RÉSUMÉ
Introdução: O câncer de pulmão é uma doença grave, sendo a segunda maior causa de morte em todo o mundo, entretanto, em alguns países desenvolvidos, tornou-se já a primeira causa de morte. Cerca de 90% dos casos de neoplasia pulmonares são causados pela inalação da fumaça do cigarro. Objetivo: Correlacionar a prevalência de tabagismo e morbimortalidade por câncer de pulmão nos estados brasileiros, além de demonstrar a associação destes com sexo e faixa etária. Métodos: Estudo de caráter ecológico acerca da prevalência de tabagismo e morbimortalidade por câncer de pulmão nos estados brasileiros, nos períodos de 2013 e 2019, dividida por sexo e faixa etária. Foram utilizados bancos de coleta de dados como o Tabnet e Pesquisa Nacional de Saúde. Resultados: As maiores taxas de mortalidade e internações hospitalares foram do público masculino, em 2013, com taxa de 2,7 e 10, respectivamente, e em 2019 com 3,3 e 11,9, respectivamente. Ademais, a maior prevalência de tabagismo foi encontrada nos homens; entretanto seu índice tem caído, enquanto a quantidade de mulheres tabagistas tem aumentado. A Região Sul demonstrou maiores números de mortalidade em ambos os períodos estudados, com taxas de 4,9 e 5,8 por 100 mil habitantes, e morbidade hospitalar com 19,9 e 23,5 por 100 mil habitantes. Já a Região Norte se configurou com as menores prevalências: em 2013 apresentou taxa de óbito por câncer de pulmão de 1,0 e morbidade hospitalar de 3,5/100 mil habitantes, em 2019 apresentou taxa de mortalidade de 4,6 e internações de 1,6/100 mil habitantes. Os coeficientes de correlação de morbidade hospitalar e prevalência de tabagismo foram R2=0,0628, r=0,251 e p=0,042, enquanto os de mortalidade e prevalência de tabagismo foram R2=0,0337, r=0,183 e p=0,140. Conclusões: Na presente pesquisa, pode-se inferir que houve associação positiva na comparação entre taxa de morbidade hospitalar e prevalência de tabagismo; em contrapartida, não foi possível observar associação positiva na correlação da taxa de mortalidade por câncer de pulmão e prevalência de tabagismo.
Introduction: Lung cancer is a serious disease, being the second leading cause of death worldwide. Moreover, in some developed countries, it has already become the leading cause of death. About 90% of lung cancer cases are caused by cigarette smoking. Objective: To correlate the prevalence of smoking and lung cancer morbidity and mortality in Brazilian states, and to demonstrate their association with sex and age group as well. Methods: An ecological study on the prevalence of smoking and lung cancer morbidity and mortality in Brazilian states between 2013 and 2019, divided by sex and age group. The data collection databases Tabnet and National Health Survey were used. Results: The highest rates of mortality and hospital admissions were among men, in 2013 with a rate of 2.7 and 10, respectively, and in 2019 with 3.3 and 11.9, respectively. In addition, the highest prevalence of smoking was found in men, but this rate has fallen, while the number of women smokers has increased. The South region showed higher mortality rates in both periods studied, with rates of 4.9 and 5.8 per 100,000 inhabitants, and hospital morbidity with 19.9 and 23.5 per 100,000 inhabitants. The North region had the lowest prevalence, where in 2013, it had a death rate from lung cancer of 1.0 and hospital morbidity of 3.5/100 thousand inhabitants, and where in 2019, it had a mortality rate of 4.6 and hospitalizations of 1.6/100 thousand inhabitants. The correlation coefficients for hospital morbidity and smoking prevalence were R2=0.0628, r=0.251 and p=0.042, while for mortality and smoking prevalence, these were R2=0.0337, r=0.183 and p=0.140. Conclusions: In the present study, it can be inferred that there was a positive association between hospital morbidity rate and prevalence of smoking, while it was not possible to observe a correlation between lung cancer mortality rate and prevalence of smoking.
