Navegando por Palavras-chave "survival"

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    The addition of ifosfamide/etoposide to cisplatin/teniposide improves the survival of children with retinoblastoma and orbital involvement
    (Lippincott Williams & Wilkins, 2007-10-01) Antoneli, Celia Beatriz Gianotti; Ribeiro, Karina Braga; Rodriguez-Galindo, Carlos; Soares, Fernando Augusto; Arias, Victor Eduardo Arrúa; Novaes, Paulo Eduardo Ribeiro dos Santos; Chojniak, Martha Maria Motono [UNIFESP]; Malogolowkin, Márcio; Universidade Federal de São Paulo (UNIFESP); Hosp Canc AC Camargo; St Jude Childrens Hosp; Childrens Hosp Los Angeles
    This study aimed to determine the impact of the addition of ifosfamide/etoposide to a regimen containing cisplatin/temposide on the survival of patients with retinoblastoma with orbital involvement. Thirty patients were treated at the A. C. Camargo Hospital, Brazil, from 1986 to 2002. From 1986 to April 1992 (period 1, n = 12), treatment consisted of 3 cycles of induction chemotherapy with cisplatin and teniposide, followed by maintenance with same drugs alternating with cyclophosphamide. vincristine, and doxorubicin every 21 days for 60 weeks. Since April 1992 (period 11, n = 18), the treatment consisted of 3 cycles of ifamide and etoposide followed by maintenance with same drugs, alternating with cisplatin and teniposide every 21 days for 36 weeks. In both periods, children were submitted to exenteration with eyelid preservation and orbital radiation therapy with 45cGy, and also received intrathecal therapy with methotrexate plus dexamethasone and cytarabine. Kaplan-Meier method was used for survival analysis. The median age was 31 months. Most patients (86.7%) presented unilateral tumors. The 3-year overall survival was 34.4% and 72.2%, respectively, for patients treated during periods I and 11 (P = 0.061). The addition of ifosfamide/etoposide to chemotherapy with cisplatin/teniposide improves survival in these patients, but further studies are still necessary.
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    Assessment of stage T1 (TNM 1997) for renal cell carcinoma: is recommended the subdivision in T1a and T1b?
    (Sociedade Brasileira de Urologia, 2003-04-01) Dall Oglio, Marcos Francisco [UNIFESP]; Srougi, Miguel [UNIFESP]; Mangini, Marcelo; Ribeiro, Eduardo [UNIFESP]; Ferraz, Márcio [UNIFESP]; Sañudo, Adriana [UNIFESP]; Leite, Kátia Ramos Moreira [UNIFESP]; Nesrallah, Luciano [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: Classification TNM 1997 defines renal cell carcinoma smaller than 7 cm and confined to the kidney as stage T1. Our goal is to discuss if tumors smaller than 4 cm have the same behavior characteristics then tumors between 4 and 7 cm, to compose the same stage of the disease. MATERIALS AND METHODS: Retrospective assessment of 138 patients in stage T1 (TNM - 97), divided into 2 groups; group-1: composed of 65 patients (47%) with tumors < 4 cm, and group-2: composed of 73 patients (53%) with tumors between 4 and 7 cm. The following prognostic factors were assessed in the recurrence of the disease and survival of patients: nuclear degree, microvascular invasion, sarcomatous degeneration, and involved lymph nodes. Statistical evaluation has been accomplished through the log rank test, chi-square test, and Fishers exact text. RESULTS: Average tumor size was 2.5 cm for group-1, and 5.3 cm for group-2. In group-2, there was the predominance of worse prognostic factors, with high-grade tumors (p = 0.01) and presence of microvascular invasion (p = 0.001). Sarcomatous tumors and involvement of lymph nodes did only happen in group-2. Disease-free survival for group-1, analyzed in the median period of 36 months, was 100%, and for group 2, in the median period of 31 months, was 81% (p = 0.008). CONCLUSION: The results obtained allow the conclusion that the present stage T1 for renal cell carcinoma gathers tumors of different evolution, being therefore recommendable the stratification in T1a for tumors smaller than 4 cm, and T1b for tumors between 4 and 7 cm.
