Terapia descongestiva como complemento a la cirugía de anastomosis linfáticovenosas y transferencia de linfonodos vascularizados: Una revisión de la literatura / Decongestive therapy as an adjunct to lymphatic-venous anastomosis surgery and vascularized lymph node transfer: A review of the literature

Resumen Introducción: El linfedema es una enfermedad inflamatoria crónica que afecta cerca de 250 millones de personas en el mundo. El tratamiento tradicional es la terapia descongestiva. Últimamente, existe la opción de complementar el tratamiento tradicional con procedimientos quirúrgicos fisiológicos como anastomosis linfáticovenosas y transferencia de linfonodos vascularizados. Sin embargo, la evidencia del uso de la terapia descongestiva en los cuidados pre y posoperatorios en estas cirugías es limitada. Objetivo: Evaluar el uso de terapia descongestiva como complemento a la cirugía de linfedema mediante anastomosis linfáticovenosas y transferencia de linfonodos vascularizados. Materiales y Método: Se realizó una revisión de la literatura en las siguientes bases de datos: Cochrane, Pubmed y Google académico, utilizando los siguientes términos mesh: "anastomosis, surgical", "lymphedema", "perioperative care", "microsurgery", "rehabilitation", "therapy", "lymph nodes", "bypass", "lymphedema and microsurgery". Se incluyó aquellos artículos que describían el uso de la terapia descongestiva en los cuidados pre- y posoperatorios. Resultados: Se identificó un total de 201 artículos y 12 fueron incluidos en el análisis. La evidencia reporta que las terapias más usadas en el cuidado pre- y posoperatorio son compresión, drenaje linfático manual y tratamientos personalizados. Sin embargo, la mayoría de los autores hace una descripción vaga de las terapias mencionadas. Discusión y Conclusión: La evidencia respecto al uso de terapia descongestiva como tratamiento complementario es débil. Los expertos recomiendan su uso, sin embargo, se necesitan futuras investigaciones que describan el uso de cada uno de sus componentes como complemento de procedimientos quirúrgicos fisiológicos para el manejo del linfedema.

Background: Lymphedema is a disease that affects about 250 million people around the world. The traditional treatment is decongestive therapy. In the past years, there is the option to complementing the traditional treatment with physiological surgical procedures such as lymphatic-venous anastomosis (LVA) and vascularized lymph node transfer (VLNT). However, the evidence for the use of decongestive therapy in pre- and post-operative care in these surgeries is limited. Aim: To evaluate the use of decongestive therapy as a complement to lymphedema surgery such a lymphatic-venous anastomosis and transfer of vascularized lymph nodes. Materials and Method: A literature review was carried out in the following databases: Cochrane, Pubmed and Academic Google, using the following mesh terms: "anastomosis, surgical", "lymphedema", "perioperative care", "microsurgery", "rehabilitation", "therapy", "lymph nodes","bypass", "lymphedema and microsurgery". "Those articles that described the use of decongestive therapy in pre- and post-operative care were included. Results: 201 articles were identified and 12 were included in the analysis. The evidence reports that the most used therapies in pre- and post-operative care are compression, manual lymphatic drainage and personalized treatments. However, most of the authors give a vague description of the mentioned therapies. Discussion and Conclusion: The evidence regarding the use of decongestive therapy as a complementary treatment is weak. Experts recommend its use; however, future research is needed to describe the use of each of its components as a complement to physiological surgical procedures for the management of lymphedema.

Síndrome de vena cava superior: una serie de casos consecutivos en pacientes internados en un hospital terciario universitario / Superior vena cava syndrome: a consecutive case series of in-hospital patients in a tertiary teaching hospital

Introducción: el síndrome de vena cava superior resulta de la obstrucción del flujo sanguíneo a través de este vaso. Casi la totalidad de los casos en la actualidad se asocian con tumores malignos. Existen controversias acerca del manejo apropiado de este cuadro. Actualmente, las terapias endovasculares son consideradas de elección. Materiales y métodos: se recolectaron y describieron, a partir de datos de la historia clínica electrónica, los casos de pacientes mayores de 18 años internados ­de forma consecutiva, que desarrollaron el síndrome­ en el Hospital Italiano de Buenos Aires en 2021. Se constataron las características basales, los tratamientos recibidos y los desenlaces clínicos intrahospitaliarios de cada uno de ellos. Resultados: un total de cinco pacientes fueron incluidos en el presente estudio y seguidos durante su instancia intrahospitalaria. Todos los casos descriptos fueron secundarios a enfermedades oncológicas. La mayoría de los pacientes presentaron un cuadro de moderada gravedad según las escalas utilizadas. En cuatro de cinco pacientes se optó por terapias endovasculares y dos de ellos fallecieron durante la internación. Discusión: existen controversias respecto del tratamiento óptimo del síndrome de vena cava superior, y heterogeneidad en la práctica clínica. Los estudios futuros deberían centrarse en identificar a aquellos pacientes que más probablemente se beneficien de las estrategias terapéuticas endovasculares, anticoagulantes o antiagregantes. (AU)

Introduction: superior vena cava syndrome results from an obstruction of blood flow through this vessel. Currently, almost all cases are associated with malignancies. There are controversies about the optimal management of this syndrome. Endovascular therapies are considered the first-line therapy. Material and methods: we collected clinical, laboratory and pharmacological data from patients admitted at the Hospital Italiano de Buenos Aires, between January 1st and November 1st 2021 with a diagnosis o superior vein cava syndrome. Baseline characteristics, treatment strategies and clinical outcomes were recorded. Results: a total of five patients were included in the present study. All cases were malignancy-related. Most of the patientsdeveloped moderate symptoms. Four out of five patients were treated with endovascular therapies and two patients died during hospitalization. Discussion: controversies regarding optimal management of the superior vena cava syndrome remain. Future research should focus on identifying those patients who are most likely to benefit from endovascular, anticoagulant or antiplatelet therapeutic strategies. (AU)

Comprometimento do apetite e fatores associados em pessoas idosas hospitalizadas com câncer / Impairment of appetite and associated factors in older adults hospitalized with cancer

