Malignant salivary gland tumors: agreement between fine needle aspiration biopsy, incisional biopsy and final histopathological diagnostic.

BACKGROUND: Incisional biopsy is indicated for intraoral tumors, but it is a contraindicated surgical procedure for major salivary glands. To avoid complications and facilitate diagnosis, fine needle aspiration biopsy (FNAB) is a type of biopsy widely used for preoperative diagnosis in these glands. MATERIAL AND METHODS: The aim of this study was to analyze the agreement between the diagnosis by FNAB (major glands), incisional biopsy (minor glands) and histopathological analysis of the surgical specimen in salivary gland tumors from a database (medical records) of patients treated in a cancer treatment reference center in the Northeast region of Brazil. RESULTS: The sample consisted of 110 cases, being 86 of them malignant tumors in major salivary glands (parotid gland=73; submandibular gland=13) and 24 cases in minor salivary glands (palate). The female gender was the most affected (57.3%), especially in patients over 60 years (42.7%). In the TNM classification, 41.8% of the cases were in T2 at the time of diagnosis, with most of the regional lymph nodes in N0 (85.5%) and 87.3% of the cases in M0. FNAB was able to identify malignant neoplasms in 68.6% of the cases (n=59), while incisional biopsy in palatal tumors obtained agreement of 75% of the cases (n=18). The analysis revealed that tumors classified as T3-T4 (p=0.012) showed greater agreement between pre- and post-surgical diagnosis. CONCLUSIONS: The results obtained in this study indicate that FNAB has similar accuracy to incisional biopsy in providing satisfactory preoperative diagnoses of malignant tumors in salivary glands.

Cytotoxic and molecular evaluation of spilanthol obtained from Acmella oleracea (L.) R. K. Jansen (jambu) in human gastric cancer cells.

Acmella oleracea (L.) is a plant popularly known as jambu in the Brazilian Amazon. This species has several biological properties, such as anaesthetic, antioxidant and anti-inflammatory activities, among others. However, there is limited information on its anticancer activity. In this context, this study aims to evaluate the effects of the hydroethanolic extract of jambu and its active compound (spilanthol) on gastric cancer cells. Hydroethanolic jambu inflorescence extract was obtained, and spilanthol was isolated by HPLC. Biological cytotoxicity assays were determined using MTT tests. In addition, an in silico study using molecular docking evaluated the inhibitory properties of spilanthol against JAK1 and JAK2 proteins. The results showed that the hydroethanolic extract and the isolated compound spilanthol exhibited cytotoxicity against cancer cells. Molecular docking revealed that spilanthol has inhibitory potential for JAK1 and JAK2 proteins. Thus, extract of jambu and spilanthol can be a possible candidate for the treatment of gastric carcinoma.

Incidence and profile of benign epithelial tumors of salivary glands from a single center in Northeast of Brazil.

BACKGROUND: Benign tumors of the salivary glands are a group of lesions with varied histopathological and clinical spectrum. The aim was to determine the incidence and clinicopathological characteristics of benign salivary gland neoplasms diagnosed between 2007 and 2016 in a single center located in northeastern Brazil. MATERIAL AND METHODS: Records regarding sex, age, anatomical location, histopathological subtype and treatment were retrieved, and data were analyzed using the Stata/IC software (version 12.0). RESULTS: There were above 7,100 cases of neoplasms in the head and neck region, of which 403 corresponded to salivary gland neoplasms. Of these, 238 (59%) were benign, being pleomorphic adenoma (PA) the most frequent neoplasm (n=178; 74.8%), followed by Warthin's tumor (WT) (n=23; 9.7%). Overall, most cases occurred in females (n=136; 57.1%) and age ranged from 11 to 83 years. The parotid gland (n=188; 79%) was the most common anatomical site, and all patients were treated by surgical excision. Of the cases diagnosed as PA, malignant transformation to carcinoma ex-pleomorphic adenoma (CAEXPA) occurred in 7 (3.9%) cases. CONCLUSIONS: The present study confirmed the clinical and demographic profile of benign salivary gland neoplasms, which contributes to the continuous knowledge of current data about these lesions.