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    Association Between Nutrition Status and Survival in Elderly Patients With Colorectal Cancer
    (Sage Publications Inc, 2017) Barao, Katia [UNIFESP]; Vicente Cavagnari, Mariana Abe [UNIFESP]; Fucuta, Patricia Silva; Forones, Nora Manoukian [UNIFESP]
    Background: Aging patients with cancer have a higher risk of mortality and treatment-associated morbidity than younger patients. Nutrition status may play an important role in cancer mortality. We aimed to evaluate the survival time of elderly patients with colorectal cancer and its association with body mass index (BMI), the patient-generated subjective global assessment (PG-SGA), and phase angle (PA). Materials and Methods: BMI, PG-SGA, and PA were determined for all patients (n = 250) at first assessment. Results: Seventy-one (28.4%) patients were in active oncologic treatment (group 1) and 179 (71.6%) were in remission (group 2). At the time of the analysis, 73 (29.2%) patients had died and 177 (70.8%) were censored. The mean (standard deviation) age was 70.9 (7.49) years
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    Avaliação de fatores prognósticos da insuficiência cardíaca em pacientes encaminhados para avaliação de transplante cardíaco
    (Sociedade Brasileira de Cardiologia - SBC, 2007-06-01) Areosa, Cleópatra Medina Noronha [UNIFESP]; Almeida, Dirceu Rodrigues de [UNIFESP]; Carvalho, Antonio Carlos [UNIFESP]; De Paola, Angelo Amato Vincenzo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: To evaluate the survival of patients with heart failure submitted to cardiac transplantation screening as well as identify poor prognostic factors using a risk score to identify patients with higher death risk. METHODS: 330 male and female patients aged 12 to 74 years old, referred for heart transplantation from January 1986 to November 2001 were evaluated. Clinical, laboratory, electrocardiographic, Holter monitoring, echocardiographic and radionuclide ventriculography data were analyzed. RESULTS: The median follow up period was 5 years; patients' survival rate was 84.5% in the first year, 74.3% in the second year, 68.9% in the third year and 60.5% in the fifth year. The prognostic variables selected through the univariate analysis were: age, Chagas' disease etiology for cardiomyopathy, NYHA functional classes III and IV, orthopnea, systolic blood pressure, mean blood pressure, pulse pressure, plasma urea, sodium, glucose, albumin, bilirubin, hemoglobin, and mean heart rate. The prognostic variables at the multivariate analysis were: ejection fraction, blood urea, and hemoglobin. The risk score: RR=exp[(-0.0942401 x ejection fraction) + (0.0105207 x blood urea) + (-0.2974991 x hemoglobin) + (-0.0132898 x age) + (-0.0099115 x blood glucose)] discriminated the population with a higher death risk. CONCLUSION: Patients' survival was satisfactory despite heart failure severity, suggesting they can be maintained on optimized clinical treatment until persistent clinical deterioration takes place. Ejection fraction, ventricular diameters, and clinical functional class alone should not be used as an indication for heart transplantation. The risk score could help discriminate the population with the poorest prognosis.
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    Characterization of cardiac arrest in the emergency department of a Brazilian University Reference Hospital: A prospective study
    (Medknow Publications & Media Pvt Ltd, 2016) Vancini-Campanharo, Cassia Regina [UNIFESP]; Vancini, Rodrigo Luiz; Barbosa de Lira, Claudio Andre; Andrade, Marlia dos Santos [UNIFESP]; Lopes, Maria Carolina Barbosa Teixeira [UNIFESP]; Okuno, Meiry Fernanda Pinto [UNIFESP]; Batista, Ruth Ester Assayag [UNIFESP]; Atallah, Álvaro Nagib [UNIFESP]; Gois, Aecio Flavio Teixeira de [UNIFESP]
    Background & objectives: Sudden cardiac arrest (CA) represents one of the greatest challenges for medicine due to the vast number of cases and its social and economic impact. Despite advances in cardiopulmonary resuscitation (CPR) techniques, mortality rates have not significantly decreased over decades. This study was undertaken to characterize patients that have suffered CA and to identify factors related to mortality. Methods: This prospective study was conducted at Emergency Department of Sao Paulo Hospital, Brazil. Two hundred and eighty five patients were followed for one year after treatment for CA. The mean age was 66.3 +/- 17.2 yr, and they were predominantly male (55.8%) and Caucasian (71.9%). Mortality rate and factors associated with mortality were the primary and secondary outcome measures. Data were collected using an in-hospital Utstein-style report. A logistic regression analysis was used to determine which variables were related to mortality. Results: Regarding the characteristics of CPR, 76.5 per cent occurred in hospital, respiratory failure was the most common presumed immediate cause of CA (30.8%) and pulseless electrical activity was the most frequent initial rhythm (58.7%). All attempts at CPR utilized chest compressions and ventilation and the most utilized interventions were epinephrine (97.2%) and intubation (68.5%). Of all patients treated, 95.4 per cent died. Patients with pulseless electrical activity had a higher risk of death than those patients with ventricular fibrillation. Interpretation & conclusions: The findings of the study highlighted that the mortality rate among CA patients was high. The variable that best explained mortality was the initial CA rhythm.
