RESUMO
Weight gain is observed in breast cancer patients receiving chemotherapy and is a well-known complication. Several factors that contributing to weight gain have been identified. However, there is a lack of information about factors associated with weight changes following adjuvant chemotherapy. A retrospective cohort of 200 pre- and post-menopausal Mexican patients treated for breast cancer was made. Anthropometric variables were measured before/after treatment. Biomarkers, cellular differentiation and chemotherapy were similar between groups. Weight gain occurred in 85.6% of pre-menopausal and 72.6% of post-menopausal women (p = .03). At the end of chemotherapy, weight and body mass index (BMI) did not differ significantly between pre-menopausal (69.3 ± 12.6 kg; 26.6 ± 4.8 kg/m2 ) and post-menopausal women (69.5 ± 10.9 kg; 27.3 ± 4.4 kg/m2 ) (p = .91 and 0.34). Dexamethasone doses were higher in pre-menopausal (85.7 ± 39.1 g) than post-menopausal patients (79.2 ± 22.5 g; p = .13). Weight loss was observed in 9.2% of pre-menopausal and 20.2% of post-menopausal patients (p = .04). A multivariate analysis revealed that age (OR = 2.7; 95% CI = 1.26-5.79; p = .01), menopausal status (OR = 2.29; 95% CI = 1.09-4.80; p = .03), dexamethasone dosage (OR = 2.1; 95% CI = 1.04-4.23; p = .03) and daily caloric intake (OR = 2.3; 95% CI = 1.12-5.10; p = .02) were independent variables that inducted weight gain. Pre- and post-menopausal women gained weight, but more pre-menopausal patients showed gain. An effort should be made to administer lower steroid doses to reduce weight gain.
Assuntos
Antineoplásicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Quimioterapia Adjuvante , Aumento de Peso , Redução de Peso , Adulto , Fatores Etários , Idoso , Antineoplásicos Hormonais/administração & dosagem , Índice de Massa Corporal , Peso Corporal , Estudos de Coortes , Dexametasona/administração & dosagem , Relação Dose-Resposta a Droga , Ingestão de Energia , Feminino , Humanos , México , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Pós-Menopausa , Pré-Menopausa , Estudos RetrospectivosRESUMO
BACKGROUND:Cardiac biomarker release signifying myocardial injury post-transcatheter aortic valve replacement (TAVR) is common, yet its clinical impact within a large TAVR cohort receiving differing types of valve and procedural approaches is unknown.OBJECTIVES:This study sought to determine the incidence, clinical impact, and factors associated with cardiac biomarker elevation post TAVR.METHODS:This multicenter study included 1,131 consecutive patients undergoing TAVR with balloon-expandable (58%) or self-expandable (42%) valves. Transfemoral and transapical (TA) approaches were selected in 73.1% and 20.3% of patients, respectively. Creatine kinase-myocardial band (CK-MB) measurements were obtained at baseline and at several time points within the initial 72 h post TAVR. Echocardiography was performed at baseline and at 6- to 12-month follow-up.RESULTS:Overall, 66% of the TAVR population demonstrated some degree of myocardial injury as determined by a rise in CK-MB levels (peak value: 1.6-fold [interquartile range (IQR): 0.9 to 2.8-fold]). A TA approach and major procedural complications were independently associated with higher peak of CK-MB levels (p < 0.01 for all), which translated into impaired systolic left ventricular function at 6 to 12 months post TAVR (p < 0.01). A greater rise in CK-MB levels independently associated with an increased 30-day, late (median of 21 [IQR: 8 to 36] months) overall and cardiovascular mortality (p < 0.001 for all)...
Assuntos
Biomarcadores , Creatina Quinase , Estenose das Carótidas , Substituição da Valva Aórtica TranscateterRESUMO
College students are in a key life stage for the adoption of lifestyles that will be practiced in the family, society and work. During this period, students gain greater autonomy and take responsibility for their own care. University time becomes a critical step in the development of lifestyles. There is a high prevalence of risk factors for non-communicable diseases in university students such as pre-hypertension especially in men and hypercholesterolemia in women. Other risk factors include smoking, physical inactivity, overweight, obesity, low fruit and vegetable consumption, and high consumption of saturated fats. Some differences of cardiovascular risk factors have been found according to gender, year of career and faculty where students attend. It is recommended to consider these differences when we design and perform educational interventions to achieve greater assertiveness and effectiveness. This article reviews the evidence about cardiovascular risk factors in university students according to gender, year of career and faculty where students attend, following the model proposed by Cecchini et al and according to the Framingham study.