Association between socioeconomic markers and adult telomere length differs according to sex: Pro-Saúde study.

Understanding the social determinants of telomere length is critical to evaluate the risk of early biological aging. We investigated sex differences on the association between socioeconomic status (SES) and demographic markers and leukocyte telomere length (LTL) in Brazilian adults. This cross-sectional study was conducted in a subsample (women=228; men=200) nested within the Pro-Saúde study, a prospective cohort study of university civil servants in Rio de Janeiro, Brazil (2012-2013). Adjusted multivariate models were used to test the relationship between SES markers (marital status, educational attainment, father's educational attainment, race/skin color, household income, and childhood experience of food deprivation) and LTL. After adjusting for age and potential health-related confounders, lower educational attainment was associated with shorter LTL among men (ß=-0.05, 95% confidence interval (CI)=95%CI: -0.10, 0.00, P=0.03). In women, LTL was inversely associated with unmarried status (ß=-0.05, 95%CI: -0.09, 0.00, P=0.03), lower father's educational attainment (ß=-0.05, 95%CI: -0.13, 0.00, P=0.04), and childhood experience of food deprivation (ß=-0.07, 95%CI: -0.13, 0.00, P=0.04). Our findings suggested that the association between SES markers and LTL differs according to sex. SES markers able to induce lifelong stress, reflected in LTL, appeared to be more related to individual factors in men, whereas in women they were family-related.

Association between socioeconomic markers and adult telomere length differs according to sex: Pro-Saúde study

Understanding the social determinants of telomere length is critical to evaluate the risk of early biological aging. We investigated sex differences on the association between socioeconomic status (SES) and demographic markers and leukocyte telomere length (LTL) in Brazilian adults. This cross-sectional study was conducted in a subsample (women=228; men=200) nested within the Pro-Saúde study, a prospective cohort study of university civil servants in Rio de Janeiro, Brazil (2012-2013). Adjusted multivariate models were used to test the relationship between SES markers (marital status, educational attainment, father's educational attainment, race/skin color, household income, and childhood experience of food deprivation) and LTL. After adjusting for age and potential health-related confounders, lower educational attainment was associated with shorter LTL among men (β=-0.05, 95% confidence interval (CI)=95%CI: -0.10, 0.00, P=0.03). In women, LTL was inversely associated with unmarried status (β=-0.05, 95%CI: -0.09, 0.00, P=0.03), lower father's educational attainment (β=-0.05, 95%CI: -0.13, 0.00, P=0.04), and childhood experience of food deprivation (β=-0.07, 95%CI: -0.13, 0.00, P=0.04). Our findings suggested that the association between SES markers and LTL differs according to sex. SES markers able to induce lifelong stress, reflected in LTL, appeared to be more related to individual factors in men, whereas in women they were family-related.

Effect of Rolipram on in vitro maturation, gene expression and embryonic development in bovines / Efeito de rolipram na maturação in vitro, expressão gênica e desenvolvimento embrionário em bovinos

The aim of this work was to evaluate the effect of the Rolipram during the maturation of bovine oocytes and gene expression of embryos produced in vitro. Bovine ovaries were collected in slaughterhouse. The COCs were selected and divided into 5 groups: Control 0 time; Control: IVM for 24 hours; Rolipram treatments with IVM blocking for 24 hours in maturation medium containing (100, 150 and 200µM). After 24 hours all groups were reseated in IVM for another 24 hours. Subsequently COCs were subjected to the same IVM system and fertilized, being checked for cleavage post fertilization and for blastocyst. In addition, performed expression of the following genes: Mater, BMP15 and Bax. No difference was found in gene expression. Of oocytes evaluated shortly after follicular aspiration, 79.00% were in GV, GVBD, MI, while 13.40%, were in MII and 7.60%, D/NI. Significant difference was observed in different concentrations (T100, T200 and T150µM) in oocytes that have reached the MII phase compared to control treatments (P= 0.003). Differences were observed in cleavage rate (P< 0.05) between T150 and T200 when compared to the C/24 Group. A high difference was observed on blastocyst rate (P< 0.001) among treatments compared to the control group.(AU)

