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1.
Infectio ; 25(3): 176-181, jul.-set. 2021. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1250089

ABSTRACT

Abstract Objective: To determine the mortality and survival of COVID-19 cases in Colombia between March and July 2020. Materials and methods: A retrospective cohort study in the Colombian population between March 6 to July 8, 2020, with the data reported to the National Institute of Health. Survival analysis was performed considering the real-time PCR results, died or recovered, the onset of symptoms until the date of death, or the final time of the cohort. The actuarial variation and Long-Rank test were applied for survival. Risk factors were determined by Cox regression. Results: The overall survival rate was 100%, 98%, 97%, and 95% for day 1, 10, 20 and 30, respectively. Differences were found in survival in age, sex, region, and hospitaliza tion time spending (p <0.01), the 30-day survival rate was 96% and 95% for females and males, respectively. The region with the highest survival was Antioquia with 99% and the lower Barranquilla with 93%. The age group with the lowest survival was ≥80 years of age with 60%, and being hospitalized represented a survival rate of 68%. Conclusions: This study is one of the first to estimate survival in the Colombian population diagnosed with COVID-19.


Resumen Objetivo: determinar la mortalidad y supervivencia de casos de COVID-19 en Colombia entre marzo y julio de 2020. Materiales y métodos: Estudio de cohorte retrospectivo en población colombiana entre el 6 de marzo al 8 de julio de 2020, con los datos reportados al Instituto Nacional de Salud. El análisis de supervivencia se realizó considerando los resultados de la PCR en tiempo real, fallecido o recuperado, el inicio de los síntomas hasta la fecha del fallecimiento o el momento final de la cohorte. Para la supervivencia se aplicó la variación actuarial y la prueba de rango largo. Los factores de riesgo se determinaron mediante regresión de Cox. Resultados: La tasa de supervivencia general fue del 100%, 98%, 97% y 95% para los días 1, 10, 20 y 30, respectivamente. Se encontraron diferencias en la su pervivencia en cuanto a edad, sexo, región y tiempo de hospitalización (p <0,01), la tasa de supervivencia a 30 días fue del 96% y 95% para mujeres y hombres, respectivamente. La región con mayor supervivencia fue Antioquia con 99% y la Baja Barranquilla con 93%. El grupo de edad con menor supervivencia fue el ≥80 años con 60%, y la hospitalización representó una tasa de supervivencia del 68%. Conclusiones: Este estudio es uno de los primeros en estimar la supervivencia en la población colombiana diagnosticada con COVID-19.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Survival Analysis , COVID-19 , Survival Rate , Risk Factors , Cohort Studies , Mortality , Colombia , Survivorship , Methods
2.
Rev. cuba. estomatol ; 58(2): e3265, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1289407

ABSTRACT

Introducción: Gracias a su eficiencia y al uso exclusivo de cerámicas libres de metal, en rehabilitación oral se ha logrado alcanzar los estándares estéticos y mecánicos, manteniendo o, incluso, superando, la calidad de los tratamientos en comparación con las restauraciones metal cerámicas tradicionales. Actualmente los mecanismos de confeccion de cerámica libre están evolucionando cada vez mas hacia las tecnologías maquinadas CAD-CAM y disminuyendo su producción mediante la técnica de Inyeccion PRESS. Objetivo: Comparar la tasa de supervivencia de prótesis fija unitaria realizadas con cerámicas feldespáticas convencionales y reforzadas con disilicato de litio, confeccionadas con sistema CAD/CAM de CEREC® chair-side, en comparación con el método de inyección de laboratorio PRESS convencional de prensión. Métodos: Revisión sistemática realizada a través de búsqueda de evidencia científica en PubMed, PubMed Clinical Queries, Epistemónikos, Tripdatabase, Cochrane Library, recursos electrónicos de la Universidad de los Andes y bibliografía retrógrada, de artículos publicados hasta el año 2019. Se incluyeron todos aquellos estudios referentes a prótesis fija unitaria de cerámicas feldespática convencional y feldespática reforzada con disilicato de litio, confeccionadas mediante CAD/CAM y/o método convencional. Resultados: Un total de 28 artículos cumplieron los criterios de inclusión: 21 estudios observacionales de cohorte, 4 ensayos clínicos aleatorizados y 3 no aleatorizados. A corto y mediano plazo, CAD/CAM de CEREC® registró tasas de supervivencia de 98 por ciento y 91,9 por ciento, respectivamente. El sistema convencional registró tasas de supervivencia de 97,5 por ciento a corto plazo y 93 por ciento a mediano. Conclusiones: A corto plazo se describe en la literatura que CAD/CAM de CEREC® tuvo una tasa de supervivencia ligeramente superior al sistema convencional. Por otro lado, a mediano plazo CAD/CAM de CEREC® presentó una leve disminución respecto al sistema convencional. Aún no hay estudios disponibles para determinar la supervivencia clínica de los tratamientos a largo plazo(AU)


Introduction: Thanks to its efficiency and the exclusive use of metal-free ceramics, in oral rehabilitation it has been possible to achieve aesthetic and mechanical standards, maintaining or even exceeding the quality of the treatments compared to traditional metal-ceramic restorations. Currently, free ceramic manufacturing mechanisms are increasingly evolving towards CAD-CAM machined technologies and decreasing their conventional production through the PRESS Injection technique. Objective: Compare the survival rate of single-unit fixed prostheses made with conventional feldspathic ceramics and reinforced with lithium disilicate by the CEREC® CAD/CAM chairside system, with the conventional PRESS laboratory injection method. Methods: A systematic review was conducted of scientific evidence included in papers published until the year 2019 in PubMed, PubMed Clinical Queries, Epistemonikos, Tripdatabase, Cochrane Library, electronic resources of Los Andes Peruvian University, and retrograde bibliography. The papers selected dealt with conventional and lithium-disilicate reinforced feldspathic ceramic single-unit prostheses made by CAD/CAM and/or the conventional method. Results: A total 28 papers met the inclusion criteria. Of these, 21 were observational cohort studies, four were randomized clinical assays and three were non-randomized assays. Short- and mid-term, CEREC® CAD/CAM achieved survival rates of 98 percent and 91.9 percent, respectively. The conventional system achieved survival rates of 97.5 percent short-term and 93 percent mid-term. Conclusions: As described in the literature, CEREC® CAD/CAM had a slightly higher survival rate than the conventional system in the short term. In the medium term, however, CEREC® CAD/CAM displayed a slight reduction in comparison with the conventional system. No studies are available to determine the clinical survival of the treatments in the long term(AU)


Subject(s)
Humans , Ceramics/adverse effects , Dental Prosthesis Design/methods , Computer-Aided Design/trends , Denture, Partial, Fixed/adverse effects , Review Literature as Topic , Survival Rate , Cohort Studies , Observational Studies as Topic , Esthetics, Dental
3.
An. Facultad Med. (Univ. Repúb. Urug., En línea) ; 8(1): e203, jun. 2021. tab, graf
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1248717

