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Introduction: Breast cancer (BC) is the most common cancer among women globally. Vitamin D has been considered a protective factor; however, its relationship with any aspect of the disease remains controversial. Methods: A cross-sectional, single-center clinical study was conducted between 2015 and 2018, including 141 women diagnosed with BC and 239 women in the control group, with mean ages of 43.1 and 41.7 years, respectively (p = 0.103). Serum levels of vitamin D and lipid profile were measured. Clinical and nutritional data were obtained through interviews and medical records. Results: The vitamin D dosage presented an average value of 25.5 ng/mL and 31.0 ng/mL in the case and control groups, respectively (p < 0.001). The vitamin D cut-off point for discriminating the presence of BC was 27.45 ng/mL. Additionally, low-density lipoprotein cholesterol levels were higher in the case group (121.4 mg/dL) compared to the control group (110.7 mg/dL) (p = 0.002), whereas high-density lipoprotein cholesterol levels were lower in the case group (47.6 mg/dL) compared to the control group (53.3 mg/dL) (p = 0.001). Alcohol consumption was significantly higher in the case group than in the control group (2.7 vs. 5.3 doses/day; p < 0.001). Conclusion: The results indicate a significant association between lower vitamin D levels and BC, persisting after multivariate analysis (p < 0.001). These findings could inform prevention strategies, highlighting the importance of maintaining adequate vitamin D levels and potentially identifying a risk group.
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Objective: Evaluate the value of imprint cytology in the intraoperative analysis of sentinel lymph node (SLN) in patients with breast cancer. Methods: An agreement study for the evaluation of the imprint cytology technique as a diagnostic test for intraoperative SLN among patients diagnosed with breast cancer from January 2007 to January 2017. Results: We studied 210 cases of breast cancer patients submitted to intraoperative sentinel node imprint cytology, aged between 24 and 86 years (mean age 59 years and median age 60 years). The sensitivity of the intraoperative study was 58.3% (95%CI 46.169.8%) and the specificity was 97.8% (95%CI 93.899.5). The positive predictive value (PPV) was 93.3% (95%CI 81.798.6) and the negative predictive value (NPV) was 81.8% (95%CI 75.187.4). From the analyzed variables, the presence of macrometastasis was the only one that significantly increased the sensitivity of the imprint to 73.2% (95%CI 59.784.2), while micrometastasis presented a sensitivity of only 6.3% (95%CI 0.230.2). Conclusion: The use of imprint cytology in the intraoperative SLN study showed good accuracy in predicting axillary status. However, the surgeon and pathologist are fully aware of the set of clinical and histological variables that can influence the sensitivity of the method.
Objetivo: Avaliar o valor do imprint citológico na análise intraoperatória do linfonodo sentinela (LS) em pacientes com câncer de mama. Métodos: Estudo de concordância para avaliação da técnica do imprint citológico como teste diagnóstico do LS no intraoperatório, entre pacientes com diagnóstico de câncer de mama, no período de janeiro de 2007 a janeiro de 2017. Resultados: Foram estudados 210 casos de pacientes com câncer de mama submetidas à citologia de impressão (IC) do linfonodo sentinela no intraoperatório, com idade entre 24 e 86 anos (média de 59 anos e mediana de 60 anos). A sensibilidade do estudo intraoperatório foi de 58,3% (IC95% 46,169,8) e a especificidade de 97,8% (IC95% 93,899,5). O valor preditivo positivo (VPP) foi de 93,3% (IC95% 81,798,6) e o valor preditivo negativo (VPN) de 81,8% (IC95% 75,187,4%). Das variáveis analisadas, a presença de macrometástase foi a única que aumentou significativamente a sensibilidade do imprint para 73,2% (IC95%, 59,784,2%), enquanto na micrometástase apresentou sensibilidade de apenas 6,3% (IC95% 0,230,2). Conclusão: A utilização do imprint citológico no estudo intraoperatório do LS apresentou boa acurácia na previsão do status axilar. Entretanto, é importante o pleno conhecimento, pelo cirurgião e patologista, do conjunto de variáveis clínicas e histológicas que podem influenciar a sensibilidade do método
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INTRODUCTION: The aim of this study was to investigate the incidence of adverse effects and protective effects from influenza vaccine among elderly individuals who were vaccinated through the public healthcare system in the municipality of Tubarão, State of Santa Catarina. METHODS: A prospective cohort study was conducted between May and September 2008. A group of 341 patients was recruited, among whom 289 had been vaccinated through the public system (VSUS) and 52 had not been vaccinated (NV). The incidence of protective effects was observed by comparing the VSUS and NV groups. RESULTS: It was observed that 22.5% of the vaccinated subjects exhibited at least one adverse effect. Comparing the VSUS and NV groups in relation to the incidence of flu symptoms presented during the winter, at least one symptom was observed in 47% and 28.8% (RR = 1.11; 1.02-1.22; p = 0.0156), respectively. CONCLUSIONS: These findings demonstrate that the incidence of adverse effects was low. The high incidence of flu symptoms in the VSUS group, in comparison with NV, may be related to the profile of subjects who are in the habit of getting vaccinated against influenza.
Assuntos
Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Estudos de Coortes , Feminino , Humanos , Incidência , Vacinas contra Influenza/efeitos adversos , Influenza Humana/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Setor PúblicoRESUMO
INTRODUÇÃO: O presente estudo buscou identificar os efeitos adversos e o efeito protetor da vacina contra influenza, em idosos acima de 60 anos, aplicada pela rede pública no município de Tubarão, Santa Catarina. MÉTODOS: Foi realizada uma coorte prospectiva de pacientes durante o período de maio a setembro de 2008. Foram recrutados 341 idosos, sendo 289 vacinados na rede pública (VSUS) e 52 não vacinados (NV). A incidência do efeito protetor foi verificada através da comparação dos grupos VSUS com os NV. RESULTADOS: Um percentual de 22,5 por cento de pacientes apresentou pelo menos um efeito adverso. Comparando o grupo VSUS e NV quanto à incidência de sintomas gripais durante o inverno, a presença de pelo menos um sintoma foi verificada em 47 por cento e 28,8 por cento (RR = 1,11; 1,02-1,22; p = 0,0156), respectivamente. CONCLUSÕES: Os resultados apontam uma baixa incidência de efeitos adversos. A maior incidência de sintomas gripais no grupo VSUS comparado ao NV pode estar relacionado às características da população que costuma fazer a vacina contra influenza.
INTRODUCTION: The aim of this study was to investigate the incidence of adverse effects and protective effects from influenza vaccine among elderly individuals who were vaccinated through the public healthcare system in the municipality of Tubarão, State of Santa Catarina. METHODS: A prospective cohort study was conducted between May and September 2008. A group of 341 patients was recruited, among whom 289 had been vaccinated through the public system (VSUS) and 52 had not been vaccinated (NV). The incidence of protective effects was observed by comparing the VSUS and NV groups. RESULTS: It was observed that 22.5 percent of the vaccinated subjects exhibited at least one adverse effect. Comparing the VSUS and NV groups in relation to the incidence of flu symptoms presented during the winter, at least one symptom was observed in 47 percent and 28.8 percent (RR = 1.11; 1.02-1.22; p = 0.0156), respectively. CONCLUSIONS: These findings demonstrate that the incidence of adverse effects was low. The high incidence of flu symptoms in the VSUS group, in comparison with NV, may be related to the profile of subjects who are in the habit of getting vaccinated against influenza.