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Id: biblio-951964
Autor: Antunes, Denise Espíndola; Viana, Karolline Alves; Costa, Paulo Sucasas; Costa, Luciane Rezende.
Título: Moderate sedation helps improve future behavior in pediatric dental patients - a prospective study
Fonte: Braz. oral res. (Online);30(1):e107, 2016. tab, graf.
Idioma: en.
Resumo: Abstract There is little evidence on the long-term effects of pharmacological management in children undergoing dental treatment. This study aimed to assess children's behavior in consecutive dental sessions following oral rehabilitation using different pharmacological regimens for behavioral control. Participants were preschoolers who were previously treated for caries under one of the following: no sedative, oral sedation with midazolam, oral sedation with midazolam/ketamine, or general anesthesia. The children's behavior in the follow-up sessions was assessed using the Ohio State University Behavioral Rating Scale (OSUBRS); higher scores represented less cooperative behavior (range 5-20). Follow-up assessments were conducted on 50 children under four years old for up to 29 months. Data were analyzed by the Friedman/Wilcoxon tests and Cox regression model. OSUBRS mean (standard deviation) scores for the whole sample decreased from 11.9 (5.4) before treatment to 6.8 (3.2) at the final recall session (p < 0.001). Moderate sedation with midazolam (OR 2.9, 95%CI 1.2-6.9) or midazolam/ketamine (OR 4.3, 95%CI 1.6-11.4) improved children's future behavior. The general anesthesia group (n = 4) had a small sample size and the results should be considered with caution. Although invasive dental treatment negatively affected the child's behavior in the dental chair, they became more cooperative over time. Moderately sedated children showed better prospective behavior than those in the non-sedation group.
Descritores: Comportamento Infantil/efeitos dos fármacos
Sedação Consciente/métodos
Assistência Odontológica para Crianças/métodos
-Midazolam/uso terapêutico
Modelos de Riscos Proporcionais
Estudos Prospectivos
Reprodutibilidade dos Testes
Análise de Variância
Fatores Etários
Resultado do Tratamento
Ansiedade ao Tratamento Odontológico/prevenção & controle
Estatísticas não Paramétricas
Cárie Dentária/terapia
Hipnóticos e Sedativos/uso terapêutico
Anestesia Geral/métodos
Ketamina/uso terapêutico
Anestésicos Dissociativos/uso terapêutico
Limites: Humanos
Masculino
Feminino
Pré-Escolar
Tipo de Publ: Ensaio Clínico Controlado Aleatório
Responsável: BR1.1 - BIREME


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Id: biblio-952042
Autor: Braúna, Ana Paula Vasques Sales; Abreu, Mauro Henrique Nogueira Guimarães de; Resende, Vera Lúcia Silva; Castilho, Lia Silva de.
Título: Risk factors for dental caries in children with developmental disabilities
Fonte: Braz. oral res. (Online);30(1):e79, 2016. tab, graf.
Idioma: en.
Resumo: Abstract The aim of the present study was to investigate risk factors for dental caries in children with developmental disabilities who were treated at a clinical reference service for patients with special needs in Belo Horizonte, MG, Brazil. This is a retrospective cohort study that evaluated 401 dental charts of individuals without dental caries or restorations in their first dental appointment. The dependent variable was the time of occurrence of new dental caries or restorations and was measured in months. Gender, age, International Code of Diseases (ICD), mother´s education, sugar consumption, use of fluoride toothpaste, oral hygiene, mouth breathing, reports of xerostomia, gingival status, use of psychotropic or asthma drugs, and history of asthma were covariates. The Cox proportional hazards regression model was used to estimate the raw and adjusted hazard ratios and their respective 95% confidence intervals. The average time that individuals remained free of dental caries/restoration was equal to 107.46 months (95%CI 95.41 to 119.51), with a median of caries-free children up to 94 months. For each point increase in the scale of sucrose consumption, the increase in caries risk was 1.07 (95%CI 1.01 to 1.15). Sucrose consumption was the only risk factor for dental caries found in this group of individuals with developmental disabilities.