ABSTRACT

El vino tinto variedad Vitis vinifera L. cv Tannat en los últimos años ha tomado relevancia por su alta concentración de polifenoles, esto le podría significar un rol protector sobre el genoma disminuyendo la formación de lesiones oxidativas. Los efectos a nivel celular de las radiaciones ionizantes en blancos como el ADN, componentes de cascadas de transducción de señales, resultan en lesiones letales, mutagénicas y recombinogénicas y en retardos en el ciclo celular. Se utilizó como modelo eucariota poblaciones de Saccharomyces cerevisiae en fase exponencial expuestas a radiación gamma (200 Gy) en presencia, o ausencia, de vino Tannat (10 % v/v) o de ácido tánico (60 µg/mL). Se estimaron las probabilidades de sobrevida y frecuencia mutagénica en distintas condiciones. Las muestras celulares expuestas a radiación ionizante presentaron una fracción de sobrevida de 0.21 ± 0.02 mientras que en las muestras irradiadas en presencia de vino Tannat o de ácido tánico la fracción de sobrevida fue de 0.33 ± 0.03 y 0.30 ± 0.03 respectivamente. Se observó en las poblaciones irradiadas un aumento significativo de la probabilidad de mutagénesis. En el caso de los tratamientos combinados se observó que la frecuencia mutagénica fue significativamente menor (gamma Tannat: 33%, gamma ácido tánico: 45% ). Estos resultados preliminares podrían indicar radioprotección moderada por parte de los compuestos estudiados, efecto que podría explicarse por las interacciones redox del ácido tánico y polifenoles contenidos en el vino con los radicales libres formados por las radiaciones ionizantes, además de la activación de vías de reparación genómica.


The red wine variety Vitis vinifera L. cv Tannat in recent years has gained relevance due to its high concentration of polyphenols, this could mean a protective role on the genome, reducing the formation of oxidative lesions. The effects at the cellular level of ionizing radiation on targets such as DNA, components of signal transduction cascades, result in lethal, mutagenic and recombinogenic lesions and delays in the cell cycle. Exponential phase populations of Saccharomyces cerevisiae exposed to gamma radiation (200 Gy) in the presence or absence of Tannat wine (10% v / v) or tannic acid (60 µg / ml) were used as a eukaryotic model. The probabilities of survival and mutagenic frequency in different conditions were estimated. Cellular samples exposed to ionizing radiation presented a survival fraction of 0.21 ± 0.02, while in samples irradiated in the presence of Tannat wine or tannic acid, the survival fraction was 0.33 ± 0.03 and 0.30 ± 0.03 respectively. A significant increase in the probability of mutagenesis was observed in irradiated populations. In the case of the combined treatments, it was observed that the mutagenic frequency was significantly lower (Tannat gamma: 33%, Tannic acid gamma: 45%). These preliminary results could indicate moderate radioprotection by the compounds studied, an effect that could be explained by the redox interactions of tannic acid and polyphenols contained in wine with the free radicals formed by ionizing radiation, in addition to the activation of genomic repair pathways.


A variedade de vinho tinto Vitis vinifera L. cv Tannat nos últimos anos tem ganhado relevância devido à sua alta concentração de polifenóis, o que pode significar um papel protetor do genoma, reduzindo a formação de lesões oxidativas. Os efeitos no nível celular da radiação ionizante em alvos como o DNA, componentes de cascatas de transdução de sinal, resultam em lesões letais, mutagênicas e recombinogênicas e atrasos no ciclo celular. Populações de fase exponencial de Saccharomyces cerevisiae expostas à radiação gama (200 Gy) na presença ou ausência de vinho Tannat (10% v / v) ou ácido tânico (60 µg / ml) foram utilizadas como modelo eucariótico. Foram estimadas as probabilidades de sobrevivência e frequência mutagênica em diferentes condições. As amostras celulares expostas à radiação ionizante apresentaram uma fração de sobrevivência de 0,21 ± 0,02, enquanto nas amostras irradiadas na presença de vinho Tannat ou ácido tânico, a fração de sobrevivência foi de 0,33 ± 0,03 e 0,30 ± 0,03, respectivamente. Um aumento significativo na probabilidade de mutagênese foi observado nas populações irradiadas. No caso dos tratamentos combinados, observou-se que a frequência mutagênica foi significativamente menor (Tannat gama: 33%, ácido tânico gama: 45%). Esses resultados preliminares podem indicar radioproteção moderada pelos compostos estudados, efeito que pode ser explicado pelas interações redox do ácido tânico e polifenóis contidos no vinho com os radicais livres formados pela radiação ionizante, além da ativação de vias de reparo genômico.


Subject(s)
Animals , Saccharomyces cerevisiae/drug effects , Saccharomyces cerevisiae/genetics , Tannins/pharmacology , Mutagenesis/drug effects , Polyphenols/pharmacology , Gamma Rays/adverse effects , Radiation-Protective Agents/pharmacology , Survival Rate , Drug Therapy, Combination , Mutation Rate
4.
Rev. cuba. cir ; 60(1): e1033, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1289375

ABSTRACT

Introducción: En el mundo moderno, el traumatismo es la primera causa de mortalidad y discapacidad en menores de 35 años. Múltiples son los esfuerzos para tratar de definir su pronóstico desde el momento en que se produce. Con el decurso de los años se han creado varias escalas, para describir la gravedad de las lesiones, las alteraciones fisiológicas que se producen, así como para evaluar los sistemas de atención. Objetivo: Describir el comportamiento de los lesionados en el Hospital "Calixto García" según variables. Métodos: Se realizó un estudio observacional descriptivo, prospectivo y longitudinal en 1582 lesionados atendidos en el servicio de Cirugía General. Resultados: El intervalo trauma/ingreso superó los 60 minutos en un número elevado y la mitad de ellos presentó parámetros clínicos de inestabilidad hemodinámica en la recepción; se logró su compensación en la primera hora de admitidos en 7 de cada 10 lesionados. Más de la mitad desarrolló alguna complicación y predominó la estadía hospitalaria entre 15 y 21 días. Conclusiones: Algunas de las variables estudiadas se comportaron similar a la literatura consultada. Los resultados sugieren la necesidad de implementar un programa de atención prehospitalaria al lesionado más efectivo para mejorar la atención y el índice de sobrevida en los mismos(AU)