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    CPAP and survival in moderate-to-severe obstructive sleep apnoea syndrome and hypoxaemic COPD
    (European Respiratory Soc Journals Ltd, 2010-01-01) Machado, M-C. L. [UNIFESP]; Vollmer, W. M.; Togeiro, Sonia Maria [UNIFESP]; Bilderback, A. L.; Oliveira, M-V. C. [UNIFESP]; Leitão Filho, Fernando Sergio; Queiroga, F. [UNIFESP]; Lorenzi-Filho, G.; Krishinan, J. A.; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Kaiser Permanente Ctr Hlth Res; Johns Hopkins Univ; Univ Chicago
    Obstructive sleep apnoea syndrome (OSAS) often coexists in patients with chronic obstructive pulmonary disease (COPD). the present prospective cohort study tested the effect of OSAS treatment with continuous positive airway pressure (CPAP) on the survival of hypoxaemic COPD patients. It was hypothesised that CPAP treatment would be associated with higher survival in patients with moderate-to-severe OSAS and hypoxaemic COPD receiving long-term oxygen therapy (LTOT).Prospective study participants attended two outpatient advanced lung disease LTOT clinics in São Paulo, Brazil, between January 1996 and July 2006. of 603 hypoxaemic COPD patients receiving LTOT, 95 were diagnosed with moderate-to-severe OSAS. of this OSAS group, 61 (64%) patients accepted and were adherent to CPAP treatment, and 34 did not accept or were not adherent and were considered not treated.The 5-yr survival estimate was 71% (95% confidence interval 53-83%) and 26% (12-43%) in the CPAP-treated and nontreated groups, respectively (p<0.01). After adjusting for several confounders, patients treated with CPAP showed a significantly lower risk of death (hazard ratio of death versus nontreated 0.19 (0.08-0.48)).The present study found that CPAP treatment was associated with higher survival in patients with moderate-to-severe OSAS and hypoxaemic COPD receiving LTOT.
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    Digitoxin Prolongs Survival of Female Rats With Heart Failure Due to Large Myocardial Infarction
    (Churchill Livingstone Inc Medical Publishers, 2009-11-01) Helber, Izo [UNIFESP]; Dos Santos, Alexandra A. [UNIFESP]; Antonio, Ednei L. [UNIFESP]; Flumignan, Ronald L. G. [UNIFESP]; Bocalini, Danilo S. [UNIFESP]; Piccolo, Camila [UNIFESP]; Gheorghiade, Mihai; Tucci, Paulo J. F. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Northwestern Univ
    Background: We analyzed whether digitoxin affects the survival of rats with congestive heart failure.Methods and Results: the influence of digitoxin (0.1 mg. 100 g.day, orally) on the survival of infarcted female rats (n = 170) randomized as Control Infarcted (CI, n = 85) or Digitoxin (D, n = 85) was evaluated for 280 days. Mean Survival was 235 +/- 7 days for CI and 255 +/- 5 days for D (log-rank test: P = .0602). Digitoxin did not affect survival in rats with congestive heart failure from myocardial infarction <40% of the left ventricle, but did prolong survival in rats with infarction >= 40%. the log-rank test defined higher mortality (P = .0161) in CI > 40% (56%) than in D > 40% (34%), with a hazard ratio of 2.03. Pulmonary water content and papillary muscle mechanics were analyzed in CI (n = 7) and D (n = 14) survivors. Significant differences were observed regarding pulmonary water content (CI: 82 +/- 0.3; D: 80 +/- 0.3%; P = .0014), developed tension (CI: 2.7 +/- 0.3; D: 3.8 +/- 0.3 g/mm(2); P = .0286) and +dT/dt (CI: 24 +/- 3; D: 39 4 mg mm(2). s; P = .0109).Conclusion: in conclusion, long-term digitoxin administration reduced cardiac impairment after myocardium infarction, attenuated myocardial dysfunction, reduced pulmonary congestion, and provided the first evidence regarding the efficiency of digitoxin in prolonging survival in experimental cardiac failure. (I Cardiac Fail 2009;15.-798-804)
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    Epidemiological and clinical factors impact on the benefit of riluzole in the survival rates of patients with ALS
    (Assoc Arquivos Neuro- Psiquiatria, 2017) Favero, Francis Meire [UNIFESP]; Voos, Mariana Callil; de Castro, Isac; Caromano, Fatima Aparecida; Bulle Oliveira, Acary Souza [UNIFESP]
    Objective: To investigate the impact of epidemiological and clinical factors on the benefit of riluzole in patients with amyotrophic lateral sclerosis (ALS). Methods: The survival rate of 578 patients with ALS (1999-2011) was analyzed by descriptive statistics and Kaplan-Meier curves. Considering the median of the sample survival time (19 months), patients were divided in two groups: below (B19) and above the median (A19). Kaplan-Meier curves compared the survival rates of patients treated with riluzole and with patients who did not take the medication. Results: Riluzole increased the survival rates of patients with lower limb onset who were diagnosed after the first appointment in B19. Patients with bulbar onset and diagnosed on the first, or after the first appointment showed higher survival rates in A19. Males lived longer than females in both groups. Conclusion: Epidemiological and clinical factors influenced the benefit of riluzole in the survival rates of patients with ALS.