Descritores: Deficiências do Desenvolvimento/complicações
Cárie Dentária/etiologia
-Higiene Bucal
Fatores de Tempo
Cremes Dentais
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Fatores de Risco
Antiasmáticos/efeitos adversos
Sacarose na Dieta/efeitos adversos
Dentifrícios
Estimativa de Kaplan-Meier
Fluoretos
Limites: Humanos
Masculino
Feminino
Lactente
Pré-Escolar
Criança
Adolescente
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: biblio-952048
Autor: Oeiras, Valéria Jacques; Silva, Valéria Assis Almeida e; Azevedo, Leidiana Aguiar; Lobato, Vanessa Soares; Normando, David.
Título: Survival analysis of banding and bonding molar tubes in adult patients over a 12-month period: a split-mouth randomized clinical trial
Fonte: Braz. oral res. (Online);30(1):e136, 2016. tab, graf.
Idioma: en.
Resumo: Abstract: This split-mouth randomized clinical trial aimed to compare the survival rate of bonding and banding molar tubes in adult orthodontic patients. Eligibility criteria included adults (aged >18 years), no active caries, restorations, or fractures in the upper and lower molars. The main outcome was any type of first-time failure in molar tubes. A computer-generated randomization scheme was used in a 1:1 ratio. The survival rate was estimated for 32 adult patients, in whom a tube was bonded to a molar tooth using composite resin on one side and a band was cemented with glass ionomer onto the same tooth in the contralateral arch. A total of 59 banded and 59 bonded molars were followed up for 12 months. Blinding was not applicable. Survival analysis including Cox regression was used at p < 0.05. The survival rate of bonded molars was not statistically different from that of banded molars (log-rank test, p = 0.97). Hazard ratio (HR) was 0.72 (95%CI, 0.38-1.31). Bonded upper molars yielded a survival rate of 81.25% (26 out of 32) compared to 71.87% (23 out of 32) for banded upper molars. The survival rate was 66.66% (18 out of 27) for banded lower molars and 59.25% for bonded lower molars (16 out of 27). The HR for lower vs. upper arch was 2.16 (95%CI, 1.18-3.98). No serious problem was observed other than gingivitis associated with plaque accumulation. In contrast to previous studies in young patients, in adults, bonding orthodontic tubes to molars is similar to molar banding. However, both procedures had a high failure rate in the lower arch.
Descritores: Aparelhos Ortodônticos
Colagem Dentária/métodos
Dente Molar
-Fatores de Tempo
Modelos de Riscos Proporcionais
Reprodutibilidade dos Testes
Resultado do Tratamento
Desenho de Aparelho Ortodôntico
Cimentos de Ionômeros de Vidro/uso terapêutico
Limites: Humanos
Masculino
Feminino
Adolescente
Adulto
Adulto Jovem
Tipo de Publ: Ensaio Clínico Controlado Aleatório
Responsável: BR1.1 - BIREME


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Id: biblio-952077
Autor: Anna Luisa de Brito, Pacheco; Isabel Cristina, Olegário; Clarissa Calil, Bonifácio; Ana Flávia Bissoto, Calvo; José Carlos Pettorossi, Imparato; Daniela Prócida, Raggio.
Título: One year Survival Rate of Ketac Molar versus Vitro Molar for Occlusoproximal ART Restorations: a RCT
Fonte: Braz. oral res. (Online);31:e88, 2017. tab, graf.
Idioma: en.