Resumo Objetivo Investigar o comprometimento do apetite em pessoas idosas hospitalizadas com câncer e sua associação com estado nutricional e presença de caquexia. Métodos Estudo transversal realizado com pessoas idosas de ambos os sexos, diagnosticadas com neoplasia maligna, de julho de 2017 a março de 2019 em um hospital universitário. A amostra final foi composta por 90 pacientes. O comprometimento do apetite foi identificado pelo Questionário de Apetite e Sintomas para Pacientes com Câncer (CASQ) e o estado nutricional pela Avaliação Subjetiva Global Produzida pelo Próprio Paciente (ASG-PPP). A presença de caquexia foi avaliada pela perda de peso >5% nos últimos 6 meses; ou índice de massa corporal (IMC) <20 kg/m2 e perda de peso >2%; ou índice de músculo esquelético apendicular consistente com sarcopenia e perda de peso >2%. Resultados Houve predomínio de indivíduos do sexo masculino (56,7%), autodeclarados não brancos (56,7%), com tumores localizados no trato gastrointestinal (75,6%) e mediana de idade de 67 anos. 75,6% dos indivíduos apresentaram comprometimento do apetite, 57,8% suspeita de desnutrição ou desnutrição de algum grau, 54,4% caquexia e 92,2% necessidade de intervenção nutricional. Houve associação entre as categorias do CASQ com estado nutricional (p=0,001) e presença de caquexia (p=0,050). Após análise de regressão logística, a desnutrição permaneceu associada ao comprometimento do apetite [OR: 4,68 (IC 95%: 1,50-14,56), p=0,008]. Conclusão A presença de desnutrição aumentou as chances de comprometimento do apetite, o que reforça a necessidade da triagem e intervenção nutricional precoces, a fim de reduzir e/ou evitar os agravos nutricionais.

Abstract Objective To investigate appetite impairment in older adults hospitalized with cancer and its association with nutritional status and cachexia. Method A cross-sectional study, conducted with older adults men and women diagnosed with malignant neoplasia from July 2017 to March 2019 at a university hospital. The final sample consisted of 90 patients. Appetite was evaluated using the Cancer Appetite and Symptom Questionnaire (CASQ) and nutritional status was determined using the Patient-Generated Subjective Global Assessment (PG-SGA). Presence of cachexia was assessed by weight loss >5% in the last 6 months; or body mass index (BMI) <20 kg/m2 and weight loss >2%; or appendicular skeletal muscle index consistent with sarcopenia and weight loss >2%. Results There was a predominance of male (56.7%) self-declared non-white individuals (56.7%), with tumors in the gastrointestinal tract (75.6%) and median age of 67.0 years. 75.6% of the individuals have impaired appetite, 57.8% suspected malnutrition or malnutrition of some degree, 54.4% cachexia and 92.2% needed nutritional intervention. There was significant association between CASQ categories with nutritional status (p= 0.001) and presence of cachexia (p=0.050). After logistic regression analysis, malnutrition remained associated with impaired appetite assessed by CASQ score [OR: 4.68 (CI 95%: 1.50-14.56), p=0.008] Conclusion The presence of malnutrition increased the chances of appetite impairment, which reinforces the need for early nutritional screening and intervention, in order to reduce and/or avoid nutritional problems.

Medical adhesive-related skin injury in cancer patients: A prospective cohort study / Lesión cutánea relacionada con adhesivos médicos en pacientes con cáncer: cohorte prospectiva / Lesão de pele relacionada a adesivo médico em paciente com câncer: coorte prospectiva

Objective: to estimate the incidence of medical adhesive-related skin injury in the peripheral venous catheter fixation region in critical cancer patients, to identify risk factors, and to establish a risk prediction model for its development. Method: a prospective cohort study with a sample of 100 adult and aged patients hospitalized in an intensive care unit. The data were analyzed using descriptive, bivariate and multivariate statistics with Cox regression. Results: the incidence of medical adhesive-related skin injury was 31.0% and the incidence density was 3.4 cases per 100 people-days. The risk factors were as follows: alcoholism, smoking habit, hospitalization due to deep vein thrombosis, acute respiratory failure, immediate postoperative period, heart disease, dyslipidemia, use of antiarrhythmics, blood transfusion, friction injury, pressure injury, turgor, edema, hematoma, petechiae, low values in the Braden scale, clinical severity of the patient, elasticity, moisture, texture and color. The predictive model consisted in the following: decreased skin turgor, presence of hematoma and edema. Conclusion: medical adhesive-related skin injury at the peripheral venous catheter insertion site has a high incidence in critical cancer patients and is associated with decreased turgor, presence of hematoma and edema, evidence that can support the clinical practice.

Objetivo: estimar la incidencia de lesión cutánea relacionada con adhesivos médicos en la región de fijación del catéter venoso periférico en pacientes oncológicos críticos, identificar factores de riesgo y establecer un modelo de predicción de riesgo para su desarrollo. Método: cohorte prospectiva con una muestra de 100 pacientes adultos y adultos mayores ingresados en una unidad de terapia intensiva. Los datos se analizaron mediante estadística descriptiva, bivariada y multivariada con regresión de Cox. Resultados: la incidencia de lesión cutánea relacionada con adhesivos médicos fue del 31,0% y la densidad de incidencia fue de 3,4 casos por 100 personas-día. Los factores de riesgo fueron: alcoholismo, tabaquismo, hospitalización por trombosis venosa profunda, insuficiencia respiratoria aguda, postoperatorio inmediato, cardiopatía, dislipidemia, uso de antiarrítmicos, transfusión de sangre, lesión por fricción, lesión por presión, turgencia, edema, hematoma, petequias, bajos valores en la escala de Braden, gravedad clínica del paciente, elasticidad, humedad, textura y coloración. El modelo predictivo estuvo compuesto por: disminución de la turgencia cutánea, presencia de hematomas y edema. Conclusión: la lesión cutánea relacionada con adhesivos médicos en el sitio de inserción del catéter venoso periférico tiene una alta incidencia en pacientes oncológicos críticos y se asocia a disminución de la turgencia, presencia de hematoma y edema, dicha evidencia puede servir de base para la práctica clínica.