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    Estudo de qualidade de vida e depressão dos receptores de transplante renal, relacionado com doadores com critérios expandido de doação
    (Universidade Federal de São Paulo (UNIFESP), 2016-07-26) Monteiro, Patricia Amaral [UNIFESP]; Silva Filho, Alvaro Pacheco e [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: The quality of life has been the focus of interest of researchers since it can be very revealing about the clinical situation that patients under replacement therapy, as kidney transplantation, are passing through. To measure the quality of life and depression in kidney transplant patients with expanded criteria donors, we use the WHOQOL-Abbreviated instrument, since it evaluates the patient in their physical, psychological, social relationships and environmental context, and the CES-D, which assesses the degree of depression. These instruments were applied to assess if there is some degree of depression and assess what level of quality of life in renal transplant patients associated with expanded criteria donors. Method: This study is cross-cohort work in which the perception of quality of life and depression of patients were evaluated in a single interview through questionnaires. Data were presented as mean ± standard deviation with minimum and maximum value of each variable and presented in tables. Control group was not used because the data were only descriptive, not having the object of comparison. Results: 36 patients receiving a kidney graft from donor with expanded criteria were included. Depression presents a slight increase trend among the female group. The quality of life showed improvement with personal patient satisfaction with their own health and showed a perception of negative aspects such as pain, discomfort, negative feelings, and dependence on medication. Conclusion: Although, it was detected depression and alteration in quality of life, it was possible to identify in what extent factors related to expanded criteria donors might have interfered with the results, demonstrating the need for more studies on this group of donor not only in Brazil, but in a more global context.
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    Fatores prognósticos no tratamento do carcinoma epidermóide da laringe: cirurgia conservadora x radical
    (ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2007-12-01) Vidal, Maria Da Graça Caminha [UNIFESP]; Cervantes, Onivaldo [UNIFESP]; Abrahão, Márcio [UNIFESP]; Hojaij, Flávio Carneiro [UNIFESP]; Amar, Ali [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Santa Maria Hospital SCCP; Universidade de São Paulo (USP); Hospital Heliópolis
    The present study aimed at assessing the other sites as the carcinoma spreads, as well as therapeutic results, in larynx preservation and patient survival. STUDY TYPE: It is a Longitudinal Historical Cohort Study, a retrospective clinical study. MATERIALS AND METHODS: A hundred and sixty (160) patients treated at Escola Paulista de Medicina ( Paulista Medical School) - São Paulo Hospital, from January 1988 to December 2004 were examined as for the spreading of their larynx carcinoma. Those patients whose evaluations were at least two years old after treatment were the only ones accepted. The parametric tests used were: Test X2, Fisher s test, and Kaplan-Meier s curve. RESULTS: The posterior commissure and the infraglottis were significant in terms of the laryngectomy: glottal tumors AC: (p=0.03) AP: (p=0.0001); AC: (p=0.0007) AP: (p<0.0001), respectively. The infraglottis was significant in G+SG tumors in AP: (p=0.04) and in death rate AP: (p=0.03). CONCLUSION: total laryngectomy is the treatment of choice in the presence of total involvement of the posterior commissure and the infraglottis. The latter may compromise survival, according to local invasion, even in the presence of free surgical margins.
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    GerbB-2 expression is a better predictor for survival than galectin-3 or p53 in early-stage breast cancer
    (Professor D A Spandidos, 2007-07-01) Logullo, Angela Flavia [UNIFESP]; Lopes, Andréa Braga de Godoy; Nonogaki, Suely; Soares, Fernando Augusto; Mourão Netto, Mario; Nishimoto, Inês Nobuko; Brentani, Maria Mitzi [UNIFESP]; Universidade de São Paulo (USP); Hosp Canc; Inst Adolfo Lutz Registro; Universidade Federal de São Paulo (UNIFESP)
    The definition of high risk patients with early stage breast cancer is still controversial. We evaluated the ability of galectin-3, c-erbB-2 and p53 immunohistochemical expression to predict recurrence and survival in a homogeneous set of 92 patients with T1N0M0 ductal carcinoma with a long-term follow-up. In normal breast tissue, the epithelial and fibroblast components were positive for galectin-3 mostly showing nuclear and cytoplasmic reactivity. At the tumor epithelial component, galectin-3 expression was found in 46.7% of the samples with a predominant cytoplasmic staining. Similar results were presented by concurrent in situ lesions. Tumor stromal fibroblasts maintained positivity in 70 out of 92 cases (76%). We found expression of p53 in only 16 cases (17.4%), and c-erbB-2 in 17 (18.48%). A marginal association was found between co-expression of p53 and galectin-3 (p=0.055) and a significant correlation between p53 accumulation and c-erbB-2 expression (p=0.009). There was no significant association between (galectin-3 protein expression with disease-free survival or overall survival. C-erbB2 and p53 expression correlated with recurrence (p=0.002, p=0.02; respectively). Diminished overall survival at 10 years was associated with c-erbB-2 (p=0.010), but marginally with p53 expression (p=0.076). Epithelial galectin-3 expression cannot be considered a prognostic factor for patients with T1N0M0 breast cancer, p53 seems to be of minor relevance and c-erbB-2 expression was the best discriminator and may be a marker for aggressive clinical behavior in patients with early stage breast cancer.
