RESUMEN
OBJECTIVES: To conduct a systematic literature review of injury related to certain consumer products. METHODS: Forty-six empirical research reports along with 32 surveillance reports from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) were examined to determine the approximate number of injuries associated with a given product per year and any trends in frequency. Percentages of injuries that: (1) resulted in hospitalization, (2) appeared to result from the product itself and (3) were associated with risky or inappropriate use and/or non-use of a helmet were also extracted from the reports. RESULTS: Outdoor play and sports equipment appear to be associated with the greatest numbers of injuries. A relatively high proportion of injuries appear to result from inappropriate or risky use of a product and/or inadequate safety precautions. CONCLUSION: This review identified the following areas of concern regarding consumer products and injuries: lack of helmet use by people using in-line skates, sleds, snowboards, downhill skis and personal-powered watercraft; operation of all-terrain vehicles (ATVs) and snowmobiles by alcohol-impaired people; operation of snowmobiles at excessive speeds; poor design of playground equipment; and unsafe storage and use of matches.
TITLE: Blessures associées à des produits de consommation au Canada : revue systématique de la littérature. OBJECTIFS: Effectuer une revue systématique de la littérature portant sur les blessures associées à certains produits de consommation. MÉTHODOLOGIE: Nous avons analysé 46 rapports de recherche de nature empirique et 32 rapports de surveillance du Système canadien hospitalier d'information et de recherche en prévention des traumatismes (SCHIRPT) dans le but de déterminer le nombre approximatif de blessures par année associées à chaque produit ainsi que toute tendance dans les fréquences. Nous avons également extrait des rapports les pourcentages des blessures qui ont donné lieu à une hospitalisation, qui semblaient résulter du produit lui-même et qui étaient associées à une utilisation inappropriée ou dangereuse ou à l'absence de casque. RÉSULTATS: Les équipements de sport et de jeu de plein air semblent être associés aux nombres de blessures les plus élevés. Une proportion relativement importante de blessures semble résulter d'une utilisation inappropriée ou dangereuse du produit et du non respect des mesures de sécurité requises. CONCLUSION: Cette revue a permis de relever plusieurs sujets de préoccupation à propos des blessures associées à des produits de consommation : absence de casque lors de l'utilisation de patins à roues alignées, de traîneau, de planche à neige, de skis alpins ou de motomarine; conduite d'un véhicule tout terrain (VTT) ou d'une motoneige avec facultés affaiblies par l'alcool; conduite d'une motoneige à une vitesse excessive; conception défectueuse de certains équipements de terrain de jeu; entreposage et utilisation non sécuritaires d'allumettes.
Asunto(s)
Seguridad de Productos para el Consumidor , Heridas y Lesiones/epidemiología , Canadá/epidemiología , Diseño de Equipo , Humanos , Equipos de Seguridad/estadística & datos numéricos , Asunción de RiesgosRESUMEN
Some families seem to have an increased risk of several different cancers and a reduced risk of others. Either genetic predisposition or a shared environment may explain this familial clustering, and the type of cause can affect how family members should be advised. We used data from a case-control study to examine the risk of cancer in the mother, sisters and brothers of men with testicular cancer. Our results show a significant relative risk (RR=1.7; 95% confidence interval (CI): 1.05-2.6) of cancer for sisters of testicular cancer patients in comparison with the sisters of controls. When data were combined for brothers and sisters, the RR for all cancers was 1.53 (CI: 1.1-2.3). Despite the limitations of our data, there is evidence for cancer clustering in the families of testicular cancer patients. Unfortunately, the evidence is consistent with either a genetic or environmental etiology.