O objetivo deste trabalho foi avaliar o efeito do rolipram durante a maturação de oócitos bovinos, expressão gênica e embriões produzidos in vitro. Os ovários bovinos foram coletados no matadouro. Os COCs foram selecionados e divididos em cinco grupos: controle 0 tempo; controle: MIV por 24 horas; tratamentos rolipram com bloqueio MIV por 24 horas em meio de maturação contendo 100, 150 e 200µM. Após 24 horas, todos os grupos foram recolocados em MIV por mais 24 horas. Subsequentemente COCs foram submetidos ao mesmo sistema MIV e fertilizados, sendo avaliada a taxa de clivagem e de blastocisto, além da expressão dos seguintes genes: Mater, BMP15 e Bax. Nenhuma diferença foi observada na expressão gênica. Dos oócitos avaliados logo após a aspiração folicular, 79,0% estavam em GV, GVBD, MI, enquanto 13,40% estavam em MII, e 7,60% em D/NI. A diferença significativa foi observada em diferentes concentrações (T100, T200 e T150µM) em oócitos que atingiram a fase MII em comparação aos tratamentos de controle (P=0,3). Diferenças foram observadas nas taxas de clivagem (P<0,5) entre T150 e T200 quando comparadas com as taxas do grupo C/24. Uma grande diferença foi observada na taxa de blastocisto (P<0,1) entre os tratamentos em relação ao grupo controle.(AU)

Cervical vaporization in LSIL and persistent HPV infection.

OBJECTIVE: To assess rates of negative cytology and high-risk HPV testing after CO2 laser treatment for low-grade lesions and persistent infection with high-risk HPV as well as factors that can influence these rates. MATERIAL AND METHODS: Between February 2011 and January 2015, 124 cervical vaporizations were performed with a CO2 laser in patients presenting persistent infection with high-risk HPV or LSIL of CIN I that had persisted for more than 2 years. Data on parity, condom use, oral contraceptive use, smoking, vaccination against HPV, and immune status were collected and the relationship with rates of negative cytology and high-risk HPV testing was studied. RESULTS: We performed cytology, colposcopic and high-risk HPV detection 6 months after treatment in 116 patients (93%). Seventy-nine percent of patients had benign cytology in this control and 60% had negative results for HPV. Both parameters were normalized in 54% of patients. Mean follow-up was 22.35 months. Rates of negative cytology testing showed no significant relationship with any of the variables studied. Regarding rates of negative high-risk HPV testing, there is a statistically significant relationship with age younger than 45 years; type of high-risk HPV other than 16 and 18; and nulliparity and condom use. Among patients with persistent HPV infection and abnormal cytology at 6 months of vaporization, 55% had normalized cytology results but only 14.7% had negative results for high-risk HPV at the end of follow-up. CONCLUSIONS: CO2 laser vaporization is a simple, safe, and successful outpatient treatment that can be performed without anesthesia.

