and total milk (0.22), and very low values (-0.04 to -0.12) with fat, protein, and somatic cell count. We found no differences between flows during the first 3 lactations, with a reduction as the lactation number increased. Months in milk since parturition affected MF1, being highest in the first 3mo (0.67-0.71kg/min) and decreasing until the end of lactation (0.58kg/min). The effect of herd-test day was significant for all traits. Inclusion of all these effects for the analysis of milk flow traits is considered necessary.


Assuntos
Indústria de Laticínios , Cabras , Animais , Cruzamento , Feminino , Lactação , Leite , Fatores de Tempo
7.
J Comp Pathol ; 154(2-3): 169-79, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26804204

RESUMO

Human gliomas are malignant brain tumours that carry a poor prognosis and are composed of a heterogeneous population of cells. There is a paucity of animal models available for study of these tumours and most have been created by genetic modification. Spontaneously arising canine gliomas may provide a model for the characterization of the human tumours. The present study shows that canine gliomas form a range of immunohistochemical patterns that are similar to those described for human gliomas. The in-vitro sphere assay was used to analyze the expansion and differentiation potential of glioma cells taken from the periphery and centre of canine tumours. Samples from the subventricular zone (SVZ) and contralateral parenchyma were used as positive and negative controls, respectively. The expansion potential for all of these samples was low and cells from only three cultures were expanded for six passages. These three cultures were derived from high-grade gliomas and the cells had been cryopreserved. Most of the cells obtained from the centre of the tumours formed spheres and were expanded, in contrast to samples taken from the periphery of the tumours. Spheres were also formed and expanded from two areas of apparently unaffected brain parenchyma. The neurogenic SVZ contralateral samples also contained progenitor proliferating cells, since all of them were expanded for three to five passages. Differentiation analysis showed that all cultured spheres were multipotential and able to differentiate towards both neurons and glial cells. Spontaneously arising canine gliomas might therefore constitute an animal model for further characterization of these tumours.


Assuntos
Neoplasias Encefálicas/veterinária , Modelos Animais de Doenças , Doenças do Cão/patologia , Glioma/veterinária , Animais , Neoplasias Encefálicas/patologia , Cães , Feminino , Glioma/patologia , Humanos , Imuno-Histoquímica , Masculino
8.
Rev. bras. oftalmol ; 74(5): 288-291, set.-out. 2015. tab, ilus
Artigo em Português | LILACS | ID: lil-757453

RESUMO

Objetivo:Descrever e analisar a prevalência de baixa acuidade visual e suas causas em estudantes do ensino público de Belo Horizonte/MG.Métodos:Estudo transversal de 1452 escolares de 5 a 19 anos, do ensino público de Belo Horizonte/MG, triados e atendidos entre 2011 e 2014.Resultados:Da amostra total, 150 pacientes (10,33%) apresentaram baixa acuidade visual à triagem, recebendo encaminhamento para atendimento oftalmológico. Quarenta (26,66%) foram encaminhados e compareceram à consulta, onde 29 (72,5%) apresentaram indicação de correção visual. O astigmatismo miópico simples e composto foram os diagnósticos mais relacionados à prescrição de óculos.Conclusão:O estudo mostrou que a prevalência de baixa acuidade visual na população estudada foi compatível com demais programas semelhantes. Em contrapartida, a taxa de abstenção foi maior do que o esperado, evidenciando a importância da criação de medidas preventivas e informativas quanto à importância do cuidado com a saúde ocular.