Asunto(s)
Neoplasias/epidemiología , Neoplasias Testiculares/genética , Análisis por Conglomerados , Femenino , Humanos , Masculino , Madres , Riesgo , Neoplasias Testiculares/epidemiologíaRESUMEN
BACKGROUND AND OBJECTIVES: Tumor thickness is considered the single most important predictor of survival in clinically localized malignant melanoma. A recent study found tumor volume a more sensitive predictor of survival than thickness. Volume measurement, however, is complicated, time consuming, and based on biologically imprecise mathematical models of tumor configuration. This report compares the prognostic power of cross-sectional area (CSA), a simpler measurement than volume, with tumor thickness. METHODS: Forty-five patients with clinically localized malignant melanoma and a minimum 5-year follow-up post excision with negative resection margins were retrospectively followed for disease recurrence or death. Digitalized histologic images of each tumor were made from the original pathology slides and stored on a compact disc. Maximum tumor thickness and CSA were calculated for each primary melanoma using an image analysis program and compared for predictive accuracy of 5-year survival. RESULTS: CSA was positively correlated with maximum tumor thickness (r = 0.76). Both measures had a similar predictive accuracy for survival. Patients with melanomas less than 8 mm2 had superior 5-year (94%) and disease-free survival rates (78%) compared to patients with melanomas exceeding 8 mm2 (5-year survival, 62%; 5-year disease-free survival, 23%). CONCLUSIONS: CSA is an easily calculated measurement that is as predictive for 5-year survival as is Breslow's thickness. Prospective assessment of CSA is warranted.
Asunto(s)
Melanoma/patología , Neoplasias Cutáneas/patología , Adulto , Anciano , Anciano de 80 o más Años , Supervivencia sin Enfermedad , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Recurrencia , Estudios RetrospectivosRESUMEN
PURPOSE: To describe the survival rates among Canadian children and teenagers with cancer diagnosed between 1985 and 1988 using population-based data, specifically for the more common forms of childhood cancer, and to assess the effect of age at diagnosis and sex as prognostic factors for selected childhood cancers. DESIGN: Retrospective survival study based on incident cases of cancer identified by the National Cancer Incidence Reporting System and follow-up ascertained by computer record linkage to the Canadian Mortality Database. SUBJECTS: A total of 4409 patients with cancer first diagnosed at 19 years of age or younger between 1985 and 1988, and followed up to Dec. 31, 1991. MAIN OUTCOME MEASURES: Survival rates calculated at 1, 3 and 5 years according to the actuarial life table and the proportional hazards models. RESULTS: The 5-year survival rate for all cancers combined was 71%. Females with acute lymphoblastic leukemia and astrocytoma had markedly higher survival rates than their male counterparts (p < 0.05). Age at diagnosis was a significant predictor of survival among children with acute lymphoblastic leukemia or acute nonlymphoblastic leukemia (p < 0.01), infants having a substantially poorer prognosis than older children. Conversely, the survival rate among infants with neuroblastoma was higher than that among older children, 87% surviving for 5 years after diagnosis. CONCLUSIONS: The survival rate among Canadian children and teenagers with cancer is favourable in relation to the rate among adults with cancer. Nonetheless, the 5-year survival rates for several childhood cancers remain poor (i.e., less than 65%). The survival rates among Canadian children with cancer are similar to those among children with cancer in other developed countries.
Asunto(s)
Neoplasias/mortalidad , Adolescente , Adulto , Canadá/epidemiología , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Tasa de Supervivencia , Factores de TiempoRESUMEN
Matrix metalloproteinases (MMPs) and their inhibitors (tissue inhibitors of metalloproteinases, TIMPs) play essential roles in the remodelling of the extracellular matrix (ECM). Results of in vivo and in vitro studies suggest that the balance between MMPs and TIMPs is altered in neoplasia, contributing to the invasive and metastatic properties of malignant tumours. In this study we have analysed the expression of five MMP genes and TIMP-1 and TIMP-2 in 37 benign and malignant lesions of human breast using Northern blot analysis. MMP-9 (92 kDa gelatinase) and MMP-11 (stromelysin 3) were most consistently expressed by carcinomas. Based on detection of either MMP-9 or MMP-11 mRNAs, we were able to distinguish between malignant and benign disease with a predictive accuracy of 90% with 94% sensitivity and 85% specificity. Subsequently, these results were compared with results for carcinomas of colon and lung and malignant non-Hodgkin's lymphomas (NHL). Elevated MMP-9 and TIMP-1 expression was observed in all four systems. MMP-11 characterised all carcinomas as well as carcinomas in situ but was not detectable in NHL. Our data therefore argue that there are remarkably similar patterns of specific functions involved in ECM remodelling that correlate with malignancy in different human tumours of different histogenesis. However, MMP-11 expression is a characteristic of tumours of epithelial origin that is not found in lymphoid neoplasia. Thus it suggests that MMP-11 may play a regulatory role in the invasion and metastasis of carcinomas.
