ABSTRACT
Fundamento: Estudiar la prevalencia de anticuerpos neutralizantes en el personal sanitario y de apoyo tras la administración de la segunda dosis de vacuna BNT162b2 (PfizerBioNTech). Material y métodos: En diciembre 2021 llevamos a cabo un estudio en el Departamento de Salud de Orihuela, Alicante (España), formado por 1.500 trabajadores. En los participantes del estudio, recogimos variables demográficas y realizamos un test «point-of-care» (POC) de inmunocromatografía para medir la presencia de anticuerpos neutralizantes (OJABIO® SARS-CoV-2 Neutralizing Antibody Detection Kit, fabricado por Wenzhou OJA Biotechnology Co., Ltd.- Wenzhou, Zhejiang, China) antes de la administración de la tercera dosis de vacuna. Resultados: Obtuvimos información completa de 964 (64%) trabajadores, siendo 290 varones y 674 mujeres. La edad media fue de 45,8 años (mín: 18, máx: 68) y el tiempo desde la última dosis (TUD) de vacuna fue 40,5 semanas (mín: 1,71; máx: 47,71). Un total de 131 (13,5%) habían padecido infección por SARS-CoV-2 confirmada mediante RT-PCR. La proporción de sujetos con presencia de anticuerpos neutralizantes fue de 38,5%. En el análisis multivariable el TUD de vacuna (razón de probabilidades ajustada [ORa] semana: 1,07; IC 95%: 1,04; 1,09) y la infección previa por SARS-CoV-2 (ORa: 3,7; IC 95%: 2,39; 5,63) mostraron asociación estadísticamente significativa con la presencia de anticuerpos neutralizantes. Conclusiones: El TUD de vacuna y la infección previa por SARS-CoV-2 determinaron la presencia de anticuerpos neutralizantes en 38,5% del personal sanitario y personal de apoyo.(AU)
Aim: To study the prevalence of neutralizing antibodies in healthcare workers and healthcare support personnel after the administration of the second dose of the BNT162b2 vaccine (Pfizer-BioNTech). Materials and methods: In December 2021, we undertook a study in the Health Department in Orihuela, Alicante (Spain), which consists of 1500 workers. We collected demographic variables about the study participants, and we performed a «point-of-care» immunochromatography test to measure the presence of neutralizing antibodies (OJABIO® SARS-CoV-2 Neutralizing Antibody Detection Kit, manufactured by Wenzhou OJA Biotechnology Co., Ltd. Wenzhou, Zhejiang, China) before the administration of the third dose of the vaccine. Results: We obtained complete information about 964 (64%) workers, which consisted of 290 men and 674 women. The average age was 45,8 years (min. 18, max. 68) and the average time since the last dose of the vaccine was 40,5 weeks (min. 1,71, max. 47,71). A total of 131 participants (13,5%) had suffered infection by SARS-CoV-2 confirmed using RT-PCR. The proportion of participants who showed presence of neutralizing antibodies was 38,5%. In the multivariable analysis, the time since the last dose of the vaccine (aOR week: 1,07; 95%CI: 1,04; 1,09) and previous infection by SARS-CoV-2 (aOR: 3,7; 95CI: 2,39; 5,63) showed a statistically significant association with the presence of neutralizing antibodies. Conclusions: The time since the administration of the last dose of the vaccine and the previous infection by SARS-CoV-2 determined the presence of neutralizing antibodies in 38,5% of the healthcare workers and support workers.(AU)
Subject(s)
Humans , Male , Female , Health Personnel , Antibodies, Neutralizing , Prevalence , /immunology , Spain , /epidemiologyABSTRACT
AIM: To study the prevalence of neutralizing antibodies in healthcare workers and healthcare support personnel after the administration of the second dose of the BNT162b2 vaccine (Pfizer-BioNTech). MATERIALS AND METHODS: In December 2021, we undertook a study in the Health Department in Orihuela, Alicante (Spain), which consists of 1500 workers. We collected demographic variables about the study participants, and we performed a "point-of-care" immunochromatography test to measure the presence of neutralizing antibodies (OJABIO® SARS-CoV-2 Neutralizing Antibody Detection Kit, manufactured by Wenzhou OJA Biotechnology Co., Ltd. Wenzhou, Zhejiang, China) before the administration of the third dose of the vaccine. RESULTS: We obtained complete information about 964 (64%) workers, which consisted of 290 men and 674 women. The average age was 45,8 years (min. 18, max. 68) and the average time since the last dose of the vaccine was 40,5 weeks (min. 1,71, max. 47,71). A total of 131 participants (13,5%) had suffered infection by SARS-CoV-2 confirmed using RT-PCR. The proportion of participants who showed presence of neutralizing antibodies was 38,5%. In the multivariable analysis, the time since the last dose of the vaccine (aOR week: 1,07; 95%CI: 1,04; 1,09) and previous infection by SARS-CoV-2 (aOR: 3,7; 95CI: 2,39; 5,63) showed a statistically significant association with the presence of neutralizing antibodies. CONCLUSIONS: The time since the administration of the last dose of the vaccine and the previous infection by SARS-CoV-2 determined the presence of neutralizing antibodies in 38,5% of the healthcare workers and support workers.
