Laryngeal Cancer Attributable Factors and the Influence on Survival Rates: A Single Brazilian Institution Experience

Abstract Introduction Epidemiological studies focused on prognostic factors associated with laryngeal cancer in the Brazilian population are poorly reported in the literature. Objective To evaluate the influence of certain risk factors on the survival rates of patients with squamous cell carcinoma (SCC) of the larynx. Methods This retrospective study was conducted on adult patients who were admitted to the outpatient clinic of the head and neck department in a tertiary care hospital. Evaluation of the influence of risk factors on the survival rates of patients registered in the hospital with laryngeal SCC was performed based on age, sex, initial stage, time of evolution, habits, educational levels and relapse and death. Overall survival (OS), disease-free survival (DFS) and clinical-demographic data were analyzed using the Kaplan-Meier method, Log-rank test and Cox regression. Results A total of 107 patients with a mean age of 59.8 years (range 19-81) were included in this study. Stages III and IV were associated with decreased DFS (p = 0.02) and OS (p = 0.02). Smoking patients had a greater period of disease evolution than non-smoking patients (p = 0.003). Alcohol consumption in smokers increased the risk of death by 2.8 (p = 0.002) compared with non-drinking smokers. Male patients presented lower DFS average when compared with female patients (p = 0.04). Conclusion Our study confirms that male gender, smoking habit combined with alcohol consumption, and advanced stages were strongly associated with poor prognosis.

Estilo de vida saudável em São Paulo, Brasil / Healthy lifestyle in São Paulo, Brazil / Estilo de vida saludable en São Paulo, Brasil

Resumo: O objetivo foi analisar o estilo de vida das populações adolescente, adulta e idosa do Município de São Paulo, Brasil, de acordo com variáveis demográficas e socioeconômicas. Foi realizado estudo transversal, de base populacional, com dados do Inquérito de Saúde no Município de São Paulo (ISA-Capital 2008). O estilo de vida foi definido pela avaliação da atividade física, consumo alimentar, tabagismo, consumo abusivo e dependência de álcool, de acordo com as respectivas recomendações. A prevalência de estilo de vida saudável foi de 36,9% entre idosos, 15,4% entre adultos e 9,8% entre adolescentes, sendo maior no sexo feminino entre idosos e adultos. Dentre aqueles com estilo de vida não saudável, 51,5% dos idosos, 32,2% dos adultos e 57,9% dos adolescentes não atingiram a recomendação para uma dieta adequada. A prevalência de estilo de vida saudável foi maior entre idosos, seguida pelos adultos e adolescentes. O consumo alimentar foi o principal responsável pelo estilo de vida não saudável, evidenciando a importância de intervenções para a promoção do estilo de vida saudável e, principalmente, da dieta adequada.

Abstract: The objective was to analyze adolescent, adult, and elderly lifestyles in the city of São Paulo, Brazil, according to demographic and socioeconomic variables. A cross-sectional, population-based study was performed with data from the Health Survey in São Paulo City (ISA-Capital 2008) database. Lifestyle was defined on the basis of physical activity, diet, smoking, and alcohol abuse and addiction, according to the respective guidelines. Prevalence of healthy lifestyle was 36.9% in the elderly, 15.4% in adults, and 9.8% in adolescents, and was higher in females in the elderly and adults. Among individuals with unhealthy lifestyle, 51.5% of the elderly, 32.2% of adults, and 57.9% of adolescents failed to reach the guidelines for adequate diet. Prevalence of healthy lifestyle was highest among the elderly, followed by adults and adolescents. Food consumption was the main factor associated with unhealthy lifestyle, demonstrating the importance of interventions to promote healthy lifestyle, especially adequate diet.

Resumen: El objetivo fue analizar el estilo de vida de la población adolescente, adulta y anciana del municipio de Sao Paulo, Brasil, de acuerdo con variables demográficas y socioeconómicas. Se realizó un estudio transversal, de base poblacional, utilizando datos del Encuesta de Saúde en el Municipio de São Paulo (ISA-Capital 2008). El estilo de vida fue definido por la evaluación de la actividad física, consumo alimenticio, tabaquismo, consumo abusivo y alcoholismo, de acuerdo con sus respectivas recomendaciones. La prevalencia del estilo de vida saludable fue de un 36,9% entre ancianos, un 15,4% entre adultos y un 9,8% entre adolescentes, siendo mayor en el sexo femenino entre ancianos y adultos. Entre aquellos con un estilo de vida no saludable, un 51,5% de los ancianos, un 32,2% de los adultos y un 57,9% de los adolescentes no alcanzaron la recomendación para una dieta adecuada. La prevalencia de estilo de vida saludable fue mayor entre ancianos, seguidos por los adultos y adolescentes. El consumo alimentario fue el principal responsable del estilo de vida no saludable, evidenciando la importancia de intervenciones para la promoción del estilo de vida saludable y, principalmente, de una dieta adecuada.

