RESUMO
BACKGROUND: Little has been published about the association of venous thromboembolism (VTE) and sarcoma. In this study, we sought to identify clinical features of patients with sarcoma presenting at least one VTE episode. METHODS: Our study was a retrospective case-control study of a single-institution database with univariate and multivariate analysis using chi-square and Student's t test. A p value less than .05 was considered significant. RESULTS: The overall incidence of VTE in patients with sarcoma was 7.9%. Predictive factors identified by multivariate analysis were metastatic disease and administration of chemotherapy. It was not statistically possible to correlate the risk of VTE with specific sarcoma subtypes, but observations suggested malignant peripheral nerve sheath tumor, osteosarcoma, and liposarcoma as having the highest propension. CONCLUSION: VTE is not infrequent in patients with sarcoma. Adoption of common guidelines for cancer-associated thrombosis is recommended.
Assuntos
Sarcoma/complicações , Tromboembolia Venosa/etiologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tromboembolia Venosa/patologiaRESUMO
Frequently the cause of raised intracranial pressure remains unresolved and rarely is related to spinal tumours, moreover less to spinal medulloblastoma without primary brain focus. An 18-year-old woman had a 3-month history of headache and impaired vision. Neurological examination revealed bilateral sixth cranial nerve palsies with bilateral papilloedema of grade III. No focal brain or spine lesion was found on imaging. Consecutive lumbar punctures showed high opening pressure and subsequent increasing protein level. Meningeal biopsy was negative. At one point, she developed an increasing headache, vomiting and back pain. Spine MRI showed diffuse nodular leptomeningeal enhancement with the largest nodule at T6-T7. Malignant cells were detected in cerebrospinal fluid. She underwent laminectomy with excisional biopsy, and pathology showed medulloblastoma WHO grade IV. She was treated with chemotherapy and craniospinal irradiation and made a good recovery.
Assuntos
Neoplasias Cerebelares , Meduloblastoma , Pseudotumor Cerebral , Adolescente , Neoplasias Cerebelares/complicações , Neoplasias Cerebelares/diagnóstico , Feminino , Humanos , Imageamento por Ressonância Magnética , Meduloblastoma/complicações , Meduloblastoma/diagnóstico , Coluna VertebralRESUMO
Docetaxel is active in esophagogastric junction (EGJ) adenocarcinoma, and DCF (docetaxel/cisplatin/5-fluorouracil) has shown good results in the neoadjuvant setting. Its high rate of grade 3-4 mucosal toxicity (stomatitis and diarrhea) has limited its widespread adoption. A more recent docetaxel-based triplet, FLOT (5-fluorouracil, oxaliplatin and docetaxel) may be better tolerated. We conducted a pilot study of FLOT chemotherapy in EGJ adenocarcinoma patients and dysphagia to prospectively assess the rate of grade 3-4 mucosal toxicity and of pathological complete response (pCR) rate. Dysphagia and quality of life were measured with validated questionnaires. Ten patients were enrolled. Grade 3-4 mucosal toxicity rate was 0 %; pCR rate was 11 %; and near-complete pathological response rate 11 %. Dysphagia improvement or resolution was seen in 90 % of patients, and quality of life was stable before and after chemotherapy. FLOT is a safe and active neoadjuvant chemotherapy option for EGJ adenocarcinoma and should be compared to other standard regimens in randomized trials.
Assuntos
Adenocarcinoma/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Esofágicas/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Quimioterapia Adjuvante , Docetaxel , Junção Esofagogástrica/patologia , Feminino , Fluoruracila/administração & dosagem , Fluoruracila/efeitos adversos , Humanos , Leucovorina/administração & dosagem , Leucovorina/efeitos adversos , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Compostos Organoplatínicos/administração & dosagem , Compostos Organoplatínicos/efeitos adversos , Oxaliplatina , Projetos Piloto , Qualidade de Vida , Neoplasias Gástricas/tratamento farmacológico , Taxoides/administração & dosagem , Taxoides/efeitos adversosRESUMO
UNLABELLED: The present study was conducted to assess knowledge and attitude of unmarried female students in King Abdul-Aziz University (KAU) towards premarital screening (PMS) program, to determine predictors of high students' knowledge scores and to improve their knowledge about PMS through conduction of an educational campaign. Multi-stage stratified random sample method was used with recruitment of 1563 students from all faculties of KAU, during the educational year 2008-2009. The Pre-test included 30 knowledge items and 14 attitude statements with student's response through a 5-point Likert scale. Health education was conducted using audiovisual aids through pre-designed educational materials. Statistical analysis was done by SPSS version 16. RESULTS: Students' knowledge about the program was generally low before the educational campaign. The predictors of high knowledge scores were being a health science student (aOR=4.15; 95% CI: 2.97-5.81), age ≥20 years (aOR=2.78; 95% CI: 2.01-3.85), family history of hereditary diseases and income ≥10,000 SR/month. Regarding attitude, almost all students (99.0%) agreed on the importance of PMS. After the educational program, students' knowledge about PMS was markedly improved. The mean students' knowledge score was 9.85 ± 5.36 in Pre-test and improved to 18.45 ± 4.96 in Post-test, with a highly statistical significant difference (paired t=25.40, p<0.000). CONCLUSION AND RECOMMENDATIONS: The educational program was successful in improving students' knowledge about the PMS. Conduction of similar educational programs and adding PMS in the curriculum of secondary and university education are recommended.
Assuntos
Educação em Saúde/métodos , Conhecimentos, Atitudes e Prática em Saúde , Programas de Rastreamento , Adolescente , Adulto , Feminino , Humanos , Arábia Saudita , Pessoa Solteira , Estudantes , Universidades , Adulto JovemRESUMO
UNLABELLED: Dengue is increasingly recognized as one of the world's major infectious diseases. Dengue vectors, human knowledge and human behavior have each been reported to play an important role in the transmission of the disease. A cross-sectional approach was conducted to assess knowledge, attitudes and practice (KAP) of high school female students, teachers and supervisors towards Dengue fever (DF), and to determine scoring predictors of high school students' knowledge and practice scores. A multistage, stratified, random sample method was applied. A total of 2693 students, 356 teachers and 115 supervisors completed confidential self-administered questionnaires. RESULTS: Students obtained the lowest mean knowledge score compared to the other two groups (F=51.5, P<0.001). A positive family history of DF (a OR=2.05; 95% CI=1.15-3.64), having literate mothers (>or=secondary education), and students' age >or=17 were the predictors of high students' knowledge score. The only predictor of high practice score was obtaining high knowledge score (a OR=2.06; 95% CI=1.73-2.44). CONCLUSION: KAP towards DF was deficient among target populations, especially among students. School-based educational campaigns and social mobilization for raising knowledge and changing it into sound practice is urgently needed for controlling dengue epidemics in Jeddah.