Body weight loss as an indicator of breast cancer recurrence.

Body weight loss (BWL), a major prognostic factor in breast cancer, was included as a parameter to be monitored in the recent breast cancer surveillance guidelines of the American Society of Clinical Oncology. The aim of this work was prospectively to evaluate BWL as an indicator of breast cancer recurrence. Body weight was measured every 2 months for 10.4+/-3.7 (SD) months in 109 disease-free breast cancer patients in stage II node-positive and stage III disease. The correlation between unexplained BWL and recurrence was studied. Attempts were made to define the limits in weight variations among disease-free patients beyond which recurrence could be suspected. Unexplained BWL was observed in 16/19 (84%) patients developing recurrence, versus 9/90 (10%) patients remaining disease-free. There was a significant (p < 0.001) correlation between BWL and recurrence. BWL anticipated the diagnosis of recurrence by 6 (range 4-12) months. Based on the average percentage weight variation +/- 2 SD (95% confidence interval) of the disease-free group, the limits for BWL beyond which recurrence could be suspected were a 5.8% decrease in the last 6 months, 3.6% in the last 2 months or 3.0% of the patient's mean weight. However, because of the large variation in the amplitude of individual weight oscillations among disease-free patients (from < 0.5% to > 5.9% of the mean weight), individual limits derived from the patient's own body weight curve seemed more reliable. The results suggest that unexplained BWL is a valuable indicator of incipient breast cancer recurrence. Careful monitoring of body weight in breast cancer patients during follow-up is encouraged.

Treatment of Brazilian kala-azar with a short course of amphocil (amphotericin B cholesterol dispersion).

Amphotericin B is an effective but toxic antileishmanial agent. Lipid-encapsulated amphotericin B should have a high therapeutic index for visceral leishmaniasis because reticuloendothelial cells, the sole site in which Leishmania is found, will phagocytize and concentrate the complex. Amphotericin B cholesterol dispersion (Amphocil; 2 mg/[kg.d] intravenously) was administered to 10 Brazilians with kala-azar for 10 days (cohort 1) and to 10 Brazilians with kala-azar for 7 days (cohort 2). All patients were successfully treated: 19 of the 20 patients were without visible parasites in the bone marrow; the mean time to afebrility was 4.2 days; spleen size regressed by a mean of 79% 2 months after therapy; and no patient had clinical or laboratory abnormalities by the end of 6-12 months of follow-up. Side effects were fever and chills accompanied by respiratory distress, but not nephrotoxicity, in children < 3 years of age.

Contribuiçåo da medicina complementar para a integralidade da assistência das ações de educaçåo em saúde da Unidade de Saúde da Família de Nazaré-Inabi, nos grupos de hipertensos e diabéticos / Contribution of complementary medicine to integrate assistance of helth education actions in Nazaré-Inabi's Family Health Unit, in hypertensive and diabetic groups

Estresse, correria, poluiçåo e preocupações såo alguns dos problemas da vida moderna que mexem com a nossa saúde e tiram nossa energia. Atividades como a medicina complementar podem repor essa energia perdida, proporcionando a vitalidade, a calma, o alívio das dores, a melhoria da circulaçåo sangüinea e o tônus muscular, dentre outros benefícios. Este trabalho tem como objetivo apresentar a experiência com atividades de medicina complementar, inicidas em maio de 2002, dentro da ações de educaçåo em saúde, desenvolvidas na comunidade de Nazaré-Inabi, no município de Macaragibe. O trabalho ocorreu sob a orientaçåo dos profissionais da equipe e de convidados que realizam, em outros espaços, atividades com este fim.