Objective:To describe and analyze the prevalence of visual impairment and its causes in public school students in Belo Horizonte/MG.Methods:Cross-sectional study of 1.452 public school children from 5 to 19 years old, in Belo Horizonte/MG, screened and evaluated between 2011 and 2014.Results:Of the total sample, 150 patients (10,33%) had low visual acuity at the screening, and were referred to an ophthalmologist to further examination. Forty (26%) of the referred patients presented at the ambulatory, where 29 (72,5%) of these showed indication of visual correction. Simple and compound myopic astigmatism were the most frequent diagnoses associated with prescription glasses.Conclusion:The study showed that the prevalence of visual impairment in this population were consistent with other similar programs. By contrast, the abstention rate was much higher than the expectation, showing the importance of preventive and informative actions about the eye health care.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Baixa Visão/epidemiologia , Atenção à Saúde , Saúde Ocular , Erros de Refração/epidemiologia , Instituições Acadêmicas , Acuidade Visual , Brasil , Estudos Transversais
9.
Metallomics ; 7(8): 1229-32, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25926057

RESUMO

Copper(I) coordinating ligands in the Alzheimer's disease context have remained unexplored, despite the biological relevance of this redox state of the copper ion. Here, we show that the PTA ligand can remove copper from Aß, prevent reactive oxygen species production and oligomer formation, two deleterious events in the disease's etiology.


Assuntos
Adamantano/análogos & derivados , Doença de Alzheimer/metabolismo , Peptídeos beta-Amiloides/metabolismo , Cobre/isolamento & purificação , Compostos Organofosforados/farmacologia , Adamantano/farmacologia , Doença de Alzheimer/tratamento farmacológico , Peptídeos beta-Amiloides/química , Cobre/metabolismo , Humanos , Oxirredução , Espécies Reativas de Oxigênio/metabolismo
10.
Eur J Histochem ; 57(1): e9, 2013 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-23549468

RESUMO

Finding a marker of neural stem cells remains a medical research priority. It was reported that the proteins doublecortin and nucleostemin were related with stem/progenitor cells in central nervous system. The aim of the present immunohistochemical study was to evaluate the expression of these proteins and their pattern of distribution in canine brain, including age-related changes, and in non-nervous tissues. We found that doublecortin had a more specific expression pattern, related with neurogenesis and neuronal migration, while nucleostemin was expressed in most cells of almost every tissue studied. The immunolabeling of both proteins decreased with age. We may conclude that nucleostemin is not a specific marker of stem/progenitor cells in the dog. Doublecortin, however, is not an exclusive marker of neural stem cells, but also of neuronal precursors.


Assuntos
Envelhecimento/fisiologia , Encéfalo/metabolismo , Regulação da Expressão Gênica/fisiologia , Proteínas Associadas aos Microtúbulos/biossíntese , Células-Tronco Neurais/metabolismo , Neuropeptídeos/biossíntese , Proteínas Nucleares/biossíntese , Animais , Encéfalo/citologia , Cães , Proteínas do Domínio Duplacortina , Feminino , Masculino , Células-Tronco Neurais/citologia
11.
Rev Esp Salud Publica ; 80(1): 27-39, 2006.
Artigo em Espanhol | MEDLINE | ID: mdl-16553258

RESUMO

The Ministry of Health and Consumer Affairs and the Autonomous Governments of Spain have designed and agreed by consensus with the sanitary professionals and major employer's organizations and Unions a Integral Health Surveillance Programme of asbestos-exposed workers, in order to assure appropriate, uniform and harmonized action throughout the national territory with relation to these workers. PROGRAM DESCRIPTION: This initiative started from the Occupational Health Working group of the Interterritorial Council, with inputs from the Asbestos Working Group of the National Occupational Safety and Health Commission. It was agreed with occupational medicine and infirmary professionals and was approved by the Health and Labour authorities. The program is organised in seven main activities. CURRENT PROGRAM STATUS: two years after the Programme approval a total of 5778 workers are included in the Registry of asbestos-exposed workers. 208 workers have COPD, 198 benign pleural disease, 8 lung cancer, 10 mesothelioma and 7 workers have other cancers possibly related to asbestos (gastric, larynx and colon cancer). REMARKS: the agreement and participation reached in this Programme allow achieving much higher coverage of occupational prevention policies than those obtained with a mere law approval, as we could see during the second year of implementation of the Programme in which the number of attended workers has doubled.