Resumo: Abstract Good survival rates for single-surface Atraumatic Restorative Treatment (ART) restorations have been reported, while multi-surface ART restorations have not shown similar results. The aim of this study was to evaluate the survival rate of occluso-proximal ART restorations using two different filling materials: Ketac Molar EasyMix (3M ESPE) and Vitro Molar (DFL). A total of 117 primary molars with occluso-proximal caries lesions were selected in 4 to 8 years old children in Barueri city, Brazil. Only one tooth was selected per child. The subjetcs were randomly allocated in two groups according to the filling material. All treatments were performed following the ART premises and all restorations were evaluated after 2, 6 and 12 months. Restoration survival was evaluated using Kaplan-Meier survival analysis and Log-rank test, while Cox regression analysis was used for testing association with clinical factors (α = 5%). There was no difference in survival rate between the materials tested, (HR = 1.60, CI = 0.98-2.62, p = 0.058). The overall survival rate of restorations was 42.74% and the survival rate per group was Ketac Molar = 50,8% and Vitro Molar G2 = 34.5%). Cox regression test showed no association between the analyzed clinical variables and the success of the restorations. After 12 months evaluation, no difference in the survival rate of ART occluso-proximal restorations was found between tested materials.
Descritores: Tratamento Dentário Restaurador sem Trauma/métodos
Cimentos de Ionômeros de Vidro/uso terapêutico
-Fatores de Tempo
Teste de Materiais
Modelos de Riscos Proporcionais
Resultado do Tratamento
Falha de Restauração Dentária
Restauração Dentária Permanente/métodos
Estimativa de Kaplan-Meier
Limites: Humanos
Masculino
Feminino
Pré-Escolar
Criança
Tipo de Publ: Ensaio Clínico Controlado Aleatório
Responsável: BR1.1 - BIREME


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Id: biblio-1004740
Autor: Batista, Wilson Roberto; Applied Statistics SectorSantos, Gianni; Vital, Flávia Maria Ribeiro; Department of SurgeryMatos, Delcio.
Título: Immunoexpression of TS, p53, COX2, EGFR, MSH6 and MLH1 biomarkers and its correlation with degree of differentiation, tumor staging and prognostic factors in colorectal adenocarcinoma: a retrospective longitudinal study
Fonte: Säo Paulo med. j;137(1):33-38, Jan.-Feb. 2019. tab.
Idioma: en.
Resumo: ABSTRACT BACKGROUND: There are cases of colorectal tumors that, although small, show more aggressive evolution than large tumors. This motivated us to study whether there are any proteins capable of alerting about these changes. The aim here was to correlate the immunoexpression of the TS, p53, COX2, EGFR, MSH6 and MLH1 biomarkers in tumors in patients with colorectal adenocarcinoma, with the degree of cell differentiation, tumor staging and clinical-pathological prognostic factors. DESIGN AND SETTING: Retrospective observational study at a public tertiary-level hospital. METHODS: We analyzed tissue-microarray paraffin blocks of tumor tissues that had been resected from 107 patients. We used Fisher's exact test to study associations between tumor differentiation/staging and the immunoexpression of biomarkers. We also used Kaplan-Meier estimation, the log-rank test and the adjusted Cox regression model to investigate the patients' overall survival (in months) according to biomarkers and disease-free interval. RESULTS: The degree of tumor differentiation and tumor staging were not associated with the biomarkers, except in cases of patients in stages III or IV, in which there was a correlation with MLH1 expression (P=0.021). Patient survival and disease-free interval were not associated with the biomarkers. CONCLUSION: There were no associations between the degree of tumor differentiation, staging, length of survival or disease-free interval and the immunoexpression of the TS, p53, COX2, EGFR or MSH6 tumor markers. In advanced cases of colorectal adenocarcinoma (stages III and IV), there was a higher percentage of MLH1-negative results.
Descritores: Neoplasias Colorretais/mortalidade
Neoplasias Colorretais/patologia
Adenocarcinoma/patologia
Biomarcadores Tumorais/análise
-Valores de Referência
Timidilato Sintase/análise
Imuno-Histoquímica
Adenocarcinoma/mortalidade
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Estudos Longitudinais
Proteína Supressora de Tumor p53/análise
Análise Serial de Tecidos
Proteínas de Ligação a DNA/análise
Ciclo-Oxigenase 2/análise
Estimativa de Kaplan-Meier
Receptores ErbB/análise
Proteína 1 Homóloga a MutL/análise
Estadiamento de Neoplasias
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Idoso de 80 Anos ou mais
Adulto Jovem
Tipo de Publ: Estudo Observacional
Responsável: BR1.1 - BIREME


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Id: biblio-1059101
Autor: Ciocîrlan, Maria; Manuc, Mircea; Diculescu, Mircea; Ciocîrlan, Mihai.