Introducción: El cáncer de pulmón es una enfermedad grave, siendo la segunda causa de muerte en todo el mundo, sin embargo, en algunos países desarrollados, ya se ha convertido en la primera causa de muerte. Alrededor del 90% de los casos de neoplasias pulmonares están causados por la inhalación del humo del cigarrillo. Objetivo: Correlacionar la prevalencia de tabaquismo y la morbimortalidad por cáncer de pulmón en los estados brasileños, además de demostrar la asociación de estos con el género y el grupo de edad. Métodos: estudio ecológico sobre la prevalencia de tabaquismo y morbimortalidad por cáncer de pulmón en los estados brasileños, dentro de los períodos 2013 y 2019, divididos por sexo y grupo de edad. Se utilizaron bancos de recogida de datos como Tabnet y la Encuesta Nacional de Salud. Resultados: las mayores tasas de mortalidad e ingresos hospitalarios se dieron en el público masculino, en 2013 con una tasa de 2,7 y 10, respectivamente, y en 2019 con 3,3 y 11,9, respectivamente. Además, la mayor prevalencia del tabaquismo se encontró en los hombres, sin embargo, su tasa ha disminuido, mientras que la cantidad de mujeres fumadoras ha aumentado. La región Sur presentó cifras más altas de mortalidad en ambos periodos estudiados, con tasas de 4,9 y 5,8 por 100.000 habitantes, y de morbilidad hospitalaria con 19,9 y 23,5 por 100.000 habitantes. Mientras que la región Norte se configuró con las prevalencias más bajas, en 2013 presentó una tasa de mortalidad por cáncer de pulmón de 1,0 y una morbilidad hospitalaria de 3,5/100.000 habitantes, en 2019 presentó una tasa de mortalidad de 4,6 y hospitalizaciones de 1,6/100.000 habitantes. Los coeficientes de correlación para la morbilidad hospitalaria y la prevalencia del tabaquismo fueron R2=0,0628, r=0,251 y p=0,042, mientras que para la mortalidad y la prevalencia del tabaquismo fueron R2=0,0337, r=0,183 y p=0,140. Conclusiones: En la presente investigación se puede inferir que existe una asociación positiva en la comparación entre la tasa de morbilidad hospitalaria y la prevalencia de tabagismo, en contrapartida, no fue posible observar una asociación positiva en la correlación de la tasa de mortalidad por cáncer de pulmón y la prevalencia de tabagismo.
Sujet(s)
Humains , Trouble lié au tabagisme , Cancérogènes , Produits du tabac , Tumeurs du poumonRÉSUMÉ
Resumen La investigación tuvo como objetivo comprender las experiencias alrededor de la sexualidad desde la teoría de los holones en un grupo de mujeres diagnosticadas con cáncer ginecológico en la ciudad de Pereira, Colombia. Se implementó un diseño cualitativo y fenomenológico, con la participación de seis mujeres entre 30 y 60 años, a quienes se aplicaron entrevistas semiestructuradas explorando los holones de reproductividad, género, erotismo y vinculación afectiva interpersonal. Las entrevistas fueron transcritas y analizadas de forma manual, mediante codificación abierta y axial para identificar categorías emergentes. En los discursos de las mujeres se evidenciaron elementos relacionados a los holones de la sexualidad. En el holón de reproductividad, se encontró una resignificación del rol reproductivo como madres; en el holón de género, se presentaron actitudes positivas hacia el cuerpo y amenazas a la identidad de género por causa de los cambios provocados por la enfermedad; en el holón de erotismo, las mujeres relataron experiencias sexuales marcadas por el dolor y el apoyo erótico de la pareja; y en el holón de vinculación afectiva interpersonal, se evidenciaron situaciones de estabilidad conyugal, separación temporal con la pareja y sostenimiento de vínculos abusivos durante el proceso de tratamiento oncológico. Estos hallazgos muestran una amplia reconfiguración integral de la sexualidad femenina en cada uno de los holones y realizan un aporte significativo a la comprensión de las subjetividades de las mujeres en el proceso de afrontar el cáncer ginecológico. Se recomienda realizar nuevas investigaciones con mayor cantidad de participantes y en otras regiones de Colombia.