Assuntos
Asbestose/prevenção & controle , Monitoramento Ambiental , Exposição Ocupacional , Asbestose/epidemiologia , Monitoramento Epidemiológico , Humanos , Serviços de Saúde do Trabalhador/normas , Vigilância da População/métodos , Serviços Preventivos de Saúde/normas , Gestão de Riscos
12.
Arch Bronconeumol ; 41(9): 484-8, 2005 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-16194510

RESUMO

OBJECTIVE: Retrospective study on the relation between the use of blood products and survival rates in patients treated surgically for stage I non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: The study included 856 patients who underwent surgical resection from 1969 to 2000 for stage I NSCLC, classified histologically according to the current guidelines of the Spanish Society of Pulmonary and Thoracic Surgery (SEPAR). Patients who died in the postoperative period were excluded from the study. A series of clinicopathological variables were recorded, including the perioperative use or not of blood products. Descriptive, univariate, and multivariate statistical analyses were performed. Follow up concluded in December of 2003. RESULTS: One hundred twenty-five patients (14.6%) underwent a perioperative transfusion. A significant association was found between the use of blood products and tumor size (P<.001), pneumectomy (P<.001), and cell type (P<.05). The respective 2, 5, and 10-year survival rates were 78%, 63%, and 54% for the nontransfusion group, and 73%, 59%, and 46% for the transfusion group. Both survival curves were compared and no significant differences were found (P=.23). Multivariate regression analysis included tumor size, patient age, and histologic cell type (squamous cell carcinoma or not); no relation between transfusion and survival was found. CONCLUSIONS: In our series, we found no difference in survival rates for patients with stage I NSCLC after perioperative blood transfusion.


Assuntos
Transfusão de Sangue , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Neoplasias Pulmonares/cirurgia , Pneumonectomia , Idoso , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Análise de Sobrevida
13.
Arch Bronconeumol ; 41(9): 489-92, 2005 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-16194511

RESUMO

OBJECTIVE: To determine the incidence and causes of perioperative mortality following lung transplant for cystic fibrosis. PATIENTS AND METHODS: We analyzed the cases of 57 patients. Fifty-five patients received double lung transplants, 1 received a heart-double lung transplant, and 1 received a combined double lung and liver transplant. Information related to the organ donor, recipient, lung graft, and early postoperative period was gathered. Perioperative mortality was defined as death resulting from anesthesia or surgery regardless of how many days had passed. The Kaplan-Meier method was used to analyze survival. A Cox logistic regression model was used to determine variables affecting mortality. RESULTS: Survival was 83.7% at 1 year after transplantation, 77.3% at 2 years, and 66.9% at 5 years. Five (8.7%) patients died as a result of anesthesia or surgery. A ratio of PaO2 to inspired oxygen fraction (FiO2) less than 200 mm Hg in the early postoperative period was observed in 8 (14%) patients. Primary graft failure occurred in 4 patients, due to pneumonia in 2 and to biventricular dysfunction in 2. Three of those patients died. Two patients with PaO2/FiO2 greater than 200 mm Hg died after surgery, one from septic shock due to Pseudomonas cepacia and the other from massive cerebral infarction. PaO2/FiO2 upon admission to the recovery care unit was the only variable significantly associated with perioperative mortality in the logistic regression model (P=.0034). CONCLUSIONS: The only factor significantly related to perioperative mortality in patients receiving transplants for cystic fibrosis was PaO2/FiO2 upon admission to the recovery unit.


Assuntos
Fibrose Cística/cirurgia , Transplante de Pulmão/mortalidade , Adolescente , Adulto , Criança , Fibrose Cística/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Análise de Sobrevida
14.
Arch Bronconeumol ; 41(8): 430-3, 2005 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-16117948

RESUMO

OBJECTIVE: To determine the prognostic factors for the survival in a group of patients operated on for a non-small cell lung cancer classified as T2N1M0. PATIENTS AND METHODS: Two hundred sixteen patients treated exclusively with surgery were studied. Kaplan-Meier survival and Cox multivariable regression analyses were used. RESULTS: The overall survival rate was 39.8% at 5 years and 29.9% at 10 years. Sex, age, presence or absence of symptoms, type of resection, number, and location of affected lymph nodes had no effect on survival. Tumor size (P=.04) and histologic type (P=.03) did significantly affect prognosis. Both variables entered into the Cox multivariable regression model. CONCLUSIONS: Patients operated on for non-small cell lung cancer classified as T2N1M0 have an overall probability of 5-year survival of approximately 40%. However, the prognosis for this group of patients is heterogeneous: in our study it was affected by the histologic type (45.5% for squamous cell and 25% for non-squamous cell cancers) and tumor size (53% for tumors with a diameter of 5 cm).