Subject(s)
COVID-19 , Vaccines , Male , Humans , Female , SARS-CoV-2 , Prevalence , Spain/epidemiology , BNT162 Vaccine , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , Health Personnel , Antibodies, Neutralizing , Serologic Tests , COVID-19 TestingABSTRACT
BACKGROUND: The incidence of non-AIDS defining cancer (NADC) is higher in people living with HIV (PLWH) than in the general population, and it is already one of the leading causes of death in the HIV-infected population. It is estimated that the situation will be aggravated by the progressive aging of PLWH. Early diagnosis through intensive cancer screening may improve the ability for therapeutic interventions and could be critical in reducing mortality, but it might also increase expenditure and harms associated with adverse events. The aim of this study is to evaluate an enhanced screening program for early diagnosis of cancer in PLWH compared to standard practice. The specific objectives are (1) to compare the frequency of cancer diagnosed at an early stage, (2) to analyze safety of the enhanced program: adverse events and unnecessary interventions, (3) to analyze the cost-utility of the program, and (4) to estimate the overall and site-specific incidence of NADC in PLWH. METHODS: We will conduct a multicenter, non-blinded, randomized, controlled trial, comparing two parallel arms: conventional vs enhanced screening. Data will be recorded in an electronic data collection notebook. Conventional intervention group will follow the standard of care screening in the participating centers, according to the European AIDS Clinical Society recommendations, and the enhanced intervention group will follow an expanded screening aimed to early detection of lung, liver, anal, cervical, breast, prostate, colorectal, and skin cancer. The trial will be conducted within the framework of the Spanish AIDS Research Network Cohort (CoRIS). DISCUSSION: The trial will evaluate the efficacy, safety, and efficiency of an enhanced screening program for the early diagnosis of cancer in HIV patients compared to standard of care practice. The information provided will be relevant since there are currently no studies on expanded cancer screening strategies in patients with HIV, and available data estimating cost effectiveness or cost-utility of such as programs are scarce. An enhanced program for NADC screening in patients with HIV could lead to early diagnosis and improve the prognosis of these patients, with an acceptable rate of unnecessary interventions, but it is critical to demonstrate that the benefits clearly outweigh the harms, before the strategy could be implemented. TRIAL REGISTRATION: ClinicalTrials.gov NCT04735445. Registered on 25 June 2019.
Subject(s)
Acquired Immunodeficiency Syndrome , HIV Infections , Neoplasms , Early Detection of Cancer , HIV Infections/complications , HIV Infections/diagnosis , HIV Infections/epidemiology , Humans , Male , Mass Screening , Neoplasms/diagnosis , Neoplasms/epidemiologyABSTRACT
BACKGROUND: The impact of COVID-19 on the diagnosis and management of tuberculosis (TB) patients is unknown. METHODS: Participating centres completed a structured web-based survey regarding changes to TB patient management during the COVID-19 pandemic. The study also included data from participating centres on patients aged ≥18 diagnosed with TB in 2 periods: March 15 to June 30, 2020 and March 15 to June 30, 2019. Clinical variables and information about patient household contacts were retrospectively collected. RESULTS: A total of 7 (70%) TB units reported changes in their usual TB team operations. Across both periods of study, 169 patients were diagnosed with active TB (90 in 2019, 79 in 2020). Patients diagnosed in 2020 showed more frequent bilateral lesions in chest X-ray than patients diagnosed in 2019 (P = 0.004). There was a higher percentage of latent TB infection and active TB among children in households of patients diagnosed in 2020, compared with 2019 (P = 0.001). CONCLUSIONS: The COVID-19 pandemic has caused substantial changes in TB care. TB patients diagnosed during the COVID-19 pandemic showed more extended pulmonary forms. The increase in latent TB infection and active TB in children of patient households could reflect increased household transmission due to anti-COVID-19 measures.