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    Improving survival among Brazilian children with perinatally-acquired AIDS
    (Brazilian Society of Infectious Diseases, 2004-12-01) Matida, Luiza Harunari [UNIFESP]; Marcopito, Luiz Francisco [UNIFESP]; Succi, Regina Célia de Menezes [UNIFESP]; Marques, Heloisa Helena de Souza; Della Negra, Marinella; Grangeiro, Alexandre; Hearst, Norman; São Paulo State STD/AIDS Program; Universidade Federal de São Paulo (UNIFESP); University of São Paulo; Infectious Disease Institute; National STD/AIDS Program; University of California
    Brazil was the first developing country to provide free, universal access to antiretroviral treatment for AIDS patients. The Brazilian experience thus provides the first evidence regarding the impact of such treatment on the survival of perinatally acquired AIDS cases in the developing world. MATERIAL AND METHODS: This retrospective cohort study used medical record reviews to examine characteristics and trends in the survival of a representative sample of 914 perinatally acquired AIDS cases in 10 Brazilian cities diagnosed between 1983 and 1998. RESULTS: Survival time increased steadily and substantially. Whereas half of the children died within 20 months of diagnosis at the beginning of the epidemic, 75% of children diagnosed in 1997 and 1998 were still alive after four years of follow-up. CONCLUSIONS: Advances in management and treatment have made a great difference in the survival of Brazilian children with AIDS. These results argue strongly for making such treatment available to children in the entire developing world.
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    Initial care and outcome of glioblastoma multiforme patients in 2 diverse health care scenarios in Brazil: does public versus private health care matter?
    (Oxford Univ Press Inc, 2014-07-01) Maia Loureiro, Luiz Victor; Pontes, Luciola de Barros; Callegaro-Filho, Donato; Koch, Ludmila de Oliveira; Weltman, Eduardo; Victor, Elivane da Silva; Santos, Adrialdo Jose [UNIFESP]; Rodrigues Borges, Lia Raquel [UNIFESP]; Segreto, Roberto Araujo [UNIFESP]; Fleury Malheiros, Suzana Maria [UNIFESP]; Hosp Israelita Albert Einstein; Universidade Federal de São Paulo (UNIFESP)
    The aim of this study was to describe the epidemiological and survival features of patients with glioblastoma multiforme treated in 2 health care scenarios-public and private-in Brazil.We retrospectively analyzed clinical, treatment, and outcome characteristics of glioblastoma multiforme patients from 2003 to 2011 at 2 institutions.The median age of the 171 patients (117 public and 54 private) was 59.3 years (range, 18-84). the median survival for patients treated in private institutions was 17.4 months (95% confidence interval, 11.1-23.7) compared with 7.1 months (95% confidence interval, 3.8-10.4) for patients treated in public institutions (P < .001). the time from the first symptom to surgery was longer in the public setting (median of 64 days for the public hospital and 31 days for the private institution; P = .003). the patients at the private hospital received radiotherapy concurrent with chemotherapy in 59.3% of cases; at the public hospital, only 21.4% (P < .001). Despite these differences, the institution of treatment was not found to be an independent predictor of outcome (hazard ratio, 1.675; 95% confidence interval, 0.951-2.949; P = .074). the Karnofsky performance status and any additional treatment after surgery were predictors of survival. A hazard ratio of 0.010 (95% confidence interval, 0.003-0.033; P < .001) was observed for gross total tumor resection followed by radiotherapy concurrent with chemotherapy.Despite obvious disparities between the hospitals, the medical assistance scenario was not an independent predictor of survival. However, survival was directly influenced by additional treatment after surgery. Therefore, increasing access to resources in developing countries like Brazil is critical.