Objetivo: estimar a incidência de lesão de pele relacionada a adesivo médico em região de fixação de cateter venoso periférico em pacientes oncológicos críticos, identificar fatores de risco e estabelecer modelo de predição de risco para o seu desenvolvimento. Método: coorte prospectiva com amostra de 100 pacientes adultos e idosos internados em unidade de terapia intensiva. Os dados foram analisados por estatística descritiva, bivariada e multivariada com regressão de Cox. Resultados: a incidência da lesão de pele relacionada a adesivo médico foi de 31,0% e a densidade de incidência foi de 3,4 casos por 100 pessoas-dia. Os fatores de risco foram: etilismo, tabagismo, internação por trombose venosa profunda, insuficiência respiratória aguda, pós-operatório imediato, cardiopatia, dislipidemia, uso de antiarrítmico, hemotransfusão, lesão por fricção, lesão por pressão, turgor, edema, hematoma, petéquias, valores baixos na escala de Braden, gravidade clínica do paciente, elasticidade, umidade, textura e coloração. Compuseram o modelo preditivo: turgor de pele diminuído, presença de hematomas e edema. Conclusão: a lesão de pele relacionada a adesivo médico em sítio de inserção de cateter venoso periférico tem elevada incidência em pacientes oncológicos críticos e está associada ao turgor diminuído, presença de hematoma e edema, evidências essas que podem embasar a prática clínica.

Estudio sobre los niveles de dependencia en pacientes oncológicos con sintomatología respiratoria / Study on the levels of dependence of the oncological patient with respiratory symptomatology

La incidencia del cáncer (Ca) en España está en aumento (247.771 nuevos diagnósticos). La Supervivencia de pacientes oncológicos a los 5 años es 53%. Principal problema, es la calidad de esa supervivencia. Un Importante factor condicionante son los niveles de dependencia de los pacientes en tratamiento activo. Objetivo principal: Evaluar el nivel de dependencia de los pacientes oncológicos con disnea. METODOLOGÍA: Estudio observacional prospectivo transversal con muestreo no probabilístico de asignación accidental. La muestra se reclutó del Servicio de Oncología Médica del Hospital Universitario de Salamanca. Se procedió a la derivación de los pacientes al programa de terapia ocupacional con la consiguiente inclusión de estos en el estudio. Posteriormente y tras obtener el consentimiento informado firmado, se procedió a evaluar. Se utilizó la escala de Lawton-Brody, y el índice de Barthel. Se diseñó una hoja de registro para datos sociodemográficos y clínicos. RESULTADOS: Muestra total de 180 individuos. Edad media de 68,48 (±10,513) años. El 52,8% varones, por un 47,2% mujeres. El 22,8% presentaban diagnóstico de Ca de mama, un 31,7% Ca pulmonar y un 45,6% Ca relacionado con el aparato digestivo. En cuanto a los niveles de dependencia, escala de Lawton-Brody, puntuación media de 4,31 (±1,832) puntos (niveles de dependencia moderados); índice de Barthel, puntuación media de 42,53 (±2,789) puntos (nivel de dependencia moderado). Peores puntuaciones en diagnóstico anatomopatológico pulmonar. Correlación fuerte y estadísticamente significativa entre ABVD y AIVD (r=0,803, para p<0,05), y correlación significativa (r=-0,403, para p<0,001) entre la edad y la realización de AIVD. CONCLUSIÓN: Los pacientes oncológicos con disnea presentan unos niveles de dependencia moderada.

The incidence of cancer (Ca) in Spain is increasing (247,771 new diagnoses). Survival of cancer patients at 5 years is 53%. The main problem is the quality of that survival. An important conditioning factor is the level of dependence of patients in active treatment. Aim: To evaluate the level of dependence of cancer patients with dyspnea. METHODOLOGY: Cross-sectional prospective observational study with non-probabilistic accidental assignment sampling. Sample was recruited from the Service of Medical Oncology at the Salamanca University Hospital. The patients were referred to the occupational therapy program with their consequent inclusion in the study. Subsequently, and after obtaining signed informed consent, an evaluation was carried out. The Lawton-Brody scale and the Barthel index were used. A record sheet for sociodemographic and clinical data was designed. RESULTS: Total sample of 180 individuals. Average age of 68.48 (± 10.513) years. 52.8% men, by 47.2% women. 22.8% had a diagnosis of breast Ca, 31.7% pulmonary Ca and 45.6% Ca related to the digestive system. Regarding the levels of dependency, Lawton-Brody scale, mean score of 4.31 (± 1,832) points (moderate levels of dependency); Barthel index, mean score of 42.53 (± 2.789) points (moderate level of dependence). Worse scores in pulmonary pathological diagnosis. Strong and statistically significant correlation between ABVD and AIVD (r = 0.803, for p <0.05), and significant correlation (r = -0.403, for p <0.001) between age and AIVD performance. CONCLUSION: Oncology patients with dyspnoea show moderate levels of dependence.

Family experience living with advanced neoplasm: a glance at the rural population / Experiencia familiar que vive con neoplasia avanzada: una mirada a la población rural / Experiência de famílias convivendo com neoplasia avançada: um olhar à população rural

ABSTRACT Objectives: to understand the experience of rural families living with advanced cancer, from Family Management Style Framework's perspective. Methods: a qualitative research conducted in seven cities of the northern of state of Rio Grande do Sul in homes of 11 families (27 people). Data collection took place in 2014, using the genogram and narrative interview. Analysis followed Family Management Style Framework's theoretical model. Results: the results were organized into three categories based on conceptual components of the referred model: no more normal life: situation definition; attempt to reconcile care and work: management behavior; imminence of the finitude of life: perception of consequences. Final Considerations: living in rural context gives families specific ways of dealing with advanced cancer. Understanding the movements undertaken by rural families throughout the experience can guide nursing professionals in planning interventions collaborating with this population's health.

RESUMEN Objetivo: comprender la experiencia de las familias rurales que viven con cáncer avanzado, desde la perspectiva del Family Management Style Framework. Métodos: investigación cualitativa, realizada en siete municipios de la región norte del estado de Rio Grande do Sul, en los hogares de 11 familias (27 personas). La recopilación de datos tuvo lugar en 2014, utilizando el genograma y la entrevista narrativa. El análisis siguió el modelo teórico de Family Management Style Framework. Resultados: los resultados se organizaron en tres categorías, basadas en los componentes conceptuales del modelo referido: no hay más vida normal: definición de la situación; intento de conciliar cuidado y trabajo: comportamiento de gestión; inminencia de la finitud de la vida: percepción de las consecuencias. Consideraciones Finales: vivir en un contexto rural brinda a la familia formas específicas de tratar el cáncer avanzado. Comprender los movimientos realizados por las familias rurales a lo largo de la experiencia puede guiar a los profesionales de enfermería en la planificación de intervenciones que colaboran con la salud de esta población.