Título: Is rectus abdominis thickness associated with survival among patients with liver cirrhosis? A prospective cohort study
Fonte: Säo Paulo med. j;137(5):401-406, Sept.-Oct. 2019. tab, graf.
Idioma: en.
Resumo: ABSTRACT BACKGROUND: Sarcopenia may affect patients with liver cirrhosis and worsen disease outcomes. OBJECTIVES: To evaluate ultrasound-measured psoas major (PM) and rectus abdominis (RA) thickness for predicting survival among patients with liver cirrhosis. DESIGN AND SETTING: Prospective cohort study in a tertiary-level hospital. METHODS: 61 patients with liver cirrhosis were prospectively included during a 15-month period and followed up for at least six months. Cirrhosis was classified using the Child-Pugh score. Sarcopenia was assessed using surrogate parameters: handgrip strength (HGS), mid-arm muscle circumference (MAMC) and SGA (subjective global assessment). We used ultrasound to measure RA and PM thickness at admission. RESULTS: There were 41 men. The patients' mean age was 58.03 ± 10.8 years. 26.22% of them were Child-Pugh A, 45.9% B and 27.86% C. The patients were followed up for 11.9 ± 5.63 months. RA thickness correlated moderately with MAMC (r = 0. 596; P < 0.0001) and HGS (r = 0.515; P < 0.0001) and decreased with increasing SGA class (A, 10.6 ± 2.8 mm; B, 8.3 ± 1.9 mm; C, 6.5 ± 1.9 mm; P < 0.0001). Survival at six months was independently predicted by using the model for end-stage liver disease-serum sodium score (odds ratio, OR 1.305; 95% OR confidence interval 1.083-1.572; P = 0.005). Survival during follow-up was independently predicted by RA thickness (hazard ratio, HR 0.701; 95% HR confidence interval 0.533-0.922; P = 0.011) and ascites (HR 1.876; 95% HR confidence interval 1.078-3.267; P = 0.026). PM thickness did not have any predictive value. CONCLUSIONS: As a surrogate marker of sarcopenia, RA thickness may predict survival among patients with liver cirrhosis.
Descritores: Reto do Abdome/diagnóstico por imagem
Sarcopenia/diagnóstico por imagem
Cirrose Hepática/complicações
-Prognóstico
Romênia/epidemiologia
Índice de Gravidade de Doença
Modelos de Riscos Proporcionais
Análise de Sobrevida
Estudos Prospectivos
Força da Mão
Sarcopenia/complicações
Cirrose Hepática/mortalidade
Limites: Humanos
Masculino
Feminino
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME


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Id: biblio-1094520
Autor: Lee, Chia-Lin; Wang, Jun-Sing.
Título: Effects of hyperuricemia on incident renal replacement therapy and all-cause mortality among patients with chronic kidney disease stages 3-5: a retrospective cohort study
Fonte: Säo Paulo med. j;137(6):523-529, Nov.-Dec. 2019. tab.
Idioma: en.
Projeto: National Science Council, Taiwan; . Taichung Veterans General Hospital, Taichung, Taiwan; . National Science Council, Taiwan; . Taichung Veterans General Hospital, Taichung, Taiwan.