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    Inquérito Brasileiro de Diálise Crônica 2013 - Análise das tendências entre 2011 e 2013
    (Sociedade Brasileira de Nefrologia, 2014-12-01) Sesso, Ricardo de Castro Cintra [UNIFESP]; Lopes, Antonio Alberto; Thomé, Fernando Saldanha; Lugon, Jocemir Ronaldo; Santos, Daniel Rinaldi dos; Universidade Federal de São Paulo (UNIFESP); Universidade Federal da Bahia; Universidade Federal do Rio Grande do Sul; Universidade Federal Fluminense; Faculdade de Medicina do ABC
    Introduction: National chronic dialysis data have had impact in the treatment planning. Objective: To report data of the annual survey of the Brazilian Society of Nephrology about chronic kidney disease patients on dialysis in July 2013 and compare with 2011-12. Methods: A survey based on data of dialysis units from the whole country. The data collection was performed by using a questionnaire filled out on-line by the dialysis units. Results: Three hundred thirty four (51%) of the dialysis units in the country answered the questionnaire. In July 2013, the total estimated number of patients on dialysis was 100,397. The estimated prevalence and incidence rates of chronic maintenance dialysis were 449 (range: 284 in the North region and 622 in the South) and 170 patients per million population, respectively. The estimated number of new patients starting dialysis in 2013 was 34,161. The annual gross mortality rate was 17.9%. For prevalent patients, 31.4% were aged 65 years or older, 90.8% were on hemodialysis and 9.2% on peritoneal dialysis, 31,351 (31.2%) were on a waiting list of renal transplant, 30% were diabetics, 17% had PTH levels > 600 pg/ml and 23% hemoglobin < 10 g/ dl. A venous catheter was the vascular access for 15.4% of the hemodialysis patients. Conclusion: The absolute number of patients on dialysis has increased 3% per year. The prevalence and incidence rates of patients on dialysis leveled off, while the mortality rate tended to decrease compared with 2012. There was a trend towards a better control of the anemia and PTH levels.
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    Low mRNA Expression of the Apoptosis-Related Genes CASP3, CASP8, and FAS Is Associated With Low Induction Treatment Response in Childhood Acute Lymphoblastic Leukemia (ALL)
    (Wiley-Blackwell, 2010-07-15) Mata, Juliana F.; Silveira, Vanessa S.; Mateo, Elvis C.; Cortez, Maria A. A.; Queiroz, Rosane G. P.; Yunes, Jose Andres; Lee, Maria Lucia M. [UNIFESP]; Toledo, Silvia Regina Caminada de [UNIFESP]; Petrilli, Antonio Sergio [UNIFESP]; Brandalise, Silvia R.; Tone, Luiz G.; Scrideli, Carlos A.; Universidade de São Paulo (USP); Pio XII Fdn Canc Hosp Barretos; Ctr Infantil Boldrini; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Campinas (UNICAMP)
    Background. Defects in apoptosis signaling have been considered to be responsible for treatment failure in many types of cancer, although with controversial results. the objective of the present study was to assess the expression profile of key apoptosis-related genes in terms of clinical and biological variables and of the survival of children with acute lymphoblastic leukemia (ALL). Procedure. the levels of mRNA expression of the apoptosis-related genes CASP3, CASP8, CASP9, FAS, and BCL2 were analyzed by quantitative real-time PCR in consecutive samples from 139 consecutive children with ALL at diagnosis treated by the Brazilian protocol (GBTLI-ALL 99). Gene expression levels and clinical and biological features were compared by the Mann-Whitney test. Event-free survival (EFS) was calculated by Kaplan-Meier plots and log-rank test. Results. A significant correlation was detected between CASP3, CASP8, CASP9, and FAS expression levels (P<0.01) in ALL samples. Higher levels of BCL2 were significantly associated with white blood cell (WBC) count <50,000/mm(3) at diagnosis (P=0.01) and low risk group classification (P=0.008). Lower expression levels of CASP3, CASP8 and FAS gene were associated with a poor response at day 7 according the GBTLI-ALL 99 protocol (P=0.03, P=0.02 and P=0.008, respectively). There was a relationship between FAS gene expression lower than the 75th percentile and lower 5-year EFS (P=0.02). Conclusion. These findings suggest an association between lower expression levels of the pro-apoptotic genes and a poor response to induction therapy at day 7 and prognosis in childhood ALL. Pediatr Blood Cancer 2010;55:100-107. (C) 2010 Wiley-Liss, Inc.