Los estudiantes universitarios se encuentran en una etapa del ciclo vital clave para la adopción de estilos de vida, que practicarán en el ámbito familiar, social y laboral. En este periodo los estudiantes adquieren mayor autonomía y asumen la responsabilidad de su autocuidado, por lo cual se convierte en una etapa crítica para el desarrollo de sus estilos de vida. Existe una alta prevalencia de factores de riesgo de enfermedades crónicas no transmisibles en los universitarios, entre los que destacan pre-hipertensión especialmente en hombres y la hipercolesterolemia en mujeres. También el tabaquismo, sedentarismo, sobrepeso, obesidad, bajo consumo de frutas y verduras, y alto consumo de grasas saturadas. Se encontraron diferencias en los factores de riesgo cardiovascular de acuerdo al género, curso y facultad de los estudiantes. Se recomienda consideran estas diferencias al diseñar y realizar intervenciones educativas para lograr una mayor asertividad y efectividad. El presente artículo revisa la evidencia sobre los factores de riesgo cardiovascular en estudiantes universitarios de acuerdo al género, curso y facultad, según el modelo propuesto por Cecchini y cols. y al estudio de Framingham.
Assuntos
Adulto Jovem , Estudantes , Doenças Cardiovasculares , Universidades , Comportamento Alimentar , Dieta Saudável , Fatores de RiscoRESUMO
Background: University students are especially vulnerable towards substance abuse Aim: To describe and compare drug consumption in students of a Chilean university who attended first and fourth year of studies, according to gender and faculty. Material and Methods: A representative, stratified and proportional sample of305 students was randomly chosen by faculty, career, grade and gender during2009. The consumption of alcohol, tobacco and illicit drugs was evaluated using an anonymous survey. Results: Students from health care faculties had the lower prevalence of consumption of tobacco, alcohol, tobacco-alcohol and marijuana, during the first and fourth year. Education area and social sciences faculties had the highest prevalence of consumption. Fourth year students had higher rates of consumption than their first year counterparts. Females had significantly lower rates of alcohol and marijuana consumption. Conclusions: Alcohol, tobacco and marijuana consumption was higher among students from education and social sciences faculties and those attending the fourth year of studies.
Assuntos
Feminino , Humanos , Masculino , Adulto Jovem , Consumo de Bebidas Alcoólicas/epidemiologia , Fumar Maconha/epidemiologia , Fumar/epidemiologia , Estudantes/estatística & dados numéricos , Chile/epidemiologia , Estudos Transversais , Prevalência , Ciências Sociais/estatística & dados numéricos , Estatísticas não Paramétricas , Fatores de Tempo , UniversidadesRESUMO
BACKGROUND: University students are especially vulnerable towards substance abuse AIM: To describe and compare drug consumption in students of a Chilean university who attended first and fourth year of studies, according to gender and faculty. MATERIAL AND METHODS: A representative, stratified and proportional sample of 305 students was randomly chosen by faculty, career, grade and gender during 2009. The consumption of alcohol, tobacco and illicit drugs was evaluated using an anonymous survey. RESULTS: Students from health care faculties had the lower prevalence of consumption of tobacco, alcohol, tobacco-alcohol and marijuana, during the first and fourth year. Education area and social sciences faculties had the highest prevalence of consumption. Fourth year students had higher rates of consumption than their first year counterparts. Females had significantly lower rates of alcohol and marijuana consumption. CONCLUSIONS: Alcohol, tobacco and marijuana consumption was higher among students from education and social sciences faculties and those attending the fourth year of studies.
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Fumar Maconha/epidemiologia , Fumar/epidemiologia , Estudantes/estatística & dados numéricos , Chile/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Ciências Sociais/estatística & dados numéricos , Estatísticas não Paramétricas , Fatores de Tempo , Universidades , Adulto JovemRESUMO
El propósito de este proyecto fue investigar la influencia de la cirugía ortognática en los signos y los síntomas presentes en los pacientes con desórdenes temporomandibulares (DTM). Se escogieron dieciséis pacientes con patrón esquelético clase iii que fueron examinados antes y después de cirugía ortognática. A ocho de los pacientes se les realizó osteotomía oblicua de rama (OOR) y a los ocho restantes se les practicó osteotomía sagital de rama (OSR). A dos pacientes de cada grupo se les realizó también osteotomía Le Fort i Los signos y síntomas relacionados con DTM fueron evaluados antes de cirugía y los cambios en estos fueron valorados al primero, tercero y sexto mes posquirúrgico. Como resultados, no se encontraron diferencias significativas en la frecuencia de ruidos articulares, o de dolor en la articulación temporomandibular (ATM) o dolor muscular, entre ambos grupos de pacientes. En las revisiones a los tres y seis meses después de la cirugía los pacientes mostraron mejoría de los signos y síntomas de los DTM. Todos los pacientes mostraron disminución de la movilidad mandibular. De seis pacientes que se quejaban de cefaleas en la evaluación prequirúrgica, cinco mejoraron significativamente después de la cirugía. Se concluyó que no hay diferencia significativa con respecto a la mejoría de los signos y los síntomas asociados a la DTM, entre la OOR y la OSR El número de casos incluidos en este estudio es reducido y por lo tanto los resultados no son concluyentes.