RESUMO Objetivos: compreender a experiência das famílias rurais que convivem com a neoplasia avançada, na perspectiva do Family Management Style Framework. Métodos: pesquisa qualitativa, realizada em sete municípios da região Norte do Rio Grande do Sul, no domicílio de 11 famílias (27 pessoas). A coleta de dados ocorreu em 2014, utilizando o genograma e a entrevista narrativa. A análise seguiu o modelo teórico Family Management Style Framework. Resultados: os resultados foram organizados em três categorias, a partir dos componentes conceituais do referido modelo: não existe mais vida normal: definição da situação; tentativa de conciliar cuidado e trabalho: comportamento de manejo; iminência da finitude da vida: percepção das consequências. Considerações Finais: viver no contexto rural confere à família maneiras específicas de agir diante da neoplasia avançada. Compreender os movimentos empreendidos pelas famílias rurais no decorrer da experiência pode guiar os profissionais de enfermagem no planejamento de intervenções colaborando com a saúde dessa população.

Impacto clínico y epidemiológico de la infección por SARS-CoV-2 en pacientes adultos con tumores sólidos / Clinical and epidemiological impact of SARS-CoV-2 infection in adult patients with solid tumors

La infección por SARS-CoV-2 en pacientes con cáncer puede ser severa y con importante mortalidad. Diseñamos un estudio prospectivo observacional que tuvo como objetivo describir el impacto clínico y epidemiológico de la infección por SARS-CoV-2 en pacientes con tumores sólidos. Se incluyeron 27 pacientes con neoplasias activas, con una mediana de edad de 72 años, y mediana de score de Charlson de 6. Las infecciones fueron de adquisición nosocomial en 18,5% de los pacientes, y el 74% tuvo infiltrados pulmonares, con una alta proporción de patrón mixto y consolidativo en imágenes. Casi la mitad de los pacientes tuvo enfermedad severa y crítica. Presentaron complicaciones e infecciones hospitalarias el 26% y 14,8% respectivamente. La mortalidad a 30 días fue de 25,9%, mayormente relacionada al COVID-19. La infección por SARS-CoV-2 en nuestra población tuvo considerable impacto clínico y epidemiológico

SARS-CoV-2 infection in cancer patients can be severe, and with significant mortality. We performed a prospective observational study to describe the clinical and epidemiological impact of SARS-CoV-2 infection in solid tumors patients. Twenty-seven patients with active neoplasms were included, with a median age of 72 and a median Charlson score of 6. Infections were nosocomially acquired in 18.5% of the patients, and 74% had pulmonary infiltrates, with a high proportion of mixed and consolidative pattern in images. Almost half of the patients had a severe and critical illness. Twenty-six percent and 14.8% had complications and hospital infections, respectively. The 30-day mortality was 25.9%, mostly related to COVID-19. SARS-CoV-2 infection in our population had a considerable clinical and epidemiological impacto

Mean platelet volume as a prognostic factor for venous thromboembolic disease / Volumen plaquetario medio como factor pronóstico de la enfermedad tromboembólica venosa

ABSTRACT Background: Mean platelet volume (MPV) is a risk factor for cardiovascular and inflammatory diseases. Aim: To evaluate the association between high MPV and 90-day mortality after an episode of venous thromboembolism (VTE). Material and Methods: Retrospective cohort of 594 patients with a median age of 73 years (58% women) with a first episode VTE, included in an institutional Thromboembolic Disease registry between 2014 and 2015. MPV values were obtained from the automated blood cell count measured at the moment of VTE diagnosis. Volumes ≥ 11 fL were classified as high. All patients were followed for 90 days to assess survival. Results: The main comorbidities were cancer in 221 patients (37%), sepsis in 172 (29%) and coronary artery disease in 107 (18%). Median MPV was 8 fl (8-9), brain natriuretic peptide 2,000 pg/ml (1,025-3,900) and troponin 40 pg/ml (19.5-75). Overall mortality was 20% (121/594) during the 90 days of follow-up. Thirty three deaths occurred within 7 days and 43 within the first month. The loss of patients from follow-up was 5% (28/594) at 90 days. Mortality among patients with high MP was 36% (23/63). The crude mortality hazard ratio (HR) for high MPV was 2.2 (95% confidence intervals (CI) 1.4-3.5). When adjusted for sepsis, oncological disease, heart disease, kidney failure and surgery, the mortality HR of high MPV was 2.4 (CI95% 1.5-3.9) in the VTE group, 2.3 (CI95% 1.5-4.4) in the deep venous thrombosis group, and 2.9 (CI95% 1.6 −5.6) in the pulmonary embolism group. Conclusions: High MPV is an independent risk factor for mortality following an episode of VTE.

Antecedentes: El volumen plaquetario medio (VPM) es un factor de riesgo de complicaciones cardiovasculares y enfermedades inflamatorias. Objetivo: Evaluar la asociación entre VPM alto y la mortalidad a los 90 días después de un episodio de tromboembolismo venoso (ETV). Material y Métodos: Cohorte retrospectiva de 594 pacientes adultos con una edad media de 73 años (58% mujeres) con un primer episodio de ETV incluidos en un registro de enfermedad tromboembólica institucional entre 2014 y 2015. Se obtuvieron valores de VPM desde el hemograma tomado en el momento del diagnóstico de ETV y un volumen ≥ 11 fL fue clasificado como alto. Todos los pacientes fueron seguidos durante 90 días para determinar sobrevida. Resultados: Las comorbilidades fueron cáncer en 221 pacientes (37%), sepsis en 172 (29%) y enfermedad coronaria en 107 (18%). La mediana de VPM fue 8 fl (89), el péptido natriurético cerebral fue de 2.000 pg/ml (1.025-3.900) y la troponina fue de 40 pg/ml (19,5-75). La mortalidad global a 90 días fue 20% (121/594). Treinta y tres muertes ocurrieron dentro de los 7 días y 43 en el primer mes. La pérdida de seguimiento de pacientes fue de 5% (28/594) a los 90 días. La mortalidad en el grupo con VPM alto fue 36% (23/63). La razón de riesgo (HR) cruda de la mortalidad para un VPM alto fue de 2,2 (intervalos de confianza (IC) de 95% 1,4-3,5). Cuando se ajustó por sepsis, enfermedad oncológica, enfermedad cardíaca, insuficiencia renal y cirugía, la HR de muerte para un VPM alto fue de 2,4 (IC95% 1,5-3,9) en el grupo de ETV; 2,3 (IC95% 1,5-4,4) en el grupo de trombosis venosa profunda; y 2,9 (CI95% 1,6 −5,6) en el grupo de embolia pulmonar. Conclusiones: Un VPM alto es un factor de riesgo independiente de mortalidad después de un episodio de ETV.

