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1.
Vaccimonitor (La Habana, Print) ; 30(2)mayo.-ago. 2021. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1252326

RESUMO

Este reporte corresponde al análisis de la calidad de vida de los pacientes que se incluyeron en el ensayo clínico fase III de evaluación de la vacuna CIMAvaxEGF® en cáncer de pulmón de células no pequeñas. La calidad de vida se evaluó empleando los cuestionarios EORTC QLQ-C30 y QLQ-C13, al inicio y cada 3 meses hasta el fallecimiento del paciente a criterio del investigador. Para comparar las medianas entre los dos grupos se utilizó la prueba no paramétrica de Mann-Whitney. Las comparaciones entre el nivel basal y los diferentes tiempos de seguimiento se realizaron a través de la prueba no paramétrica de Wilcoxon. El cuestionario QLQ-C30 evidenció un beneficio en cuanto a calidad de vida para el grupo vacunado con la vacuna CIMAvaxEGF® en las escalas funcionales (global, rol y social), en las escalas de síntomas de la enfermedad y del tratamiento (dolor) se observó que mejora la calidad de los mismos a favor de los pacientes tratados con la vacuna CIMAvaxEGF®. El cuestionario QLQ-C13, también evidenció ventajas para el grupo vacunado desde el punto de vista de beneficio clínico en los síntomas (disnea, disfagia, alopecia y dolor en el pecho). Se señala como significativo que disminuye la hemoptisis y la tos en el grupo vacunado, observándose un empeoramiento en el grupo control(AU)


This report corresponds to quality of life analysis of patient with non-small cell lung cancer included in the phase III clinical trials Evaluation of CIMAvaxEGF® vaccine in lung cancer. The quality of life was evaluate using the EORTC questionnaires QLQ-C30 y QLQ-C13, at the beginning and every 3 months. To compare the median between two groups the Mann-Whitney non-parametric test was used. To compare the baseline and different follows times the Wilcoxon non-parametric test was used. The QLQ-C30 questionnaire showed a benefit in terms of the quality of life for the CIMAvaxEGF® vaccine group on the functional scores (global, role and social) and symptoms of the disease (pain). The QLQ-LC13 questionnaire showed a benefit in terms of the quality of life for the CIMAvaxEGF® vaccine group on the symptoms scores (dyspnea, dysphagia, alopecia and chest pain). It is noted as significant that the hemoptysis decreases in the group vaccinated as well as the dysphagia, the cough and the dyspnea observing a worsening in the control group(AU)


Assuntos
Humanos , Masculino , Feminino , Qualidade de Vida , Inquéritos e Questionários , Ensaios Clínicos Fase III como Assunto , Carcinoma Pulmonar de Células não Pequenas/epidemiologia , Vacinas Anticâncer
2.
BMC Infect Dis ; 21(1): 510, 2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34059022

RESUMO

OBJECTIVE: To determine the prevalence of Latent Tuberculosis in patients with hematological neoplasms at the Instituto Nacional de Cancerología in Mexico City using the Tuberculin skin test (TST). METHODS: This retrospective study included all patients with a recent diagnosis of hematological neoplasms who were admitted for treatment from 2017 to 2018 and who were screened for latent tuberculosis with the TST. The prevalence of latent tuberculosis in this group, tolerance and therapeutic adherence in treated patients are described. RESULTS: The files of 446 patients with hematological malignancy who had a TST were reviewed. The prevalence of latent tuberculosis was 31.2% (n = 139). Ninety-three patients received isoniazid, 15.1% had some adverse reactions, but only 4 (4.3%) had to discontinue treatment. Two patients with latent tuberculosis under treatment with Isoniazid reactivated tuberculosis infection. CONCLUSIONS: The prevalence in our study was within the range of other similar Mexican populations. Isoniazid treatment had an adequate tolerance and adherence. Longer follow-up could offer more information on the risk of reactivation in both groups.


Assuntos
Neoplasias Hematológicas/epidemiologia , Tuberculose Latente/epidemiologia , Adulto , Antituberculosos/efeitos adversos , Antituberculosos/uso terapêutico , Institutos de Câncer , Feminino , Neoplasias Hematológicas/microbiologia , Humanos , Isoniazida/efeitos adversos , Isoniazida/uso terapêutico , Tuberculose Latente/diagnóstico , Tuberculose Latente/tratamento farmacológico , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Mycobacterium tuberculosis/efeitos dos fármacos , Prevalência , Estudos Retrospectivos , Teste Tuberculínico , Tuberculose/epidemiologia , Tuberculose/etiologia
3.
BMC Cancer ; 21(1): 690, 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34112140