Assuntos
Osteotomia , Articulação TemporomandibularRESUMO
Las glándulas salivales son estructuras pares, simétricas y localizadas junto a la rama y el cuerpo de la mandíbula, involucran glándulas parótida (saliva serosa), submaxilar (predominantemente serosa) y sublingual (predominantemente mucosa). Además existen numerosas glándulas salivales menores en la superficie de la mucosa bucal, yugal, palatina y sublingual de la cavidad bucal (300-400 aproximadamente) que producen saliva mucosa. El objetivo de esta revisión bibliográfica es hacer una reseña sobre los diversos proceos infecciosos que afectan las glándulas salivales, los diferentes enfoques diagnósticos y pautas de tratamiento. Los trastornos infecciosos de las glándulas salivares entran en el área de responsabilidad de la odontología, todo facultativo debe estar familiarizado con estos tratornos, las técnicas de diagnóstico aplicables y estar en capacidad de referir aquellos casos que son competencia de los especialistas.
Assuntos
Humanos , Masculino , Feminino , Doenças das Glândulas Salivares/diagnóstico , Doenças das Glândulas Salivares/patologia , Glândulas Salivares/patologia , Actinomicose , Doença Aguda , Antibacterianos/uso terapêutico , Cálculos das Glândulas Salivares/diagnóstico , Cálculos das Glândulas Salivares/patologia , Doença Crônica , Colômbia , Doenças das Glândulas Salivares/epidemiologia , Doenças das Glândulas Salivares/etiologia , Doenças das Glândulas Salivares , Glândula Sublingual/patologia , Glândula Sublingual , Glândula Submandibular/patologia , Glândula Submandibular , Imageamento por Ressonância Magnética , Glândula Parótida , Parotidite , Saliva , Sarcoidose , Sialadenite , Tomografia Computadorizada por Raios X , TuberculoseRESUMO
El ameloblatoma es el tumor benigno más común, representa el 1 por ciento de todos los tumores odontogénicos y conmprende del 11 al 18 por ciento de las lesiones de los maxilares. El 80 por ciento de los casos se han descrito en la mandíbula en la zona del cuerpo y ángulo; afecta por igual a hombres y mujeres, con una mayor prevalencia entre la tercera y la cuarta década de vida. Este tumor se presenta con diferentes aspectos clínicos, radiográficos e histopatológicos y aunque es una patología benigna, es localmente invasora, se le atribuye una alta tasa de recidiva. El objetivo de este artículo es presentar la experiencia lograda con el diagnóstico y tratmaiento de 10 casos de ameloblastoma en pacientes entre los 12 y 73 años; el 80 por ciento de ellos localizados en la mandíbula, que producían diferentes manifestaciones clínicas tales como: asimetría facial, desplazamiento dental, resorción radicular, alteración de la oclusión, dolor, dificultad para la masticación y fractura patológica. Se realizó una clasificación radiográfica de acuerdo con su imagen en uniloculares o multiloculares. Histopatológicamente se agruparon según la variante observada, además, se describen diferentes alternativas de tratamientos y las complicaciones surgidas. Dos pacientes había sido intervenidos porque presentaron previamente quiste dentígero en la misma zona y otros dos casos consultaron por recidiva de amelobalstoma luego de cinco años de ser intervenidos en otras instituciones.
