Análisis estadístico implicativo para la identificación de factores pronósticos de la mortalidad por cáncer de próstata / Statistical analysis involving mortality prediction factors for the identification of prostate cancer

Se efectuó una investigación observacional y analítica, desde septiembre de 2013 hasta igual mes de 2014, con el fin de evaluar la utilidad de una nueva técnica de análisis estadístico implicativo para la identificación de los factores pronósticos de la mortalidad por cáncer de próstata en la provincia de Santiago de Cuba. Según la regresión logística, los factores que empeoraron el pronóstico en los pacientes con cáncer de próstata fueron la afectación ganglionar y el grado III de la diferenciación histológica, y según el análisis estadístico implicativo, lo hicieron la afectación ganglionar, las metástasis y las complicaciones. El análisis estadístico implicativo complementó a la regresión logística en la identificación de los factores pronósticos, con lo cual se logró una mejor comprensión de la causalidad y se elevó la calidad de este tipo de estudio

An observational and analytic investigation was carried out, from September, 2013 to the same month in 2014, with the purpose of evaluating the usefulness of a new technique of involving statistical analysis for the identification of mortality prediction factors for prostate cancer in Santiago de Cuba. According to the logistical regression, the factors that worsened the prediction in the patients with prostate cancer were the ganglionic disorder and the grade III of the histological differentiation, and according to the involving statistical analysis, the ganglionar disorder, the metastasis and complications. The involving statistical analysis supplemented the logistical regression in the identification of the prediction factors, with which a better understanding of the causation was achieved and there was an increase in the quality of this type of study

Prognostic significance of early phase donor chimerism after allogeneic peripheral blood stem cell transplantation / 中华血液学杂志

Objective: To evaluate the prognostic significance of early phase full donor chimerism (FDC) after myeloablative allogeneic peripheral blood stem cell transplantation (allo-PBSCT). Methods: The clinical data of 72 hematological patients received myeloablative allo-PBSCT from Feb. 2016 to Jul. 2017 were analyzed retrospectively. The median age was 36.5 years (range 4-59), 44 were males and 28 females. Of the donors, there were 35 HLA matched sibling donors, 27 haploidentical donors and 10 unrelated donors. Polymerase chain reaction amplification of short tandem repeat sequence (PCR-STR) was used to detect donor cell chimerism (DC) rate of recipient bone marrow at one, two and three months after transplantation. Results: The median follow-up was 462 d (range: 47-805 d), 55 cases were still alive, and 45 cases were disease-free survival (DFS) at the end of follow-up. The 2-year overall survival (OS) and DFS were (68.9±7.7)% and (59.5±6.3)%, respectively. A number of 16 cases underwent relapses, with 2-year cumulative incidence of (24.1±5.3)%. The median time of recurrence was 157(32-374) d. Forty cases (55.6%) developed acute graft-versus-host diseases (aGVHD), with median time of 35.5 (13-90) d. Chronic GVHD (cGVHD) occurred in 23 patients (31.9%), with median time of 169 (94-475) d. Univariate analysis found the following factors were not related to OS, DFS or relapse rate (RR), including age, sex, blood type and sex of donor-recipient, occurrence of aGVHD and cGVHD. The OS and DFS in cases reached FDC and no FDC at two months after transplantation were (85.2±6.9)% vs (66.1±7.7)% (P=0.051) and (76.7±7.7)% vs (48.9±8.1)% (P=0.021), respectively. The RR rate in FDC group was lower than that in no FDC group [(16.6±6.8)% vs (30.4±7.8)%, P=0.187, respectively]. Conclusion: The present study confirmed the important value for predicting the prognosis with whether or not the patients reached FDC at the early phase after allo-PBSCT. The OS and DFS in cases with FDC at two months after transplantation were significantly higher than those of no FDC patients.

Prognostic significance of early phase donor chimerism after allogeneic peripheral blood stem cell transplantation / 中华血液学杂志

Objective@#To evaluate the prognostic significance of early phase full donor chimerism (FDC) after myeloablative allogeneic peripheral blood stem cell transplantation (allo-PBSCT).@*Methods@#The clinical data of 72 hematological patients received myeloablative allo-PBSCT from Feb. 2016 to Jul. 2017 were analyzed retrospectively. The median age was 36.5 years (range 4-59), 44 were males and 28 females. Of the donors, there were 35 HLA matched sibling donors, 27 haploidentical donors and 10 unrelated donors. Polymerase chain reaction amplification of short tandem repeat sequence (PCR-STR) was used to detect donor cell chimerism (DC) rate of recipient bone marrow at one, two and three months after transplantation.@*Results@#The median follow-up was 462 d (range: 47-805 d), 55 cases were still alive, and 45 cases were disease-free survival (DFS) at the end of follow-up. The 2-year overall survival (OS) and DFS were (68.9±7.7)% and (59.5±6.3)%, respectively. A number of 16 cases underwent relapses, with 2-year cumulative incidence of (24.1±5.3)%. The median time of recurrence was 157(32-374) d. Forty cases (55.6%) developed acute graft-versus-host diseases (aGVHD), with median time of 35.5 (13-90) d. Chronic GVHD (cGVHD) occurred in 23 patients (31.9%), with median time of 169 (94-475) d. Univariate analysis found the following factors were not related to OS, DFS or relapse rate (RR), including age, sex, blood type and sex of donor-recipient, occurrence of aGVHD and cGVHD. The OS and DFS in cases reached FDC and no FDC at two months after transplantation were (85.2±6.9)% vs (66.1±7.7)% (P=0.051) and (76.7±7.7)% vs (48.9±8.1)% (P=0.021), respectively. The RR rate in FDC group was lower than that in no FDC group [(16.6±6.8)% vs (30.4±7.8)%, P=0.187, respectively].@*Conclusion@#The present study confirmed the important value for predicting the prognosis with whether or not the patients reached FDC at the early phase after allo-PBSCT. The OS and DFS in cases with FDC at two months after transplantation were significantly higher than those of no FDC patients.