Subject(s)
COVID-19 , Tuberculosis , Child , Contact Tracing , Humans , Pandemics , Retrospective Studies , SARS-CoV-2 , Spain/epidemiology , Tuberculosis/diagnosis , Tuberculosis/drug therapy , Tuberculosis/epidemiologyABSTRACT
Chagas disease (CD) is an emergent disease in Europe that can behave as an opportunistic infection in HIV positive patients. The objective of this study was to evaluate the implementation of a CD screening programme in an HIV unit. An immunochromatography (ICT) of Trypanosoma cruzi was performed as a screening tool in HIV-positive patients born in CD endemic countries. ELISA and IFAT were used to confirm the diagnosis. A total of 155 patients, 116 males and 38 females, were included. Mean age was 36.9 years (± 8.4) and mean length of stay in Spain at the screening was 7.1 years (± 4.7). T. cruzi ICT was positive in four cases (2.6%), being confirmed (by ELISA and IFAT) in three of those (1.9%). Factors associated with confirmed positive T.cruzi serology were: Bolivia origin (p=0.016), Bolivia or Argentina origin (p=0.002), Southern Cone origin (p=0.015), rural origin (p=0.023), previously living in an adobe-made (p=0.001) or thatch-roofed house (p<0.0001), having a previous CD test (p=0.015), previous knowledge about CD (p=0.019), about vector (p=0.009) or recorded seeing vectors at home (p=0.012). Units dealing with HIV patients from endemic areas of American trypanosomiasis should implement CD screening protocols. Interviews of patients coming from endemic areas should include CD epidemiological questions.
Subject(s)
Chagas Disease/diagnosis , Chagas Disease/epidemiology , Emigrants and Immigrants , HIV Infections/complications , Adult , Chromatography, Affinity/methods , Cross-Sectional Studies , Enzyme-Linked Immunosorbent Assay/methods , Female , Fluorescent Antibody Technique/methods , Hispanic or Latino , Humans , Male , Mass Screening/methods , Middle Aged , Parasitology/methods , SpainABSTRACT
Cardiac tamponade constitutes an exceptional form of actinomycosis. We describe a case of primary hepatic actinomycosis presenting as purulent pericarditis with cardiac tamponade in a 20-year-old patient with previous esophagectomy and colonic interposition, successfully managed by computed tomography-guided percutaneous drainage and a prolonged course of antibiotic treatment. Actinomyces israelii was identified in the pericardial fluid by 16S rRNA gene sequencing. The literature on the simultaneous presentation of cardiac and hepatic actinomycosis is reviewed.
