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OBJECTIVE: Currently programmed cell death protein 1 (PD-1) inhibitors in combination with other therapies are being evaluated to determine their efficacy in cancer treatment. However, the effect of PD-ligand (L) 1 expression on disease outcomes in stage III (EC III) non-small cell lung cancer is not completely understood. Therefore, this study aimed to assess the influence of PD-L1 expression on the outcomes of EC III non-small cell lung cancer. METHODS: This study was conducted on patients diagnosed with EC III non-small cell lung cancer who underwent treatment at a tertiary care hospital. PD-L1 expression was determined using immunohistochemical staining, all patients expressed PD-L1. Survival was estimated using the Kaplan-Meier method. Relationships between variables were assessed using Cox proportional regression models. RESULTS: A total of 49 patients (median age=69 years) with EC III non-small cell lung cancer and PD-L1 expression were evaluated. More than half of the patients were men, and most were regular smokers. The patients were treated with neoadjuvant chemotherapy, surgery, or sequential or combined chemotherapy and radiotherapy. The median progression-free survival of the entire cohort was 14.2 months, and the median overall survival was 20 months. There was no significant association between PD-L1 expression and disease progression, clinical characteristics, or overall survival. CONCLUSIONS: PD-L1 expression was not correlated with EC III non-small cell lung cancer outcomes. Whether these findings differ from the association with immune checkpoint inhibitors remains to be addressed in future studies.
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Antígeno B7-H1 , Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Estadiamento de Neoplasias , Humanos , Carcinoma Pulmonar de Células não Pequenas/metabolismo , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/terapia , Masculino , Feminino , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/mortalidade , Antígeno B7-H1/análise , Antígeno B7-H1/metabolismo , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Prognóstico , Estimativa de Kaplan-Meier , Imuno-Histoquímica , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Biomarcadores Tumorais/metabolismo , AdultoRESUMO
ABSTRACT Objective Currently programmed cell death protein 1 (PD-1) inhibitors in combination with other therapies are being evaluated to determine their efficacy in cancer treatment. However, the effect of PD-ligand (L) 1 expression on disease outcomes in stage III (EC III) non-small cell lung cancer is not completely understood. Therefore, this study aimed to assess the influence of PD-L1 expression on the outcomes of EC III non-small cell lung cancer. Methods This study was conducted on patients diagnosed with EC III non-small cell lung cancer who underwent treatment at a tertiary care hospital. PD-L1 expression was determined using immunohistochemical staining, all patients expressed PD-L1. Survival was estimated using the Kaplan-Meier method. Relationships between variables were assessed using Cox proportional regression models. Results A total of 49 patients (median age=69 years) with EC III non-small cell lung cancer and PD-L1 expression were evaluated. More than half of the patients were men, and most were regular smokers. The patients were treated with neoadjuvant chemotherapy, surgery, or sequential or combined chemotherapy and radiotherapy. The median progression-free survival of the entire cohort was 14.2 months, and the median overall survival was 20 months. There was no significant association between PD-L1 expression and disease progression, clinical characteristics, or overall survival. Conclusions PD-L1 expression was not correlated with EC III non-small cell lung cancer outcomes. Whether these findings differ from the association with immune checkpoint inhibitors remains to be addressed in future studies.
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Neoadjuvant chemotherapy is considered a new treatment option for potentially resectable pancreatic cancer. However, data are not well established on overall survival and delaying surgery in resectable pancreatic cancer, as well as on those patients that ultimately cannot undergo surgery. We analyzed pancreatic cancer patients treated in a tertiary hospital from January 2016 to December 2020. Patients with resectable stage I and II pancreatic cancer were evaluated regarding surgery, neoadjuvant treatment, and other clinical demographics. The survival function was estimated using the Kaplan-Meier method, and the relationship between the variables of interest and the overall survival (OS) was assessed by adopting the proportional regression Cox models. A total of 216 patients were evaluated. 81 of them with resectable/borderline resectable disease and 135 with unresectable /metastatic disease at diagnosis. Median OS for stage I and II disease were 36 and 28 months, respectively. For resectable pancreatic cancer median OS was 28 months, for borderline resectable pancreatic cancer median OS was 11 months. Median OS for stage III (locally advanced) and stage IV (metastatic) were 10 and 7 months, respectively (p < 0.0001). Median OS of 9 months were obtained for patients with stage I and II that did not undergo surgery compared to 25 months in patients that underwent surgery in any time (p < 0.001). Comparing patients with localized disease, median OS for patients treated with upfront surgery was 28 months, compared to 15 months in patients treated with neoadjuvant approach (p = 0.04). Most patients that did not undergo surgery have decline of performance status or disease progression on neoadjuvant treatment. On multivariable analysis in pancreatic cancer stages I and II, including age, sex, borderline or resectable disease, CA 19-9, positive lymph nodes and neoadjuvant treatment, the surgery was the only factor associated with improved overall survival (p = 0.04). Upfront surgery should still be considered a standard of care approach for resectable pancreatic cancer. Biomarker driven studies and randomized trials with combination therapies are necessary to address neoadjuvant chemotherapy and delaying surgery in purely resectable pancreatic cancer.