Influência do Tratamento Quimioterápico no Comportamento Alimentar e Qualidade de Vida de Pacientes Oncológicos / Influence of Chemotherapy Treatment on Eating Behavior and Quality of Life of Oncologic Patients / Influencia del Tratamiento de Quimioterapia en el Comportamento Alimentario y Calidad de Vida de los Pacientes con Cáncer

Introdução: O câncer é uma doença de origem multifatorial, com crescimento irregular e descontrolado de células, cujo tratamento pode desencadear aversões alimentares e mudanças na qualidade de vida. Objetivo: Avaliar a influência do tratamento quimioterápico no comportamento alimentar e na qualidade vida de pacientes oncológicos. Método: Estudo longitudinal e observacional, realizado de junho a outubro de 2018, no Hospital Universitário da Universidade Federal do Piauí. Os dados foram obtidos em dois momentos: T0, socioeconômicos, demográficos, clínicos, de comportamento alimentar e qualidade de vida; e T1, de comportamento alimentar e qualidade de vida. Foram utilizados os testes Shapiro-Wilk, t-Student e Wilcoxon; Pearson e Spearman com p< 0,05. Resultados: Dos 17 pacientes, a maioria era do sexo feminino (82,4%), média de 54,2 anos, renda familiar de um a dois salários mínimos (64,7%) e de etnia parda (76,5%). O câncer mais frequente foi o de mama (52,9%). Houve aversões alimentares em T1 para: "sopas e massas" (p=0,001), "carnes e peixes" (p=0,016), e "doces, sobremesas e aperitivos" (p=0,001). Houve diferença significativa na qualidade de vida quanto à medida global de saúde (p=0,001) e dificuldade financeira (p=0,026), assim também como nas correlações entre qualidade de vida e comportamento alimentar. Conclusão: Os resultados reforçam a necessidade de constante monitoramento nutricional desde o início do tratamento quimioterápico com o intuito de evitar e/ou reduzir suas repercussões negativas no estado nutricional e, consequentemente, na qualidade de vida. Além disso, a realização de mais estudos, com amostra e intervalo de tempo maiores, é necessária.

Introduction: Cancer is a multifactorial disease with uncontrolled cells growth, whose treatment can trigger food aversions and changes in quality of life. Objective: To evaluate the influence of chemotherapy treatment on eating behavior and quality of life of oncologic patients. Method: A longitudinal and observational study, carried out from June to October of 2018, at the University Hospital of the Federal University of Piauí. The data were obtained in two moments: T0, socioeconomic, demographic, clinical, food behavior and quality of life, and T1, food behavior and quality of life. The following tests were used: Shapiro-Wilk, t-Student and Wilcoxon; Pearson and Spearman, with p <0.05. Results: Of the 17 patients, the majority were females (82.4%), medium age of 54.2 years, family income of 1 to 2 minimum wages (64.7%) and ethnics, brown (76.5%). Breast cancer was the most frequent (52.9%). There were food aversions in T1, for "soups and pastas" (p=0.001), "meats and fish" (p=0.016), and "sweets, desserts and appetizers (p=0.001). There was a significant difference in quality of life regarding the general health status (p=0.001) and financial difficulty (p=0.026), as well as in correlations between quality of life and food behavior. Conclusion: The results reinforce the need of constant nutritional monitoring since the beginning of the chemotherapy in order to avoid and/or reduce the negative repercussions on the nutritional status and, consequently, on the quality of life. In addition, more studies with longer time ranges and larger samples are required.

Introducción: El cáncer es una enfermedad de origen multifactorial, con crecimiento descontrolado de células, cuyo tratamiento puede desencadenar aversiones alimenticias y cambios en la calidad de vida. Objetivo: Evaluar la influencia del tratamiento quimioterápico en el comportamiento alimentario y en la calidad de vida de pacientes oncológicos. Método: Estudio longitudinal y observacional, realizado de junio a octubre de 2018, en el Hospital Universitario de la Universidad Federal de Piauí. Los datos fueron obtenidos en dos momentos: T0, socioeconómicos, demográficos, clínicos, de comportamiento alimentario y calidad de vida y T1, de comportamiento alimentario y calidad de vida. Se utilizaron las pruebas: Shapiro-Wilk, t-Student y Wilcoxon; Pearson y Spearman, con p <0,05. Resultados: De los 17 pacientes, la mayoría eran mujeres (82,4%), promedio de 54,2 años, ingreso familiar de 1 a 2 salarios mínimos (64,7%) y de etnia parda (76,5%). El cáncer más frecuente fue el de mama (52,9%). Se observaron aversiones alimentarias en T1, para algunos grupos de alimentos. Se observó una diferencia significativa em la calidad de vida en cuanto a la medida global de salud (p=0,001) y dificultad financiera (p=0,026), así como las correlaciones entre calidad de vida y comportamiento alimentario. Conclusión: Los resultados refuerzan la necesidad de constante monitoreo nutricional desde el inicio del tratamiento quimioterápico con el fin de evitar y/o reducir lãs repercusiones negativas de este en el estado nutricional y en calidad de vida. Además, la realización de más estúdios com muestra e intervalo de tempo mayor, son necesarios.

Local dermal application of a compound lidocaine cream in pain management of cancer wounds

The aim of this study was to explore the analgesic effect of local application of compound lidocaine/prilocaine cream on cancer wounds during wound care in order to reduce the amount of morphine intake or completely replace the systemic morphine administration and optimize the protocol for cancer wound pain management. All patients were enrolled with a visual analog scale (VAS) pain score ≥4. Before wound care, 60 patients were randomly divided into 2 groups of 30 each: morphine group (10 mg tablet); topical 5% compound lidocaine cream group (0.2 g/cm2). VAS scores, heart rate, and Kolcaba comfort level were recorded for the two groups 10 min before and 10, 15, 20, and 25 min after wound care and data were analyzed statistically. The means for the pain score and heart rate of the topical lidocaine/prilocaine cream group were lower than those of the morphine group (P<0.01) and the Kolcaba comfort level was higher (P<0.01). Local dermal application of the compound lidocaine cream can be used as an alternative to the systemic morphine administration in cancer wound care for its safety and effectiveness. In addition, it can improve the patients' comfort and quality of life.