Introduction: In the modern world, trauma is the leading cause of death and disability in people under 35 years of age. Multiple efforts are made to define its prognosis from the moment it occurs. Over the years, several scales have been created to describe the severity of injuries, the physiological changes that occur, as well as to assess care systems. Objective: To describe the behavior of injured patients in Calixto García Hospital according to variables. Methods: A observational, descriptive, prospective and longitudinal study was carried out with 1582 injured patients treated in the general surgery service. Results: The trauma/admission interval exceeded sixty minutes in a high number of cases. Half of them presented clinical parameters of hemodynamic instability at admission. Compensation was achieved at the first hour of admission in seven out of ten injured patients. More than half the patients developed some complication. There was a predomination of hospital stay between 15 and 21 days. Conclusions: Some of the variables studied behaved similarly to the way described in the consulted literature. The results suggest the need to implement a more effective prehospital care program for the injured patients to improve care and survival rate(AU)


Subject(s)
Humans , Wounds and Injuries/complications , Prehospital Care , Reference Parameters/methods , Length of Stay , Epidemiology, Descriptive , Survival Rate , Prospective Studies , Longitudinal Studies , Observational Studies as Topic
5.
Rev. cuba. hematol. inmunol. hemoter ; 37(1): e1249, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1251713

ABSTRACT

Introducción: Con el protocolo LPM-TOA para tratamiento de la leucemia promielocítica, se han obtenido excelentes resultados, ya que se logra sobrevida global prolongada y posible curación de los enfermos. En la inducción se utilizan dos drogas cardiotóxicas: las antraciclinas y el trióxido de arsénico y en la consolidación los enfermos reciben una dosis elevada de arsénico. Objetivo: Evaluar la toxicidad cardíaca tardía en pacientes con leucemia promielocítica tratados según el protocolo LPM-TOA. Métodos: Se realizó un estudio observacional descriptivo, prospectivo y longitudinal que incluyó 20 pacientes tratados con protocolo LPM-TOA, seguidos en consulta entre enero y julio 2019. Los pacientes tenían más de dos años de haber recibido las drogas cardiotóxicas. Se revisaron las historias clínicas y se determinó la fracción de eyección ventricular izquierda y la deformidad longitudinal global, mediante ecocardiograma. Resultados: Se presentaron hombres y mujeres con igual frecuencia, edad promedio 41,5 ± 11,0 años. Durante la inducción, en menos de la mitad de los enfermos se suspendió el arsénico por elevación del segmento QT corregido; en la mayoría solo se suspendió por uno o dos días. La mayor parte de los pacientes tuvo la fracción de eyección ventricular izquierda con valores entre 61 y 70 por ciento y la deformidad longitudinal global fue - 24 - 22 por ciento Conclusiones: En los pacientes estudiados, el tiempo de haber recibido el trióxido de arsénico y la dosis recibida, no influyó en la función cardíaca(AU)


Introduction: The PML-ATO protocol for the treatment of promyelocytic leukemia has obtained excellent results, achieving high overall survival rates and the possible healing of patients. Two cardiotoxic drugs are used in the induction process: anthracyclines and arsenic trioxide, whereas during consolidation patients receive a high dose of arsenic. Objective: Evaluate the late cardiotoxicity in patients with promyelocytic leukemia treated by the PML-ATO protocol. Methods: An observational prospective longitudinal descriptive study was conducted of 20 patients treated with the PML-ATO protocol and followed-up in outpatient consultation from January to July 2019. More than two years had elapsed since the patients received the cardiotoxic drugs. A review was carried out of the patients' medical records and echocardiographic determination was made of left ventricular ejection fraction and overall longitudinal deformity. Results: Men and women presented the same frequency; mean age was 41.5 ± 11.0 years. During induction, arsenic was suspended in less than half the patients due to corrected QT elevation. In most it was only suspended for one or two days. Most patients had left ventricular ejection fraction values between 61 percent and 70 percent, whereas overall longitudinal deformity was - 24 percent - 22 percent. Conclusions: In the patients studied, cardiac function was not affected by the time elapsed since arsenic trioxide administration or the dose received(AU)


Subject(s)
Humans , Leukemia, Promyelocytic, Acute/mortality , Leukemia, Promyelocytic, Acute/therapy , Anthracyclines , Arsenic Trioxide/therapeutic use , Medical Records , Survival Rate , Cardiotoxicity/drug therapy
6.
Arq. gastroenterol ; 58(1): 93-99, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1248989

ABSTRACT

ABSTRACT BACKGROUND: As age advances, a higher burden of comorbidities and less functional reserve are expected, however, the impact of aging in the surgical outcomes of gastric cancer (GC) patients is unknown. OBJECTIVE: The aim of this study is to evaluate surgical outcomes of GC patients according to their age group. METHODS: Patients submitted to gastrectomy with curative intent due to gastric adenocarcinoma were divided in quartiles. Each group had 150 patients and age limits were: ≤54.8, 54.9-63.7, 63.8-72, >72. The outcomes assessed were: postoperative complications (POC), 90-day postoperative mortality, disease-free survival (DFS) and overall survival (OS). RESULTS: Major surgical complications were 2.7% in the younger quartile vs 12% for the others (P=0.007). Major clinical complications raised according to the age quartile: 0.7% vs 4.7% vs 5.3% vs 7.3% (P<0.042). ASA score and age were independent risk factors for major POC. The 90-day mortality progressively increased according to the age quartile: 1.3% vs 6.0% vs 7.3% vs 14% (P<0.001). DFS was equivalent among quartile groups, while OS was significantly worse for those >72-year-old. D2 lymphadenectomy only improved OS in the three younger quartiles. Age >72 was an independent risk factor for worse OS (hazard ratio of 1.72). CONCLUSION: Patients <55-year-old have less surgical complications. As age progresses, clinical complications and 90-day mortality gradually rise. OS is worse for those above age 72, and D2 lymphadenectomy should be individualized after this age.


RESUMO CONTEXTO: Conforme a idade avança, se esperam mais morbidades e menor reserva funcional. Entretanto não está claro qual o impacto do envelhecimento nos resultados cirúrgicos do câncer gástrico (CaG). OBJETIVO: O intuito deste estudo é avaliar os resultados cirúrgicos de pacientes com CaG de acordo com o grupo etário. MÉTODOS: Pacientes submetidos a gastrectomia por adenocarcinoma gástrico com intuito curativo foram divididos em quartis. Cada grupo incluiu 150 indivíduos e os limites etários foram: ≤54,8; 54,9-63,7; 63,8-72; >72. Os resultados avaliados foram: complicações pós-operatórias (CPO), mortalidade em 90 dias, sobrevida livre de doença (SLD) e sobrevida global (SG). RESULTADOS: Complicações cirúrgicas maiores ocorreram em 2,7% dos pacientes no quartil mais jovem vs 12% para os demais (P=0,007). A incidência de complicações clínicas maiores aumentou conforme o quartil: 0,7% vs 4,7% vs 5,3% vs 7,3% (P<0,042). A pontuação ASA e a idade foram fatores de risco independentes para CPO maiores. A mortalidade em 90 dias aumentou progressivamente conforme o quartil etário: 1,3% vs 6,0% vs 7,3% vs 14% (P<0,001). A SLD foi equivalente entre os quartis, enquanto a SG foi significativamente pior para os >72 anos de idade. Linfadenectomia D2 aumentou a SG apenas para os 3 quartis mais jovens. Idade > 72 foi fator independente de risco para pior SG (razão de chances de 1,72) CONCLUSÃO: Pacientes < 55 anos tem menos complicações cirúrgicas. Conforme a idade avança, as complicações clínicas e a mortalidade em 90 dias aumenta gradualmente. A SG é pior se >72 anos e a indicação de linfadenectomia D2 deve ser individualizada a partir dessa idade.