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Terapia Neoadjuvante , Neoplasias Pancreáticas , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Humanos , Terapia Neoadjuvante/métodos , Pâncreas/patologia , Pancreatectomia/métodos , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/cirurgia , Estudos Retrospectivos , Neoplasias PancreáticasRESUMO
JUSTIFICATIVA E OBJETIVOS: A criança internada, na maioria das vezes, é submetida à punção venosa e talvez essa seja a experiência mais estressante percebida no decorrer da sua internação. O objetivo deste estudo foi avaliar a intensidade da dor da criança em idade escolar quando submetida á punção venosa periférica.MÉTODO: Após aprovação pelo Comitê de Ética em Pesquisa da Instituição, usando a escala de faces e a escala visual numérica para a avaliação da dor no momento da punção venosa, foram estudadas 31 crianças em idade escolar submetidas à punção venosa, sendo que 67,74% delas já haviam sido internadas e vivenciadas o procedimento anteriormente.RESULTADOS: Em relação à intensidade da dor 48,39% das crianças informaram que foi de intensidade leve, 32,27% sentiram dor moderada, 9,67% dor insuportável, sendo que 9,67% das crianças informaram não ter sentido nenhuma dor no momento da punção venosa. Analisando as etapas do procedimento verificou-se que o uso do garrote causou mais desconforto em 32,28% das crianças, a introdução da agulha foi responsável pelo maior desconforto em 29,03% e a infusão de medicamentos foi a causa do maior desconforto para 16,12% das crianças.CONCLUSÃO: Embora o procedimento de punção venosa periférica seja bastante comum na unidade pediátrica, a dor e o desconforto não estão relacionados apenas à punção propriamente dita, mas também ao uso do torniquete para melhor expor a veia e a infusão do liquido.
BACKGROUND AND OBJECTIVES: Hospitalized children are very often submitted to venous puncture and this might be the most stressing experience perceived by them throughout their hospital stay. This study aimed at assessing pain intensity in school-age children submitted to peripheral venous puncture.METHOD: After the Institution?s Research Ethics Committee approval and using the faces scale and the numeric scale visual to evaluate pain at venous puncture, 31 school-age children submitted to venous puncture were evaluated, being that 67.74% of them had already been hospitalized and experienced the venous puncture procedure.RESULTS: With regard to pain intensity, 48.39% of children informed that it was mild, 32.27% felt moderate pain, 9.67% unbearable pain and 9.67% of children said they had no pain during venous puncture. Analyzing the stages of the procedure we have observed that tourniquet has caused greater discomfort to 32.28% of children, needle introduction was responsible for greater discomfort to 29.03% and drug infusion was the cause of greater discomfort to 16.12% of children.CONCLUSION: Although peripheral venous puncture is very common in pediatric units, pain and discomfort are not related only to the puncture itself, but also to the use of tourniquet to better expose the vein and to the drug infusion.
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Polycyclic aromatic and monoaromatic (benzene, toluene and xylene, or BTX) hydrocarbons were monitored in Rio de Janeiro, Brazil, during the summer of 1998/1999. The levels of these aromatic chemicals decreased with distance from main roads, indicating mobile sources are the main pollutant emitters in this Latin American city. Benzo[ghi]perylene/indeno[1,2,3-cd]pyrene and benzene/toluene ratios corroborate this idea. However, higher benzene/toluene ratios at one of the major access routes into the city suggest pollutant inputs from a nearby refinery. Literature data were reviewed in order to outline differences and similarities among sources and levels of aromatic pollutants in large urban agglomerations worldwide. Concentrations of benzo[a]pyrene and benzene, which are well-known carcinogenic chemicals, were relatively low in Rio de Janeiro. This fact was attributed to specific atmospheric conditions during the tropical summer and differences in vehicle fuel composition.
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Poluentes Atmosféricos/análise , Benzeno/análise , Hidrocarbonetos Policíclicos Aromáticos/análise , Tolueno/análise , Xilenos/análise , Benzo(a)pireno/análise , Brasil , Carcinógenos/análise , Cidades , Monitoramento Ambiental , IndústriasRESUMO
As varizes dos membros inferiores acometem inúmeros pacientes na fase produtiva da vida. Os sintomas mais comuns são queimação, a sensação de dor em peso e o edema.Com o objetivo de abordar uma população alvo em fase produtiva da vida com varizes primárias e sintomáticas em membros inferiores, foi realizado em nossa Instituição o tratamento cirúrgico dos pacientes em esquema de"mutirão".O objetivo deste estudo foi avaliar as características da população submetida a cirurgia de varizes "sob esquema de mutirão", o tipo de cirurgia realizada,o período de intemação e custos do tratamento em nossa Instituição.Foram avaliados 50 pacientes, sendo que os sintomas dor em peso,queimação e edema estiveram presentes em 90 por cento, 86 por cento e 94 por cento dos casos respectivamente.Encontramos 29 veias safenas magnas dilatadas e insuficientes em 16 pacientes.Em nossos resultados encontramos a safenectomia em 16 pacientes e a fleboextração bilateral em 34. A média de intemação foi de 1,38 dias e o custo médio cirurgia foi de 113,28 reais, sendo que o repasse do Ministério da Saúde para a Instituição foi de 135,00 reais por cirurgia.Concluimos que o objetivo foi alcançado, beneficiando a população sintomática em fase produtiva da vida, e os custos repassados para Instituição foram suficientes para cobrir os gastos com a internação hospitalar...