Prevalência de distúrbios da comunicação, deglutição e motricidade orofacial em crianças e adolescentes no momento da matrícula em um hospital oncológico / Prevalence of communication, swallowing and orofacial myofunctional disorders in children and adolescents at the time of admission at a cancer hospital

RESUMO Objetivo Descrever a prevalência dos distúrbios da comunicação, deglutição e motricidade orofacial em um grupo de crianças e adolescentes, no momento da matrícula hospitalar em um instituto oncológico. Método Estudo transversal, com a inclusão de crianças com dois anos ou mais e adolescentes de ambos os gêneros, matriculados na Seção de Oncologia Pediátrica do Instituto Nacional de Câncer José de Alencar Gomes da Silva (INCA) no período de março de 2014 a abril de 2015 para investigação e/ou tratamento de tumores sólidos. Foi utilizado um protocolo para registro das informações sociodemográficas e clínicas e os achados da avaliação clínica fonoaudiológica, que contemplava aspectos do sistema sensório-motor oral, deglutição, fala, linguagem, voz e audição. Resultados Oitenta e oito crianças/adolescentes (41,3%) avaliados apresentavam algum tipo de distúrbio fonoaudiológico. As alterações fonoaudiológicas mais frequentes foram o distúrbio miofuncional orofacial, a disfonia e os transtornos de linguagem. Os menos frequentes foram a disacusia, a paralisia de língua e o trismo. A variável clínica que teve associação estatisticamente significante com a presença de alterações fonoaudiológicas foi o local da lesão. Conclusão O estudo demonstrou uma alta prevalência de alterações fonoaudiológicas em crianças e adolescentes no momento da matrícula hospitalar em um hospital oncológico. A ocorrência de transtornos fonoaudiológicos foi maior nos grupos de participantes com lesões localizadas no sistema nervoso central e na região da cabeça e pescoço.

ABSTRACT Purpose Describe the prevalence of communication, swallowing and orofacial myofunctional disorders in a group of children and adolescents at the time of registration at a cancer hospital. Methods A cross-sectional study conducted with children aged ≥2 and adolescents, of both genders, admitted to the Pediatric Oncology Section of the Instituto Nacional de Câncer José de Alencar Gomes da Silva (INCA) from March 2014 to April 2015 for investigation and/or treatment of solid tumors. A protocol was used to record the sociodemographic and clinical information and findings of the speech-language pathology clinical evaluation, which included aspects of the oral sensorimotor system, swallowing, speech, language, voice, and hearing. Results Eighty-eight children/adolescents (41.3%) presented some type of speech-language disorder. The most frequent speech-language disorders were orofacial myofunctional disorder, dysphonia, and language impairments, whereas the less frequent ones were dysacusis, tongue paralysis, and trismus. Site of the lesion was the clinical variable that presented statistically significant correlation with presence of speech-language disorders. Conclusion High prevalence of speech-language disorders was observed in children and adolescents at the time of admission at a cancer hospital. Occurrence of speech-language disorders was higher in participants with lesions in the central nervous system and in the head and neck region.

Variáveis associadas ao controle do odor em feridas neoplásicas: conhecimento para o cuidado de enfermagem / Variables associated with neoplastic wound odor control: knowledge for nursing care / Variables asociadas al control del olor en heridas neoplásicas: conocimiento para el cuidado de enfermería

Objetivo: analisar variáveis importantes à construção do conhecimento de enfermeiros para o controle do odor de feridas neoplásicas. Método: revisão integrativa de 2002 a 2015 sobre o tema, realizada em 2016, através da Base de Dados de Enfermagem, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Índice bibliográfico espanhol em Ciências da Saúde, Medical Literature Analysis and Retrieval System Online e a Cochrane Library, levando à seleção de 19 artigos. Resultados: identificadas três dimensões do conhecimento: autoavaliação, técnico-científico e competências e habilidades, e 26 variáveis a elas relacionadas. O conhecimento técnico-científico, foi mais valorizado, com maior número de variáveis citadas. Conclusão: os resultados poderão contribuir para melhor compreensão dos enfermeiros quanto aos requisitos necessários à construção e aperfeiçoamento do conhecimento em relação ao controle desse sintoma tão desafiador ao profissional de saúde e ao paciente, e beneficiarão gestores e pesquisadores na construção de instrumentos para avaliação de desempenho.

Objective: to analyze variables that are important to building nurses' knowledge of neoplastic wound odor control. Method: this integrative review, conducted in 2016, in Nursing Database, Latin American and Caribbean Health Sciences database, Spanish Bibliographic Index in Health Sciences, Medical Literature Analysis and Retrieval System online and the Cochrane Library, selected 19 articles published on the subject from 2002 to 2015. Results: three knowledge dimensions were identified: self-assessment, scientific and technical knowledge, competences and abilities, and 26 variables related to them. Technical and scientific knowledge was more highly valued, as reflected by the higher number of variables cited. Conclusion: the results may contribute to improving nurses' understanding of the necessary requisites for building and refining knowledge about controlling this symptom which is challenging to health personnel and patients, and will benefit managers and researchers in building performance evaluation tools.

Objetivo: analizar las variables importantes para la construcción del conocimiento de enfermeros sobre el control del olor de las heridas neoplásicas. Método: revisión integrativa de 2002 a 2015 sobre el tema, realizada en 2016, a través de la Base de Datos de Enfermería, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Índice Bibliográfico Español en Ciencias de la Salud, Medical Literature Analysis and Retrieval System Online y Cochrane Library, que conduce a la selección de 19 artículos. Resultados: se identificaron tres dimensiones del conocimiento: la autoevaluación, el conocimiento técnico-científico, competencias y habilidades y 26 variables asociadas a ellos. El conocimiento técnico-científico fue más valorado, con más variables mencionadas. Conclusión: los resultados podrán contribuir a una mejor comprensión de los enfermeros sobre los requisitos necesarios para la construcción y perfeccionamiento del conocimiento en cuanto al control de este síntoma tan desafiador para el profesional de salud y el paciente y beneficiarán a los gestores e investigadores en la construcción de herramientas para la evaluación del desempeño.