Resumo: ABSTRACT BACKGROUND: Findings regarding the effects of hyperuricemia on renal function and mortality have been inconsistent. OBJECTIVES: To investigate the effects of hyperuricemia on incident renal replacement therapy and all-cause mortality among patients with chronic kidney disease (CKD). DESIGN AND SETTING: Retrospective cohort study conducted in a medical center in Taiwan. METHODS: Patients with CKD in stages 3-5, without histories of renal replacement therapy, were consecutively recruited from 2007 to 2013. Their medical history, laboratory and medication data were collected from hospital records. The mean uric acid level in the first year of follow-up was used for analyses. Hyperuricemia was defined as mean uric acid level ≥ 7.0 mg/dl in men or ≥ 6.0 mg/dl in women. The primary outcomes were incident renal replacement therapy and all-cause mortality, and these data were retrospectively collected from hospital records until the end of 2015. RESULTS: A total of 4,381 patients were analyzed (mean age 71.0 ± 14.8 years; males 62.7%), and the median follow-up period was 2.5 years. Patients with hyperuricemia were at increased risk of incident renal replacement therapy and all-cause mortality, especially those with CKD in stages 4 or 5. Compared with patients with CKD in stage 3 and normouricemia, patients with CKD in stages 4 or 5 presented significantly higher risk of all-cause mortality only if they had hyperuricemia. CONCLUSIONS: In patients with CKD in stages 3-5, hyperuricemia was associated with higher risk of incident renal replacement therapy and all-cause mortality. Whether treatment with uric acid-lowering drugs in these patients would improve their outcomes merits further investigation.
Descritores: Terapia de Substituição Renal
Hiperuricemia/sangue
Insuficiência Renal Crônica/sangue
-Ácido Úrico/análise
Índice de Gravidade de Doença
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Fatores de Risco
Seguimentos
Hiperuricemia/complicações
Hiperuricemia/fisiopatologia
Hiperuricemia/mortalidade
Insuficiência Renal Crônica/complicações
Insuficiência Renal Crônica/fisiopatologia
Insuficiência Renal Crônica/mortalidade
Taxa de Filtração Glomerular
Limites: Humanos
Masculino
Feminino
Pessoa de Meia-Idade
Idoso
Idoso de 80 Anos ou mais
Responsável: BR1.1 - BIREME


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Id: biblio-1045650
Autor: Bambury, I; Mullings, A; Fletcher, H; Johnson, N; Tulloch-Reid, M.
Título: Cervical intraepithelial neoplasia in a cohort of HIV-positive women at the University Hospital of the West Indies: management and outcome / Neoplasia intraepitelial cervical en una cohorte de mujeres VIH-positivas en el Hospital Universitario de West Indies: manejo y resultados
Fonte: West Indian med. j;62(4):313-317, 2013. graf, tab.
Idioma: en.
Resumo: OBJECTIVE: To determine the rate of recurrence of cervical intraepithelial neoplasia (CIN) in HIVpositive women evaluated at the University H ospital of the West Indies (UHWI). METHOD: A chart review of all non-pregnant HIV-positive women who attended the gynaecologic and colposcopic clinics between January 1994 and December 2004 identified 21 such women. Fifteen of these patients who had CIN and had at least one follow-up Pap smear were the main subjects of this study. These patients were compared to 21 HIV-negative controls who were seen during the same period and who also had at least one follow-up Pap smear. Treatment modalities for the groups included cold coagulation and large loop excision of the transformation zone (LLETZ). Cox proportional hazards analysis was used to determine the effect of HIV status on the time to first recurrence of CIN. RESULTS: The mean ages of the subjects were 32.7 ± 8.0 and 33.2 ± 8.1 years, respectively. With a mean follow-up period of 1.7 years, the rate of recurrence of CIN in patients with and without HIV was 66.24 (95% CI 27.6, 159.1) and 3.0 (95% CI 1.3, 7.3) per 100 person years. The hazards rate ratio for recurrence in subjects with HIV after adjusting for age and CIN stage was 19.1 (95% CI 4.4, 82.1). CONCLUSION: HIV increases the risk of recurrence of CIN.