Assuntos
Humanos , Masculino , Adolescente , Adulto , Pessoa de Meia-Idade , Feminino , Ameloblastoma , Neoplasias Maxilomandibulares , Tumores Odontogênicos/classificação , Ameloblastoma , Cauterização , Colômbia , Crioterapia , Imageamento por Ressonância Magnética , Odontoma , Prognóstico , Radioterapia , Recidiva , Unidade Hospitalar de Odontologia/estatística & dados numéricos , Interpretação Estatística de Dados , Tomografia Computadorizada por Raios XRESUMO
We review the pathological specimens sent to the Pathology Department from January 1983 to June 1988 that belonged to 7567 patients. For this study we have selected specimens from 1139 patients (15.05% of the total), who were submitted to valvular replacement surgery. We analyzed 1037 "native" valves and 186 prosthesis. Rheumatic fever was confirmed in 68% of "native" valves. The remaining 32% includes a group in which this etiology was not confirmed by histology in spite of the clinical diagnosis. The leading cause of biological prosthesis replacement was dysfunction caused by calcification and fibrosis, and for mechanical prosthesis it was thrombosis. Included in this study are 747 patients who received 836 heterologous valves of bovine pericardium, fabricated at the "Instituto Nacional de Cardiología (INC)". The price of imported mechanical prosthesis is superior to the price of the prosthesis manufactured at INC. The difference varies between 1400% and 4000% depending on mechanical prosthesis type. The survival rate of the receiving patients of the INC implants was 82.2%, and the dysfunction rate of these prosthesis was 3.38% for the period studied, four and a half years.
Assuntos
Bioprótese , Doenças das Valvas Cardíacas/patologia , Próteses Valvulares Cardíacas , Adolescente , Adulto , Idoso , Criança , Feminino , Próteses Valvulares Cardíacas/mortalidade , Próteses Valvulares Cardíacas/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Falha de Prótese , Estudos RetrospectivosRESUMO
A case of small and large cells non Hodgkin lymphoma with an unusual involvement of the lung is presented. The tumor was located in the inferior lower lobe of the right lung and coincided with hemorrhagic pleural effusion. The cytopathological study of the fluid was negative for neoplastic cells, so were the aspiration biopsy of the lung and the pleural biopsy. The transmission and scanning electron microscopic study of the pleural fluid demonstrated lymphoid atypical cells. The patient was treated by resection of the lower right lobe and pleurectomy. The difficulties in the differential diagnosis of this type on non Hodgkin lymphoma are discussed. The importance of scanning and transmission electron microscopy is stressed when the light cytologic studies are negative in processes suggestive of being neoplasms. After one year of the lobectomy and treatment with vincristine-epirubicin-cyclophosphamide and methyl-prednisolone, the patient is in good condition without evidence of neoplastic activity.
Assuntos
Neoplasias Pulmonares/diagnóstico , Linfoma não Hodgkin/diagnóstico , Humanos , Neoplasias Pulmonares/patologia , Linfoma não Hodgkin/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
The presence of rigid coronary arterial segments was detected during a survey for coronary atherosclerosis in men who died of violent causes. These lesions which traditionally are considered of non-clinical significance, in the absence of stenosis are probably responsible of the clinical and electrocardiographical abnormalities as seen in patients with "normal" coronary arteries using coronary angiography, the best current procedure for the detection of isolated coronary atherosclerosis. We propose these lesions are to be considered as functional lesions and consequently that these lesions should be considered by both, the pathologist and the clinician. Our hypothesis is to be tested in the near future when new diagnostic advances with the possibility of detection of coronary pathology in vivo, appear. The prevalence of these abnormalities in different age-groups as well as the topography are presented. The concordance of these lesions with coronary stenosis is also presented.
Assuntos
Doença da Artéria Coronariana/patologia , Acidentes , Adolescente , Adulto , Autopsia , Constrição Patológica/patologia , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/prevenção & controle , Estudos Transversais , Humanos , Masculino , México , Pessoa de Meia-IdadeRESUMO
This report compares quantitative measures of atherosclerosis in aortas and coronaries from autopsies of deceased men from Mexico City collected during 1960 to 1964 and 1986 to 1987. The comparison of lesions in two different time periods provides an opportunity for determining whether the extent of atherosclerosis has changed over time in Mexico City. Three pathologists independently evaluated the extent of fatty streaks (FS), fibrous plaques (FP), calcified plaques (CA), and complicated lesions (CO) in 165 aortas and 120 sets of coronary arteries collected during 1986 to 1987 for comparison with similar gradings of 128 aortas and coronary arteries from the International Atherosclerosis Project in 1960 to 1964. Neither FS nor more advanced lesions differed significantly in either the descending thoracic or abdominal aorta between the two collection periods. In contrast, there were more extensive FP and raised atherosclerotic lesions (RL = FP + CA + CO) in the coronary artery segments evaluated in the younger age groups in 1986 to 1987 versus 1960 to 1964. Additional analyses, based on 75 pairs of aortas and 32 pairs of coronary arteries from age-matched cases, all regraded by the team of pathologists after blind coding, showed more FS in both aortic segments and more extensive involvement with RL in the three main branches of the coronary arteries in the more recent study. An overview of our findings suggests that atherosclerosis, particularly in the coronary arteries, is increasing in Mexico City. This hypothesis merits careful testing in parallel with consideration of possible changes in the risk factors that could be responsible for changes in extent of lesions.