Abstract The research aimed to understand the experiences around sexuality, from the holon theory, in a group of women diagnosed with gynecological cancer from Pereira, Colombia. A qualitative and phenomenological design was carried out, with the participation of six women between 30 and 60 years of age, to whom semi-structured interviews were applied, exploring the holons of reproductivity, gender, eroticism and interpersonal affective bonding. The interviews were transcribed and analyzed manually, using open and axial coding to identify emerging categories. In the women's discourses, elements related to the holons of sexuality were evident. In the holon of reproductivity, a resignification of the reproductive role as mothers was found; in the holon of gender, positive attitudes towards their bodies and threats to gender identity due to the changes caused by the disease were presented; in the holon of eroticism, women reported sexual experiences characterized by pain and erotic support from their partners; and in the holon of affective interpersonal bonding, they reported situations of marital stability, temporary separation from their partners and abusive ties during the process of cancer treatment. These findings show a comprehensive reconfiguration of female sexuality in each of the holons and make a significant contribution to the understanding of women's subjectivities in the process of coping with gynecological cancer. Further research with a larger number of participants and in other regions of Colombia is recommended.
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Abstract Background: Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive technique that acts on the activity of the cerebral cortex employing electrical currents. Aim: The objective of this project is to evaluate the effectiveness of rTMS on pain and quality of life in patients with chemotherapy-induced peripheral neuropathic pain. Method: Ten patients with chemotherapy-induced peripheral neuropathic pain received 20 sessions of rTMS, consisting of 15 minutes of treatment repeated 5 times per week for four weeks (10 Hz, 20s, 30 trains with 81% intensity). Patients were evaluated using the Brief pain inventory (BPI) and the Functional Assessment of Cancer Therapy and neurotoxicity (FACT-GOG-NTX 13). Results: There were significant differences in BPI mean severity, interference score and FACT-GOG-NTX 13 (p<0,05). Conclusion: The pilot study results suggest that rTMS is potentially beneficial for the treatment of chemotherapy-induced peripheral neuropathy. rTMS over the M1 had an important reduction in pain severity, interference with daily activities, and quality of life scores. However, results should be taken with caution due to the small sample size, absence of a control group and short period of follow-up.
Resumen Antecedentes: La estimulación magnética transcraneal repetitiva (EMTr) es una técnica no invasiva que actúa sobre la actividad de la corteza cerebral, empleando corrientes eléctricas. Objetivo: El objetivo de este proyecto es evaluar la eficacia de la EMTr sobre el dolor y la calidad de vida en pacientes con dolor neuropático periférico inducido por quimioterapia. Métodos: Diez pacientes con dolor neuropático periférico inducido por quimioterapia recibieron 20 sesiones de EMTr que consistieron en un tratamiento de 15 minutos repetido 5 veces por semana durante cuatro semanas (10 Hz, 20 s, 30 trenes con 81 % de intensidad). Los pacientes fueron evaluados mediante el Inventario Breve de Dolor (BPI) y la Evaluación Funcional de la Terapia del Cáncer y la neurotoxicidad (FACT-GOG-NTX 13). Resultados: Hubo diferencias significativas en la severidad media del dolor del BPI, la puntuación de interferencia y el FACT-GOG-NTX 13 (p<0,05). Conclusión: Los resultados del estudio piloto sugieren que la rTMS es potencialmente beneficiosa para el tratamiento de la neuropatía periférica inducida por la quimioterapia. La rTMS sobre M1 tuvo una reducción importante de la severidad del dolor, la interferencia con las actividades diarias y las puntuaciones de calidad de vida. Sin embargo, los resultados deben tomarse con cautela debido al pequeño tamaño de la muestra, la ausencia de un grupo de control y el corto período de seguimiento.
