RESUMO
BACKGROUND/AIMS: To assess if the study on the involvement of perigastric lymph nodes, the only ones resected in D1 lymphadenectomy, is a valid prognostic marker in patients undergoing curative resection for gastric cancer. METHODOLOGY: A retrospective study was performed in 101 patients with gastric cancer, 34 women and 67 men, with a mean age of 61 years, undergoing curative resection by gastrectomy and D1 lymphadenectomy. Tumor size, the depth of tumoral invasion of the wall, nodal involvement and 5-year survival were assessed. RESULTS: Both tumor size and the depth of tumoral invasion of the wall were significantly related to metastatic involvement of perigastric lymph nodes. Similarly, tumoral involvement of the first-level lymph nodes was significantly associated with survival. CONCLUSIONS: D1 lymphadenectomy can provide adequate prognostic information in patients with gastric cancer undergoing curative resection.
Assuntos
Excisão de Linfonodo , Neoplasias Gástricas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Gastrectomia , Humanos , Linfonodos/patologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico , Estômago/patologia , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Taxa de SobrevidaRESUMO
BASIS: Analysis of the application of the Minimum Data Set in the vigilance of nosocomial infection. Study of the risk of nosocomial infection according to the Deyo-Charlson Comorbidity Index. METHODS: The database of the Minimum Data Set of the hospital was related with the database containing the infections collected by the Infectious Diseases Surveillance Unit of the Preventive Medicine Service for the year 1997. Surgical procedures were classified by the North American system of vigilance of nosocomial infections. The diagnoses appearing in the Deyo-Charlson Index were localised. The rates of nosocomial infection were calculated in relation to the presence of comorbidities and procedures. RESULTS: Not all discharges were codified (6.2%). Mortality and the rate of nosocomial infection were lower in codified discharges than in non-codified (4 and 1.5 respectively, p<0.01). Amongst the codified discharges, the rates of nosocomial infection and the surgical site are higher amongst surgery patients than in non-surgery cases according to the North American vigilance system of nosocomial infections. Nosocomial infection is associated with a higher hospital mortality. As scoring increases on the Deyo-Charlson Index, there is a rise in the rate of nosocomial infection (1.8% to 9.9%), average stay (average 14-22 days) and hospital mortality (0.2% to 17.8%). CONCLUSIONS: The validity of these results depends on the validity of the data gathered in the Minimum Data Set, which is in its turn determined, amongst other factors, by the quality of the Discharge Report with respect to its inclusion of diagnoses and principal and secondary procedures, and by exhaustiveness in the codification of hospital discharges.
RESUMO
INTRODUCTION: This is a prospective descriptive study of intervention without aleatory assignation, carried out in the Chantrea Health Centre. Its aim is to determine the characteristics of the smokers who are taking part in two interventions by the Smokers' Aid Program (Programa de Ayuda al Fumador-PAF), and to evaluate the factors that influence the latter's success. MATERIAL AND METHODS: The characteristics of 100 smokers were analyzed. They were offered one of the two PAF interventions: Minimal Intervention 1 (MN1): they are given a support brochure in the first consultations, contacted by telephone after one month and called to consultation after 6 months to measure CO. Minimal Intervention 2 (MN2): the smoker makes 5 consultations of support in giving up smoking (+ or - nicotine patches) with the doctor, nurse or social worker indiscriminately. The factors that were influential in abandoning the habit with 65 subjects were evaluated. RESULTS: 60% of the subjects were male with an average age of 41 (DE 29). 29% showed a pathology related to tobacco, with no relation found between this and the success of the interventions. Those who chose MN2 (38%) had started tobacco consumption at an earlier age and were more dependent on nicotine. Of the 65 smokers who completed the program, 37% continued not to smoke after 6 months. Those who managed to give up smoking were of a greater average age, had spent more years smoking and belonged above all to the MN1 intervention. DISCUSSION: Notable successes are achieved if the actions are carried out by the First Aid Team. We find no significant differences between the characteristics of those who give up smoking and those who do not. Not even a serious pathology, related to tobacco, is predictive of success. The smoker's dependence on nicotine must be taken into account in the intervention.