Subject(s)
Humans , Aged , Stomach Neoplasms/surgery , Adenocarcinoma/surgery , Postoperative Complications , Survival Rate , Retrospective Studies , Gastrectomy/adverse effects , Lymph Node Excision , Middle Aged
7.
Braz. j. med. biol. res ; 54(2): e9173, 2021. tab, graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1142586

ABSTRACT

This study aimed to explore the correlation of kinesin family member 2A (KIF2A) expression with disease risk, clinical characteristics, and prognosis of acute myeloid leukemia (AML), and investigate the effect of KIF2A knockdown on AML cell activities in vitro. Bone marrow samples were collected from 176 AML patients and 40 healthy donors, and KIF2A expression was measured by real-time quantitative polymerase chain reaction. Treatment response, event-free survival (EFS), and overall survival (OS) were assessed in AML patients. In vitro, KIF2A expression in AML cell lines and CD34+ cells (from healthy donors) was measured, and the effect of KIF2A knockdown on AML cell proliferation and apoptosis in HL-60 and KG-1 cells was detected. KIF2A expression was greater in AML patients compared to healthy donors, and receiver operating characteristic curve indicated that KIF2A expression predicted increased AML risk (area under curve: 0.793 (95%CI: 0.724-0.826)). In AML patients, KIF2A expression positively correlated with white blood cells, monosomal karyotype, and high risk stratification. Furthermore, no correlation of KIF2A expression with complete remission or hematopoietic stem cell transplantation was found. Kaplan-Meier curves showed that KIF2A expression was negatively correlated with EFS and OS. In vitro experiments showed that KIF2A was overexpressed in AML cell lines (KG-1, HL-60, ME-1, and HT-93) compared to CD34+ cells, moreover, cell proliferation was reduced but apoptosis was increased by KIF2A knockdown in HL-60 and KG-1 cells. In conclusion, KIF2A showed potential to be a biomarker and treatment target in AML.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Leukemia, Myeloid, Acute/diagnosis , Leukemia, Myeloid, Acute/genetics , Kinesin/genetics , Biomarkers, Tumor/genetics , Survival Rate , Risk Factors , Apoptosis , HL-60 Cells , Cell Proliferation , Gene Knockdown Techniques
8.
Rev. ANACEM (Impresa) ; 15(1): 42-48, 2021. tab
Article in Spanish | LILACS | ID: biblio-1282102

ABSTRACT

INTRODUCCIÓN: La pandemia por SARS-COV-2 ha generado mortalidad por exceso, aun así, se deben revisar la mortalidad atribuida a otras enfermedades. El siguiente trabajo pretende identificar la tendencia de mortalidad no relacionada con COVID-19 en la región del Bio-bio, periodo 2016-2020. Material y Método: Estudio descriptivo, ecológico, longitudinal. Se estudió la población de la región del Biobío, periodo 2016-2020. Los datos se obtuvieron del departamento de estadística e información en Salud. Se estudió: Distribución etaria, sexo, tasa de mortalidad general y específica, y promedio anual del número de muertos en el periodo 2016-2019; excluyendo la causa de muerte por enfermedad COVID-19 o sospechosa de COVID-19. Se realizó un análisis descriptivo. Se utilizó el programa Microsoft Excel 365® para análisis. Resultados: 2016-2019 fallecieron más hombres (n=19.110; 53,00%), siendo el principal grupo etario de 75-79 años (n=2.433; 12,73%), en el caso de las mujeres fue el grupo de 90-99 años (n=2.832; 16,71%). En 2020, fallecieron más hombres que mujeres, de los mismos grupos etarios respectivamente. Tasa de mortalidad general 2020 fue 544,39 x100.000 hbts., inferior a la de otros años, excepto en 2016. Sin embargo, el periodo Enero-abril 2020, la tasa de mortalidad es mayor comparado con los años anteriores. El promedio de muertes 2016-2019 fue 9.016,0 ±186,5, siendo el total en 2020 n=9.057. Discusión: La pandemia ha afectado a pacientes con patologías que han presentado una atención poco efectiva u inoportuna, falleciendo por el SARS-COV-2 o por sus comorbilidades, camuflándose sus registros. Lo cual dificultará interpretar dichos valores.


INTRODUCTION: The SARS-COV-2 pandemic has generated excess mortality, even so, the mortality attributed to other diseases should be reviewed. The study objective was to identify the mortality trend unrelated to COVID-19 in the Bio-bio Region between 2016-2020. Material and Method: Descriptive, ecological, longitudinal study. The population of the Biobío region was studied between the years 2016-2020. Data were obtained from the Department of Statistics and Health Information, DEIS. It was studied: Age distribution, sex, general and specific mortality rate, annual average of the number of deaths between 2016-2020, excluding mortality from (or suspected) COVID-19 disease. A descriptive analysis was performed. Microsoft Excel 365® software was used for the analysis. Results: 2016-2019 mortality rate was higher for men (n=19,110; 53.00%), with the highest rates in the 75-79 years group (n=2,433; 12.73%); women 90- 99 years (n=2,832; 16.71%) presented the highest mortality rates. In 2020 more men than women continued to die in the same age groups, respectively. The general mortality rate 2020 was 544,39 x 100,000 inhabitants, which is lower than that of any other year, except for 2016. However, from January to April 2020, the mortality rate was higher when compared to the previous years. The average of deaths 2016-2019 was 9,016.0 ± 186.5, meanwhile in the same period in 2020 was 9,057. Discussion: The pandemic has affected patients with pathologies who have presented ineffective or untimely care, dying from SARS-COV-2 or its comorbidities, then their records get camouflaged, which will make it difficult to interpret these values.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Disease , Mortality/trends , Cause of Death/trends , COVID-19 , Chile/epidemiology , Epidemiology, Descriptive , Survival Rate , Models, Statistical , Pandemics
9.
Rev. odontol. UNESP (Online) ; 50: e20210015, 2021. tab
Article in English | LILACS, BBO | ID: biblio-1289856