OBJETIVO: Determinar la tasa de recurrencia de la neoplasia intraepitelial cervical (NIC) en las mujeres VIH-positivas evaluadas en el Hospital Universitario de West Indies (HUWI). MÉTODO: Una revisión de las historias clínicas de todas las mujeres VIH-positivas no embarazadas que asistieron a la clínica ginecológica y la clínica colposcópica entre enero de 1994 y diciembre de 2004, identificó 21 de estas mujeres. Quince de estas pacientes que tenían NIC y habían tenido al menos una prueba de Papanicolaou de seguimiento, fueron los sujetos principales de este estudio. Estas pacientes fueron comparadas con 21 controles de VIH-negativos que fueron vistos durante el mismo período y que también tuvieron al menos una prueba de Papanicolaou de seguimiento. Las modalidades de tratamiento para los grupos incluyeron coagulación fría y escisión con asa grande de la zona de transformación (LLETZ). El modelo de análisis de riesgos proporcionales de Cox fue utilizado para determinar el efecto del estatus de VIH al momento de la primera recurrencia de CIN. RESULTADOS: Las edades promedios de los sujetos fueron 32.7 ± 8.0 y 33.2 ± 8.1 años, respectivamente. Con un período de seguimiento promedio de 1.7 años, la tasa de recurrencia de NIC en pacientes con y sin VIH fue 66.24 (95% IC 27.6, 159.1) y 3.0 (95% IC 1.3, 7.3) por 100 persona/años. El cociente de tasas de riesgo de recurrencia en pacientes con VIH después de ajustar por edad y etapa de CIN fue 19.1 (95% IC 4.4, 82.1). CONCLUSIÓN: El VIH aumenta el riesgo de recurrencia de la NIC.
Descritores: Infecções por HIV/complicações
Neoplasias do Colo do Útero/terapia
Neoplasia Intraepitelial Cervical/terapia
Recidiva Local de Neoplasia
-Fatores de Tempo
Esfregaço Vaginal
Estudos de Casos e Controles
Modelos de Riscos Proporcionais
Neoplasias do Colo do Útero/complicações
Estudos de Coortes
Resultado do Tratamento
Neoplasia Intraepitelial Cervical/complicações
Colposcopia
Técnicas de Ablação
Teste de Papanicolaou
Hospitais Universitários
Jamaica
Limites: Humanos
Feminino
Adulto
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: biblio-1003937
Autor: Chao Pereira, Caridad; Ortega Cedeño, Henderson; Gutiérrez Rojas, Ángela Rosa; Casas Morell, Eloisa.
Título: Índice de masa corporal e interleuquina 6 en la mortalidad de pacientes con insuficiencia cardiaca crónica / Body mass index and interleukin 6 in the mortality of chronic heart failure patients
Fonte: Rev. cuba. med;57(3), jul.-set. 2018. ilus, tab.
Idioma: es.
Resumo: Introducción: La insuficiencia cardiaca crónica es una de las primeras causas de muerte cardiovascular a nivel mundial, se plantea un efecto paradójico del peso corporal en la mortalidad de estos pacientes. Objetivo: Evaluar el índice de masa corporal (IMC) como factor pronóstico en la mortalidad de pacientes con insuficiencia cardiaca crónica y su relación con la concentración en sangre de interleuquina 6. Métodos: Se realizó un estudio analítico de cohorte prospectivo en pacientes con insuficiencia cardiaca crónica, en el periodo comprendido entre enero de 2016 y diciembre de 2016 seguidos durante un año. La muestra se constituyó por 109 pacientes. Para el análisis estadístico se utilizó el modelo de regresión de Cox y se calculó la significación estadística según correspondió. Resultados: La categoría bajo peso mostró mayor influencia sobre el riesgo de muerte, OR 2,943 (IC: 1,378-6,285). La variable sobrepeso-obesidad presentó un OR por debajo de 1, a medida que aumentó el IMC disminuyó la concentración de IL6. Conclusiones: El índice de masa corporal permite ofrecer información de pronóstico. La menor concentración en sangre de interleuquina 6 en los pacientes obesos respecto a los normo pesos puede ser una explicación a la mayor supervivencia que mostraron estos pacientes(AU)