RESUMO

BACKGROUND: Published findings suggest sex differences in lung cancer risk and a potential role for sex steroid hormones. Our aim was to perform a meta-analysis to investigate the effects of sex steroid hormone exposure specifically on the risk of lung cancer in women. METHODS: The PubMed, MEDLINE, Web of Science, and EMBASE databases were searched. The pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) for female lung cancer risk associated with sex steroid hormones were calculated overall and by study design, publication year, population, and smoking status. Sensitivity analysis, publication bias, and subgroup analysis were performed. RESULTS: Forty-eight studies published between 1987 and 2019 were included in the study with a total of 31,592 female lung cancer cases and 1,416,320 subjects without lung cancer. Overall, higher levels of sex steroid hormones, both endogenous (OR: 0.92, 95% CI: 0.87-0.98) and exogenous (OR: 0.86, 95% CI: 0.80-0.93), significantly decreased the risk of female lung cancer by 10% (OR: 0.90, 95% CI: 0.86-0.95). The risk of lung cancer decreased more significantly with a higher level of sex steroid hormones in non-smoking women (OR: 0.88, 95% CI: 0.78-0.99) than in smoking women (OR: 0.98, 95% CI: 0.77-1.03), especially in Asia women (OR: 0.84, 95% CI: 0.74-0.96). CONCLUSIONS: Our meta-analysis reveals an association between higher levels of sex steroid hormone exposure and the decreased risk of female lung cancer. Surveillance of sex steroid hormones might be used for identifying populations at high risk for lung cancer, especially among non-smoking women.

4.
An Sist Sanit Navar ; 0(0)2021 Jun 15.
Artigo em Espanhol | MEDLINE | ID: mdl-34132245

RESUMO

BACKGROUND: Cutaneous, superficial and or suprafascial leiomyoma are divided into three variants: piloleiomyomas (PL), angioleiomyomas (AL) and genital leiomyomas (GL) that include the vulvar, scrotal and areolar forms. This study set out to establish the clinical and histological characteristics and incidence of each variant, and any likely associations with internal neoplasms. METHODS: A review was carried out of 255 cases of cutaneous leiomyomas diagnosed between 1982 and 2018 at the Pathology departments of three hospitals (Navarra and Alicante). Demographic, clinical, histological and immunohistochemical variables were described and compared. RESULTS: The incidence of PL in Navarra was 4.3 cases per million inhabitants a year, with another 20 cases of AL and 1.4 cases of GL. Cutaneous forms make up approximately 3.5% of the total leiomyomas. The population with PL suffered more frequently from breast cancer (OR?=?4.8; CI 95%: 1.3-17.4; p?=?0.006). Nipple leiomyomas are small, accompanied by localised pain, and are predominantly fascicular or solid, with very infrequent effect on the subcutaneous cellular tissue and scarce atypia. This makes for a contrast with the other GLs, which are medium sized and infrequently painful, predominantly nodular, and frequent effect on the subcutaneous tissue and atypia. CONCLUSIONS: The information provided here about the clinical and histological characteristics of the different varieties of leiomyomas indicate that there is a need to reconsider the classification of nipple leiomyomas outside the group of GLs. An association between PL and breast carcinoma was detected, which needs to be confirmed in future studies so as to determine if this leiomyoma is a risk marker for breast cancer.

5.
Br J Anaesth ; 2021 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-34148733

RESUMO

BACKGROUND: The COVID-19 pandemic has heavily impacted elective and emergency surgery around the world. We aimed to confirm the incidence of perioperative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and associated mortality after surgery. METHODS: Analysis of routine electronic health record data from NHS hospitals in England. We extracted data from Hospital Episode Statistics in England describing adult patients undergoing surgery between January 1, 2020 and February 28, 2021. The exposure was SARS-CoV-2 infection defined by International Classification of Diseases (ICD)-10 codes. The primary outcome measure was 90 day in-hospital mortality. Data were analysed using multivariable logistic regression adjusted for age, sex, Charlson Comorbidity Index, Index of Multiple Deprivation, presence of cancer, surgical procedure type and admission acuity. Results are presented as n (%) and odds ratios (OR) with 95% confidence intervals (CI). RESULTS: We identified 2 666 978 patients undergoing surgery of whom 28 777 (1.1%) had SARS-CoV-2 infection. In total, 26 364 (1.0%) patients died in hospital. SARS-CoV-2 infection was associated with a much greater risk of death (SARS-CoV-2: 6153/28 777 [21.4%] vs no SARS-CoV-2: 20 211/2 638 201 [0.8%]; OR=5.7 [95% CI, 5.5-5.9]; P<0.001). Amongst patients undergoing elective surgery, 2412/1 857 586 (0.1%) had SARS-CoV-2, of whom 172/2412 (7.1%) died, compared with 1414/1 857 586 (0.1%) patients without SARS-CoV-2 (OR=25.8 [95% CI, 21.7-30.9]; P<0.001). Amongst patients undergoing emergency surgery, 22 918/582 292 (3.9%) patients had SARS-CoV-2, of whom 5752/22 918 (25.1%) died, compared with 18 060/559 374 (3.4%) patients without SARS-CoV-2 (OR=5.5 [95% CI, 5.3-5.7]; P<0.001). CONCLUSIONS: The low incidence of SARS-CoV-2 infection in NHS surgical pathways suggests current infection prevention and control policies are highly effective. However, the high mortality amongst patients with SARS-CoV-2 suggests these precautions cannot be safely relaxed.