ABSTRACT

Abstract Introduction The investigation of peri-implant diseases risk indicators helps to prevent and target treatment techniques. Objective The aim of this cross-sectional study was to determine the occurrence of peri-implantitis and its potential risk indicator factors, besides to assess the long-term success and survival rates of dental implants after 8 to 10 years of function. Material and method For this, fifty individuals who had received their implant-supported rehabilitation between 2003 and 2005 were included. Data regarding demographics, medical and dental history were collected and a complete clinical examination was performed. Multivariate analysis was used to identify potential risk indicator factors related to the occurrence of peri-implantitis. Overall, 211 implants had been placed; 197 were in function, 9 were still submerged, and 5 had been lost. Result Success and survival rates were 81.5% and 97.6%, respectively. Peri-implant mucositis affected 77.1% of subjects and 52.3% of implants. Peri-implantitis was diagnosed in 14 individuals (29.2%) and 25 implants (12.7%). Subjects with osteoporosis (OR = 2.84) and generalized bleeding on probing (OR = 8.03) were significantly associated with higher odds of peri-implantitis. At the implant level, visible plaque (OR = 4.45) and deep probing depths (OR = 4.47) were significantly associated with peri-implantitis. Conclusion Through these results, our study suggests that osteoporosis and generalized periodontal/peri-implant mucosa inflammation increase the likelihood of peri-implantitis.


Resumo Introdução A investigação dos fatores indicadores de risco para as doenças peri-implantares auxilia na prevenção e direcionamento das técnicas de tratamento Objetivo O objetivo deste estudo transversal foi determinar a ocorrência de peri-implantite e seus potenciais fatores indicadores de risco, além de avaliar as taxas de sucesso e sobrevida em longo prazo dos implantes dentários após 8 a 10 anos de função Material e método Foram incluídos cinquenta indivíduos que receberam sua reabilitação implanto-suportada entre 2003 e 2005. Dados demográficos, história médica e odontológica foram coletados e um exame clínico completo foi realizado. A análise multivariada foi utilizada para identificar potenciais fatores indicadores de risco relacionados à ocorrência de peri-implantite. Ao todo, 211 implantes foram colocados; 197 estavam em função, 9 ainda estavam submersos e 5 haviam sido perdidos. Resultado As taxas de sucesso e sobrevivência foram de 81,5% e 97,6%, respectivamente. A mucosite peri-implantar afetou 77,1% dos indivíduos e 52,3% dos implantes. A peri-implantite foi diagnosticada em 14 indivíduos (29,2%) e 25 implantes (12,7%). Indivíduos com osteoporose (OR = 2,84) e sangramento generalizado à sondagem (OR = 8,03) foram significativamente associados a uma maior chance de peri-implantite. Ao nível do implante, a placa visível (OR = 4,45) e as maiores profundidades de sondagem (OR = 4,47) foram significativamente associadas à peri-implantite. Conclusão Por meio desses resultados, nosso estudo sugere que a osteoporose e a inflamação generalizada da mucosa periodontal / peri-implantar aumentam a probabilidade de peri-implantite.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Dental Implants , Survival Rate , Risk Factors , Peri-Implantitis , Prevalence , Indicators (Statistics) , Disease Prevention
10.
Rev. cuba. invest. bioméd ; 40(supl.1): e1564, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1289465

ABSTRACT

Introducción: La supervivencia global de pacientes con cáncer de esófago continúa siendo baja a pesar de los avances terapéuticos realizados en las últimas décadas. Objetivo: Evaluar respuesta al tratamiento y supervivencia global. Métodos: Se realizó un estudio retrospectivo y observacional en pacientes con carcinoma epidermoide esofágico avanzado, tratados con nimotuzumab combinado con quimioradioterapia, atendidos en el Servicio de Oncología Clínica del Hospital Ameijeiras, entre enero 2013 y junio de 2019 (n = 94). Se utilizó chi-cuadrado para la asociación de variables, con un valor p< 0,05. Se evaluó supervivencia global por el método de Kaplan Meier, y la prueba de Log-Rank para la comparación de las curvas. Resultados: La tasa de respuesta objetiva y de control de enfermedad fue 64,9 por ciento y 83 por ciento, respectivamente. El esquema de quimioterapia con cisplatino/fluouracilo fue el empleado con más frecuencia. Las variables con mayor respuesta y significación estadística fueron: ECOG cero, color de piel no blanca, tratamiento radiante ≥ 50 Gy, y más de catorce dosis de nimotuzumab. La mediana de supervivencia fue 13,03 meses (IC95 por ciento -10,9; 15,2), y las variables asociadas a una mayor probabilidad de supervivencia fueron: ECOG cero, dosis de quimioterapia > 75 por ciento de lo planificado, tratamiento radiante ≥ 50 Gy, más de catorce dosis de nimotuzumab, y alcanzar una respuesta objetiva (p< 0,05). Solo 5,8 por ciento de los pacientes presentaron toxicidades clasificadas como grado 3-5. Conclusiones: En condiciones de práctica clínica, este esquema de combinación obtuvo óptimas tasas de respuesta objetiva y supervivencia con buen perfil de toxicidad(AU)


Introduction: Overall survival of esophageal cancer patients remains low despite the therapeutic advances achieved in the last decades. Objective: Evaluate response to treatment and overall survival. Methods: An observational retrospective study was conducted of patients with advanced esophageal squamous cell carcinoma treated with nimotuzumab combined with chemoradiotherapy at the Clinical Oncology Service of Ameijeiras Hospital from January 2013 to June 2019 (n = 94). Association of variables was analyzed with the chi-square test, using a value of p < 0.05. Overall survival was evaluated with the Kaplan-Meier method, whereas the Log-Rank test was used to compare the curves. Results: Objective response and disease control rates were 64.9 percent and 83 percent, respectively. The chemotherapy scheme with cisplatin / fluorouracil was the most commonly applied. The variables with the greatest response and statistical significance were ECOG zero, skin color not white, radiation therapy ≥ 50 Gy and more than 14 doses of nimotuzumab. Median survival was 13.03 months (CI 95 percent -10,9; 15,2), whereas the variables associated to a greater probability of survival were ECOG zero, chemotherapy dose > 75% of plan, radiation therapy ≥ 50 Gy, more than 14 doses of nimotuzumab, and achieving an objective response (p< 0.05). Only 5.8 percent of the patients presented toxicities classified as grades 3-5. Conclusions: In clinical practice conditions, this combination scheme achieved optimum objective response and survival rates with a good toxicity profile(AU)


Subject(s)
Humans , Esophageal Neoplasms/drug therapy , Esophageal Neoplasms/radiotherapy , Survival Rate , Retrospective Studies
11.
Braz. dent. sci ; 24(3): 1-7, 2021. tab
Article in English | LILACS, BBO | ID: biblio-1281776