Mesotelioma Peritoneal Maligno. Presentación de un caso / Malignant Peritoneal Mesothelioma. Case presentation

El mesotelioma es un tumor poco frecuente, sobretodo en localización peritoneal. Originado en las células mesoteliales de superficies serosas. Su etiología es desconocida, aunque en muchos casos se relaciona con exposición a asbestos. Su frecuencia va en aumento en los últimos años, tiene mayor incidencia en varones de edad media. Se presentó un paciente de 73 años diabético e hipertenso que llevaba 21 días con sensación de llenura, aumento de volumen del abdomen, decaimiento marcado, pérdida del apetito. En este período presentó una pérdida de peso corporal de 10 kilos. Por todo lo anterior se decidió su ingreso para estudio y tratamiento (AU).

The mesothelioma is a little frequent tumor, especially in peritoneal location, originated in the mesothelial cells of serous surfaces. Its etiology is unknown, although in many cases it is related with exposition to asbestos. Its frequency increases in the last years, showing higher incidence in medium-age male people. The case of a diabetic, hypertensive patient aged 73 years was presented. He was already 21 days feeling bloating, having increase of the abdominal volume, remarked weakness, appetite loss. In this period he had a body weight loss of 10 kg. For that all, his admission was decided for study and treatment (AU).

Trypanosoma cruzi seroprevalence and associated risk factors in cancer patients from Southern Brazil

Abstract: INTRODUCTION: The aim of this study was to investigate the prevalence of Chagas disease in patients treated at a Public Oncology Service in the City of Pelotas, Southern Brazil. METHODS: This study included 200 individuals undergoing cancer treatment and involved the use of a questionnaire and venous blood collection for the detection of anti-Trypanosoma cruzi antibody. RESULTS: The study found a 5% prevalence of patient seropositivity. Significant variables are presented and discussed in the article. CONCLUSIONS: Serological T. cruzi checks are recommended in cancer patients, especially individuals from endemic areas in Brazil and other Latin American countries.

Caracterización de pacientes hospitalizados con neoplasia activa y diagnóstico de enfermedad tromboembólica venosa mediante la puntuación de Khorana en el Instituto Nacional del Cáncer / Khorama score as a predictive tool for thromboembolic events in high risk patients

Background: There is an established relation between cancer and the development of thromboembolic venous disease. Khorana et al developed a predictive score using clinical characteristics and laboratory values to stratify patients according to their risk. Aim: To characterize using Khorana score, patients with active cancer and a diagnosis of thromboembolic disease during hospitalization in an oncology hospital. Material and Methods: Review of records of the pharmacy of the hospital, selecting patients who received heparin in therapeutic doses during their hospitalization. Using laboratory values available in the medical records, the Khorama score was calculated. Results: Twenty seven patients with thromboembolic events, aged 60 ± 2 years (56% males) were selected for the study. Eighty percent of them were catalogued in the intermediate and high risk group according to Khorana score. Conclusions: Khorana score is a simple scale that might be useful to establish early prophylactic measures in patients with high risk for thromboembolic events, especially those with cancer.

Atrial Fibrillation and Non-cardiovascular Diseases: A Systematic Review / Fibrilação Atrial e Doenças Não Cardiovasculares: Uma Revisão Sistemática

Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with an unfavorable prognosis, increasing the risk of stroke and death. Although traditionally associated with cardiovascular diseases, there is increasing evidence of high incidence of AF in patients with highly prevalent noncardiovascular diseases, such as cancer, sepsis, chronic obstructive pulmonary disease, obstructive sleep apnea and chronic kidney disease. Therefore, considerable number of patients has been affected by these comorbidities, leading to an increased risk of adverse outcomes.The authors performed a systematic review of the literature aiming to better elucidate the interaction between these conditions.Several mechanisms seem to contribute to the concomitant presence of AF and noncardiovascular diseases. Comorbidities, advanced age, autonomic dysfunction, electrolyte disturbance and inflammation are common to these conditions and may predispose to AF.The treatment of AF in these patients represents a clinical challenge, especially in terms of antithrombotic therapy, since the scores for stratification of thromboembolic risk, such as the CHADS2 and CHA2DS2VASc scores, and the scores for hemorrhagic risk, like the HAS-BLED score have limitations when applied in these conditions.The evidence in this area is still scarce and further investigations to elucidate aspects like epidemiology, pathogenesis, prevention and treatment of AF in noncardiovascular diseases are still needed.

A fibrilação atrial (FA) é a arritmia cardíaca mais comum e está associada a um prognóstico desfavorável, aumentando o risco de acidente vascular encefálico e a mortalidade. Apesar de tradicionalmente associada a doenças cardiovasculares, verifica-se atualmente uma elevada incidência de FA em pacientes portadores de doenças não cardiovasculares bastante prevalentes na população geral, como câncer, sepse, doença pulmonar obstrutiva crônica, síndrome da apneia obstrutiva do sono e na doença renal crônica. Assim, cada vez mais um número considerável de doentes é afetado pela concomitância de tais doenças, acarretamento um maior risco de desfechos adversos.Os autores realizaram uma revisão sistemática da literatura buscando elucidar a interação entre essas condições.Existem diversos mecanismos que parecem contribuir para a presença concomitante de FA e doenças não cardiovasculares. Comorbidades em geral, idade avançada, disfunção autonômica, distúrbio eletrolítico e inflamação são comuns a essas doenças e podem predispor à FA.O tratamento de FA nesses pacientes constitui um desafio clínico, especialmente em relação à terapêutica antitrombótica, uma vez que os scores de estratificação de risco tromboembólico como o CHADS2 ou CHADS2DS2VASC, bem como os de risco hemorrágico como o HAS-BLED, apresentam limitações quando aplicados nas doenças em questão.As evidências nesta área ainda são escassas, sendo necessárias investigações futuras para esclarecer aspectos como a epidemiologia, a patogênese, a prevenção e o tratamento da AF nas doenças não cardiovasculares.

Depressão, déficit cognitivo e fatores associados à desnutrição em idosos com câncer / Depression, cognitive deficit and factors associated with malnutrition in elderly people with cancer

Objetiva-se analisar a presença de depressão, a função cognitiva, o estado nutricional e os fatores associados à desnutrição em idosos em tratamento para o câncer. Foi realizado um estudo transversal em um centro oncológico em Minas Gerais que incluiu a aplicação de um questionário sociodemográfico e de saúde, a avaliação de sintomas depressivos, da função cognitiva e do estado nutricional. Foram avaliados 96 idosos, 50% do sexo feminino e com idade média de 70,6 anos. O déficit cognitivo foi identificado em 39,6% e a presença de depressão em 17,7% dos avaliados, com um maior número de sintomas depressivos sexo feminino (p = 0,017). Foi diagnosticada desnutrição moderada ou suspeita de desnutrição em 29,2% dos avaliados, desnutrição grave em 14,6% e 47,9% apresentou necessidade de intervenção nutricional crítica. Na análise multivariada foram condições independentemente associadas à desnutrição o déficit funcional (RP: 3,40; IC: 1,23-9,45), a presença de dois ou mais sintomas de impacto nutricional (RP: 3,22; IC: 1,03-10,10) e o tratamento atual por quimioterapia (RP: 2,96; IC: 1,16-7,56). Idosos com câncer apresentaram elevada prevalência de desnutrição e de necessidade de intervenção nutricional. A avaliação da depressão e do déficit cognitivo também devem ser partes integrantes na abordagem deste grupo.