Quantitative ultrasound at the hand phalanges in patients with bisphosphonate-related osteonecrosis of the jaws

Patients with bisphosphonate-related osteonecrosis of the jaws (BRONJ) who received intravenous or oral bisphosphonates (BP) were selected for determination of their bone microarchitecture as a risk predictor of BRONJ development. The diagnosis of BRONJ was made based on clinical and radiographic findings. The control group consisted of healthy patients. All patients underwent quantitative and qualitative ultrasound measurements of bone at the hand phalanges carried out using the DBM Sonic BP. Ultrasound bone profile index (UBPI), amplitude-dependent speed of sound (AD-SoS), bone biophysics profile (BBP), and bone transmission time (BTT) were measured. The BRONJ group consisted of 17 patients (62 ± 4.24; range: 45-82); 10 (58.8%) were male and seven (41.1%) were female, of whom 11 (64.7%) suffered from multiple myeloma, three (17.6%) from osteoporosis, one (5.8%) from prostate cancer, one (5.8%) from kidney cancer, and one (5.8%) from leukemia. Fourteen (82.3%) of them received intravenous BP whereas three (17.6%) received oral BP. Nine (9/17; 52.9%) patients developed bone exposure: two in the maxilla and seven in the mandible. Regarding quantitative parameters, Ad-SoS was low in the BRONJ group, but not significant. The UBPI score was significantly reduced in BRONJ patients with exposed bone when compared to controls (0.47 ± 0.12 vs. 0.70 ± 0.15; p = 0.004). The present study demonstrated that quantitative ultrasound was able to show bone microarchitecture alterations in BRONJ patients, and suggests that these analyses may be an important tool for early detection of bone degeneration associated with BRONJ.

Estilo de vida saudável em São Paulo / Healthy lifestyle in Sao Paulo

Estudos epidemiológicos têm comprovado a associação que as doenças cardiovasculares mantêm com um conjunto relativamente pequeno de fatores de risco modificáveis, como o tabagismo, o consumo de álcool, a dieta inadequada e a inatividade física. Objetivos: Analisar o estilo de vida saudável e não saudável da população adolescente, adulta e idosa do município de São Paulo, de acordo com as variáveis demográficas, socioeconômicas e com a quantidade e o tipo de domínios não cumpridos. Métodos: Trata-se de estudo transversal, de base populacional, realizado em 2008 e que utilizou dados do Inquérito de Saúde do Município de São Paulo (ISA-Capital 2008). As informações foram obtidas por meio de um questionário estruturado e entrevistas domiciliares realizadas por pessoas treinadas e supervisionadas durante toda a realização do inquérito. A população do estudo foi obtida por amostragem probabilística complexa, por conglomerados, em dois estágios: setores censitários e domicílios. Das 3271 pessoas entrevistadas, 1652 indivíduos adolescentes (1219; =15,3 anos), adultos (2059; =38,7 anos) e idosos (60 ou mais; =70,8 anos) de ambos os sexos possuíam dados de avaliação da atividade física, tabagismo, consumo alimentar, consumo abusivo e dependência de álcool. O estilo de vida foi determinado pela avaliação de cinco domínios: atividade física, consumo alimentar, tabagismo, consumo abusivo e dependência de álcool, de acordo com as respectivas recomendações. Os indivíduos foram...

Epidemiological studies have confirmed the association that cardiovascular disease maintain with a relatively small cluster of modifiable risk factors, like smoking, alcohol consumption, poor diet and physical inactivity. Objective: To analyze the healthy and unhealthy lifestyle of adolescents, adults and elderly population in São Paulo city, according to demographic and socioeconomic variables, and according to the number and type of no met domains. Methods: It is a cross-sectional study, population-based, conducted in 2008, which used data from the Health Survey of São Paulo (ISA Capital - 2008). The information was obtained through a structured questionnaire and household interviews conducted by trained and supervised people during the whole survey. The study population was obtained by complex probability sampling, by clusters, in two stages: census tracts and household. From 3271 surveyed people, 1652 adolescents (1219; =15.3 years), adults (2059; =38.7 years) and elderly (60 or more; =70.8 years) subjects of both sexes had data for assessment of physical activity, smoking, dietary intake, alcohol abuse and alcohol dependence. The lifestyle was determined by the valuation of five domains: physical activity, smoking, dietary intake, alcohol abuse and alcohol dependence, according to the respective recommendations. The subjects were classified as healthy or unhealthy lifestyle. Those classified as unhealthy lifestyle were also categorized according to the...