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Biomarcadores de Tumor/análisis , Neoplasias de la Mama/patología , Neoplasias Colorrectales/patología , Glicoproteínas/biosíntesis , Neoplasias Pulmonares/patología , Linfoma no Hodgkin/patología , Metaloendopeptidasas/biosíntesis , Biosíntesis de Proteínas , Transcripción Genética , Adenofibroma/metabolismo , Adenofibroma/patología , Mama/citología , Mama/metabolismo , Mama/patología , Enfermedades de la Mama/metabolismo , Enfermedades de la Mama/patología , Neoplasias de la Mama/metabolismo , Neoplasias Colorrectales/metabolismo , Femenino , Enfermedad Fibroquística de la Mama/metabolismo , Enfermedad Fibroquística de la Mama/patología , Gelatinasas/biosíntesis , Glicoproteínas/análisis , Humanos , Neoplasias Pulmonares/metabolismo , Linfoma no Hodgkin/metabolismo , Metaloproteinasa 11 de la Matriz , Metaloendopeptidasas/análisis , Invasividad Neoplásica , Metástasis de la Neoplasia , Valor Predictivo de las Pruebas , Proteínas/análisis , ARN Mensajero/análisis , ARN Mensajero/biosíntesis , Sensibilidad y Especificidad , Inhibidor Tisular de Metaloproteinasa-2 , Inhibidores Tisulares de MetaloproteinasasRESUMEN
In order to evaluate risk factors for germ cell cancers, we conducted a case-control study of 510 men with testicular cancer aged 15 to 79 years and 996 randomly selected age-matched controls in the provinces of British Columbia and Alberta, Canada. Subjects completed a mailed questionnaire providing data on education level, ethnic origin, medical history, smoking, occupation, and recreational and sports activity. The response rate among cases was 80.3 percent and among controls was 68.1 percent. After controlling for age and ethnic origin, undescended testis was associated positively with risk of testicular cancer (odds ratio [OR] = 3.5; 95 percent confidence interval [CI] = 2.2-5.7) as was inguinal hernia requiring surgery (OR = 2.0, CI = 1.3-2.9), and hydrocoele (OR = 2.6, CI = 1.4-5.1). Risk of testicular cancer increased with height, with subjects taller than 180 cm having a significantly increased risk compared with those 174 cm or less (OR = 1.5, CI = 1.1-2.1). A moderate to high level of recreational activity level was associated inversely with testicular cancer risk (OR = 0.6, CI = 0.5-0.8).