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    Management of Gastric Cancer in Ontario
    (Wiley-Blackwell, 2010-07-01) Coburn, Natalie G.; Lourenco, Laercio G. [UNIFESP]; Rossi, Seana E.; Gunraj, Nadia; Mahar, Alyson L.; Helyer, Lucy K.; Law, Calvin; Rabeneck, Linda; Paszat, Lawrence; Sunnybrook Hlth Sci Ctr; Univ Toronto; Inst Clin Evaluat Sci; Universidade Federal de São Paulo (UNIFESP); Dalhousie Univ
    Objective: To describe the processes of care for gastric cancer in Ontario and identify areas in which care and possibly survival can be improved Summary Background Data: Survival in North America is poor for patients with gastric cancer, with stage-matched survival markedly worse than is seen in Asian and European series Few Western studies have examined processes of care associated with gastric cancerMethods: We identified all cases of gastric cancer in Ontario. Canada from April 1. 2000 to March 31, 2005. and describe the demographics of patients. staging of the cancer. treatment. and survivalResults: in this series of 3.666 patients, 81% of cases had a CT scan performed prior to resection and 90% of cases received an upper endoscopy We found that 55% of patients were treated palliatively and only 1,645 patients underwent a curative-intent resectmn Among patients who did not receive a resection over 50% of the cases appeared to have had a diagnostic laparoscopy rather than a laparotomy Survival was related to the type of resection performed, likely reflecting the extent of disease Higher institution volume and age were related to improved survival for curative-intent casesConclusion: in this population-based analysis. we found evidence of under-utilization of pre-operative radiology and endoscopy Many patients were treated palhatively. reflecting presentation of the cancer at an advanced stage for curative patients. survival was associated with age. surgical type. and resection in a higher volume institution Surg Oncol 2010:102.54-63 (C) 2010 Wiley-Liss, Inc
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    MET Is Highly Expressed in Advanced Stages of Colorectal Cancer and Indicates Worse Prognosis and Mortality
    (Int Inst Anticancer Research, 2009-11-01) Oliveira, Antonio Talvane Torres de [UNIFESP]; Matos, Delcio [UNIFESP]; Logullo, Angela Flavia [UNIFESP]; Silva, Sandra Regina Morini da [UNIFESP]; Artigiani Neto, Ricardo [UNIFESP]; Longat Filho, Adhemar; Saad, Sarhan Sydney [UNIFESP]; Barretos Canc Hosp; Universidade Federal de São Paulo (UNIFESP); Univ Minho; Universidade de São Paulo (USP)
    The aim of the present study was to evaluate by immunohistochemistry the prognostic meaning of the tumor marker MET (hepatocyte growth factor) in patients submitted to surgical resection due to primary colorectal adenocarcinoma. Patients and Methods: A retrospective study was carried out that included 286 consecutive patients with colorectal adenocarcinoma, submitted to surgical resection at Barretos Cancer Hospital, from 1993 to 2002. The histopathological expression of the MET tumor marker was evaluated using an anti-protein monoclonal antibody against MET by the streptavidin-biotin-peroxidase technique. The expression of the tumor marker was semi-quantitative, and the slide samples were independently analyzed by three pathologists unaware of patient clinical and histopathological data. Results: The tumor marker expression was positive in 236 (79%) out of a total of 286 patients. This expression was statistically significantly different between stages I and IV (p=0.004), for overall survival (p=0.009), and for cancer-related mortality rates (p=0.022). However, no association between the tumor marker and recurrence (p=0.89) or disease-free interval (p=0.91) was observed. Conclusion: MET has shown significant expression at advanced stages of the disease, as well as for overall survival and cancer-related mortality rates demonstrating to be a valuable marker for poor prognosis in colorectal cancer patients.
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    Performance of adjuvant treatment correlates with survival in reoperated glioblastomas
    (Assoc Arquivos Neuro- Psiquiatria, 2016) Zanovello, Willey Goncalves [UNIFESP]; Malheiros, Suzana Maria Fleury [UNIFESP]; Stávale, João Norberto [UNIFESP]; Lanzoni, Oreste Paulo [UNIFESP]; Canteras, Miguel Montes [UNIFESP]; Santos, Adrialdo José [UNIFESP]; Slaviero, Felipe [UNIFESP]; Fernandes, Bruno [UNIFESP]; Cavalheiro, Sergio [UNIFESP]; Paiva Neto, Manoel Antonio de [UNIFESP]
    Objective: To analyze cases of recurrent glioblastoma subjected to reoperation at a Brazilian public healthcare service. Methods: A total of 39 patients subjected to reoperation for recurrent glioblastoma at the Department of Neurosurgery, Sao Paulo Hospital, Federal University of Sao Paulo, from January 2000 to December 2013 were retrospectively analyzed. Results: The median overall survival was 20 months (95% confidence interval -CI = 14.9-25.2), and the median survival after reoperation was 9.1 months (95% CI: 2.8-15.4). The performance of adjuvant treatment after the first operation was the single factor associated with overall survival on multivariate analysis (relative risk - RR = 0.3