Assuntos
Carcinoma Broncogênico/patologia , Carcinoma Broncogênico/cirurgia , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Adulto , Idoso , Carcinoma Broncogênico/mortalidade , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Análise de Sobrevida
15.
Arch Bronconeumol ; 41(4): 180-4, 2005 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-15826526

RESUMO

OBJECTIVE: To determine the causes of death in patients treated surgically for nonsmall cell lung cancer (NSCLC) in stage IA and to evaluate the impact on survival of not performing systematic lymph node dissection and of the number of nodes resected. PATIENTS AND METHODS: The study sample consisted of 156 patients operated on for NSCLC and classified in stage IA according to TNM staging. Only palpable or visible lymph nodes were dissected. Kaplan-Meier survival curves were compared using a log-rank test. RESULTS: At the end of the study, 85 (54.5%) patients had died, 67 (42.9%) were alive, and 4 (2.5%) were lost to follow up. Twenty-three (14.7%) died from a recurrence of NSCLC: 2 with local tumors (1.2%), 2 with mediastinal node involvement (1.2%), and 19 (12.1%) with distant metastasis. The cause of death was unrelated to NSCLC in 62 (39.7%) cases: 33 (21.1%) had a new tumor, 18 of which were bronchogenic, and 29 (18.5%) had nonmalignant disease. The 5-year survival rate was 81.4%. The rate was 88.9% among patients from whom no lymph nodes were excised and 79.9% among those with node excision, although the difference was not statistically significant (P=.4073). CONCLUSIONS: Our experience suggests that neither the fact of not performing systematic lymph node dissection nor the number of nodes resected has an impact on survival. A substantial number of patients died of causes unrelated to the NSCLC for which they had been treated.


Assuntos
Carcinoma Broncogênico/mortalidade , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Neoplasias Pulmonares/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Broncogênico/patologia , Carcinoma Pulmonar de Células não Pequenas/patologia , Causas de Morte , Feminino , Humanos , Neoplasias Pulmonares/patologia , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Taxa de Sobrevida
16.
Arch Bronconeumol ; 40(3): 110-3, 2004 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-14998474

RESUMO

OBJECTIVE: To assess the prognostic value of a series of clinicopathological variables in stage I nonsmall cell lung cancer, for tumors up to 3 cm in diameter. PATIENTS AND METHOD: The study included 271 patients. Survival was analyzed with the Kaplan-Meier method. The Cox model was used for multivariate analysis. RESULTS: Five- and ten-year survival were 78.63% and 67.59%, respectively. Survival did not significantly depend on sex, age, extent of resection, histology, visceral pleural invasion, level of bronchial invasion or T1 versus T2. The decade in which resection was performed did affect survival (P=.0037). Five-year survival was 58% for operations between 1970 and 1980, 77% for operations between 1981 and 1990, and 84% for operations between 1991 and 2000. Tumor size also affected survival (P=.0046), which was 86% for patients with tumors of less than or equal to 2 cm in diameter and 73% for those with tumors of more than 2 cm in diameter. In the multivariate analysis both variables entered into regression, remaining predictive of survival. CONCLUSION: We found evidence for a prognostic stage migration (Will Rogers phenomenon) according to the decade in which resection was performed and that tumor size affected survival in our population. Finally, the current system of TNM staging fails in conforming groups of patients with a homogenous prognosis.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/patologia , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Taxa de Sobrevida
17.
Arch Bronconeumol ; 39(3): 111-4, 2003 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-12622969

