Severe COVID-19 in pregnant women: Analysis of placental features and perinatal outcomes.

OBJECTIVES: Changes in placental features, such as maternal and fetal vascular malperfusion, are associated with SARS-CoV-2 infection. The anatomopathologic study of the placenta is crucial for understanding pregnancy and fetal complications. To that end, this study aimed to describe placental features and analyze the association between placental findings and perinatal outcomes in a cohort of pregnant women with severe COVID-19. METHODS: This nested study within a prospective cohort study consisted of 121 singleton pregnant women with a diagnosis of severe COVID-19. Placental pathologic findings were described, and the associations between severe COVID-19 and clinical parameters and perinatal outcomes were assessed. RESULTS: The prevalence of maternal vascular malperfusion was 52.1%, followed by fetal vascular malperfusion at 21.5%, ascending intrauterine infections at 11.6%, and inflammatory lesions at 11.6%. Other lesions were observed in 39.7% of the placentas examined. Inflammatory lesions were an independent factor (P = .042) in 5-minute Apgar scores below 7. Ascending infection was associated with fetal death (P = .027). CONCLUSIONS: Maternal vascular malperfusion was the most prevalent placental feature in patients with severe COVID-19. Chorangiosis is associated with poor perinatal outcomes.

Machine learning for predicting survival of colorectal cancer patients.

Colorectal cancer is one of the most incident types of cancer in the world, with almost 2 million new cases annually. In Brazil, the scenery is the same, around 41 thousand new cases were estimated in the last 3 years. This increase in cases further intensifies the interest and importance of studies related to the topic, especially using new approaches. The use of machine learning algorithms for cancer studies has grown in recent years, and they can provide important information to medicine, in addition to making predictions based on the data. In this study, five different classifications were performed, considering patients' survival. Data were extracted from Hospital Based Cancer Registries of São Paulo, which is coordinated by Fundação Oncocentro de São Paulo, containing patients with colorectal cancer from São Paulo state, Brazil, treated between 2000 and 2021. The machine learning models used provided us the predictions and the most important features for each one of the algorithms of the studies. Using part of the dataset to validate our models, the results of the predictors were around 77% of accuracy, with AUC close to 0.86, and the most important column was the clinical staging in all of them.

Survival inequalities in head and neck cancers: A hospital-based cohort study.

BACKGROUND: We investigated whether the socioeconomic status (SES) influenced survival rates in oropharynx cancers (OPC), oral cavity cancers (OCC), and larynx cancers (LC) in Brazilian patients. METHODS: This hospital-based cohort study assessed the age-standardized 5-year relative survival (RS) using the Pohar Perme estimator. RESULTS: Overall, we identified 37 191 cases, and 5-year RS were 24.4%, 34.1%, and 44.9% in OPC, OCC, and LC, respectively. In multiple Cox regression, the highest risk of death occurred in the most vulnerable social strata for all subsites-that is, illiterates or patients relying on publicly funded healthcare services. Disparities increased over time by 34.9% in OPC due to the rising of survival rates in the highest SES, whereas they reduced by 10.2% and 29.6% in OCC and LC. CONCLUSIONS: The potential inequities were more significant for OPC than for OCC and LC. It is urgent to tackle social disparities to improve prognoses in highly unequal countries.

Câncer de glândulas salivares maiores - análise de sobrevida e resultados do tratamento em uma instituição hospitalar / Major salivary glands cancer - survival analysis and results of the treatment in one hospitalar institution

Introdução: Este estudo foi desenhado para demonstrar aexperiência e os resultados de uma única instituição de umtumor relativamente incomum. Objetivos: Relatar os resultadosdo tratamento dos tumores de glândulas salivares maiores doHospital do Câncer de Barretos e compará-los com os dadosda literatura. Método: Realizou-se a análise retrospectiva deregistros hospitalares de 38 pacientes tratados com cirurgia,radioterapia exclusiva ou adjuvante à cirurgia no Hospital doCâncer de Barretos entre Janeiro de 2002 e Dezembro de2006. Foi realizada análise descritiva dos dados demográficose epidemiológicos. O cálculo de sobrevida global foi feitoutilizando-se o método de Kaplan-Meier. Resultados: Dos 38pacientes avaliados no estudo, 6 (15,8%) apresentavam estádioI, 13 (34,2%) estádio II, 3 (7,9%) estádio III e 16 (42,1%) estádioIVa-b. Destes, 4 pacientes (10,5%) foram tratados com cirurgiaexclusiva; 27 pacientes (71%) com cirurgia e radioterapiaadjuvante; e 7 pacientes (18,5%) com radioterapia exclusiva. Asobrevida global em 5 anos dos pacientes tratados foi de 56,2%.Os pacientes que realizaram cirurgia exclusiva tiveram 75,0%de sobrevida global em 5 anos; os que realizaram cirurgia eradioterapia adjuvante 61,8% e os que fizeram radioterapiaexclusiva 28,6%. Conclusão: A radioterapia como tratamentoexclusivo ou adjuvante foi realizada em 89,5% dos pacientestratados no presente estudo. Os resultados de sobrevida globalem 5 anos da radioterapia adjuvante à cirurgia são semelhantesaos descritos na literatura.