ABSTRACT

Objective: The aim of this study was to evaluate implant and prosthesis survival rates in full-arch rehabilitation supported by implants with platform-switched Morse taper connection submitted to immediate or delayed loading, after up to 5 years of follow-up. Material and Methods: Data was retrospectively collected from clinical records of patients who were treated by means of implant-supported full-arch rehabilitation. Survival rates of implants and prostheses were evaluated according to immediate or delayed loading. Results: The sample comprised 967 implants. Of those, 627 were submitted to immediate loading (IL) while 340 to delayed loading (DL). After a follow-up period of up to 5 years, the implant survival rate for IL was of 99.7% (622/627 implants) and 97.2% (333/340 implants) for DL. The overall implant survival rate was 98.8% (955/967 implants). Prosthesis survival rate was 100% (N = 178) for both groups. Significantly more implants in the DL group presented bone loss (p > 0.01), either greater or lower than 2 mm, during the follow-up period. Conclusion:Within their limits, the present results suggest that full-arch rehabilitation with platform-switched Morse taper connection implants can lead to surgical and prosthetic predictable outcomes. Moreover, immediate loading protocol seems to be a good option for the rehabilitation of fully edentulous patients, as it involves a shorter treatment time, which may lead to greater patient satisfaction. (AU)


Objetivo: O objetivo deste estudo foi avaliar as taxas de sobrevivência de implantes e próteses em reabilitações de arco completo suportadas por implantes de conexão cone Morse e platform switching submetidos à carga imediata ou tardia, após até 5 anos de acompanhamento. Material e Métodos: Os dados foram coletados retrospectivamente em prontuários clínicos de pacientes que foram tratados por meio de reabilitação de arco completo suportada por implantes. As taxas de sobrevivência de implantes e próteses foram avaliadas de acordo com a carga imediata ou tardia. Resultados: A amostra foi composta por 967 implantes. Destes, 627 foram submetidos à carga imediata (IL) e 340 à carga tardia (DL). Após um período de acompanhamento de até 5 anos, a taxa de sobrevivência de implantes para IL foi de 99,7% (622/627 implantes) e de 97,2% (333/340 implantes) para DL. A taxa de sobrevivência geral dos implantes foi de 98,8% (955/967 implantes). Taxa de sobrevivência da prótese de 100% (N = 178) foi encontrada para ambos os grupos. Significantemente mais implantes no grupo DL apresentaram perda óssea (p > 0,01), seja maior ou menor que 2 mm, durante o período de acompanhamento. Conclusão: Os presentes resultados sugerem, dentro de seus limites, que a reabilitação de arco completo com implantes de conexão cone Morse e platform switching pode obter resultados cirúrgicos e protéticos previsíveis. Além disso, o protocolo de carga imediata parece ser uma boa opção para a reabilitação de pacientes totalmente edêntulos, pois envolve um menor tempo de tratamento, o que pode levar a uma maior satisfação do paciente (AU)


Subject(s)
Humans , Rehabilitation , Dental Implants , Survival Rate , Retrospective Studies
12.
Rev Rene (Online) ; 22: e70836, 2021. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1340613

ABSTRACT

RESUMO Objetivo analisar a associação da sobrevida às medidas de atendimento de emergência, sintomas clínicos e marcadores bioquímicos usados para pacientes intoxicados por paraquat. Métodos coorte retrospectiva, norteada pela ferramenta Strengthening the Reporting of Observational Studies in Epidemiology . O protocolo de coleta e análise de dados foi baseado em duas fases: primeira, com o levantamento das fichas de investigação de intoxicações exógenas da Secretaria de Vigilância Epidemiológica; segunda, com a análise das informações nos prontuários médicos impressos. Resultados dos 36(100%) pacientes investigados, 19(53,0%) sobreviveram; no tocante às manifestações clínicas, houve significância estatística para o sistema respiratório (p=0,003); no que tange às variáveis bioquímicas, houve significância estatística para as enzimas hepáticas. As medidas de emergências inicias 13(56,5%) dos sobreviventes receberam lavagem gástrica com carvão ativado. Conclusão observou-se falta de eficácia dos impactos das medidas de atendimento de emergência e dos medicamentos em aumentar a sobrevida dos pacientes.


ABSTRACT Objective to analyze the association of survival to emergency care measures, clinical symptoms and biochemical markers used for paraquat intoxicated patients. Methods retrospective cohort, guided by the Strengthening the Reporting of Observational Studies in Epidemiology tool. The data collection and analysis protocol were based on two phases: first, with the survey of the investigation forms of exogenous poisoning from the Secretariat of Epidemiological Surveillance; second, with the analysis of information in printed medical records. Results of the 36 (100%) patients investigated, 19 (53.0%) survived; regarding the clinical manifestations, there was statistical significance for the respiratory system (p=0.003); regarding the biochemical variables, there was statistical significance for liver enzymes. The initial emergency measures 13(56.5%) of survivors received gastric lavage with activated charcoal. Conclusion we observed a lack of efficacy of the impacts of emergency care measures and medications in increasing patient survival.


Subject(s)
Paraquat , Poisoning , Survival Rate , Amazonian Ecosystem , Emergencies
13.
Article in English | WPRIM | ID: wpr-880372

ABSTRACT

INTRODUCTION@#The survival of HIV/AIDS patients on antiretroviral therapy (ART) is determined by a number of factors, including economic, demographic, behavioral, and institutional factors. Understanding the survival time and its trend is crucial to developing policies that will result in changes. The aim of this study was to compare the survival estimates of different subgroups and look into the predictors of HIV/AIDS patient survival.@*METHODS@#A retrospective cohort study of HIV/AIDS patients receiving ART at the University of Gondar teaching hospital was carried out. To compare the survival of various groups, a Kaplan-Meier survival analysis was performed. The Cox proportional hazards model was used to identify factors influencing HIV/AIDS patient survival rates.@*RESULTS@#In the current study, 5.91% of the 354 HIV/AIDS patients under ART follow-up were uncensored or died. Age (HR = 1.051) and lack of formal education (HR = 5.032) were associated with lower survival rate, whereas family size of one to two (HR = 0.167), three to four (HR = 0.120), no alcoholic consumption (HR = 0.294), no smoking and chat use (HR = 0.101), baseline weight (HR = 0.920), current weight (HR = 0.928), baseline CD4 cell count (HR = 0.990), baseline hemoglobin (HR = 0.800), and no TB diseases were associated with longer survival rate.@*CONCLUSIONS@#Fewer deaths were reported in a study area due to high patient adherence, compared to previous similar studies. Age, educational status, family size, alcohol consumption, tobacco and chat usage, baseline and current weight, baseline CD4 cell count, baseline hemoglobin, and tuberculosis (TB) diseases were all significant predictors of survival of HIV/AIDS patients.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Anti-HIV Agents/therapeutic use , Cohort Studies , Ethiopia/epidemiology , Female , HIV Infections/mortality , Hospitals , Humans , Male , Middle Aged , Proportional Hazards Models , Retrospective Studies , Survival Rate , Young Adult
14.
Article in Chinese | WPRIM | ID: wpr-880090