The study sought to analyze the presence of depression, cognitive function, nutritional status and factors associated with malnutrition in the elderly undergoing treatment for cancer. A cross-sectional study was conducted in a cancer clinic in Minas Gerais, which included the application of a sociodemographic and health questionnaire, assessment of depressive symptoms, cognitive function and nutritional status. 96 elderly people were evaluated, 50% of which were female and the mean age was 70.6 years. Cognitive impairment was identified in 39.6% and the presence of depression in 17.7%, with a higher number of depressive symptoms in females (p = 0,017). Moderate malnutrition or suspected malnutrition was diagnosed in 29.2%, severe malnutrition in 14.6% and 47.9% had a critical need for nutritional intervention. In multivariate analysis, functional impairment was independently associated with malnutrition (PR: 3.40; CI: 1.23-9.45), the presence of two or more symptoms of nutritional impact (PR: 3.22; CI: 10.03-10.10) and current treatment by chemotherapy (PR: 2.96; CI: 1.16-7.56). The elderly with cancer showed a high prevalence of malnutrition and a need for nutritional intervention. The assessment of depression and cognitive impairment should also be an integral part in addressing this group.

Oral alterations in children with cancer: literature review / Alteraciones orales en niños con cáncer: revisión del tema

For dentists, there is little information on malignant tumors and complications both because their natural evolution is secondary to treatment, despite cancer in children represents 3 percent of all cancer cases. The goal is to make a brief review of the most common neoplasm in children, to identify them and find out the oral alterations with highest incidence both as secondary to the pathology and as a side effect of treatment. This review analyses various types of malignant neoplasms which may occur in this stage of life. They are divided into haematological: leukemias, lymphomas and solid tumors. The most common leukemia is acute lymphoblastic (ALL) followed by acute myeloid and granulocytic. Lymphomas develop from the lymphatic system and are divided into Hodgkin's and non-Hodgkin's. Cancer has become a chronic disease favoring a new group of patients who achieve survival but suffer side effects due to therapies, drugs, doses and the child's characteristics. Oral complications appear in 40 percent of cases and the most frequent are mucositis, opportunistic infection, xerostomia, bleeding, periodontal disease and disorders in the development of teeth and jaw. Although cancer is located outside of the maxillofacial area, chemotherapy is aggressive for a developing organism. The side effects of radiation therapy affect the general and specific area to radiate as well as the surrounding organs and tissues. Recently, advances in diagnosis and treatment have increased survival from 20 percent to 80 percent, with long-term treatment.

Existe poca información para el odontólogo sobre tumores malignos y complicaciones por su evolución natural como secundaria al tratamiento a pesar de ser el cáncer en niños el 3 por ciento de todos los cánceres. El objetivo es hacer una revisión sucinta de las neoplasias más frecuentes en niños, identificarlas y conocer las alteraciones orales con mayor incidencia secundarias tanto a la patología como el efecto secundario del tratamiento. Realizamos una revisión analizando los diferentes tipos de neoplasias malignas que puede presentarse en esta etapa de vida, las cuales se dividen en hematológicos: leucemias y linfomas y tumores sólidos. La leucemia más frecuente es la linfoblastica aguda (LLA), después la Mieloide Aguda, y Granulocítica. Los linfomas se desarrollan del sistema linfático, se dividen en Hodgkin y no Hodgkin. El cáncer se ha convertido en una enfermedad crónica. Ello favorece un nuevo grupo de pacientes que logran supervivencia suficiente para que puedan producirse efectos secundarios por las terapias utilizadas, fármacos, dosis y las características de cada niño. Las complicaciones orales aparecen en un 40 por ciento, las más frecuentes: mucositis, infección oportunista, xerostomía, hemorragias, enfermedad periodontal, alteraciones del desarrollo de dientes y maxilar. Aunque el cáncer esté localizado fuera del área maxilofacial, la quimioterapia es agresiva en un organismo en desarrollo. Los efectos secundarios de la radioterapia son generales y específicos de la zona a irradiar, órganos y tejidos circundantes. Últimamente, los avances en diagnóstico y tratamiento aumentaron la supervivencia del 20 por ciento al 80 por ciento, con tratamientos a largo plazo.

Dermatomyositis: analysis of 109 patients surveyed at the Hospital das Clínicas (HCFMUSP), São Paulo, Brazil

BACKGROUND: Dermatomyositis affects striated muscles, skin and other organs. OBJECTIVE: To characterize the disease from January 1992 to December 2002, assessing its classification, cutaneous and systemic manifestations, and also laboratory results, therapeutic and prognostic findings compared to those in the literature. METHODS: Data were obtained from medical records of 109 patients who were classified into five groups: 23 juvenile dermatomyositis; 59 primary idiopathic dermatomyositis; 6 amyopathic dermatomyositis; 7 dermatomyositis associated with neoplasms and 14 dermatomyositis associated with other connective tissue diseases. RESULTS: Sixty patients were classified as "definite" diagnosis; 33 as "possible"; four as "probable" and 12 and as amyopathic. The average age at diagnosis was 36 years. Cutaneous manifestations occurred in all patients; the most frequent symptom was loss of proximal muscle strength; the most common pulmonary disorder was interstitial lung disease, and gastritis was the most prevalent digestive manifestation. Tumors were documented in 6.42% of cases. Lactate dehydrogenase was the muscle enzyme most frequently elevated in the majority of cases. Skin biopsies were performed in 68 patients; muscle biopsies in 53; and electroneuromyographies in 58 patients. The most commonly used treatment was corticotherapy and the mortality rate was 14.7%. CONCLUSION: in this sample, the disease appeared in younger individuals, was more frequent in women and the association with cancer was small. .