Assuntos
Arteriosclerose/epidemiologia , Adolescente , Adulto , Fatores Etários , Aorta Abdominal/patologia , Aorta Torácica/patologia , Arteriosclerose/patologia , Vasos Coronários/patologia , Humanos , Masculino , México , Pessoa de Meia-Idade , Distribuição Aleatória , Estudos RetrospectivosRESUMO
The severity and prevalence of coronary and aortic atherosclerosis was studied in 174 subjects who died from violent causes in Mexico City. As in other geographic areas, fatty streaks were found early in life (12 years old). Fibrolipid plaques were present in the thoracic aorta at age 15 and at age 19 in the abdominal segment. Complicated lesions were detected in the aorta after age 25. Because of the obvious clinical significance we looked for severe aortic lesions in the abdominal bifurcation. The prevalence of severe lesions in the bifurcation was 0 between 15 to 24 years and raised to 23.3% in the 45-54 age group. A moderate correlation was found between the severity of coronary and aortic lesions. The discordance most often found was the presence of severe coronary lesions without severe aortic involvement.
Assuntos
Doenças da Aorta/epidemiologia , Arteriosclerose/epidemiologia , Doença da Artéria Coronariana/epidemiologia , Adolescente , Adulto , Fatores Etários , Aorta Abdominal/patologia , Aorta Torácica/patologia , Doenças da Aorta/patologia , Arteriosclerose/patologia , Criança , Doença da Artéria Coronariana/patologia , Feminino , Humanos , Masculino , México , Pessoa de Meia-IdadeRESUMO
Topographic and morphologic aspects of coronary atherosclerotic "protruding" lesions were investigated in 119 accidental deaths in males living in Mexico City. Morphology and topography varied according to the arterial trunk studied and age. Left anterior descending and circumflex lesions were almost always confined to the initial 5 cms and if a lesion was present after the 3rd cm there was always a proximal lesion. Right coronary lesions occasionally were found distally even in the absence of proximal lesions. Third decade lesions were usually not calcified. Stenosis if present was rarely multivascular. Some fourth decade lesions were calcified; plurivascular stenosis was present in some cases. Fifth decade lesions show sequential stenotic lesions in the same vessel; calcium and plurivascular stenosis were often observed. However the features observed in the 3rd decade could be observed in the older subjects. Reference is made to lesions which are found in both the left main trunk and the left anterior descending. Epidemiological and clinical applications related with preventive programs are mentioned.
Assuntos
Doença da Artéria Coronariana/patologia , Adolescente , Adulto , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/prevenção & controle , Humanos , Masculino , México , Pessoa de Meia-IdadeRESUMO
For clinicians, cardiac myxomas has been a diagnostic challenge. It may simulate a valvular disfunction. The present paper displays the morphologic aspects on 17 patients with the diagnosis of atrial myxoma. In 14 cases the tumor was located in the left atrium. In all the cases stellate shaped cells were seen within a myxoid matrix. The findings in this report support the idea that myxomas are tumors and not thrombi as it has been speculated in the literature. We also consider that the cell of origin of this neoplasm is a pluripotential cell which needs further studies.
Assuntos
Neoplasias Cardíacas/patologia , Mixoma/patologia , Átrios do Coração/patologia , Neoplasias Cardíacas/ultraestrutura , Humanos , Mixoma/ultraestruturaRESUMO
The prevalence of microscopic atheroma in the proximal left anterior descending coronary artery was studied in thirty young males aged 20 to 29 years, living in Mexico City, who died in urban accidents. All of them were either unemployed or labor workers with a socioeconomical status considered to be representative of the majority of young males living in Mexico City. It was found that coronary atheroma was present in 11 of them (33%) with variable degrees of luminal obstruction. In two of them the luminal obstruction was greater than 75%. The prevalence found in this group was significantly different to that found in younger and older males who also died in accidents. Since the prevalence of coronary atheroma was not related to ventricular hypertrophy, valvular or congenital heart disease our findings indicate that in Mexico City as in other geographical regions, coronary atherosclerosis is not an unusual finding in males in the third decade of life, with a low socioeconomical status.