Taquicardia supraventricular paroxística durante el trabajo de parto / Paroxysmal supraventricular tachycardia during labor

Afortunadamente, las arritmias malignas en un embarazo de curso normal son raras y la mayoría de las quejas por palpitaciones se deben a arritmias benignas. Dentro de ellas las taquicardias supraventriculares paroxísticas (TSP) se describen en la literatura con relativa frecuencia y pueden ocurrir sólo, o incluso exacerbarse, durante el embarazo, debido a un efecto pro-arritmogénico de la gestación. Así en pacientes gestantes la carga hemodinámica y los cambios del tono autonómico facilitan la aparición de arritmias, más frecuentemente en mujeres con limitada reserva cardíaca y pueden llegar a comprometer la supervivencia del feto y de la madre debido a las consecuencias hemodinámicas o los efectos adversos de los tratamientos farmacológicos y no farmacológicos. Presentamos el caso de una gestante a término que durante el trabajo de parto, posterior a la administración de analgesia epidural con ropivacaína y fentanilo, sufre un cuadro de hipotensión materna y bradicardia materna/fetal mantenida que requiere ser medicada con efedrina y atropina intravenosa. Inmediatamente presenta palpitaciones y dolor torácico sostenido, diagnosticándosele TSP que cede con la administración de adenosina intravenosa, no repitiendo nuevos episodios durante el trabajo de parto ni puerperio. En nuestro caso la arritmia ocurrió como efecto adverso de la efedrina y administradas para recuperar el cuadro de hipotensión causada por la analgesia epidural.

Telomere length analysis in monoclonal B-cell lymphocytosis and chronic lymphocytic leukemia Binet A.

Monoclonal B-cell lymphocytosis (MBL) is an asymptomatic clinical entity characterized by the proliferation of monoclonal B cells not meeting the diagnosis criteria for chronic lymphocytic leukemia (CLL). MBL may precede the development of CLL, but the molecular mechanisms responsible for disease progression and evolution are not completely known. Telomeres are usually short in CLL and their attrition may contribute to disease evolution. Here, we determined the telomere lengths of CD5+CD19+ cells in MBL, CLL, and healthy volunteers. Twenty-one CLL patients, 11 subjects with high-count MBL, and 6 with low-count MBL were enrolled. Two hundred and sixty-one healthy volunteers aged 0 to 88 years were studied as controls. After diagnosis confirmation, a flow cytometry CD19+CD5+-based cell sorting was performed for the study groups. Telomere length was determined by qPCR. Telomere length was similar in the 3 study groups but shorter in these groups compared to normal age-matched subjects that had been enrolled in a previous study from our group. These findings suggest that telomere shortening is an early event in CLL leukemogenesis.

Oro-facial functions in experimental models of cerebral palsy: a systematic review.

Children who suffer from cerebral palsy (CP) often present comorbidities in the form of oro-facial dysfunctions. Studies in animals have contributed to elaborate potential therapies aimed at minimising the chronic disability of the syndrome. To systematically review the scientific literature regarding the possible effects that experimental models of CP can have on oro-facial functions. Two independent authors conducted a systematic review in the electronic databases Medline, Scopus, CINAHL, Web of Science and Lilacs, using Mesh and Decs terms in animal models. The motor and sensory parameters of sucking, chewing and swallowing were considered as primary outcomes; reactivity odour, controlled salivation, postural control, head mobility during feeding and the animal's ability to acquire food were secondary outcomes. Ten studies were included in the present review. Most studies used rabbits as experimental models of CP, which was induced by either hypoxia-ischemia, inflammation or intraventricular haemorrhage. Oro-facial functions were altered in all experimental models of CP. However, we found more modifications in hypoxia-ischemia models overall. On the other hand, the model of inflammation was more effective to reproduce higher damage for coordinating sucking and swallowing. All of the CP experimental models that were assessed modified the oral functions in different animal species. However, further studies should be conducted in order to clarify the mechanisms underlying oro-facial damage in order to optimise treatment strategies for children who suffer from CP.