Subject(s)
Actinomyces/isolation & purification , Actinomycosis/therapy , Cardiac Tamponade/microbiology , Pericarditis/microbiology , Actinomyces/genetics , Actinomycosis/diagnosis , Actinomycosis/drug therapy , Actinomycosis/microbiology , Amoxicillin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Cardiac Tamponade/diagnosis , Cardiac Tamponade/drug therapy , Cardiac Tamponade/therapy , Cardiovascular Infections/drug therapy , Cardiovascular Infections/microbiology , Cardiovascular Infections/therapy , Clavulanic Acid/therapeutic use , Drainage , Humans , Liver Abscess, Pyogenic/drug therapy , Liver Abscess, Pyogenic/microbiology , Liver Abscess, Pyogenic/therapy , Male , Pericardial Effusion/drug therapy , Pericardial Effusion/microbiology , Pericardial Effusion/therapy , Pericarditis/diagnosis , Pericarditis/drug therapy , Pericarditis/therapy , RNA, Ribosomal, 16S/analysis , Rare Diseases , Sequence Analysis, RNA , Tomography, X-Ray Computed , Treatment Outcome , Young AdultSubject(s)
Humans , Female , Middle Aged , Multiple Myeloma/complications , Multiple Myeloma/epidemiology , Neoplasms, Second Primary/complications , Neoplasms, Second Primary/diagnosis , Neoplasms, Second Primary/epidemiology , Neoplasm Staging/methods , Neoplasm Staging , Risk Factors , Neoplasm Staging/trends , Melphalan/therapeutic use , Prednisone/therapeutic use , Vincristine/therapeutic use , Carmustine/therapeutic use , Doxorubicin/therapeutic use , Dexamethasone/therapeutic use , Retrospective StudiesSubject(s)
Herpes Simplex , Meningitis, Viral/virology , Adult , Humans , Lymphocytes , Male , RecurrenceABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Meningitis, Bacterial/complications , Meningitis, Bacterial/diagnosis , Herpes Simplex/complications , Herpes Simplex/diagnosis , Meningitis, Bacterial/physiopathology , Herpesvirus 2, Human/pathogenicity , RecurrenceABSTRACT
Objetivos: el carcinoma hepatocelular (CHC) permanece malcaracterizado en pacientes de edad avanzada y comorbilidad, circunstanciaque limita su manejo clínico. Pretendemos analizar lahistoria natural del CHC en mayores de 75 años y determinar losfactores que condicionan su supervivencia.Pacientes y métodos: análisis retrospectivo de 235 pacientescon CHC categorizados según su edad al diagnóstico: ≤ 75 años (n= 186) y > 75 años (n = 49). Tras comparar sus variables clínicas(χ2 y t-Student), realizamos un análisis de regresión logística para determinarlos factores asociados a la recepción de tratamiento locorregional(vs. sintomático); la supervivencia entre ambos grupos fuecomparada mediante el test de log-rank, con posterior análisis multivariante(modelo de riesgos proporcionales de Cox).Resultados: no se obtuvieron diferencias entre ambos gruposen su distribución por sexo, presencia de cirrosis, etiología, Child-Pugh, estadio BCLC, ascitis, trombosis portal, o valores de bilirrubina,AST, ALT, γGT, LDH o hematocrito. Los pacientes de edadavanzada fueron más frecuentemente diagnosticados en presenciade manifestaciones clínicas, con enfermedad multifocal, no localizada,y niveles de α-fetoproteína > 400 ng/ml (todas, p < 0,05). Estegrupo recibió tratamiento exclusivamente sintomático en el 78% delos casos (vs. 33% entre pacientes jóvenes), y sólo tres de ellos fueronsometidos a resección (p < 0,0001). La edad > 75 años actuócomo predictor de la no recepción de terapia locorregional (p <0,0001). La supervivencia del grupo de mayor edad (9,8 ± 1 meses)difirió significativamente respecto a la de los pacientes más jóvenes(25,6 ± 2 meses) (p < 0,00001). En el análisis multivariante, la edadavanzada se mantuvo como factor pronóstico de pobre supervivencia(p = 0,025); sin embargo, pierde su significación al estratificar dichoanálisis por sub-grupos de tratamiento (p = 0,344).Conclusiones: la menor supervivencia demostrada en pacientesancianos con CHC, al margen de diferencias en cuanto a extensióntumoral o insuficiencia hepatocelular, parece condicionada por la aplicaciónde abordajes terapéuticos subóptimos en esta población