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    Primary cardiac disease in systemic lupus erythematosus patients: protective and risk factors-data from a multi-ethnic Latin American cohort
    (Oxford Univ Press, 2014-08-01) Garcia, Mercedes A.; Alarcon, Graciela S.; Boggio, Gabriela; Hachuel, Leticia; Ines Marcos, Ana; Carlos Marcos, Juan; Gentiletti, Silvana; Caeiro, Francisco; Sato, Emilia Inoue [UNIFESP]; Borba, Eduardo F.; Tavares Brenol, Joao C.; Massardo, Loreto; Fernando Molina-Restrepo, Jose; Vasquez, Gloria; Guibert-Toledano, Marlene; Barile-Fabris, Leonor; Amigo, Mary-Carmen; Huerta-Yanez, Guillermo F.; Cucho-Venegas, Jorge M.; Chacon-Diaz, Rosa; Pons-Estel, Bernardo A.; Grp Latino Amer Estudio Lupus; Hosp Interzonal Gen Agudos Gen San Martin; Univ Alabama Birmingham; Univ Nacl Rosario; Hosp Prov Rosario; Hosp Privado; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Univ Fed Rio Grande do Sul; Pontificia Univ Catolica Chile; Univ CES; Univ Antioquia; Ctr Invest Med Quirurg; Hosp Especialidades Ctr Med Nacl Siglo XXI; Ctr Med ABC; Hosp Miguel Hidalgo; Hosp Nacl Guillermo Almenara Irigoyen EsSalud; Hosp Univ Caracas
    Objectives. the aim of this study was to assess the cumulative incidence, risk and protective factors and impact on mortality of primary cardiac disease in SLE patients (disease duration <= 2 years) from a multi-ethnic, international, longitudinal inception cohort (34 centres, 9 Latin American countries).Methods. Risk and protective factors of primary cardiac disease (pericarditis, myocarditis, endocarditis, arrhythmias and/or valvular abnormalities) were evaluated.Results. of 1437 patients, 202 (14.1%) developed one or more manifestations: 164 pericarditis, 35 valvulopathy, 23 arrhythmias, 7 myocarditis and 1 endocarditis at follow-up; 77 of these patients also had an episode of primary cardiac disease at or before recruitment. in the multivariable parsimonious model, African/Latin American ethnicity [odds ratio (OR) 1.80, 95% CI 1.13, 2.86], primary cardiac disease at or before recruitment (OR 6.56, 95% CI 4.56, 9.43) and first SLICC/ACR Damage Index for SLE assessment (OR 1.31, 95% CI 1.14, 1.50) were risk factors for the subsequent occurrence of primary cardiac disease. CNS involvement (OR 0.44, 95% CI 0.25, 0.75) and antimalarial treatment (OR 0.62, 95% CI 0.44, 0.89) at or before recruitment were negatively associated with the occurrence of primary cardiac disease risk. Primary cardiac disease was not independently associated with mortality.Conclusion. Primary cardiac disease occurred in 14.1% of SLE patients of the Grupo Latino Americano de Estudio de Lupus cohort and pericarditis was its most frequent manifestation. African origin and lupus damage were found to be risk factors, while CNS involvement at or before recruitment and antimalarial treatment were protective. Primary cardiac disease had no impact on mortality.
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    Results of a Randomized, Prospective Clinical Trial Evaluating Metronomic Chemotherapy in Nonmetastatic Patients With High-Grade, Operable Osteosarcomas of the Extremities: A Report From the Latin American Group of Osteosarcoma Treatment
    (Wiley, 2017) Senerchia, Andreza A. [UNIFESP]; Macedo, Carla Renata [UNIFESP]; Ferman, Sima; Scopinaro, Marcelo; Cacciavillano, Walter; Boldrini, Erica; Lins de Moraes, Vera Lucia; Rey, Guadalupe; de Oliveira, Claudia T.; Castillo, Luis; Almeida, Maria Tereza; Borsato, Maria Luisa; Lima, Eduardo; Lustosa, Daniel; Barreto, Jose Henrique; El-Jaick, Tatiana; Aguiar, Simone; Brunetto, Algemir; Greggiani, Lauro; Cogo-Moreira, Hugo [UNIFESP]; Atallah, Alvaro [UNIFESP]; Petrilli, Antonio Sergio [UNIFESP]
    BACKGROUND: Metronomic chemotherapy (MC) consists of the administration of a low dose of chemotherapy on a daily or weekly basis without a long break to achieve an antitumoral effect through an antiangiogenic effect or stimulation of the immune system. The potential effect of MC with continuous oral cyclophosphamide and methotrexate in patients with high-grade operable osteosarcomas (OSTs) of the extremities was investigated. METHODS: Patients with high-grade OSTs who were 30 years old or younger were eligible for registration at diagnosis. Eligibility for randomization included 1) nonmetastatic disease and 2) complete resection of the primary tumor. The study design included a backbone of 10 weeks of preoperative therapy with methotrexate, adriamycin, and platinum (MAP). After surgery, patients were randomized between 2 arms to complete 31 weeks of MAP or receive 73 weeks of MC after MAP. The primary endpoint was event-free survival (EFS) from randomization. RESULTS: There were 422 nonmetastatic patients registered (May 2006 to July 2013) from 27 sites in 3 countries (Brazil, Argentina and Uruguay), and 296 were randomized to MAP plus MC (n = 139) or MAP alone (n = 157). At 5 years, the EFS cumulative proportions surviving in the MAP-MC group and the MAP-alone group were 61% (standard error [SE], 0.5%) and 64% (SE, 0.5%), respectively, and they were not statistically different (Wilcoxon [Gehan] statistic = 0.724