Letalidad de citocalasina B y otros compuestos aislados del hongo Aspergillus spp. (Trichocomaceae) endófito de Bauhinia guianensis (Fabaceae) / Lethality of cytochalasin B and other compounds isolated from fungus Aspergillus sp. (Trichocomaceae) endophyte of Bauhinia guianensis (Fabaceae)

Los hongos endofíticos son hongos que colonizan los tejidos internos de las plantas; varios compuestos biológicamente activos se han aislado a partir de estos hongos. Existen pocos estudios de compuestos aislados de hongos endófitos de plantas amazónicas. Por lo tanto, este estudio tuvo como objetivo el aislamiento y la identificación estructural de ergosterol (1), peróxido de ergosterol (2), mevalonolactona (3), citocalasina B (4) y citocalasina H (5) a partir de Aspergillus spp. EJC 04, un hongo endofítico de Bauhinia guianensis. La citocalasina B (4) y el derivado diacetato de citocalasina B (4a) mostraron una alta letalidad en el ensayo de Artemia salina. Esta es la primera aparición de citocalasinas en hongos endófitos amazónica de B. guianensis

Endophytic fungi are fungi that colonize internal tissues of plants; several biologically active compounds have been isolated from these fungi. There are few studies of compounds isolated from endophytic fungi of Amazon plants. Thus, this study aimed the isolation and structural identification of ergosterol (1), ergosterol peroxide (2), mevalonolactone (3), cytochalasin B (4) and cytochalasin H (5) from Aspergillus sp. EJC 04, an endophytic fungus from Bauhinia guianensis. The cytochalasin B (4) and the diacetate derivative of cytochalasin B (4a) showed high lethality in the brine shrimp assay. This is the first occurrence of cytochalasins in Amazonian endophytic fungi from B. guianensis

Lethality of cytochalasin B and other compounds isolated from fungus Aspergillus sp. (Trichocomaceae) endophyte of Bauhinia guianensis (Fabaceae).

Endophytic fungi are fungi that colonize internal tissues of plants; several biologically active compounds have been isolated from these fungi. There are few studies of compounds isolated from endophytic fungi of Amazon plants. Thus, this study aimed the isolation and structural identification of ergosterol (1), ergosterol peroxide (2), mevalonolactone (3), cytochalasin B (4) and cytochalasin H (5) from Aspergillus sp. EJC 04, an endophytic fungus from Bauhinia guianensis. The cytochalasin B (4) and the diacetate derivative of cytochalasin B (4a) showed high lethality in the brine shrimp assay. This is the first occurrence of cytochalasins in Amazonian endophytic fungi from B. guianensis.

[External cephalic version]. / Versión cefálica externa.

Objetives: To analyze the rate of successful external cephalic versions in our center and caesarean sections that would be avoided with the use of external cephalic versions. Material and methods: From January 2012 to March 2016 external cephalic versions carried out at our center, which were a total of 52. We collected data about female age, gestational age at the time of the external cephalic version, maternal body mass index (BMI), fetal variety and situation, fetal weight, parity, location of the placenta, amniotic fluid index (ILA), tocolysis, analgesia, and newborn weight at birth, minor adverse effects (dizziness, hypotension and maternal pain) and major adverse effects (tachycardia, bradycardia, decelerations and emergency cesarean section). Results: 45% of the versions were unsuccessful and 55% were successful. The percentage of successful vaginal delivery in versions was 84% (4% were instrumental) and 15% of caesarean sections. With respect to the variables studied, only significant differences in birth weight were found; suggesting that birth weight it is related to the outcome of external cephalic version. Probably we did not find significant differences due to the number of patients studied. Conclusion: For women with breech presentation, we recommend external cephalic version before the expectant management or performing a cesarean section. The external cephalic version increases the proportion of fetuses in cephalic presentation and also decreases the rate of caesarean sections.

Antibacterial activity of alkaloids produced by endophytic fungus Aspergillus sp. EJC08 isolated from medical plant Bauhinia guianensis.