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O câncer, frequentemente relacionado ao envelhecimento, impulsiona pacientes a buscarem tratamento hospitalar ou métodos alternativos, como plantas medicinais. Este estudo visou avaliar os perfis sociodemográfico e clínico e o consumo de plantas para fins medicinais entre pacientes idosos em tratamento oncológico no Hospital Araújo Jorge (HAJ). Dados de 55 pacientes foram analisados, abrangendo informações sociodemográficas, tipos de câncer, tratamento, a utilização de plantas medicinais, o objetivo de uso, as fontes de informações sobre plantas e se notaram alguma reação adversa após o consumo. A faixa etária mais encontrada foi 61 a 70 anos (67,27%), a maioria dos pacientes eram homens (63,64%), com ensino fundamental incompleto (32,73%), casados (56,36%) e que moram no interior de Goiás (43,64%). Quanto ao tratamento, a maioria realizava quimioterapia (40,00%) e o câncer gástrico foi mais relatado (14,54%). Sobre o uso de plantas medicinais, a maioria relatou simpatizar com o consumo (58,18%), e acredita em sua segurança devido à origem natural (59,37%). Informações sobre o uso de plantas medicinais eram obtidas com amigos, vizinhos e familiares (21,81%). Ao relatar sobre o consumo de plantas medicinais durante a quimioterapia, a maioria não percebeu nenhum efeito (40,63%). Foram citadas 17 plantas, que eram utilizadas no tratamento anticâncer (29,00%) e preparadas como infusões (18,75%) pelo uso das folhas frescas (60,00%), principalmente para uso interno (46,87%). Diante disso, a atenção farmacêutica se mostra vital para guiar pacientes nas práticas seguras e eficazes de consumo. Isso inclui direcionar sobre doses adequadas, efeitos colaterais e interações, garantindo bem-estar e prevenindo riscos à saúde.
Cancer, which is often related to ageing, drives patients to seek hospital treatment or alternative methods such as medicinal plants. This study aimed to evaluate the sociodemographic and clinical profile and the consumption of plants for medicinal purposes among elderly patients undergoing cancer treatment at the Araújo Jorge Hospital (AJH). Data from 55 patients was analyzed, covering sociodemographic information, types of cancer, treatment, the use of medicinal plants, the purpose of use, the source of information about plants and whether they noticed any adverse reactions after consumption. The most common age group was 61 to 70 years (67.27%), the majority of patients were men (63.64%), had incomplete primary education (32.73%), were married (56.36%) and lived in the interior of Goiás (43.63%). With regard to treatment, the majority were undergoing chemotherapy (40,00%) and gastric cancer was the most frequently reported (14.54%). With regard to the use of medicinal plants, the majority were sympathetic to their consumption (58.18%) and believed them to be safe due to their natural origin (59.37%). Information on the use of medicinal plants was obtained from friends, neighbors and family members (21.81%). When reporting on the consumption of medicinal plants during chemotherapy, the majority did not notice any effect (40.63%). Seventeen plants were mentioned, which were used for anticancer treatment (29,00%) and prepared as infusions (18.75%) with fresh leaves (60,00%), mainly for internal use (46.87%). In view of this, pharmaceutical care is vital to guide patients in safe and effective consumption practices. This includes guidance on appropriate doses, side effects and interactions, ensuring well-being and preventing health risks.
Sujet(s)
Humains , Mâle , Femelle , Adulte d'âge moyen , Sujet âgé , Sujet âgé de 80 ans ou plusRÉSUMÉ
A instabilidade de microssatélites é um fenômeno genético caracterizado pela alteração na repetição de sequências de nucleotídeos conhecidas como microssatélites. Esta instabilidade pode ocorrer devido a defeitos nos genes reparadores de DNA, como os genes MLH1, MSH2, MSH6 e PMS2. A inflamação crônica tem sido associada ao desenvolvimento do câncer colorretal. Os genes da instabilidade de microssatélites estão envolvidos na regulação da resposta inflamatória, podendo influenciar a progressão tumoral. Estudos demonstraram que a presença de instabilidade de microssatélites em tumores colorretais está relacionada a uma maior infiltração de células imunes, como linfócitos T, macrófagos e neutrófilos, que podem modular a resposta inflamatória no microambiente tumoral. O estresse oxidativo é caracterizado pelo desequilíbrio entre a produção de espécies reativas de oxigênio e a capacidade antioxidante do organismo e desempenha um papel importante na carcinogênese. Os genes da instabilidade de microssatélites podem influenciar a resposta ao estresse oxidativo, afetando a capacidade das células tumorais de lidar com o dano oxidativo e promovendo a sobrevivência celular. O objetivo deste trabalho consiste na compreensão dos genes envolvidos na instabilidade de microssatélites no câncer colorretal e como eles contribuem para o desenvolvimento da doença, relacionando com processos inflamatórios e estresse oxidativo nas células tumorais. Justifica-se pela necessidade de compreensão das interconexões entre a instabilidade de microssatélites, inflamação e o estresse oxidativo em pacientes com câncer colorretal.