Factores pronósticos de las complicaciones de las fístulas arteriovenosas autólogas para hemodiálisis / Prediction factors of the autologous arteriovenous fistula complications for hemodialysis

Se realizó un estudio retrospectivo, transversal y descriptivo, para determinar los factores pronósticos sobre la aparición de complicaciones en 300 pacientes con una fístula arteriovenosa creada, atendidos en el Servicio de Angiología y Cirugía Vascular del Hospital Provincial Docente "Saturnino Lora" de Santiago de Cuba durante el trienio 2012- 2015. Entre los resultados principales predominaron el sexo femenino (52,7%), el grupo etario de 51-60 años (55,6%), la hipertensión arterial y la diabetes mellitus como factores de riesgo más comunes, así como la complicación de la FAV a nivel de la muñeca, principalmente en las féminas (34,2 %). Se concluyó que las complicaciones de la fístula arteriovenosa dependen de la presencia o no de factores de riesgo, que pueden ser un marcador negativo que afecta la calidad de vida del paciente y por sí mismos determinan el tiempo de supervivencia.

A retrospective, cross-sectional and descriptive study was carried out, to determine the prediction factors about the emergence of complications in 300 patients with a created arteriovenous fistula, assisted in the Angiology and Vascular Surgery Service of "Saturnino Lora" Teaching Provincial Hospital in Santiago de Cuba during the triennium 2012 - 2015. Among the main results the female sex (52.7%), the 51-60 age group (55.6%), hypertension and diabetes mellitus prevailed as the most common risk factors, as well as the AVF complication at wrist level, mainly in females (34.2%). It was concluded that the arteriovenous fistula complications depend on the presence or not of risk factors that can be a negative marker that affects the patient's life quality and per se determine the survival time.

Análisis estadístico implicativo para la identificación de factores pronósticos de la mortalidad por cáncer de pulmón / Statistical analysis involving the identification of mortality prediction factors due to lung cancer

Se realizó un estudio observacional y analítico para evaluar la utilidad de una nueva técnica de análisis estadístico implicativo en la identificación de los factores pronósticos de una entidad clínica en la provincia de Santiago de Cuba, de septiembre de 2013 a igual mes de 2014, en cuyo caso fue seleccionado el cáncer de pulmón por ser la neoplasia maligna más frecuente en el territorio. Como factores pronósticos de tumores pulmonares, según la regresión logística fueron identificados la afectación ganglionar, la presencia de metástasis y la localización central del tumor, y según el análisis estadístico implicativo se detectaron la afectación ganglionar, la presencia de metástasis, el grado III de diferenciación histológica y el estadio avanzado. El análisis estadístico implicativo resultó ser una técnica apropiada que complementa a la regresión logística en la identificación de factores pronósticos, pues se logra una mejor comprensión de la causalidad y eleva la calidad de este tipo de investigación.

An observational and analytic study to evaluate the usefulness of a new technique of statistical analysis involving the prediction factors identification of a clinical entity in Santiago de Cuba, was carried out from September, 2013 to the same month in 2014, in this case lung cancer was selected for being the most frequent malignancy in the territory. As prediction factors of lung tumors, according to the logistical regression the nodular involvement, the metastasis and the central localization of the tumor were identified, and according to the statistical involving analysis, the nodular involvement, and metastasis, histologic differentiation stage III and advanced stage were detected. The statistical involving analysis turned out to be an appropriate technique that supplements logistical regression in the prediction factors identification, because a better understanding of the causation is achieved and the quality of this investigation increases.

Factores de riesgo relacionados con las infecciones posoperatorias / Risk factors related to the postoperative infections

Se realizó una investigación descriptiva y observacional, de serie de casos, basada en los 258 pacientes que presentaron complicaciones posoperatorias infecciosas, tras habérseles practicado intervenciones quirúrgicas, tanto de forma electiva como urgente, en el período comprendido desde enero de 2012 hasta diciembre de 2014. Entre los principales resultados se obtuvo un predominio de los pacientes mayores de 60 años (38,4 %) y operados con urgencia (82,1 %); razón por la cual se observó que las intervenciones clasificadas como contaminadas (43,4 %) y sucias (23,6 %) ocuparon un lugar importante en la génesis de esta complicación. También fue más frecuente la infección del sitio operatorio superficial (55,5 %) respecto al resto de las localizaciones. Se pudo concluir que factores como el nivel de contaminación de la intervención, el tiempo quirúrgico prolongado, el estado físico preoperatorio en las clases II y III de la American Society of Anesthesiology, el tipo de operación y la edad del paciente, fueron decisivos en la aparición de las infecciones posquirúrgicas.

A descriptive and observational serial cases investigation, based on the 258 patients that presented infectious postoperative complications, after undergoing surgical interventions, either in an elective way or as an emergency, was carried out from January, 2012 to December, 2014. Among the main results there was a prevalence of the patients older than 60 (38.4%) and those undergone surgery as an emergency (82.1%); reason why it was observed that the interventions classified as polluted (43.4%) and dirty (23.6%) occupied an important place in the genesis of this complication. It was also more frequent the infection of the superficial operative place (55.5%) regarding the rest of the localizations. It was concluded that factors as the intervention contamination level, the long-lasting surgical time, preoperative physical state in the classes II and III of the American Society of Anesthesiology, operation type and the patient's age, were decisive in the emergence of postsurgical infections.