RESUMO

INTRODUCTION: Lung donors are scarce and lung transplantation resources limited, leading to a need to look at transplants in terms of efficiency. Because emergency transplants (C-0) are assumed to yield poor results, most countries do not perform them on a regular basis. Spain, however does accept the concept of emergency lung transplantation for patients who are on waiting lists. We assess outcome for our patients who have received scheduled and emergency transplants. MATERIAL AND METHOD: The survival of patients receiving lung transplants in our service from 1992 through 2001 was studied using, Kaplan-Meier, Cox regression and chi-squared statistical analyses. We compared outcome and perioperative mortality (over 30 days) for scheduled versus C-0 procedures, analyzing the influence of certain variables (age, sex, emergency status, type of transplant, mechanical ventilation and use of extracorporeal membrane oxygenation). RESULTS: Eleven of 183 lung transplants were C-0 and 172 were scheduled. Forty-one were single-lung and 142 were double-lung transplants. Perioperative mortality was 36.4% for emergency procedures and 8.7% for scheduled procedures (p = 0.0035). Survival was significantly better for scheduled patients than for C-0 patients (p = 0.0032), although outcome was similar when perioperative mortality was not taken into account (58.16% vs. 57.14% at 5 years for scheduled and C-0 patients, respectively). CONCLUSIONS: Long-term survival after lung transplantation shows that the procedure is effective and efficient in C-0 patients, in spite of perioperative risk, provided the patient has been adequately monitored.


Assuntos
Transplante de Pulmão , Adolescente , Adulto , Fatores Etários , Distribuição de Qui-Quadrado , Criança , Emergências , Oxigenação por Membrana Extracorpórea , Feminino , Seguimentos , Humanos , Transplante de Pulmão/mortalidade , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Análise de Regressão , Respiração Artificial , Estudos Retrospectivos , Fatores Sexuais , Análise de Sobrevida , Fatores de Tempo
18.
Lung Cancer ; 36(1): 43-8, 2002 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11891032

RESUMO

BACKGROUND: The aim of this work is to estimate the prognostic value of a set of clinical-pathological factors in patients resected for non-small cell lung cancer (NSCLC) and classified as stage IB, in order to create a prognostic model for establishing risk groups, and to validate that model. METHODS: Among 637 patients resected and classified as stage IB, we analyzed sex, age, symptoms, location, type of resection, cell type, histology, and tumor size. The Kaplan-Meier method was used to estimate the survival. The results were compared using the log-rank test. All the significant variables from this univariable method were then included in a multivariable method of estimation of the proportional risk for survival data developed by Cox, using the variables selected, a regression model was developed for accurately predicting survival. To validate the predictive capability of the regression model, we randomly divided our patients into training and test subsets, containing 322 and 315 cases, respectively. RESULTS: The overall 5-year survival rate of the series was 60%. The cell type, the squamous or non-squamous and the tumor size showed a significant influence on survival in the univariable analysis, while, according to the Cox model, only the tumor size and the squamous or non-squamous type entered into regression. Hazard rates were calculated for each patient. The mean risk was 0.87 +/- 0.25 (range 30-1.94). The series was divided into three risk groups (low, intermediate, and high risk) according to the fitted hazard rates, using cut-off points (one standard deviation from the mean). The 5-year survival rates were 85, 59, and 44%, respectively. To validate the model, we repeated the analysis for training and test subsets. Only the tumor size had a significant influence on survival in the univariable analysis. Using the Cox model, also the tumor size entered into regression. The mean risk was 0.79 +/- 0.29 (range 0.09-2.12). Cut-off points were 0.50 and 1.08 for the low, intermediate, and high-risk groups. The 5-year survival rates were 83, 58, and 40%, respectively. We validated the regression model obtained in the training subset by demonstrating its capacity in identifying risk groups in the test subset. The 5-year survival rates were 83, 61, and 49.5% for the low, intermediate, and high-risk groups, respectively (P = 0.0104). CONCLUSIONS: Stage IB does not succeed in configuring a group of patients with a homogeneous prognosis, as there is a wide variability in a 5-year survival. The estimation of prognosis derived from a multivariable analysis can obviate the limitations of the actual staging system for NSCLC.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/mortalidade , Neoplasias Pulmonares/mortalidade , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Grandes/mortalidade , Carcinoma de Células Grandes/patologia , Carcinoma de Células Grandes/cirurgia , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Estadiamento de Neoplasias , Fatores de Risco , Taxa de Sobrevida
19.
Arch Bronconeumol ; 38(1): 16-20, 2002 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-11809132