ABSTRACT

OBJECTIVE@#To investigate the expression of CD73 in acute myeloid leukemia (AML) patients with NPM1 mutant and wild-type, and to evaluate the therapeutic efficacy and prognosis of CD73 to the AML patients.@*METHODS@#160 patients with AML treated in our hospital from June 2015 to June 2019 were enrolled, and 40 non-AML bone marrow samples from healthy people were selected as controls during the same period. The expression of CD73 in healthy people, NPM1 mutation and NPM1 wild-type AML patients were compared, and the relationship between the expression of CD73 and its clinicopathological characteristics, as while as efficacy in AML patients were analyzed. The patients were followed up, and the influence of CD73 to the prognosis of different AML patients was analyzed.@*RESULTS@#The positive expression rate of CD73 in AML patients (23.75%) was significantly higher than that in the healthy control group (0.62%), and the positive expression rate of CD73 in AML patients with NPM1 mutation (74.75%) was significantly higher than that with NPM1 wild-type (25.51%) (both P<0.001). AML patients with CD73 positive expression was associated with age, FAB typing, disease risk classification, and NPM1 gene mutation (both P<0.05). The overall survival rate of AML patients with NPM1 gene mutation was 75.98%, which was significantly higher than the patients with NPM1 wild-type (34.68%)(P<0.001), the median survival time of AML patients with NPM1 gene mutation in the CD73@*CONCLUSION@#The expression of CD73 was increased in AML patients with NPM1 gene mutation, and CD73 showed different prognostic significance in AML patients with different NPM1 gene mutation. The combination of clinicopathologic features, CD73 expression and NPM1 gene in AML patients is helpful to determine their prognosis and guide the formulation of relevant treatment plans.


Subject(s)
Humans , Leukemia, Myeloid, Acute/genetics , Mutation , Nuclear Proteins/genetics , Prognosis , Survival Rate , fms-Like Tyrosine Kinase 3
15.
Article in Chinese | WPRIM | ID: wpr-880036

ABSTRACT

OBJECTIVE@#To investigate the clinical features and prognostic factors of patients with extranodal NK/T cell lymphoma (ENKTL).@*METHODS@#The clinical data of patients with ENKTL from November 2009 to November 2019 was collected and retrospectively analyzed to clarify the clinical features of ENKTL, and evaluate the factors that affected survival and prognosis.@*RESULTS@#Forty-seven patients with ENKTL were collected, median age was 40 (12-82) years old, and more common in males than females, at the ratio of 1.47∶ 1. The median follow-up was 28 (1-112) months, and 5-year overall survival (OS) rate was 49.3%. The 5-year OS rates of the subjects with ECOG performance stage 0-1 and ≥2 were 51.6% and 0 (P=0.001), respectively. The 5-year OS rates of International Prognostic Index (IPI) score 0-1 and ≥2 were 60.0% and 40.6% (P=0.027), respectively. The 5-year OS rates of Ann Arbor staging Ⅰ/Ⅱ and stage Ⅲ/Ⅳ were 61.3% and 31.7% (P=0.005), respectively. The 5-year OS rates of the patients with presentation of B symptoms and without presentation of B symptoms were 79.0% and 30.1% (P=0.013), respectively. The 5-year OS rates of plasma EBV-DNA level < 5×10@*CONCLUSION@#ECOG score, B symptoms, the copy number of EBV-DNA, and treatment regimens are independent prognostic factors for OS of patients with ENKTL.


Subject(s)
Adult , Aged , Aged, 80 and over , Disease-Free Survival , Female , Humans , Lymphoma, Extranodal NK-T-Cell/therapy , Male , Middle Aged , Prognosis , Retrospective Studies , Survival Rate , Transplantation, Autologous
16.
Article in Chinese | WPRIM | ID: wpr-880024

ABSTRACT

OBJECTIVE@#To analyze the relationship between the expression level of SQLE and the prognosis of patients with acute myeloid leukemia (AML) through large sample data.@*METHODS@#The data of genome, transcriptome, gene chip expression, and clinical information were statistically analyzed in multiple cohorts of AML patients with large samples.@*RESULTS@#It was found that the expression level of SQLE gene in tumor cells of AML patients was significantly higher than that of healthy controls (P=0.001). In the three AML corhort, the SQLE high expression group showed a worse therapeutic outcome (OS, P=0.009, P=0.0001, P=0.006; EFS, P=0.005, P=0.001). The unvariate and multivariate survival prognosis analysis indicated that the high expression of SQLE suggests lower event-free survival rate (EFS, HR=1.551, P<0.05) and overall survival rate (OS, HR=1.484, P<0.05). At the same time, it was also found that among different risk subgroups, the expression of SQLE in high risk group was higher (P<0.001, P=0.01), while the patients with high SQLE expression, who received allogeneic HSCT, had longer overall survival time (P=0.006).@*CONCLUSION@#The up-regulation SQLE expression suggests a poor prognosis for the patients with AML.


Subject(s)
Disease-Free Survival , Humans , Leukemia, Myeloid, Acute , Prognosis , Survival Rate , Transcriptome
17.
Article in Chinese | WPRIM | ID: wpr-879902

ABSTRACT

OBJECTIVE@#To study the clinical features and prognosis of children with acute megakaryocytic leukemia (AMKL) and the clinical effect of acute myeloid leukemia 03 (AML03) regimen for the treatment of pediatric AMKL.@*METHODS@#The clinical data were collected from 47 children with AMKL who were diagnosed from May 2011 to December 2019. The treatment outcomes and prognostic factors were analyzed. The Kaplan-Meier method and the log-rank test were used for survival analysis.@*RESULTS@#Among the 47 children with AMKL, 22 with non-Down syndrome-AMKL were treated by the AML03 regimen, with a median follow-up time of 11.4 months. For the 22 non-Down syndrome-AMKL patients, the remission rate of bone marrow cytology was 85% and the negative rate of minimal residual disease (MRD) was 79% after induction Ⅱ, with a 2-year overall survival (OS) rate of (50±13)% and a 2-year event-free survival (EFS) rate of (40±12)%. The group with positive immunophenotypic marker CD56 had significantly lower 2-year EFS and OS rates than the group with negative CD56 (@*CONCLUSIONS@#Children with AMKL tend to have a low remission rate and a poor prognosis. Positive immunophenotypic marker CD56, bone marrow cytology during early treatment response, and MRD results are important factors influencing the prognosis. Allogeneic hematopoietic stem cell transplantation has no significant effect on the prognosis of AMKL.


