RESUMEN
PURPOSE: Chronic inflammation contributes to cancer development via multiple mechanisms. We hypothesized that cardiovascular diseases (CVD) are also an independent risk factor for survival in non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Prospective multicenter data from 345 consecutive NSCLC patients treated from January 2013 to January 2017 were assessed. Median follow-up for all patients was 13 months (range 3-60 months). There were 109 patients with baseline heart disease (HD 32%), 149 with arterial hypertension (43%), 85 with diabetes mellitus (25%), 129 with hyperlipidemia (37%) and 45 with venous thromboembolism events (VTE 13%). A total of 289 patients (84%) were treated with platinum-based chemotherapy (CT), 300 patients (87%) received thoracic radiation therapy (RT; median radiation dose: 60 Gy [range 12-70]); and 50 (15%) patients underwent surgery. RESULTS: Our cohort consisted of 305 men (88%) and 40 (12%) women, with a median age of 67 years (range 31-88 years). Seventy percent had a Karnofsky performance status (KPS) ≥ 80. Multivariate analyses showed a lower OS and higher risk of distant metastasis in patients with advanced stages (p = 0.05 and p < 0.001, respectively) and HD (HR 1.43, p = 0.019; and HR 1.49, p = 0.025, respectively). Additionally, patients with VTE had lower local control (HR 1.84, p = 0.025), disease-free survival (HR 1.64, p = 0.020) and distant metastasis-free survival (HR 1.73, p = 0.025). CONCLUSIONS: HD and VTE are associated with a higher risk of mortality and distant metastasis in NSCLC patients. Chronic inflammation associated with CVDs could be an additional pathophysiologic factor in the development of distant metastasis.
Asunto(s)
Adenocarcinoma/mortalidad , Carcinoma de Células Grandes/mortalidad , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Carcinoma de Células Escamosas/mortalidad , Enfermedades Cardiovasculares/mortalidad , Neoplasias Pulmonares/mortalidad , Adenocarcinoma/complicaciones , Adenocarcinoma/patología , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Grandes/complicaciones , Carcinoma de Células Grandes/patología , Carcinoma de Pulmón de Células no Pequeñas/complicaciones , Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Células Escamosas/complicaciones , Carcinoma de Células Escamosas/patología , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/patología , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Medición de Riesgo , Tasa de SupervivenciaRESUMEN
Optimum operation and automatic control of large-scale solid substrate fermentation (SSF) bioreactors is difficult. Though advanced control algorithms can handle most challenges encountered properly, for real-time SSF processes such controllers are expensive and time consuming to design and tune. With these considerations, advanced control algorithm tests using realistic simulations appear more appropriate. We used a phenomenological process model of an SSF pilot bioreactor, coupled with a realistic noise model, to test linear model predictive controllers. We focused on the effect noise has on the performance of the control algorithms, and how to enhance performance using a combination of low-pass (Butterworth) and outlier shaving (Hampel) filters. In simulations undertaken directly with the phenomenological model it was relatively straightforward to achieve good control performance. Nevertheless, control degraded sharply when the output of the phenomenological model was contaminated with noise using our realistic noise model, even with proper signal filtering.
Asunto(s)
Reactores Biológicos/microbiología , Técnicas de Cultivo de Célula/instrumentación , Gibberella/metabolismo , Giberelinas/metabolismo , Modelos Biológicos , Triticum/microbiología , Artefactos , Técnicas de Cultivo de Célula/métodos , Simulación por Computador , Diseño de Equipo , Análisis de Falla de Equipo , Retroalimentación/fisiología , Fermentación/fisiología , Procesos EstocásticosRESUMEN
OBJECTIVE: To analyze the results achieved with transurethral resection in the treatment of benign prostatic hyperplasia. METHODS: We analyzed the results achieved with transurethral resection in 400 patients with benign prostatic hyperplasia who had been treated at the Joaquín Albarrán teaching hospital. The procedure was utilized for prostates weighing up to 50 gm and middle lobe involvement independent of its size. Sterile water was used as irrigant since it permits excellent vision, it is low-cost and carries a low risk of complications associated with intraoperative osmotic diuresis. RESULTS: 4.75% of the cases required blood transfusion (not more than two units). The intraoperative complication rate was 2.75%; hemorrhage (2%), capsular perforation (0.5%), and one death from myocardial infarction (0.25%). Hematuria resolved within 48 h postoperatively in 83.75% and the urethral catheter was removed in 82.75% within the first 72 h. Urinary tract infection was the most common postoperative complication; 8.5% were acute and 3.25% presented late. Urethral stenosis was observed in 2.25% and sclerosis of the neck was observed in 1.75%. Good results were achieved in 360 patients (90%). The mean length of hospital stay was 3.8 days. There were two deaths (0.5%); both were due to myocardial infarction. CONCLUSIONS: Transurethral resection in the treatment of benign prostatic hyperplasia achieved good results in 90% of our patients. The length of hospital stay was short and the mortality rate was low.