6.
Artigo em Inglês | MEDLINE | ID: mdl-34148943

RESUMO

The increased use of neuroimaging and the aging of society have changed the incidence and proportion of histological types of intracranial tumors in Japan. A population-based epidemiological survey has been reported only from Kumamoto Prefecture. We performed a 10-year survey in Miyazaki Prefecture to compare our findings with the incidence rate (IR) of primary intracranial tumors (PIT) reported in the Kumamoto survey. Our study included 1915 new cases of PIT diagnosed in Miyazaki Prefecture between 2007 and 2016. The crude IR was 16.97/100000/year. The most common tumor was meningioma (46.3%), followed by glioma (17.1%), pituitary adenoma (13.1%), schwannoma (8.2%), and malignant lymphoma (3.8%). The age-specific IR of all PITs and of meningiomas, gliomas, pituitary adenomas, schwannomas, lymphomas, and germ cell tumors was similar in both prefectures. To directly compare with the age-adjusted IRs reported in the Kumamoto survey, we calculated the IR for the two prefectures. The age-adjusted IR of primary brain tumors in Miyazaki Prefecture was 14.65/100000/year, which was slightly higher than in the Kumamoto survey (14.09/100000/year between 1989 and 2008). The age-adjusted IR of glioma, schwannoma, and malignant lymphoma showed only a small difference between Miyazaki and Kumamoto. However, the age-adjusted IR of meningiomas was higher in Miyazaki than Kumamoto (6.15- vs. 4.97/100000/year), but the IR of pituitary adenoma was higher in Kumamoto than Miyazaki (2.66- vs. 2.13/100000/year). Although there were some differences between the two surveys, the IR of PIT showed a similar pattern in Kumamoto and Miyazaki, which are neighboring districts on Kyushu Island.

7.
Eur J Cancer ; 152: 18-25, 2021 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-34062483

RESUMO

OBJECTIVES: Cutaneous melanoma (CM) and keratinocyte cancer (KC) cause considerable morbidity and mortality. We analysed long-term trends of CM and KC in different white populations. MATERIAL AND METHODS: Age-standardised (European Standard Population 2013) incidence and mortality rates (ASIR, ASMR) of CM were extracted from cancer registries in Denmark, New Zealand and the US SEER-Database. ASIRs of KC were sourced from registries of the German federal states Saarland and Schleswig-Holstein, and from Scotland. Age-period-cohort models were used to project melanoma incidence trends. RESULTS: In Denmark between 1943 and 2016, melanoma ASIR increased from 1.1 to 46.5 in males, and from 1.0 to 48.5 in females, estimated to reach 60.0 and 73.1 in males and females by 2036. Melanoma mortality in Denmark (1951-2016) increased from 1.4 to 6.7 (males) and 1.2 to 3.7 (females). In New Zealand between 1948 and 2016, ASIR increased from 2.7 to 81.0 (males) and from 3.8 to 54.7 (females), slight declines are estimated by 2036 for both genders. Melanoma mortality increased six-fold in New Zealand males between 1950 and 2016; smaller increases were observed in females. We observed three- to four-fold increases in melanoma incidence in US whites, predicted to rise to 56.1 and 36.2 in males and females until 2036. Melanoma mortality also increased among US whites between 1970 and 2017, female melanoma mortality remained stable. Similar trends are shown for KC. CONCLUSIONS: In white populations, incidence of CM and KC significantly increased. CM incidence continues to rise in the short term but is predicted to decline in future.

