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2.
Pancreatology ; 19(6): 807-812, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31378582

RESUMO

BACKGROUND/OBJECTIVES: Acute Pancreatitis (AP) is one of the leading gastrointestinal conditions requiring hospitalization. It has been suggested that statins could exert a protective role in the natural history of AP; however, their influence is not entirely clear. Our objective was to investigate the relationship between statin intake and AP. METHODS: Retrospective analysis of a prospective registry of patients diagnosed with AP. Statin intake on admission as well as clinical, analytical, demographic and radiological data were recorded. OUTCOME PARAMETERS: Severity of AP, SIRS development, organ failure, local complications, intensive care admission, collection drainage, hospital length of admission, and death. Univariate and multivariate analyses as well as a propensity score logistic regression were conducted. RESULTS: From March 2014-October 2018 we studied 356 patients. 101 patients (28%) were taking statins. 55 (15%) suffered from moderate/severe pancreatitis. Multivariate analysis showed a 50% less risk of suffering from moderate/severe AP (OR 0.50 95% CI 0.22-1.0, p 0.50) and 33% less risk of developing local complications (OR 0.33 95%CI 0.15-0.80, p 0.014) among statin consumers, with a tendency towards less SIRS. Propensity score analysis confirmed that patients on statins suffering from AP had a lower risk to have a moderate/severe episode (OR 0.409 95%CI 0.192-0.872, p 0.031), to develop local complications (OR 0.47 95%CI 0.20-1.06, p 0.11) and SIRS (OR 0.516 95% CI 0.28-0.93, p 0.041). CONCLUSIONS: Patients taking statins who suffer from an episode of AP are more likely to follow a mild course and have a lower risk of developing local complications and SIRS.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Pancreatite/prevenção & controle , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatite/complicações , Pontuação de Propensão , Sistema de Registros , Estudos Retrospectivos , Medição de Risco , Síndrome de Resposta Inflamatória Sistêmica/epidemiologia , Síndrome de Resposta Inflamatória Sistêmica/etiologia , Resultado do Tratamento , Adulto Jovem
3.
Am J Ophthalmol ; 180: 39-45, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28572063

RESUMO

PURPOSE: To describe the time, frequency, and clinical characteristics of treatment failure after I-125 brachytherapy in patients with uveal melanoma treated and followed in a Spanish referral ocular oncology unit. DESIGN: Prospective, consecutive, interventional case series. METHODS: Patients diagnosed with uveal melanoma from 1995 to 2016 and treated with episcleral brachytherapy were included. Demographic data collection, ophthalmic evaluation, ultrasound scan, and systemic studies were performed at baseline, every 6 months thereafter for 5 years, and subsequently at annual intervals. Recurrence was defined as presence of tumor growth after treatment. Baseline analysis was performed by descriptive methods and survival by Kaplan-Meier curves. RESULTS: From 732 patients diagnosed with uveal melanoma, 311 were treated with brachytherapy. In the follow-up (mean 79 months, standard deviation = 55), 16 local tumor recurrences (5.1%) were detected. All relapsing patients had choroidal tumors and 15 presented with visual symptoms. All patients were treated with I-125 brachytherapy, and 2 received associated transpupillary thermotherapy. All the eyes were enucleated after recurrence. Kaplan-Meier analysis showed a mean time of recurrence of 3.7 years (standard deviation = 2.94 years, ranging from 1 to 12 years). Three patients had metastasis in the follow-up. Kaplan-Meier analysis showed worse survival for patients with recurrence. CONCLUSION: Local treatment failure was a relatively infrequent event after I-125 brachytherapy in our series. Recurrences appear not only early but also late in the follow-up. They do not have a distinctive clinical pattern and are associated with poorer survival.


Assuntos
Braquiterapia , Radioisótopos do Iodo/uso terapêutico , Melanoma/radioterapia , Recidiva Local de Neoplasia , Neoplasias Uveais/radioterapia , Adulto , Idoso , Enucleação Ocular , Feminino , Humanos , Incidência , Estimativa de Kaplan-Meier , Masculino , Oncologia , Melanoma/diagnóstico por imagem , Melanoma/patologia , Pessoa de Meia-Idade , Estudos Prospectivos , Encaminhamento e Consulta , Espanha , Taxa de Sobrevida , Fatores de Tempo , Falha de Tratamento , Neoplasias Uveais/diagnóstico por imagem , Neoplasias Uveais/patologia , Acuidade Visual
4.
J Infect Dev Ctries ; 8(1): 1-4, 2014 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-24423706

RESUMO

Malaria still poses a real threat to travellers, particularly in areas with high transmission rates such as sub-Saharan Africa, Papua New Guinea, and the South Pacific islands. Malaria causes an estimated 660,000 deaths each year from 219 million cases of illness. It is a preventable and curable disease. Malaria symptoms appear after a period of seven days or longer, and without treatment, the disease can lead to death. Mosquito bite prevention is the main way to reduce malaria transmission. Chemoprophylaxis recommendations depend on travelers' age, destination, type of travelling, or length of stay. Pregnant women, children, and immunosuppressed travelers are the most susceptible. There are currently no licensed vaccines against malaria. Results about a research vaccine candidate known as RTS,S/AS01 are expected in 2015.


Assuntos
Malária/epidemiologia , Malária/prevenção & controle , África Subsaariana/epidemiologia , Quimioprevenção/métodos , Países em Desenvolvimento , Humanos , Controle de Mosquitos/métodos , Ilhas do Pacífico/epidemiologia , Papua Nova Guiné/epidemiologia
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