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Germinoma/epidemiología , Neoplasias Testiculares/epidemiología , Adolescente , Adulto , Anciano , Alberta/epidemiología , Colombia Británica/epidemiología , Estudios de Casos y Controles , Criptorquidismo/complicaciones , Germinoma/etiología , Humanos , Incidencia , Estilo de Vida , Masculino , Persona de Mediana Edad , Aptitud Física , Pubertad , Factores de Riesgo , Neoplasias Testiculares/etiologíaRESUMEN
OBJECTIVE: The authors relate prehospital delay and in-hospital delay to the incidence of perforation of appendicitis. SUMMARY BACKGROUND DATA: Quality assurance studies use perforation rate as an index of quality of care. This is based on the assumption commonly presented in retrospective reports that in-hospital delay to surgery influences the incidence of perforation. Only one limited study prospectively found that prehospital delay increased the perforation rate. METHODS: During a 6-month period, 95 consecutive adults undergoing appendectomies at Foothills Hospital in Calgary, Alberta, were questioned as to onset and type of first symptom (i.e., epigastric discomfort, anorexia nervosa, vomiting, and abdominal pain). Time of emergency room (ER) arrival, surgery consultation, and operating room start were taken from the chart. Surgical and pathology reports were used to identify status of appendix (normal, inflamed, suppurative, gangrenous, perforated) and presence of abscess cavity. The status of appendix was related to prehospital and in-hospital delay to establish significance. RESULTS: There were 13 (14%) normal, 67 (70%) inflamed, and 15 (16%) perforated appendices. Patients with perforated appendices waited 2.5 times longer before reporting to the ER, compared with patients with inflamed appendices (57 hours vs. 22 hours, p < 0.007). Once in the hospital, patients with perforated appendices were identified and treated faster than those with inflamed appendices (7 vs. 9 hours, p < 0.039). Analysis by ER physician was 3 hours whether the appendix was normal, inflamed, or perforated. Analysis by the surgeon was significantly shorter in patients with perforated appendices than patients with inflamed appendices (4 vs. 6 hours, p < 0.039). CONCLUSIONS: This prospective study identifies that delay in presentation accounts for the majority of perforated appendices. Clinical evaluation is effective for identifying patients with more advanced disease. Indiscriminate appendectomy as an attempt to decrease perforation is not supported by these data. Hospital perforation rates likely reflect patient factors, illness attitude, and access to medical care.
Asunto(s)
Apendicitis/complicaciones , Perforación Intestinal/etiología , Adolescente , Adulto , Apendicectomía , Humanos , Estudios Prospectivos , Calidad de la Atención de Salud , Rotura Espontánea , Factores de TiempoRESUMEN
PURPOSE: A study was undertaken to study the potential benefits for function and regional recurrence of preserving the sensory ventral branches of the cervical plexus in modified neck dissections. METHODS: Fifteen cases of squamous cell carcinoma or melanoma of the head and neck in which the sensory nerves were spared were matched to 15 cases in which the nerves were sacrificed. The subjects were examined for sensory loss, questioned regarding acute and chronic dysfunction, and followed for regional recurrence for a minimum of 2 years. RESULTS: The group whose nerves were preserved had significantly less sensory loss and a lower incidence of acute and chronic dysfunction. No subjects in either group had regional recurrence. CONCLUSION: The results of this initial study support a policy of routine preservation of the sensory ventral branches of the cervical plexus when there is no direct tumor involvement.
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Carcinoma de Células Escamosas/cirugía , Neoplasias de Cabeza y Cuello/cirugía , Escisión del Ganglio Linfático/métodos , Melanoma/cirugía , Plexo Cervical , HumanosRESUMEN
Previous reports have demonstrated synergism of midazolam and propofol for induction of anaesthesia in humans. We tested the hypothesis that in the presence of alfentanil, the combination of midazolam with propofol for a very brief operative procedure would not affect the recovery phase. During pre-oxygenation, 64 outpatients scheduled for dilatation and curettage received placebo, or low-dose midazolam (0.03 mg.kg-1), or high-dose midazolam (0.06 mg.kg-1) iv, in a randomized double-blind manner. They then received alfentanil 10 micrograms.kg-1 iv, followed by titrated doses of propofol iv for induction and maintenance of anaesthesia. Ventilation with 70% N2O in O2 by mask was controlled to achieve a PETCO2 30-40 mmHg. Outcome measures were: propofol dose (induction and maintenance), time until eye-opening to command, and time to discharge-readiness. Propofol induction dose was decreased by increasing doses of midazolam (P = 0.00005). Midazolam delayed time to eye-opening (P = 0.02) but not time to discharge-readiness. This study had an 80% power to detect a 39 min difference in time to discharge-readiness. We conclude that midazolam propofol co-induction in the presence of alfentanil delays eye-opening, but does not delay discharge after anaesthesia.
Asunto(s)
Alfentanilo/administración & dosificación , Anestesia Intravenosa , Midazolam/administración & dosificación , Alta del Paciente , Propofol/administración & dosificación , Alfentanilo/farmacología , Periodo de Recuperación de la Anestesia , Anestesia por Inhalación , Dióxido de Carbono/metabolismo , Dilatación y Legrado Uterino , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Combinación de Medicamentos , Sinergismo Farmacológico , Femenino , Humanos , Midazolam/farmacología , Persona de Mediana Edad , Óxido Nitroso , Placebos , Propofol/farmacología , Vigilia/efectos de los fármacosRESUMEN
Several studies have implicated the extracellular matrix-degrading metalloproteinases (MMPs) as essential agents in tumor cell invasion and metastasis. In the present study, we have investigated the patterns of expression of a number of MMPs and their specific tissue inhibitors (TIMP-1 and TIMP-2) in human colonic tissue samples that represent various stages of progression from adenomas showing different degrees of dysplasia to adenocarcinomas. We assessed levels of mRNA by Northern blot analysis and the results were measured semiquantitatively by densitometry. In total, we analyzed nine adenomas of varying size and with varying degrees of dysplasia, three adenomas with adenocarcinoma (malignant polyps), and five adenocarcinomas. Although expression of MMP and TIMP mRNA was highly intercorrelated, transcripts for stromelysin 3 and TIMP-2 (high) showed the strongest relation to the neoplastic process. Detection of stromelysin 3 mRNA accompanied a diagnosis of severe dysplasia or malignancy, whereas levels of TIMP-2 (high) mRNA transcripts permitted finer distinctions on the neoplastic continuum. These data indicate changes within extracellular matrix acquired during the process of malignant transformation of human sporadic colorectal neoplasia.
Asunto(s)
Neoplasias Colorrectales/química , Glicoproteínas/análisis , Metaloendopeptidasas/antagonistas & inhibidores , Metaloendopeptidasas/análisis , Proteínas de Neoplasias/análisis , Adolescente , Adulto , Anciano , Neoplasias Colorrectales/enzimología , Neoplasias Colorrectales/patología , Femenino , Expresión Génica , Glicoproteínas/genética , Humanos , Masculino , Metaloproteinasa 11 de la Matriz , Metaloendopeptidasas/genética , Persona de Mediana Edad , Proteínas de Neoplasias/genética , ARN Mensajero/análisis , ARN Mensajero/genética , Análisis de Regresión , Inhibidor Tisular de Metaloproteinasa-2 , Inhibidores Tisulares de Metaloproteinasas , Células Tumorales CultivadasRESUMEN
The value of cancer treatment was assessed using a 'natural experiment' where patients who refused treatment served as no-treatment controls in a situation where withholding treatment to form a control group is unethical. Each cancer patient who refused treatment in Alberta, Canada between 1975 and 1988 was compared with five subjects who accepted treatment, matched on cancer site, age, number of cancers, and time period. Variables associated with treatment-refusal were included in Cox's proportional hazards model of survival, with death from cancer as the endpoint and deaths from other causes as censored observations. Treatment was refused at a rate of 7.5 per 1,000. One-third of patients who refused treatment had lung cancer and most had unstaged disease. Treatment refusal was associated with a difference in median survival of approximately nine months. Site-specific analyses showed a range of effects. Case fatality among the treated patients fell by approximately 10 percent during the 14-year study period. Even in advanced disease, treatment can result in improved survival. However, the results of this study must be interpreted with caution and cannot be generalized to all cancer patients.
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Grupos Control , Neoplasias/mortalidad , Negativa del Paciente al Tratamiento , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Alberta/epidemiología , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias/patología , Neoplasias/terapia , Ocupaciones , Valor Predictivo de las Pruebas , Modelos de Riesgos Proporcionales , Sistema de Registros , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
An experiment was conducted to determine the optimal distance between sutures in closure of abdominal midline incisions. Human cadaveric fascia was harvested soon after death and stored at -70 degrees C until testing. Suture pullout tests were performed to determine the maximal force applied to the fascia before pullout. Fascia from the opposite side of the same cadaver was used as a control. In a first series of testing, we observed that the pullout force of two sutures dropped linearly as they were brought closer than 12 mm apart. In a second series we observed no increase in pullout force using multiple sutures closer together compared to fewer sutures 15 mm apart. The experiments suggest that the mechanical requirements of closing a midline abdominal incision are met by placing sutures 10-15 mm apart.