8.
Medicine (Baltimore) ; 100(22): e25842, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087827

RESUMO

ABSTRACT: To investigate the relationship between urinary cotinine and colorectal neoplasm (CRN).The participants in the health screening cohort of the National Cancer Center who underwent screening colonoscopy between June 2007 and December 2009 were included. A total of 8121 subjects who underwent urinary cotinine measurement within 14 days from the index colonoscopy were included. Cotinine positivity was defined as having a urinary cotinine level ≥50 ng/mL. Follow-up colonoscopy data were collected by reviewing the patients' medical records.Patients were classified according to their urinary cotinine level and self-reported smoking status, and the number of patients with cotinine positivity was 1960 (24.1%). There was no significant difference in the cumulative CRN and advanced CRN (ACRN) risks according to the self-reported smoking status. However, cotinine positivity at the time of index colonoscopy was an independent risk factor for CRN (hazard ratio [HR]= 1.23, P = .006) in follow-up colonoscopy. Moreover, in never- and ex-smokers, cotinine positivity was an independent risk factor for CRN (HR = 1.95, P = .019; HR = 2.12, P = .003, respectively) and ACRN (HR = 8.89, P < .001; HR = 5.03, P = .003) during follow-up colonoscopy. The cumulative incidence of CRN and ACRN was higher in the cotinine-positive never- and ex-smokers than in the cotinine-negative never- and ex-smokers (P < .001 and P = .008, respectively).CRN or ACRN is more likely to occur at follow-up colonoscopy in the urinary cotinine-positive never- and ex-smokers than in the urinary cotinine-negative group. Therefore, urinary cotinine measurements may provide useful information on never- or ex-smokers undergoing screening colonoscopy.


Assuntos
Neoplasias Colorretais/epidemiologia , Cotinina/urina , Fumantes/estatística & dados numéricos , Fumar Tabaco/epidemiologia , Adulto , Fatores Etários , Consumo de Bebidas Alcoólicas/epidemiologia , Pesos e Medidas Corporais , Colonoscopia/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais
9.
Medicine (Baltimore) ; 100(22): e26111, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087858

RESUMO

ABSTRACT: Gram-negative bacteremia is a major cause of death among hematology inpatients who require heavy-dose chemotherapy and hematopoietic stem cell transplantation. Gram-negative bacillus (GNB) is more likely to be detected when the oral health is poor. However, there is a dearth of studies on the relationship between oral assessment and prevalence of GNB in hematology inpatients.This retrospective study aimed to evaluate the relationship between the original point-rating system for oral health examinations (point-oral exam) and the prevalence of GNB in hematology inpatients at the hematology ward of the Yamanashi University Hospital. GNB was detected by cultivating samples from the sputum and blood of each patient.A total of 129 subjects underwent a medical checkup and point-oral exam. The sputum and blood culture results of 55 patients were included in this study. The total points of patients positive for GNB (n = 25, 45.5%) were significantly higher than those who were negative for GNB (total score: median, 25th, 75th, percentile; 6 [4, 7] vs 2 [1, 4]; P = .00016). Based on the receiver operating characteristic analysis, a cutoff score of 5 proved to be most useful to detect GNB.An oral evaluation with a cutoff value of 5 or higher in the point-oral exam might indicate the need for a more thorough oral management to prevent the development of systemic infections from GNB.


Assuntos
Infecções por Bactérias Gram-Negativas/epidemiologia , Neoplasias Hematológicas/epidemiologia , Saúde Bucal/estatística & dados numéricos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Hemocultura , Índice de Massa Corporal , Pesos e Medidas Corporais , Feminino , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Escarro/microbiologia
10.
Medicine (Baltimore) ; 100(22): e26121, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087861

RESUMO

ABSTRACT: This community-based study aimed to elucidate whether there is a gender difference in the effect of metabolic syndrome (MetS) and its individual components on an elevated risk for incident colorectal adenoma.A prospective cohort study was conducted by enrolling 59,767 subjects aged 40 years or older between 2001 and 2009 in Keelung, Taiwan, to test this hypothesis, excluding those with a prior history of colorectal cancer and those with colorectal cancer diagnosed at the first screening. Cox proportional hazards regression models were used to assess the effect of MetS in terms of a dichotomous classification, each individual component and the number of components for males and females.Colorectal adenoma was present in 2.7% (n = 652) of male participants and 1.1% (n = 403) of female participants. The prevalence rate of MetS was 26.7% and 23.3% for males and females, respectively. The effect of MetS on colorectal adenoma was statistically significant and similar for the 2 genders, with an adjusted hazard ratio (aHR) of 1.33 (95% CI: 1.13-1.58) in males and 1.33 (95% CI: 1.06-1.66) in females after adjustment for confounders. However, MetS led to higher risk of advanced colorectal adenoma in men than in women. Regarding the effect of each component of MetS on colorectal adenoma, abnormal waist circumference and hypertriglyceridemia led to an elevated risk of colorectal adenoma in both genders. A rising risk of colorectal adenoma among females was noted in those with a moderately higher level of glycemia (100-125 mg/dL, aHR = 1.44, 95% CI: 1.12-1.85). Hypertriglyceridemia and high blood pressure were associated with an increased risk of advance colorectal adenoma in males.Both male and female subjects with MetS had a higher risk of colorectal adenoma. The contributions from individual components of MetS varied by gender. These findings suggest that the possible risk reduction of colorectal adenoma through metabolic syndrome-based lifestyle modifications may differ between genders.


