ABSTRACT
The association of education, tobacco smoking, alcohol consumption, and interleukin-2 (IL-2 +114 and -384) and -6 (IL-6 -174) DNA polymorphisms with head and neck squamous cell carcinoma (HNSCC) was investigated in a cohort study of 445 subjects. IL-2 and IL-6 genotypes were determined by real-time PCR. Cox regression was used to estimate hazard ratios (HR) and 95 percent confidence intervals (95 percentCI) of disease-specific survival according to anatomical sites of the head and neck. Mean age was 56 years and most patients were males (87.6 percent). Subjects with 5 or more years of schooling had better survival in larynx cancer. Smoking had no effect on HNSCC survival, but alcohol consumption had a statistically significant effect on larynx cancer. IL-2 gene +114 G/T (HR = 0.52; 95 percentCI = 0.15-1.81) and T/T (HR = 0.22; 95 percentCI = 0.02-3.19) genotypes were associated with better survival in hypopharynx cancer. IL-2 +114 G/T was a predictor of poor survival in oral cavity/oropharynx cancer and larynx cancer (HR = 1.32; 95 percentCI = 0.61-2.85). IL-2 -384 G/T was associated with better survival in oral cavity/oropharynx cancer (HR = 0.80; 95 percentCI = 0.45-1.42) and hypopharynx cancer (HR = 0.68; 95 percentCI = 0.21-2.20), but an inverse relationship was observed for larynx cancer. IL-6 -174 G/C was associated with better survival in hypopharynx cancer (HR = 0.68; 95 percentCI = 0.26-1.78) and larynx cancer (HR = 0.93; 95 percentCI = 0.42-2.07), and C/C reduced mortality in larynx cancer. In general, our results are similar to previous reports on the value of education, smoking, alcohol consumption, and IL-2 and IL-6 genetic polymorphisms for the prognosis of HNSCC, but the risks due to these variables are small and estimates imprecise.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Carcinoma, Squamous Cell/mortality , Head and Neck Neoplasms/mortality , /genetics , /genetics , Polymorphism, Genetic/genetics , Alcohol Drinking/adverse effects , Cohort Studies , Carcinoma, Squamous Cell/etiology , Disease-Free Survival , Educational Status , Genotype , Head and Neck Neoplasms/etiology , Prognosis , Risk Factors , Smoking/adverse effectsABSTRACT
Objetivo. O uso de opióides, principalmente no tratamento da dor intensa aguda (pacientes no pós-operatório) e da dor crônica em pacientes oncológicos, tem sido subestimado na prática clínica em geral. Este trabalho tem o objetivo de verificar o perfil de prescriçao de opióides (meperidina e morfina) no Hospital de Clínicas de Porto Alegre (HCPA), RS. Materiais e Métodos. Análise da conduta das equipes médicas, pela revisao de 1.107 prescriçoes, relativas a 445 pacientes internados no HCPA, entre 20 de maio e 20 de julho de 1993. Os parâmetros básicos de análise, para conduta, incluíam: padrao de uso, a dose do fármaco, intervalo entre doses e analgésicos simultâneos. Discussao e Resultados. Foram encontradas apenas 6,5 por cento de prescriçoes consideradas adequadas em relaçao aos parâmetros dose, intervalo e padrao, analisados conjuntamente. O padrao se necessário foi responsável por 74 por cento do total de prescriçoes. Conclusoes. Os resultados obtidos durante a realizaçao do trabalho permitem-nos concluir que nao há um manejo adequado da dor, tanto aguda como crônica, nos pacientes internados no HCPA.
Subject(s)
Humans , Female , Pain/drug therapy , Analgesics, Opioid , Meperidine , Morphine , Pain, Postoperative/drug therapy , Pain Measurement , Analgesics, Opioid/therapeutic use , Meperidine/therapeutic use , Morphine/therapeutic useABSTRACT
O objetivo deste estudo refere-se a mortalidade por câncer do colo uterino (Cid 180), através da verificaçäo dos coeficientes de mortalidade no Rio Grande os Sul e nas 24 microrregiöes que compöem o referido Estado, com estudo das tendências (regressäo linear simples), período de 1970 a 1989. Como objetivos secundários foram abordados a feqüência relativa desta neoplasia em relaçäo ao total de óbitos por neoplasias malignas, estudo comparativo com outras localidades e correlaçäo com fatores de risco. Os dados que permitiram este estudo foram obtidos na Secretaria de Saúde e Meio Ambiente do Rio Grande do Sul, Instituto Brasileiro de Geografia e Estatística IBGE), Ministério de Saúde e Organizaçäo Mundial de Saúde. A média dos coeficientes de mortalidade/100.000 mulheres no Rio Grande do Sul (1970-1989) foi de 3,8, com tendência ascendente. Observaram-se diferenças importantes na distribuiçäo dos coeficientes de mortalidade nas 24 microrregiöes do Estado, com médias oscilando entre 2,5 e 6,7. O câncer de colo uterino ocupou o 4§ lugar na mortalidade por neoplasias entre as mulheres do Rio Grande do Sul, em 1989. Vírus de papiloma humano e tabagismo säo importantes fatores de risco nesta neoplasia
Subject(s)
Humans , Female , Uterine Cervical Neoplasms/mortality , Brazil/epidemiology , Least-Squares Analysis , Papilloma/complications , Risk Factors , Nicotiana , Uterine Cervical Neoplasms/etiologyABSTRACT
Between 1985 and 1989, at the Hospital de Clínicas de Porto Alegre (HCPA), 101 cases of cutaneous malignant melanoma (CMM) were reviewed in order to evaluate the status of the disease at diagnosis. The cases were obtained from the records of the pathology service of the HCPA. Nodular Melanoma (ND) was the most frequent type (36.6). In males, the predominant site was in the head, neck and trunk while in females it was in the lower limbs Clark level V was found in 35.6 of the cases. In 23.8, the tumor was larger than 4mm in depth according to Breslow classification. These results clearly demonstrate that the diagnosis of CMM is established in later stages of the disease.