Bauhinia guianensis is a typical plant in the Amazon region belonging to the family Leguminosea, used by local populations for the treatment of infectious and renal diseases. Previous work on the plant B. guianensis led to the isolation of substances with anti-inflammatory and analgesic activities. Thus, compounds isolated from B. guianensis with antimicrobial activities had not been identified. Given that there is a possibility of biological activity reported for a given plant being found in the endophytic fungi, we decided to isolate endophytic fungi from B. guianensis and test their antimicrobial activities. The alkaloids known as fumigaclavine C and pseurotin A were isolated by column chromatography and identified by 1D and 2D NMR techniques and mass spectrometry. The alkaloids are first reported as broad-spectrum antibacterial agents with good activity.

Polirradiculopatía torácica diabética: un dolor olvidado / Diabetic thoracic polyradiculopathy: a forgotten pain

La polirradiculopatía torácica diabética (PTD) es una manifestación neuropáticainfrecuente que suele presentarse en pacientes con diabetes de larga evoluciónjunto a otras complicaciones crónicas microangiopáticas. Se manifiestacomo un cuadro doloroso que afecta a la región torácica o a la abdominaldependiendo de las raíces implicadas. El dolor puede llegar a ser de gran intensidade incapacitante, y a menudo el diagnóstico se retrasa al valorarseprimeramente otras causas más frecuentes de aquél. El diagnóstico se confirmamediante estudio electromiográfico, debiéndose descartar otras etiologíasorgánicas, en particular las tumorales. El tratamiento incluye los fármacos comúnmenteempleados en la neuropatía diabética dolorosa, precisándose aveces la administración de corticoides, la estimulación neural transcutánea ola plasmaféresis. Presentamos un caso de PTD en un paciente joven con diabetestipo 2 de reciente diagnóstico, de un tiempo de evolución indeterminadoy con severas manifestaciones microangiopáticas. Se exponen las característicasdel cuadro clínico, el planteamiento diagnóstico y la actitud terapéutica(AU)

The diabetic thoracic polyradiculopathy (DTP) is an uncommon neuropathicmanifestation that usually appears in patients with long evolution diabetes togetherwith microangiopathic chronic complications. It appears as a painfulpicture that affects the thoracic and abdominal region depending from the affectedroots. The pain can be of great intensity and disabling and very often thediagnosis is delayed when assessing other more frequent causes first. The diagnosisis confirmed through an electromyography, having to rule out otherorganic etiologies, specially the tumoral ones. The treatment includes the mostused drugs for painful diabetic neuropathy, being sometimes the administrationof corticosteroids, transcutaneous neural stimulation or plasmapheresis required.We present the case of DTP in a young patient with a recent diagnosedT2D with an undetermined evolution time and with serious microangiopathicmanifestations, standing out the characteristics of the medical profile, the diagnosticapproach and the therapeutic attitude(AU)

Asynchronous expression of myeloid antigens in leukemic cells in a PML/RARalpha transgenic mouse model.

Acute promyelocytic leukemia (APL) is characterized by the expansion of blasts that resemble morphologically promyelocytes and harbor a chromosomal translocation involving the retinoic acid receptor alpha (RARalpha) and the promyelocytic leukemia (PML) genes on chromosomes 17 and 15, respectively. The expression of the PML/RARalpha fusion gene is essential for APL genesis. In fact, transgenic mice (TM) expressing PML/RARalpha develop a form of leukemia that mimics the hematological findings of human APL. Leukemia is diagnosed after a long latency (approximately 12 months) during which no hematological abnormality is detected in peripheral blood (pre-leukemic phase). In humans, immunophenotypic analysis of APL blasts revealed distinct features; however, the precise immunophenotype of leukemic cells in the TM model has not been established. Our aim was to characterize the expression of myeloid antigens by leukemic cells from hCG-PML/RARalpha TM. In this study, TM (N = 12) developed leukemia at the mean age of 13.1 months. Morphological analysis of bone marrow revealed an increase of the percentage of immature myeloid cells in leukemic TM compared to pre-leukemic TM and wild-type controls (48.63 +/- 16.68, 10.83 +/- 8.11, 7.4 +/- 5.46%, respectively; P < 0.05). Flow cytometry analysis of bone marrow and spleen from leukemic TM identified the asynchronous co-expression of CD34, CD117, and CD11b. This abnormal phenotype was rarely detected prior to the diagnosis of leukemia and was present at similar frequencies in hematologically normal TM and wild-type controls of different ages. The present results demonstrate that, similarly to human APL, leukemic cells from hCG-PML/RARalpha TM present a specific immunophenotype.