Assuntos
Adenoma/epidemiologia , Neoplasias Colorretais/epidemiologia , Síndrome Metabólica/epidemiologia , Adulto , Idoso , Pesos e Medidas Corporais , Feminino , Humanos , Hipertensão/epidemiologia , Hipertrigliceridemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Distribuição por Sexo , Taiwan/epidemiologia
11.
Cancer Rep (Hoboken) ; : e1448, 2021 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-34129289

RESUMO

BACKGROUND: Cancer incidence and cancer registries are essential for local epidemiological information. In Libya, scarce evidence exists with regard to incidence rates and distribution. AIM: To estimate cancer incidence in Libya and draw trends of cancer type distribution compared to regional and worldwide data. Such incidence data are needed to inform strategic decisions on cancer facilities, training, and research in the given geographical area of Misurata, the major city in the middle region and third largest in Libya. METHODS: This is an observational, multi-centre, city-wide study to account for all cancer cases. All radiology (computed tomography and magnetic resonance imaging) and pathology reports were examined across all public and private hospitals in and around Misurata. RESULTS: Four hundred and thirty cancer cases were identified to have been diagnosed during 12 months (July 2019-June 2020), yielding a cancer incidence of 71.7 per 100 000 population. Breast cancer (84, 19.5%), colorectal cancer (83, 19.3%), lung cancer (33, 7.7%), and prostate cancer (21, 4.9%) had the highest prevalence. CONCLUSION: Cancer incidence established in this study stands at 71.1, much lower than the worldwide reported incidence of 201.0. Several limitations lead to missing cancer cases from the survey period, mostly related to poor documentation, non-research friendly environment, and disorganised healthcare structure. Nevertheless, distribution by type represents a true contrast to the world cancer report. Finally, a national or regional inclusive cancer registry is essential to the flow of information that supports strategic planning and decision-making in developing cancer care in the country.

12.
Medicine (Baltimore) ; 100(19): e25637, 2021 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-34106591

RESUMO

ABSTRACT: Breast cancer has the highest incidence of cancer among women in Taiwan, and air pollutants have been documented to have multiple adverse effects on human health. There is no relevant data, there has been no research in Taiwan to discuss the relevance of air pollutants to breast cancer, and evidence is sparse and inconclusive.Air quality data used in this study was collected from the 78 air quality monitoring stations situated in 74 municipalities in Taiwan during 2000 to 2011. The daily measurements taken at each monitoring station represented the level of exposure for each participant residing in that zone. The air pollution concentration is partitioned based on the concentration level in Quartile. We calculate the annual average air pollutants concentration (CO, NO, NO2, PM2.5, THC, and CH4) and the long-term average exposure levels of these pollutants until diagnosis of breast cancer, ending the study period for each individual.Patients who were living in areas with the highest air pollutants concentration (Quartile 4) had the most people diagnosed with breast cancer (CO:1.47%, NO:1.41%, NO2:1.63%, PM2.5:0.91%, THC:1.53%, CH4:2.33%). The patients who were exposed to Quartile 1 level of CO, NO, and NO2 concentration were the oldest, and other patients who were exposed to Quartile 4 level of CO, NO, and NO2 concentration were living in the areas of highest urbanization. Participants exposed to Quartile 4 level concentrations of air pollutants were associated with highest hazards ratios for breast cancer incidences.Most participants who were exposed to the high concentration of air pollutants (CO, THC and CH4) had a significantly higher risk of breast cancer. If we can improve air pollution in the environment, we can reduce the incidence of breast cancer and save precious medical resources.


Assuntos
Poluição do Ar/efeitos adversos , Neoplasias da Mama/epidemiologia , Adulto , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Neoplasias da Mama/diagnóstico , Monitoramento Ambiental , Feminino , Humanos , Pessoa de Meia-Idade , Material Particulado , Estudos Retrospectivos , Taiwan , Adulto Jovem
13.
Clin Infect Dis ; 2021 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-34143885