Aims: hepatocellular carcinoma (HCC) remains poorly characterizedin elderly patients with comorbid conditions, a fact thatlimits the clinical management of the disease. This study analyzesthe natural history of HCC in patients older than 75, and determinesfactors that condition their survival.Patients and methods: a retrospective analysis of 235 patientswith HCC divided into 2 groups by age at diagnosis: ≤ 75(n = 186) and > 75 (n = 49). After comparing their clinical variables(χ2 and t test), a logistic regression analysis was performed todetermine factors associated with receiving locoregional treatment(versus symptomatic treatment). Survival in the 2 groups wascompared using a log rank test with subsequent multivariateanalysis (Cox proportional hazards model).Results: there were no differences between groups for sex,presence of cirrhosis, etiology, Child-Pugh score, BCLC stage,presence of ascites or portal thrombosis, or bilirubin, AST, ALT,γGT, LDH or hematocrit values. Patients of advanced age weremore frequently diagnosed in the presence of clinical manifestations,and had multifocal, non-localized disease and α-fetoproteinlevels > 400 ng/mL (all p < 0.05). This group received exclusivelysymptomatic treatment in 78% of cases (compared to 33% inyounger patients), and only 3 of them underwent surgical resection(p < 0.0001). Age older than 75 was a predictive factor fornot receiving locoregional therapy (p < 0.0001). Survival in theelderly group (9.8 ± 1 months) differed substantially from that ofyounger patients (25.6 ± 2 months) (p < .00001). Advanced agecontinued to be a prognostic factor of poor survival in the multivariateanalysis (p = 0.025), but lost significance when the analysiswas stratified by treatment subgroups (p = 0.344).Conclusions: the lower survival seen in elderly patients withHCC, beyond differences in tumor extension or liver failure, seemsconditioned by the use of suboptimal treatment in this population
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Carcinoma, Hepatocellular/mortality , Carcinoma, Hepatocellular/therapy , Liver Neoplasms/mortality , Liver Neoplasms/therapy , Survival Analysis , Age Factors , Carcinoma, Hepatocellular/diagnosis , Chi-Square Distribution , Liver Neoplasms/diagnosis , Logistic Models , Multivariate Analysis , Prognosis , Proportional Hazards Models , Retrospective StudiesABSTRACT
BACKGROUND/AIMS: This study aimed to describe the clinical, histological and immunohistochemical characteristics of primary extragastrointestinal stromal tumors (EGISTs) of the omentum and mesentery diagnosed in the Hospital 12 de Octubre, in Madrid, Spain, from 1993-2005. METHODOLOGY: The clinical data and histological and immunohistochemical findings of primary mesenchymal neoplasias were revised using the Department of Pathological Anatomy databases. RESULTS: Six EGISTs were identified. Three were primarily of the omentum and 3 mesenteric. They were found in 4 males and 2 females with an average age of 65.16 years. All were c-KIT positive, and the majority CD34 positive, while 3 were positive for muscle-specific actin. The 3 omentum cases had a mixed spindle/epithelioid pattern and low mitotic rate, while the 3 mesenteric cases had a spindle pattern, with a high mitotic rate in 2 cases, where hepatic metastasis appeared at 6 and 32 months respectively. The 3 omentum cases were alive at the time of writing, and free of disease at 16, 21 and 34 months of follow-up. EGISTs represent 11.9% of GIST cases diagnosed in the hospital over the period 2000-2005. CONCLUSIONS: In this study primary EGISTs of the omentum and mesentery showed clinicopathological and immunohistochemical characteristics similar to those previously in the literature for GISTs of the digestive tract, which supports the hypothesis that these tumors originate from extragastrointestinal c-KIT positive cells. Mesenteric location appears to be associated with a poorer prognosis.
Subject(s)
Gastrointestinal Stromal Tumors/pathology , Mesentery , Omentum , Peritoneal Neoplasms/pathology , Aged , Biomarkers, Tumor/analysis , Female , Follow-Up Studies , Gastrointestinal Stromal Tumors/diagnosis , Gastrointestinal Stromal Tumors/mortality , Gastrointestinal Stromal Tumors/secondary , Gastrointestinal Stromal Tumors/surgery , Humans , Liver Neoplasms/pathology , Liver Neoplasms/secondary , Male , Mesentery/pathology , Middle Aged , Mitotic Index , Omentum/pathology , Peritoneal Neoplasms/diagnosis , Peritoneal Neoplasms/mortality , Peritoneal Neoplasms/surgery , Survival AnalysisABSTRACT
Hemoperitoneum due to spontaneous rupture of hepatocellular carcinoma (HCC) constitutes a life-threatening situation if no appropriate therapy is provided. This complication is a well-known form of HCC presentation in countries with high incidence of liver tumours, but is an unusual event in Western countries, where it has been described in 5% or less of cases with HCC. We report three patients admitted to our centre with acute hemoperitoneum secondary to non-traumatic rupture as a first manifestation of not previously diagnosed HCC. A review of the related literature is also performed.