Asynchronous expression of myeloid antigens in leukemic cells in a PML/RARalpha transgenic mouse model

Acute promyelocytic leukemia (APL) is characterized by the expansion of blasts that resemble morphologically promyelocytes and harbor a chromosomal translocation involving the retinoic acid receptor a (RARa) and the promyelocytic leukemia (PML) genes on chromosomes 17 and 15, respectively. The expression of the PML/RARa fusion gene is essential for APL genesis. In fact, transgenic mice (TM) expressing PML/RARa develop a form of leukemia that mimics the hematological findings of human APL. Leukemia is diagnosed after a long latency (approximately 12 months) during which no hematological abnormality is detected in peripheral blood (pre-leukemic phase). In humans, immunophenotypic analysis of APL blasts revealed distinct features; however, the precise immunophenotype of leukemic cells in the TM model has not been established. Our aim was to characterize the expression of myeloid antigens by leukemic cells from hCG-PML/RARa TM. In this study, TM (N = 12) developed leukemia at the mean age of 13.1 months. Morphological analysis of bone marrow revealed an increase of the percentage of immature myeloid cells in leukemic TM compared to pre-leukemic TM and wild-type controls (48.63 ± 16.68, 10.83 ± 8.11, 7.4 ± 5.46 percent, respectively; P < 0.05). Flow cytometry analysis of bone marrow and spleen from leukemic TM identified the asynchronous co-expression of CD34, CD117, and CD11b. This abnormal phenotype was rarely detected prior to the diagnosis of leukemia and was present at similar frequencies in hematologically normal TM and wild-type controls of different ages. The present results demonstrate that, similarly to human APL, leukemic cells from hCG-PML/RARa TM present a specific immunophenotype.

[Survival and quality of life of patients with multiple organ failure one year after leaving an intensive care unit]. / Supervivencia y calidad de vida de los pacientes con fracaso multiorgánico al año del alta de una unidad de medicina intensiva.

BACKGROUND: The patients' mortality with multiple organ failure (MOF) is very high and patients who consume the most resources are those with uncertain prognosis. In order to use the limited resources adequately, it is necessary to know the cost-benefit relationship of their treatment and in this study cost, mortality, quality of life (QOL) of survivors who developed MOF has been investigated. PATIENTS AND METHODS: Mortality in the Intensive Care Unit (ICU) and mortality QOL (with modified EuroQOL Instrument) one year after discharge were studied in 239 admitted patients who developed MOF. Cost was estimated from administrative dats of cost patients-day. To determine mortality independent predicting factors, a logistic regression model was used. RESULTS: Of the 239 patients studied, 144 (60%) died in ICU and 29 (12%) died after discharge. The independent predicting factors of mortality one year after discharge from ICU were: age (p < 0.1, odds ratio [OR] = 1.02), cardiac surgery (p < 0.0000, OR = 0.1899) and trauma (p < 0.05, OR = 0.2287). Of the 66 surviving patients, 18% were severely discapacitated. Forty one percent recovered their previous QOL, 18% improved it and 39% got worse. Patients with MOF consumed 64% of ICU total resources and of these, 77% was consumed by patients who died and by severely discapacitated. CONCLUSION: A high proportion of resources were used by MOF patients, but patients who died and who remained with worst QOL consumed the highest part. Although the mortality after one year was high (72%), 80% of the survivors achieved an acceptable QOL and for this reason, treatment of these patients should not be limited if survival and QOL predictions are not 100% correct.