RESUMO

OBJECTIVES: Cervical cancer risk overall is elevated among women living with HIV (WLH). However, it is unclear whether risks of cervical cancer are similarly elevated across histologic subtypes. METHODS: Data were utilized from the HIV/AIDS Cancer Match Study, a linkage of 12 US HIV and cancer registries during 1996-2016. Cervical cancers were categorized as adenocarcinoma (AC), squamous cell carcinoma (SCC) or other histologic type. Standardized incidence ratios were estimated to compare rates of AC and SCC in WLH compared to the general population. For WLH, risk factors for AC and SCC were evaluated using Poisson regression. All-cause 5-year survival was estimated by HIV status and histology. RESULTS: Overall, 62,615 cervical cancers were identified, including 609 in WLH. Compared to the general population, incidence of AC was 1.47-times higher (95%CI: 1.03-2.05) and incidence of SCC was 3.62-times higher among WLH (95%CI: 3.31-3.94). Among WLH, there was no difference in AC rates by race/ethnicity or HIV transmission group, although SCC rates were lower among White women (vs. Black, adjusted rate ratio (aRR)=0.53; 95%CI: 0.38-0.73) and higher among women who inject drugs (vs. heterosexual transmission; aRR=1.44; 95%CI: 1.17-1.78). Among WLH, 5-year overall survival was similar for AC (46.2%) and SCC (43.8%), but notably lower than women without HIV. CONCLUSIONS: Among WLH, AC rates were modestly elevated whereas SCC rates were greatly elevated compared to the general population. These findings suggest that there may be differences in the impact of immunosuppression and HIV status in the development of AC compared to SCC, given their common etiology in HPV infection.

14.
Artigo em Inglês | MEDLINE | ID: mdl-34127405

RESUMO

OBJECTIVE: To assess the epidemiology and outcome at discharge of cancer patients requiring admission to the Intensive Care Unit (ICU). DESIGN: A descriptive observational study was made of data from the ENVIN-HELICS registry, combined with specifically compiled variables. Comparisons were made between patients with and without neoplastic disease, and groups of cancer patients with a poorer outcome were identified. SETTING: Intensive Care Units participating in ENVIN-HELICS 2018, with voluntary participation in the oncological registry. PATIENTS: Subjects admitted during over 24 h and diagnosed with cancer in the last 5 years. PRIMARY ENDPOINTS: The general epidemiological endpoints of the ENVIN-HELICS registry and cancer-related variables. RESULTS: Of the 92 ICUs with full data, a total of 11,796 patients were selected, of which 1786 (15.1%) were cancer patients. The proportion of cancer patients per Unit proved highly variable (1%-48%). In-ICU mortality was higher among the cancer patients than in the non-oncological subjects (12.3% versus 8.9%; p < .001). Elective postoperative (46.7%) or emergency admission (15.3%) predominated in the cancer patients. Patients with medical disease were in more serious condition, with longer stay and greater mortality (27.5%). The patients admitted to the ICU due to nonsurgical disease related to cancer exhibited the highest mortality rate (31.4%). CONCLUSIONS: Great variability was recorded in the percentage of cancer patients in the different ICUs. A total of 46.7% of the patients were admitted after undergoing scheduled surgery. The highest mortality rate corresponded to patients with medical disease (27.5%), and to those admitted due to cancer-related complications (31.4%).

16.
Int. braz. j. urol ; 47(3): 558-565, May-June 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1154500

RESUMO

ABSTRACT Purpose: Incidence and mortality of prostate cancer (PCa) are still increasing in developing countries. Limited access to the health system or more aggressive disease are potential reasons for this. Ethnic and social differences in developed countries seem to make inappropriate to extrapolate data from other centers. We aim to report the epidemiological profile of a PSA-screened population from a cancer center in Brazil. Materials and Methods: We retrospectively selected 9.692 men enrolled in a PCa prevention program, comprising total PSA level and digital rectal examination at the first appointment, associated with complementary tests when necessary. Men aged over 40 years-old were included after shared decision-making process. Prostate biopsy (TRUS) was performed when clinically suspected for PCa. After the diagnosis, patients underwent appropriate treatment. Results: TRUS was performed in 5.5% of men and PCa incidence was 2.6%. Overall ratio between number of patients who needed to be screened in order to diagnose one cancer was 38.9 patients, with 2.1 biopsies performed to diagnose a cancer. Positive predictive value (PPV) of TRUS biopsy in this strategy was 47.2%, varying from 38.5% (<50 years-old) to 60% (>80 years-old). We evidenced 70 patients (27.9%) classified as low risk tumors, 74 (29.5%) as intermediate risk, and 107 (42.6%) as high-risk disease. Conclusions: PSA-screening remains controversial in literature. In front of a huge miscegenated people and considering the big proportion of high-risk PCa, even in young men diagnosed with the disease, it is imperative to inform patients and health providers about these data particularities in Brazil.


Assuntos
Humanos , Masculino , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/epidemiologia , Antígeno Prostático Específico/análise , Biópsia , Brasil/epidemiologia , Saúde Pública , Valor Preditivo dos Testes , Estudos Retrospectivos , Detecção Precoce de Câncer , Pessoa de Meia-Idade
17.
Arch. pediatr. Urug ; 92(1): e202, jun. 2021. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1248841

RESUMO

Resumen: Objetivo: describir la incidencia y supervivencia en niños y adolescentes con cáncer en Uruguay y analizar su evolución mediante la comparación de los períodos 1992-1994 y 2008-2012. Material y método: estudio observacional y descriptivo. Se incluyeron todos los pacientes entre 0 y 14 años diagnosticados de cáncer en todo el territorio uruguayo en el período 2008-2012. Fuente de datos: Registros del Servicio de Hematología y Oncología Pediátrica del Centro Hospitalario Pereira Rossell. Los diagnósticos fueron agrupados de acuerdo con la International Classification of Childhood Cancer, Third Edition. La información del tamaño de la población y de su distribución según la edad fue obtenida de registros de censos nacionales y de organismos internacionales. Se determinó incidencia y supervivencia. Se estableció el seguimiento de los sobrevivientes por un mínimo de seis años para asegurar una estimación precisa de la sobrevida. Resultados: se incluyeron 504 pacientes entre 0 y 14 años. La tasa de incidencia para todos los cánceres fue de 134,6 casos por millón por año, 147,6 y 120,7 para varones y niñas, respectivamente. La mayor incidencia fue observada para leucemias (grupo I) (40,6), tumores del sistema nervioso central (grupo III) (28,0) y linfomas (grupo II) (17,6). La tasa de sobrevida a cinco años mejoró significativamente para todos los cánceres de 54,7% (1992-1994) a 70,6% (2008-2012) (varones 49,2% a 69,6%; niñas 58,9% a 72,3%). Conclusiones: este estudio aporta información confiable de la incidencia y sobrevida del cáncer en Uruguay en pacientes menores de 15 años. Los resultados hallados demuestran cambios en la distribución de la población de Uruguay, una tasa de incidencia de cáncer estable en el grupo etario analizado y un progreso significativo en la supervivencia comparado con el estudio realizado hace 20 años, pero confirman que Uruguay tiene desafíos por delante para alcanzar tasas de cura del cáncer similares a los países de Europa Occidental y América del Norte.


Summary: Objectives: describe the incidence and survival of children and adolescents with cancer in Uruguay and analyze their evolution by comparing the periods 1992-1994 and 2008-2012. Materials and methods: descriptive and observational study. We included all patients between 0 and 14 years of age diagnosed with cancer in Uruguay during 2008-2012. Data source: Pereira Rossell Children's Hospital Records of the Pediatric Hematology and Oncology Department. The diagnoses were grouped according to the Third Edition of the Childhood Cancer's International Classification. Data regarding population size and distribution by age was obtained from national census records and from international organizations. We determined incidence and survival. Follow-up of survivors was established for a minimum of 6 years to ensure an accurate estimate of survival. Results: we included five hundred and four (504) patients between 0 and 14 years of age. The incidence rate for all cancers was 134.6 cases per million per year, 147.6 and 120.7 for boys and girls, respectively. The highest incidence was leukemia (group I) (40.6), tumors of the central nervous system (group III) (28.0) and lymphomas (group II) (17.6). The 5-year survival rate improved significantly for all cancers from 54.7% (1992-1994) to 70.6% (2008-2012) (males 49.2% to 69.6%; girls 58.9% to 72.3%). Conclusions: this study provides reliable information on the incidence and survival of cancer in Uruguay in patients under 15 years of age. The results found demonstrate changes in the distribution of the population of Uruguay, a stable cancer incidence rate in the age group analyzed and significant progress in survival compared to the study carried out 20 years ago, but confirm that Uruguay has challenges ahead in order to achieve cancer cure rates similar to those of Western European and North American countries.


Resumo: Objetivos: descrever a incidência e sobrevida em crianças e adolescentes com câncer no Uruguai e analisar sua evolução comparando os períodos 1992-1994 e 2008-2012. Materiais e métodos: estudo observacional e descritivo. Incluíram-se todos os pacientes de 0 a 14 anos de idade com diagnóstico de câncer em Uruguai no período 2008-2012. Fonte de dados: Prontuários do Serviço de Hematologia e Oncologia Pediátrica do Centro Hospitalar Pereira Rossell. Os diagnósticos foram agrupados de acordo com a Classificação Internacional de Câncer Infantil, Terceira Edição. As informações sobre o tamanho da população e sua distribuição por faixa etária foram obtidas nos registros censitários nacionais e em organismos internacionais. Determinaram-se a incidência e sobrevivência. Os sobreviventes foram acompanhados por um período mínimo de 6 anos para garantir uma estimativa precisa de sobrevida. Resultados: incluíram-se 504 pacientes entre 0 e 14 anos de idade. A taxa de incidência para todos os cânceres foi de 134,6 casos por milhão por ano, 147,6 e 120,7 para meninos e meninas, respectivamente. A maior incidência observou-se para leucemias (grupo I) (40,6), tumores do sistema nervoso central (grupo III) (28,0) e linfomas (grupo II) (17,6). A taxa de sobrevida em 5 anos melhorou significativamente para todos os cânceres de 54,7% (1992-1994) para 70,6% (2008-2012) (homens 49,2% a 69,6%; meninas 58,9% a 72,3%). Conclusões: este estudo fornece informação confiável sobre a incidência e sobrevida do câncer no Uruguai em pacientes com menos de 15 anos de idade. Os resultados encontrados mostram mudanças na distribuição da população uruguaia, taxa de incidência de câncer estável na faixa etária analisada e avanço significativo na sobrevida em relação ao estudo realizado há 20 anos, mas confirmam que o Uruguai tem desafios pela frente para atingir taxas de cura do câncer semelhantes aos países da Europa Ocidental e da América do Norte.

19.
PLoS One ; 16(6): e0251761, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34077442

RESUMO

BACKGROUND: Small-cell lung cancer (SCLC) is an aggressive disease with high metastatic potential and poor prognosis. Due to its low prevalence, epidemiological and clinical information of SCLC patients retrieved from lung cancer registries is scarce. PATIENTS AND METHODS: This was an observational multicenter study that enrolled patients with lung cancer and thoracic tumors, recruited from August 2016 to January 2020 at 50 Spanish hospitals. Demographic and clinical data, treatment patterns and survival of SCLC patients included in the Thoracic Tumor Registry (TTR) were analyzed. RESULTS: With a total of 956 cases, the age of 64.7 ± 9.1 years, 78.6% were men, 60.6% smokers, and ECOG PS 0, 1 or ≥ 2 in 23.1%, 53.0% and 23.8% of cases, respectively. Twenty percent of patients had brain metastases at the diagnosis. First-line chemotherapy (CT), mainly carboplatin or cisplatin plus etoposide was administered to >90% of patients. In total, 36.0% and 13.8% of patients received a second and third line of CT, respectively. Median overall survival was 9.5 months (95% CI 8.8-10.2 months), with an estimated rate of 70.3% (95% CI 67.2-73.4%), 38.9% (95% CI 35.4-42.4%), and 14.8% (95% CI 11.8-17.8%) at 6, 12 and 24 months respectively. Median progression-free survival was 6.3 months. Higher mortality and progression rates were significantly associated with male sex, older age, smoking habit, and ECOG PS 1-2. Long-term survival (> 2 years) was confirmed in 6.6% of patients, showing a positive correlation with better ECOG PS, poor smoking and absence of certain metastases at diagnosis. CONCLUSION: This study provides an updated overview of the clinical situation and treatment landscape of ES-SCLC in Spain. Our results might assist oncologists to improve current clinical practice towards a better prognosis for these patients.

20.
Pan Afr Med J ; 38: 264, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34122691

RESUMO

Introduction: we conducted the first epidemiological study of patients with breast cancers living in Fianarantsoa. The purpose of this study was to describe the epidemiology and clinical features of these patients in the Department of Oncology Fianarantsoa. Methods: we conducted a retrospective and descriptive study in the Department of Oncology at the University Hospital Center of Tambohobe over a period of 8 years (2011-2018). All patients with breast cancer diagnosed based on cytological and/or histological examination were included. The parameters studied were: age, occupation, a family history of breast cancer, menarche, menopause, parity, use of oral contraceptives, smoking, circumstances leading to detection, breast symptoms, signs of locoregional and distant spread, tumour site and stage of the disease. Results: the study included 62 patients with an average age of 52.83 ± 10.47 years. Housewives accounted for 39% (n = 24) of cases. No patient had an early menarche. Late menopause had occurred in 6.45% (n = 4) of patients and a family history of breast cancer was found in 8.06% (n = 5) of patients. Chewing tobacco was used by 17.74% (n = 11) of patients. Patients reporting breast symptoms accounted for 95.2% (n = 59). Breast cancers had affected the upper outer quadrant in 53.23% (n = 33) of cases. Stage III breast cancer was diagnosed in 55% (n = 34) of cases and stage IV in 32% (n = 20) of cases. Conclusion: in patients diagnosed with cancer at an advanced stage, risk factors for breast cancer were little observed.

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