RESUMO

OBJECTIVE: To quantify primary graft failure (PGF) and its impact on perioperative and early mortality in single-lung transplant (SLT). METHOD: We analyzed 35 SLT procedures performed using similar techniques. PGF was defined as a PaO2/FiO2 coefficient lower than 200 mmHg during the first 72 hours or ventilation assistance lasting longer than 5 days attributable to primary lung dysfunction. We defined perioperative mortality as occurring within 30 days of surgery and early mortality within 90 days. RESULTS: Twenty-five men and 10 women received lungs, 22 for pulmonary fibrosis and 13 for emphysema; the mean age was 53.26 10.77 years. Twenty right SLTs were performed and 15 left SLTs. Twenty-nine donors were men and 6 were women, with a mean age of 29.31 12.33 years. Twenty-six died from cranial trauma, 8 from stroke and 1 from a brain tumor. The mean time of intubation was 1.69 1.35 days. The mean PaO2 was 470.71 70.82 mmHg. The mean time of ischemia was 201.77 62.64 minutes. Four patients (11.42%) developed PGF and 3 died during the perioperative period. Two additional patients died within the early postoperative period. Survival was 91.4% at one month and 85.5% at three months. The cause of donor death was the only variable that influenced the development of PGF. CONCLUSION: We observed a low incidence of PGF and of perioperative and early mortality, with one and three month survival rates similar to those reported internationally.


Assuntos
Transplante de Pulmão/efeitos adversos , Traumatismo por Reperfusão/etiologia , Adolescente , Adulto , Feminino , Humanos , Incidência , Transplante de Pulmão/métodos , Masculino , Pessoa de Meia-Idade , Traumatismo por Reperfusão/epidemiologia
20.
Vaccine ; 19(32): 4805-15, 2001 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-11535333

RESUMO

In western Europe during the spring, the largest proportion of fox populations are cubs and the key to successful rabies oral vaccination campaigns is cub vaccination. In this paper we report on studies of the serology of 93 fox (Vulpes vulpes) cubs born to unvaccinated and orally vaccinated captive vixens, some of which were orally vaccinated at 30 or at 90 days of age with the vaccinia recombinant vaccine (VR-G) that expresses the rabies virus glycoprotein. The duration of cub passively acquired antibody, the development of immune responses to oral vaccination at either 30 or 90 days of age, possible interference between passive and active immunity to such vaccination and resistance to a potentially lethal rabies challenge dose when five months old were measured. The study showed that rabies neutralising antibody can be passed to their cubs by vixens orally vaccinated with VR-G during pregnancy. Maternally derived antibody titres in cubs declined with time and disappeared by 45-75 days after birth. Thirty days old cubs serologically responded to oral vaccination. No interference between antibody of maternal origin and active immunity conferred by VR-G oral vaccination or between antibody of maternal origin and protection was observed. Thus, very young cub immunisation against rabies with VR-G per os is possible whatever the immune status of their mothers. Provided a vaccine-bait suitable for such young cubs exists, oral vaccination at den entrances with VR-G is a feasibility.


Assuntos
Anticorpos Antivirais/biossíntese , Raposas/imunologia , Imunidade Materno-Adquirida , Vacina Antirrábica/imunologia , Raiva/prevenção & controle , Vacinação/veterinária , Administração Oral , Animais , Anticorpos Antivirais/imunologia , Colostro/imunologia , Europa (Continente) , Feminino , Raposas/sangue , Imunocompetência , Masculino , Testes de Neutralização , Gravidez , Raiva/epidemiologia , Raiva/imunologia , Vacina Antirrábica/administração & dosagem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA