RESUMO
PURPOSE: Comorbidity assessment is essential in the triage of care for men with prostate cancer (PC). The aim of this study was to validate the Spanish version of the revised Charlson index (RCI) in PC. MATERIALS AND METHODS: 731 PC patients diagnosed from 1993 to 2008 were referred to our Radiation Oncology Department. The RCI classified patients into four categories RCI 0, RCI 1-2, RCI 3-4, and RCI 5 and higher. The Kaplan-Meier method and Cox proportional hazards modeling were used. We also analyzed the median age of patients who remained alive at the last control and those who died due to non-prostate cancer comorbidities. RESULTS: 636 patients were included median age: 70 years (44-85). The mean follow-up was 153.62 months, (6-288 months). Distribution of the D'Amico risk classification was 21%, 38.2%, and 40.8% for low, intermediate, and high risk, respectively. The RCI distribution categories were: 303 (46.7%) RCI 0, 102 (16%) RCI 1-2, 131 (20.6%) RCI 3-4, and 100 (15.7%) RCI 5 and higher. The probability of non-cause-specific mortality at 5 and 10 years was 2. 4% and 11.25% RCI 0, 3 and 14.1% RCI 1-2, 5.7% and 22.1% RCI 3-4, and 47% and 92% (RCI 5 and higher). The median age in the last control in patients alive or who had died by non-PC causes was 82.81 years (55.27-102). DISCUSSION: The RCI may be used to aid medical decision making in older Spanish men with PC, especially in those with a high RCI 5 and higher.
Assuntos
Tomada de Decisão Clínica , Comorbidade , Mortalidade , Neoplasias da Próstata , Adulto , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Humanos , Estimativa de Kaplan-Meier , Expectativa de Vida , Masculino , Pessoa de Meia-Idade , Prognóstico , Modelos de Riscos Proporcionais , Reprodutibilidade dos Testes , Fatores de Risco , EspanhaRESUMO
PURPOSE: Adjuvant radiotherapy (ART) for biochemical relapse (BR) after radical prostatectomy (RP) showed increased disease-free survival (DFS) in three previous randomized trials. Retrospective phase II trials evaluated if early salvage RT (ESRT) is equivalent to ART. Our study aims to compare ART and ESRT to salvage RT. MATERIALS AND METHODS: We compared RP plus ART and ESRT versus SRT. Indication for RT was made by PSA determination after RP: ART when PSA ≤ 0.2 ng/ml, ESRT when PSA ≤ 0.3 after PSA rise from 0.0 to SRT PSA ≥ 0.3. The cause of death of each patients was analyzed, DFS, cause-specific survival (CSS) overall survival (OS) and metastasis-free survival (MFS) in relation to RT intention. RESULTS: Between 1993 and 2008, 204 patients with a median age of 65 years (44-75) were treated. The median follow-up was 160 months (28.1-273.3). At diagnosis, 89.7% had localized clinical stages and 90.2% had Gleason (G) ≤ 7. The median PSA was 10 (range 4-101). The postoperative G was ≥ 7 in 66.2%; 56.4% had ≥ 2 positive margins; 29.4% received ART, 20% ESRT and 59.3% SRT. The DFS for ART, ESRT and SRT was 74, 56 and 39% with significant differences between the three groups (p < 0.001). ART + ESRT were combined versus SRT; for the DFS, the significant differences (p < 0.001) remained 67% versus 39%. Positive margins, pT3 and pre-RT PSA were significant factors on multivariate analysis. The CSS in the ART + ESRT group was 92 vs. 78% in the SRT group (p < 0.05). OS was 69% in ART + ESRT vs. 57% in SRT (p < 0.05). MFS was 82.7% in ART + ESRT vs. 67.4% in SRT. CONCLUSIONS: In this study the ART + ESRT presented benefits versus SRT in DFS, CSS, OS and MFS.
Assuntos
Neoplasias da Próstata/radioterapia , Radioterapia Adjuvante/métodos , Terapia de Salvação/métodos , Adulto , Idoso , Intervalo Livre de Doença , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Prostatectomia , Neoplasias da Próstata/mortalidade , Neoplasias da Próstata/cirurgia , Radioterapia Adjuvante/mortalidade , Estudos Retrospectivos , Terapia de Salvação/mortalidadeRESUMO
Our objective was to determine lipid peroxidation and nuclear factor-κB (NF-κB) activation in skeletal muscle and the plasma cytokine profile following maximum progressive swimming. Adult male Swiss mice (N = 15) adapted to the aquatic environment were randomly divided into three groups: immediately after exercise (EX1), 3 h after exercise (EX2) and control. Animals from the exercising groups swam until exhaustion, with an initial workload of 2 percent of body mass attached to the tail. Control mice did not perform any exercise but were kept immersed in water for 20 min. Maximum swimming led to reactive oxygen species (ROS) generation in skeletal muscle, as indicated by increased thiobarbituric acid reactive species (TBARS) levels (4062.67 ± 1487.10 vs 19,072.48 ± 8738.16 nmol malondialdehyde (MDA)/mg protein, control vs EX1). Exercise also promoted NF-κB activation in soleus muscle. Cytokine secretion following exercise was marked by increased plasma interleukin-6 (IL-6) levels 3 h post-exercise (P < 0.05). Interleukin-10 (IL-10) levels were reduced following exercise and remained reduced 3 h post-exercise (P < 0.05). Plasma levels of other cytokines investigated, monocyte chemotactic protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ) and interleukin-12 (IL-12), were not altered by exercise. The present findings showed that maximum swimming, as well as other exercise models, led to lipid peroxidation and NF-κB activation in skeletal muscle and increased plasma IL-6 levels. The plasma cytokine response was also marked by reduced IL-10 levels. These results were attributed to exercise type and intensity.
Assuntos
Animais , Masculino , Camundongos , Citocinas/sangue , Peroxidação de Lipídeos/fisiologia , Músculo Esquelético/metabolismo , NF-kappa B/metabolismo , Natação/fisiologia , Índice de Massa Corporal , /sangue , /sangue , /sangue , Malondialdeído/metabolismo , Condicionamento Físico Animal/fisiologia , Distribuição Aleatória , Espécies Reativas de Oxigênio/metabolismo , Fatores de Tempo , Substâncias Reativas com Ácido Tiobarbitúrico/metabolismoRESUMO
Our objective was to determine lipid peroxidation and nuclear factor-κB (NF-κB) activation in skeletal muscle and the plasma cytokine profile following maximum progressive swimming. Adult male Swiss mice (N = 15) adapted to the aquatic environment were randomly divided into three groups: immediately after exercise (EX1), 3 h after exercise (EX2) and control. Animals from the exercising groups swam until exhaustion, with an initial workload of 2% of body mass attached to the tail. Control mice did not perform any exercise but were kept immersed in water for 20 min. Maximum swimming led to reactive oxygen species (ROS) generation in skeletal muscle, as indicated by increased thiobarbituric acid reactive species (TBARS) levels (4062.67 ± 1487.10 vs 19,072.48 ± 8738.16 nmol malondialdehyde (MDA)/mg protein, control vs EX1). Exercise also promoted NF-κB activation in soleus muscle. Cytokine secretion following exercise was marked by increased plasma interleukin-6 (IL-6) levels 3 h post-exercise (P < 0.05). Interleukin-10 (IL-10) levels were reduced following exercise and remained reduced 3 h post-exercise (P < 0.05). Plasma levels of other cytokines investigated, monocyte chemotactic protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ) and interleukin-12 (IL-12), were not altered by exercise. The present findings showed that maximum swimming, as well as other exercise models, led to lipid peroxidation and NF-κB activation in skeletal muscle and increased plasma IL-6 levels. The plasma cytokine response was also marked by reduced IL-10 levels. These results were attributed to exercise type and intensity.
Assuntos
Citocinas/sangue , Peroxidação de Lipídeos/fisiologia , Músculo Esquelético/metabolismo , NF-kappa B/metabolismo , Natação/fisiologia , Animais , Índice de Massa Corporal , Interleucina-10/sangue , Interleucina-12/sangue , Interleucina-6/sangue , Masculino , Malondialdeído/metabolismo , Camundongos , Condicionamento Físico Animal/fisiologia , Distribuição Aleatória , Espécies Reativas de Oxigênio/metabolismo , Substâncias Reativas com Ácido Tiobarbitúrico/metabolismo , Fatores de TempoRESUMO
Acidic ribosomal P1 and P2b proteins, referred to as P proteins, and histone H3 are reported for first time in the Leishmania braziliensis complex. Deoxyribonucleic acid analysis and multiple sequence alignment suggest that both P proteins may maintain their structural function in the ribosomal stalk, in spite of the high rate of mutations detected. The deduced amino acid sequence of protein P1 showed 51% identity with Trypanosoma cruzi protein P1 and protein P2b showed 61% identity with T. cruzi protein P2b. Another conserved protein, L. (Viannia) braziliensis histone H3, showed 82% and 70% identity with histone H3 of L. (Leishmania) infantum and T. cruzi, respectively. The N-terminal end of this histone is divergent in comparison with the consensus eukaryotic sequence. Their predicted tridimensional structure was designed.
Assuntos
Genes de Protozoários , Leishmania braziliensis/genética , Proteínas de Protozoários/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Sequência Conservada , DNA de Protozoário/genética , Histonas/genética , Dados de Sequência Molecular , Fosfoproteínas/genética , Estrutura Terciária de Proteína , Proteínas Ribossômicas/genéticaRESUMO
Another additional peculiarity in Leishmania will be discussed about of the amino acid divergence rate of three structural proteins: acidic ribosomal P1 and P2b proteins, and histone H3 by using multiple sequence alignment and dendrograms. These structural proteins present a high rate of divergence regarding to their homologous protein in Trypanosoma cruzi. At this regard, L. (V.) peruviana P1 and T. cruzi P1 showed 57.4% of divergence rate. Likewise, L. (V.) braziliensis histone H3 and acidic ribosomal P2 protein exhibited 31.8% and 41.7% respectively of rate of divergence in comparison with their homologous in T. cruzi.
Assuntos
Histonas/análise , Leishmania/química , Proteínas de Protozoários/análise , Proteínas Ribossômicas/análise , Aminoácidos/análise , Animais , Leishmania/genética , FilogeniaRESUMO
PURPOSE--To study the clinical and hemodynamic aspects of a group of patient presenting non-obstructive coronary lesions. METHODS--We reviewed 963 coronary angiographies performed at a same institution. The 52 patients presenting only stenosis < or = 50 per cent after semi-quantitative measurement composed group I, which was compared with two other groups consisted of 52 patients each: one, with patients presenting univascular lesion > 50 per cent (group II) and the other with normal coronary arteriographies (group III). RESULTS--Mean age was similar in groups I and II (49.4 +/- 6.89 and 51.3 +/- 7.86, p > 0.05) and significantly higher than that of group III (44.8 +/- 6.81, p < 0.05). Risk factors did not discriminate group I (GI) from groups II (GII) and III (GIII). During a follow-up period of 63 months, the number of hospital admissions due to cardiac events and repetitions of coronary arteriography were similar in GI and GII, being significantly less frequent in GIII (p < 0.00001 and 0.001; p < 0.01 and 0.05, respectively). By the end of the follow-up period, though angina and heart failure functional classes had been similar in the three groups, patients in groups I and II were using more medications than those in group III (p < 0.0001 and 0.00001). Mean ejection fractions (per cent) were lower in GI and GII (67.04 +/- 10.13 and 68.90 +/- 11.32) than in GIII (74.69 +/- 6.40, p < 0.01). Lesions were predominantly proximal in GI when compared with GII (p < 0.05). Length, simmetry, ulceration, thrombus and proximal shoulder showed no difference between GI and GII. CONCLUSION--Patients with non-obstructive coronary lesions were similar to those with univascular lesion > 50 per cent regarding several aspects and were considerably different from those with normal coronary arteries
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Doença da Artéria Coronariana/fisiopatologia , Cineangiografia , Estudos Retrospectivos , Fatores de Risco , Seguimentos , Vasos Coronários/patologia , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana , Função Ventricular Esquerda , Volume SistólicoRESUMO
STUDY OBJECTIVE: The aim was to examine the factors associated with incomplete vaccination in an urban area in Sao Paulo, Brazil; and to explore whether differences in vaccine coverage in the catchment area of health centres remain after the demographic constitution of the population in these areas is controlled for. DESIGN: The children were selected as controls for a case-control study. 455 children were selected at random (but age matched) from the health centre registries. Data was collected from the health centre records and from home interviews. SETTING: All children were registered in FAISA, a municipal health service comprising a large network of health centres and hospitals. FAISA's services are free at the point of delivery, and over 85% of the city's children are registered. PARTICIPANTS: Participants were selected to represent, except in their age distribution, all children registered in the municipal health service. MEASUREMENTS AND MAIN RESULTS: Information was collected on subjects' vaccine history, year of birth, sex, birth order and birth weight, and health centre of registration; their mothers' age, education, and marital status; and the family's income per capita and history of migration. Analysis was undertaken to identify risk factors for vaccination and whether the differential coverage in health centres' catchment areas remained after demographic characteristics of the population were controlled for. The high coverage for DPT and polio vaccines suggests that low overall coverage was not simply a result of mothers failing to bring children for vaccination. The variable that best predicted vaccine coverage was year of birth. Children born to immigrant mothers or into large families had lower vaccine uptake. The characteristics of children and their mothers did not account for the variation in vaccination coverage in catchment areas of different health centres. CONCLUSIONS: It is likely that in this area vaccination completeness was associated mainly with the health centre's ability to deliver vaccination to the target population.
Assuntos
População Urbana , Vacinação/estatística & dados numéricos , Brasil , Estudos de Casos e Controles , Criança , Pré-Escolar , Atenção à Saúde , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Instalações de Saúde , Humanos , Política Organizacional , Distribuição Aleatória , Fatores SocioeconômicosAssuntos
Leishmaniose/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Leishmaniose/parasitologia , Masculino , VenezuelaRESUMO
Se realizo un estudio clinico, parasitologico, epidemiologico y ecologico, a la vez que se adoptaron medidas de lucha, en un foco endemico con 50 casos de leishmaniasis tegumentaria distribuidos en 13 caserios situados entre 90 y 180 m sobre el nivel del mar, al oriente del distrito Urdaneta, Estado Lara, Venezuela. Entre las variedades clinicas, se encontraron la auricular, semejante a la ulcera de los chicleros, en tres pacientes (6%); clasica ulcerosa en 42 pacientes (84%); piodermoide en cuatro pacientes (8%) y cromomicoide en un paciente (2%). Ademas de los casos en el hombre, tambien se hallo la enfermedad en 17 asnos y un perro. El agente causal se ha identificado como miembro del complejo de la Leishmania brasiliensis, y se esperan nuevos estudios para su total caracterizacion. En relacion con este foco se han identificado las siguientes especies de flebotomos antropofilos: Lutzomyia evansi, L.gomeziy Ps. panamensis