Subject(s)
Child , Disease-Free Survival , Hematopoietic Stem Cell Transplantation , Humans , Leukemia, Megakaryoblastic, Acute/therapy , Neoplasm, Residual , Prognosis , Remission Induction , Survival Rate , Treatment Outcome
18.
Article in Chinese | WPRIM | ID: wpr-879828

ABSTRACT

OBJECTIVE@#To study the clinical features of children with recurrent medulloblastoma (MB) and treatment regimens.@*METHODS@#A retrospective analysis was performed on 101 children with recurrent MB who were admitted to the hospital from August 1, 2011 to July 31, 2017. The children were followed up to July 31, 2020. The Kaplan-Meier method was used for survival analysis. The Cox regression model was used for multivariate regression analysis.@*RESULTS@#Of the 101 children, 95 underwent remission induction therapy, among whom 51 had response, resulting in a response rate of 54%. The median overall survival (OS) time after recurrence was 13 months, and the 1-, 3-, and 5-year OS rates were 50.5%±5.0%, 19.8%±4.0%, and 10%±3.3% respectively. There was no significant difference in the 5-year OS rate between the children with different ages (< 3 years or 3-18 years), sexes, pathological types, or Change stages, between the children with or without radiotherapy before recurrence or re-irradiation after recurrence, and between the children with different times to recurrence (< 12 months or ≥ 12 months after surgery) (@*CONCLUSIONS@#As for the recurrence of MB, although remission induction therapy again can achieve remission, such children still have a short survival time. Only reoperation can significantly prolong survival time, and therefore, early reoperation can be considered to improve the outcome of children with recurrent MB.


Subject(s)
Cerebellar Neoplasms/therapy , Child , Humans , Medulloblastoma/therapy , Neoplasm Recurrence, Local , Retrospective Studies , Survival Rate
19.
Article in English | WPRIM | ID: wpr-878332

ABSTRACT

Objective@#Testicular germ cell tumors (TGCT) are the most common cancer among men aged 15 to 39 years. Previous studies have considered factors related to TGCT survival rate and race/ethnicity, but histological type of the diagnosed cancer has not yet been thoroughly assessed.@*Methods@#The data came from 42,854 eligible patients from 1992 to 2015 in the Surveillance Epidemiology and End Results 18. Frequencies and column percent by seminoma and nonseminoma subtypes were determined for each covariates. We used Cox proportional hazard regression to assess the impact of multiple factors on post-diagnostic mortality of TGCT.@*Results@#Black males were diagnosed at a later stage, more commonly with local or distant metastases. The incidence of TGCT in black non-seminoma tumors increased most significantly. The difference in survival rates between different ethnic and histological subtypes, overall survival (OS) in patients with non-seminoma was significantly worse than in patients with seminoma. The most important quantitative predictor of death was the stage at the time of diagnosis, and older diagnostic age is also important factor affecting mortality.@*Conclusion@#Histological type of testicular germ cell tumor is an important factor in determining the prognosis of testicular cancer in males of different ethnic groups.


Subject(s)
Adult , Health Status Disparities , Humans , Male , Neoplasms, Germ Cell and Embryonal/pathology , Prognosis , Risk Factors , SEER Program/statistics & numerical data , Seminoma/pathology , Survival Rate/trends , Testicular Neoplasms/pathology , United States/ethnology
20.
Rev. colomb. anestesiol ; 48(4): e401, Oct.-Dec. 2020. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1144319

ABSTRACT

Abstract Introduction The use of extracorporeal membrane oxygenation (ECMO) has increased exponentially in recent years and has shown to be effective in treating adult respiratory distress syndrome (ARDS) secondary to HiNi-related pneumonia. However, evidence remains controversial. This study describes a case series of ECMO in ARDS secondary to viral pneumonia. Methods A search was conducted in the ECMO database of Fundación Cardiovascular de Colombia for the 20132017 period. A case series report was written of patients diagnosed with ARDS secondary to confirmed or suspected viral pneumonia. Results Nineteen patients with ECMO support and ARDS due to viral pneumonia were included in the study. The survival rate upon discharge was 11 patients (58%) and weaning from ECMO support was successful in 13 patients (68%). Hemorrhagic complications were the most frequent: gastrointestinal bleeding, 10 patients (53%); intracranial bleeding, 2 (10%); alveolar hemorrhage, 2 (10%);' hemothorax requiring thoracostomy with chest tube drainage, 2 (10%); cannulation site bleeding, 9 patients (47%); and surgical site bleeding in 3 patients (25%) who required tracheostomy. Other complications were: pneumothorax, 1 patient (5%); sepsis, 6 patients (32%); and growth of microorganisms in bronchial lavage, 6 patients (32%). Conclusions This study supports the use of veno-venous ECMO to achieve a higher survival rate than expected in patients with severe ARDS and refractory hypoxemia secondary to viral pneumonia. Early initiation of the therapy should improve overall results.


Resumen Introducción El uso de la oxigenación por membrana extracorpórea (ECMO) ha tenido un incremento exponencial en los últimos años y ha demostrado ser efectivo en el manejo del síndrome de dificultad respiratoria del adulto (SDRA) secundario a neumonía por H1N1, si bien la evidencia sigue siendo controvertida. En este estudio describimos una serie de casos de ECMO por SDRA secundario a neumonía viral. Métodos Se realizó una búsqueda en la base de datos de ECMO de la Fundación Cardiovascular desde el año 20132017. Reportamos una serie de casos donde se incluyeron pacientes diagnosticados con SDRA secundario a neumonía viral sospechosa o confirmada. Resultados Se incluyeron en el estudio 19 pacientes con soporte de ECMO y SDRA por neumonía viral. La sobrevida al alta fue 11 pacientes (58%) y el destete del ECMO fue exitoso en 13 pacientes (68%). Las complicaciones hemorrágicas presentadas fueron: sangrado digestivo, 10 pacientes (53%), sangrado cerebral, 2 (10%), hemorragia alveolar, 2 (10%), hemotórax con requerimiento de toracostomía a drenaje cerrado, 2 (10%), sangrado activo por sitio de canulación, 9 pacientes (53%), y 3 pacientes traqueostomizados (25%) que sangraron por el sitio quirúrgico. Otras complicaciones presentadas fueron: neumotórax, 1 paciente (5%), septicemia, 6 (32%) y crecimiento de microorganismos en lavados bronquiales 6 (32%). Conclusion El presente estudio permite indicar que el uso de la ECMO VV viabiliza una sobrevida mayor a la esperada en pacientes con SDRA severo e hipoxemia refractaria secundario a neumonía viral. Su inicio tempranamente debe mejorar los resultados globales.


Subject(s)
Humans , Male , Female , Middle Aged , Pneumonia, Viral , Poisons , Respiratory Distress Syndrome, Newborn , Extracorporeal Membrane Oxygenation , Chest Tubes , Hemothorax , Pneumothorax , Thoracostomy , Tracheostomy , Catheterization , Survival Rate , Sepsis , Bronchoalveolar Lavage , Influenza A Virus, H1N1 Subtype
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