Introduction: Chronic heart failure is one of the leading causes of cardiovascular death worldwide. A paradoxical effect of the corporal weight in the mortality of these patients is considered. Objective: To evaluate the body mass index (BMI) as a prognostic factor in the mortality of patients with chronic heart failure and the relationship with the blood concentration of interleukin 6. Methods: A prospective cohort analytical study was conducted in patients with chronic heart failure, from January 2016 to December 2016, and they were followed up for one year. 109 patients formed the sample. Cox regression model was used for statistical analysis and statistical significance was calculated as applicable. Results: The low weight category showed higher influence on the risk of death, OR 2,943 (CI: 1,378-6,285). The overweight-obesity variable presented OR below 1, as the body mass index increased, the IL6 concentration decreased. Conclusions: The body mass index allows us to offer prognostic information. The lower blood concentration of interleukin 6 in obese patients with respect to normal weight may be an explanation for the higher survival of these patients(AU)
Descritores: Índice de Massa Corporal
Interleucina-6
Sobrepeso/epidemiologia
Insuficiência Cardíaca/diagnóstico
Insuficiência Cardíaca/mortalidade
Obesidade
-Modelos de Riscos Proporcionais
Estudos Prospectivos
Limites: Humanos
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: biblio-1045687
Autor: Ignacio, DN; Griffin, JJ; Daniel, MG; Serlemitsos-Day, MT; Lombardo, FA; Alleyne, TA.
Título: An evaluation of treatment strategies for head and neck cancer in an African American population / Evaluación de las estrategias del tratamiento para el cáncer de cabeza y cuello en una población afroamericana
Fonte: West Indian med. j;62(6):504-509, July 2013. graf, tab.
Idioma: en.
Resumo: OBJECTIVE: This study evaluated treatment strategies for head and neck cancers in a predominantly African American population. METHODS: Data were collected utilizing medical records and the tumour registry at the Howard University Hospital. Kaplan-Meier method was used for survival analysis and Cox proportional hazards regression analysis predicted the hazard of death. RESULTS: Analysis revealed that the main treatment strategy was radiation combined with platinum for all stages except stage I. Cetuximab was employed in only 1% of cases. Kaplan-Meier analysis revealed stage II patients had poorer outcome than stage IV while Cox proportional hazard regression analysis (p = 0.4662) showed that stage I had a significantly lower hazard of death than stage IV (HR = 0.314; p = 0.0272). Contributory factors included tobacco and alcohol but body mass index (BMI) was inversely related to hazard of death. CONCLUSIONS: There was no difference in survival using any treatment modality for African Americans.

OBJETIVO: Este estudio evaluó las estrategias del tratamiento para los cánceres de cabeza y cuello en una población predominantemente afroamericana. MÉTODOS: Se recopilaron datos utilizando historias clínicas y el registro de tumores del Hospital Universitario Howard. Se utilizó el método de Kaplan-Meier para el análisis de supervivencia, y el análisis de regresión de riesgos proporcionales de Cox para predecir los riesgos de muerte. RESULTADOS: El análisis reveló que la estrategia principal para el tratamiento fue la radiación combinada con platino para todas las etapas, excepto la etapa I. Se empleó cetuximab en sólo 1% de los casos. El análisis de Kaplan-Meier reveló que los pacientes de etapa II tuvieron resultados más pobres que los de la etapa IV, mientras que el análisis de regresión de riesgos proporcionales de Cox (p = 0.4662) mostró que la etapa I tenía un riesgo de muerte significativamente menor que la etapa IV (HR = 0.314; p = 0.0272). Los factores contribuyentes incluyeron el tabaco y el alcohol, pero el índice de masa (IMC) fue inversamente proporcional al riesgo de muerte. CONCLUSIONES: No hubo diferencias en la supervivencia con ninguna de las modalidades de tratamiento para los afroamericanos.
Descritores: Afro-Americanos/estatística & dados numéricos
Neoplasias de Cabeça e Pescoço/terapia
-Modelos de Riscos Proporcionais
Estudos Retrospectivos
Estimativa de Kaplan-Meier
Neoplasias de Cabeça e Pescoço/mortalidade
Limites: Humanos
Masculino
Feminino
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME



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