Asunto(s)
Músculos Abdominales/cirugía , Técnicas de Sutura , Músculos Abdominales/fisiología , Anciano , Anciano de 80 o más Años , Fenómenos Biomecánicos , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
A population-based study of the biology of the thin-level melanoma according to site, Breslow's thickness, and Clark's level was undertaken. Two hundred fifteen patients were studied with a mean follow-up of 41 months. Overall, 23 patients (10.7%) had recurrences, 8 locally, 9 regionally, and 6 systemically, despite an adequate local excision. A multivariate analysis was done. In the patients with thin lesions (less than 1 mm), increasing level (p < 0.002) and head and neck site (p < 0.04) increased the risk of recurrence. Increasing thickness of melanoma up to 1 mm did not influence the risk. This study identifies a group of high-risk melanoma patients for whom adjuvant therapy to decrease recurrences should be studied.
Asunto(s)
Melanoma/patología , Melanoma/secundario , Recurrencia Local de Neoplasia/epidemiología , Neoplasias Cutáneas/patología , Estudios de Seguimiento , Humanos , Melanoma/epidemiología , Análisis Multivariante , Invasividad Neoplásica , Pronóstico , Factores de Riesgo , Neoplasias Cutáneas/epidemiologíaRESUMEN
Sixty-three women participated in a study in Calgary, Alberta to assess the rate of arm recovery and factors affecting it up to one year after axillary node dissection for breast cancer. Outcomes included objective measures of swelling, mobility, and strength, and subjective assessments of pain (at rest and with movement) and stiffness. Approximately 42% of women had residual impairment of at least one type one year after surgery, the most common problems being pain (16%) and reduced grip strength (16%). Except for lymphedema, measurements one year after surgery showed little change from measurements at 6 months, suggesting that the shorter follow-up may be appropriate for assessing the long term effects of axillary dissection. Lymphedema was the only sequela which increased over time. The results provide parameter estimates for designing studies to evaluate the role of physiotherapy after axillary dissection.
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Brazo/fisiología , Axila/cirugía , Neoplasias de la Mama/cirugía , Escisión del Ganglio Linfático/rehabilitación , Modalidades de Fisioterapia , Brazo/anatomía & histología , Femenino , Humanos , Escisión del Ganglio Linfático/efectos adversos , Linfedema/etiología , Dolor/etiología , Proyectos Piloto , Análisis de RegresiónRESUMEN
One hundred fifty-seven elderly patients with surgical wound infection were matched on wound classification and date of surgery to non-infected control patients. Factors examined for their association with wound infection included medical history, functional status, behaviour (e.g. smoking), factors predisposing to infection (e.g. results of CBC and urinalysis) and operative factors such as preparation, duration and type of operation. Conditional logistic regression analysis identified factors already known to be risk factors for wound infection at all ages (e.g. type and duration of operation), as well as factors unique to the elderly (e.g. age greater than 70 years and limited mobility).
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Envejecimiento , Infección de la Herida Quirúrgica/etiología , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Asepsia/normas , Comorbilidad , Humanos , Modelos Logísticos , Cuidados Preoperatorios , Curva ROC , Factores de Riesgo , Infección de la Herida Quirúrgica/clasificaciónRESUMEN
Aberrant expression of secreted proteinases and their specific inhibitors is believed to represent an important factor in the pathogenesis of invasion and metastases of malignant neoplasms. Our previous data indicated a link between elevated expression of tissue inhibitor of metalloproteinases-1 (TIMP-1) and the clinical aggressiveness of malignant non-Hodgkin's lymphomas. Further studies are presented on eighteen cases of high grade, large cell immunoblastic lymphoma in which expression at the RNA level of TIMP-1 and the metalloproteinase, 92 kDa gelatinase, were analyzed. Factors that may influence production of 92 kDa gelatinase, such as necrosis, vascularity, proliferative activity, and extranodal extension, as well as clinical parameters, such as age and sex, stage, location, and survival were assessed. Statistical analysis showed that, although clinical stage was the most important predictor of survival, after controlling for age at diagnosis, levels of 92 kDa gelatinase transcripts added to the ability to predict survival.
