Prognostic Value of Invasion, Markers of Proliferation, and Classification of Giant Pituitary Tumors, in a Georeferred Cohort in Brazil of 50 Patients, with a Long-Term Postoperative Follow-Up.

Although some pituitary adenomas may have an aggressive behavior, the vast majority are benign. There are still controversies about predictive factors regarding the biological behavior of these particular tumors. This study evaluated potential markers of invasion and proliferation compared to current classification patterns and epidemiogeographical parameters. The study included 50 patients, operated on for tumors greater than 30 mm, with a mean postoperative follow-up of 15.2 ± 4.8 years. Pituitary magnetic resonance was used to evaluate regrowth, invasion, and extension to adjacent tissue. Three tissue biomarkers were analyzed: p53, Ki-67, and c-erbB2. Tumors were classified according to a combination of histological and radiological features, ranging from noninvasive and nonproliferative (grade 1A) to invasive-proliferative (grade 2B). Tumors grades 2A and 2B represented 42% and 52%, respectively. Ki-67 (p = 0.23) and c-erbB2 (p = 0.71) had no significant relation to tumor progression status. P53 (p = 0.003), parasellar invasion (p = 0.03), and classification, grade 2B (p = 0.01), were associated with worse clinical outcome. Parasellar invasion prevails as strong predictive factor of tumor recurrence. Severe suprasellar extension should be considered as invasion parameter and could impact prognosis. No environmental factors or geographical cluster were associated with tumor behavior.

Prevalence of smoking and its association with the use of other drugs among students in the Federal District of Brasília, Brazil.

OBJECTIVE: To estimate the prevalence of smoking, as well as to determine the association between smoking and the use of other drugs, among middle and high school students in the Federal District of Brasília, Brazil. METHODS: Epidemiological study involving a reference population of students in the District. Our sample comprised 2,661 students from 9 to 19 years of age, in all middle and high school grades. All participating students completed a standard questionnaire. Results were analyzed by gender and type of school (public or private). RESULTS: The prevalence of smoking among students in the District was 10.5%. Smoking was found to be associated with the use of alcohol and other drugs. CONCLUSIONS: Smoking is a gateway to the use of other drugs.

Prevalência do tabagismo e associação com o uso de outras drogas entre escolares do Distrito Federal / Prevalence of smoking and its association with the use of other drugs among students in the Federal District of Brasília, Brazil

OBJETIVO: Estimar a prevalência do tabagismo e sua associação com o uso de outras drogas entre escolares, do ensino fundamental e médio, do Distrito Federal (DF). MÉTODOS: Estudo epidemiológico, tendo como população de referência escolares do DF. Nossa amostra consistiu de 2.661 alunos com idades entre 9 e 19 anos de todas as séries do ensino fundamental II e do ensino médio que responderam a um questionário padrão. Os resultados foram analisados por gênero e tipo de rede escolar. RESULTADOS: A prevalência do tabagismo entre escolares do DF foi de 10,5 por cento, sendo observada uma associação entre o uso do cigarro e o uso de álcool e outras drogas. CONCLUSÕES: O tabagismo é uma porta de entrada para o uso de outras drogas.

OBJECTIVE: To estimate the prevalence of smoking, as well as to determine the association between smoking and the use of other drugs, among middle and high school students in the Federal District of Brasília, Brazil. METHODS: Epidemiological study involving a reference population of students in the District. Our sample comprised 2,661 students from 9 to 19 years of age, in all middle and high school grades. All participating students completed a standard questionnaire. Results were analyzed by gender and type of school (public or private). RESULTS: The prevalence of smoking among students in the District was 10.5 percent. Smoking was found to be associated with the use of alcohol and other drugs. CONCLUSIONS: Smoking is a gateway to the use of other drugs.