Subject(s)
Carcinoma, Hepatocellular/complications , Hemoperitoneum/etiology , Liver Neoplasms/complications , Aged , Aged, 80 and over , Humans , Male , Rupture, SpontaneousABSTRACT
El hemoperitoneo secundario a la rotura espontánea de un carcinoma hepatocelular (CHC) supone una complicación potencialmente fatal en ausencia de un abordaje terapéutico apropiado. Constituye una forma de presentación tumoral bien establecida en medios con elevada incidencia de CHC, pero resulta infrecuente en países occidentales, donde se describe en menos del 5% de los casos. Presentamos tres pacientes atendidos en nuestro centro por hemoperitoneo agudo secundario a la rotura no traumática de un CHC, en los que dicha complicación constituyó la primera manifestación del proceso neoplásico. Realizamos igualmente una revisión de la literatura relacionada con el tema
Hemoperitoneum due to spontaneous rupture of hepatocellular carcinoma (HCC) constitutes a life-threatening situation if no appropriate therapy is provided. This complication is a well-known form of HCC presentationin countries with high incidence of liver tumours, but is an unusual event in Western countries, where it has been described in 5% or less of cases with HCC. We report three patients admitted to our centre with acute hemoperitoneum secondary to non-traumatic rupture as a first manifestation of not previously diagnosed HCC. A review of the related literature is also performed
Subject(s)
Humans , Male , Aged , Hemoperitoneum/complications , Hemoperitoneum/diagnosis , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/diagnosis , Chemoembolization, Therapeutic , Rupture, Spontaneous/complications , Atrial Fibrillation/complications , Liver Diseases/complications , Paracentesis/methods , Hypertension, Portal/complications , Hypertension, Portal/therapy , Diabetes Mellitus/complications , Pulmonary Disease, Chronic Obstructive/complications , Adenoma, Liver Cell/complications , Carcinoma, Hepatocellular/physiopathologyABSTRACT
No disponible
Subject(s)
Male , Adult , Humans , Gastrointestinal Hemorrhage/etiology , Burkitt Lymphoma/diet therapy , Duodenal Neoplasms/diagnosis , Abdominal Pain/etiology , Lymphoma, Non-Hodgkin/diagnosisABSTRACT
AIMS: Hepatocellular carcinoma (HCC) remains poorly characterized in elderly patients with comorbid conditions, a fact that limits the clinical management of the disease. This study analyzes the natural history of HCC in patients older than 75, and determines factors that condition their survival. PATIENTS AND METHODS: A retrospective analysis of 235 patients with HCC divided into 2 groups by age at diagnosis: < or = 75 (n = 186) and > 75 (n = 49). After comparing their clinical variables (chi2 and t test), a logistic regression analysis was performed to determine factors associated with receiving locoregional treatment (versus symptomatic treatment). Survival in the 2 groups was compared using a log rank test with subsequent multivariate analysis (Cox proportional hazards model). RESULTS: There were no differences between groups for sex, presence of cirrhosis, etiology, Child-Pugh score, BCLCancer stage, presence of ascites or portal thrombosis, or bilirubin, AST, ALT, gammaGT, LDH or hematocrit values. Patients of advanced age were more frequently diagnosed in the presence of clinical manifestations, and had multifocal, non-localized disease and alpha-fetoprotein levels > 400 ng/mL (all p < 0.05). This group received exclusively symptomatic treatment in 78% of cases (compared to 33% in younger patients), and only 3 of them underwent surgical resection (p < 0.0001). Age older than 75 was a predictive factor for not receiving locoregional therapy (p < 0.0001). Survival in the elderly group (9.8 +/- 1 months) differed substantially from that of younger patients (25.6 +/- 2 months) (p < .00001). Advanced age continued to be a prognostic factor of poor survival in the multivariate analysis (p = 0.025), but lost significance when the analysis was stratified by treatment subgroups (p = 0.344). CONCLUSIONS: The lower survival seen in elderly patients with HCC, beyond differences in tumor extension or liver failure, seems conditioned by the use of suboptimal treatment in this population.
Subject(s)
Carcinoma, Hepatocellular/mortality , Carcinoma, Hepatocellular/therapy , Liver Neoplasms/mortality , Liver Neoplasms/therapy , Survival Analysis , Adult , Age Factors , Aged , Aged, 80 and over , Carcinoma, Hepatocellular/diagnosis , Chi-Square Distribution , Female , Humans , Liver Neoplasms/diagnosis , Logistic Models , Male , Middle Aged , Multivariate Analysis , Prognosis , Proportional Hazards Models , Retrospective StudiesABSTRACT
No disponible