Asunto(s)
Colagenasas/análisis , Glicoproteínas/análisis , Linfoma Inmunoblástico de Células Grandes/enzimología , ARN Mensajero/análisis , ARN Neoplásico/análisis , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Linfoma Inmunoblástico de Células Grandes/mortalidad , Linfoma Inmunoblástico de Células Grandes/patología , Masculino , Metaloproteinasa 9 de la Matriz , Persona de Mediana Edad , Peso Molecular , Pronóstico , Análisis de Supervivencia , Inhibidores Tisulares de MetaloproteinasasRESUMEN
The frequency of hereditary nonpolyposis colorectal cancer was evaluated in a group of colorectal cancer patients under age 50 diagnosed in southern Alberta between 1973 and 1987. Families were identified as positive for this syndrome if three first-degree relatives in the kindred had colorectal cancer. Of the 390 patients with adenocarcinoma, 318 patients participated. The frequency of hereditary nonpolyposis colorectal cancer was 3.1% (12 families) in this group (Ci95 1.6-5.3%). Clinical characteristics reported on from the index patients include tumor location, Dukes stage at presentation, frequency of synchronous and metachronous tumors, frequency of second primaries, and survival. The 5- and 10-year actuarial survival was 86% and 69%, respectively.
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Neoplasias Colorrectales/epidemiología , Adenocarcinoma/epidemiología , Adolescente , Adulto , Anciano , Alberta/epidemiología , Neoplasias del Ano/epidemiología , Neoplasias Colorrectales/genética , Neoplasias Colorrectales/mortalidad , Neoplasias Colorrectales/patología , Familia , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Primarias Secundarias , Linaje , Tasa de SupervivenciaRESUMEN
Diffuse large cell and immunoblastic lymphomas are a heterogeneous group of tumors. They differ phenotypically and genotypically, and their clinical course varies in aggressiveness. This study evaluates the prognostic significance of proliferative activity and compares it with immunophenotype, genotype, and clinical data. Proliferative activity was measured by Ki-67 antibody. In 22 cases of diffuse large cell and immunoblastic lymphoma high proliferative activity (greater than 40%) was associated with longer disease-free survival (average 42 months). In contrast, the patients with lymphomas exhibiting low proliferative activity (less than 40%) died shortly after diagnosis (average 8 months). These differences are statistically significant and indicate a need for large-scale prospective studies.
Asunto(s)
Linfoma de Células B Grandes Difuso/patología , Adolescente , Adulto , Factores de Edad , Anciano , División Celular/fisiología , Femenino , Genotipo , Humanos , Inmunofenotipificación , Linfoma de Células B Grandes Difuso/mortalidad , Linfoma de Células B Grandes Difuso/terapia , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Curva ROC , Estudios RetrospectivosRESUMEN
Surgical wound infection occurs in fewer than 5% of operations. Nevertheless, it represents the second most common type of hospital-acquired infection and results in increased morbidity and mortality. As with all nosocomial infections, the rate of surgical wound infection increases with age. Patients over 65 years of age run an approximately 15% risk of surgical wound infection. Two-thirds of patients with invasive cancer other than non-melanotic skin cancer are aged 65 years and over. Over half of them are treated surgically for their cancer. Cancer and other chronic diseases have been cited as possible causes of the increased risk of nosocomial infection among the elderly. Using the Foothills Hospital Wound Study Data Base as the sampling frame, we conducted a case-control study of surgical wound infection and cancer among the elderly. Cancer was found not to be a risk factor for surgical wound infection. The results are discussed in relation to the role of immunity in both disorders.