Microsatellite instability is a genetic phenomenon characterized by changes in the repetition of nucleotide sequences known as microsatellites. This instability may occur due to defects in DNA repair genes, such as the MLH1, MSH2, MSH6 and PMS2 genes. Chronic inflammation has been linked to the development of colorectal cancer. Microsatellite instability genes are involved in regulating the inflammatory response and may influence tumor progression. Studies have shown that the presence of microsatellite instability in colorectal tumors is related to a greater infiltration of immune cells, such as T lymphocytes, macrophages and neutrophils, which can modulate the inflammatory response in the tumor microenvironment. Oxidative stress is characterized by the imbalance between the production of reactive oxygen species and the body's antioxidant capacity and plays an important role in carcinogenesis. Microsatellite instability genes can influence the response to oxidative stress, affecting the ability of tumor cells to deal with oxidative damage and promoting cell survival. The objective of this work is to understand the genes involved in microsatellite instability in colorectal cancer and how they contribute to the development of the disease, relating it to inflammatory processes and oxidative stress in tumor cells. It is justified by the need to understand the interconnections between microsatellite instability, inflammation and oxidative stress in patients with colorectal cancer.
Sujet(s)
HumainsRÉSUMÉ
RESUMEN Introducción: el cáncer cervical representa un grave problema de salud pública a pesar de ser altamente prevenible. Objetivo: determinar las características clínicas y epidemiológicas de la participación de las mujeres del área de influencia de un Hospital Público en la prevención del cáncer de cuello uterino entre los meses de enero a diciembre de los años 2020 al 2021. Metodología: diseño no experimental de corte transversal tipo descriptivo, con enfoque cuantitativo. Se incluyó el total de mujeres participantes de la prevención de cáncer cervical en el área de influencia del Hospital Público. Se utilizaron datos secundarios que fueron cargados en una planilla elaborada previamente. Resultados: el 61 % de las mujeres estaban en edad de riesgo, 83 % no estaban embarazadas y 17 % si, 53 % tiene antecedente de PAP y 47 %, no, 86 % tuvo resultado negativo para lesión, 9 % inflamatorio y 4 % positivo. Entre los resultados positivos el preponderante fue el de ASCUS con un 47 %. Se concluye que la mayoría de las mujeres tuvieron un resultado de PAP negativo. Entre las mujeres con resultados positivos se tuvo preponderancia de diagnósticos de ASCUS y en segundo lugar CIN I LSIL. Conclusión: las características que se encontraron significativamente asociadas al resultado de PAP fueron: formar parte del grupo de edad de riesgo y presencia de embarazo. Se sugiere seguir haciendo hincapié en la prevención y seguimiento, indagar en las edades de riesgo e incluir otras variables de interés en futuros estudios.
ABSTRACT Introduction: cervical cancer represents a serious public health problem despite being highly preventable. Objective: to determine the clinical and epidemiological characteristics of the participation of women in the area of influence of a Public Hospital in the prevention of cervical cancer between the months of January to December of the years 2020 to 2021. Methodology: non-experimental cross-sectional descriptive design, with a quantitative approach. The total number of women participating in the prevention of cervical cancer in the area of influence of the Public Hospital was included. Secondary data were used that were loaded into a previously prepared form. Results: 61 % of the women were of 13 years old at risk, 83 % were not pregnant and 17 % were pregnant, 53 % had a history of PAP and 47 % did not, 86 % had a negative result for lesion, 9 % inflammatory and 4 % positive. Among the positive results, the predominant one was ASCUS with 47 %. The majority women had a negative PAP result. As a conclusion among women with positive results, there was a predominance of ASCUS diagnoses and in second place CIN I LSIL. Conclusion: the features that were found to be significantly associated with the PAP result were: being part of the age group at risk and presence of pregnancy. It is suggested to continue emphasizing prevention and follow-up, to investigate the ages at risk and to include other variables of interest in future studies.
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RESUMEN El propósito del estudio fue describir las características clínicas, anatomopatológicas, tratamiento y supervivencia de los pacientes con cáncer de tiroides diferenciado. Se realizó un estudio de cohorte retrospectiva con datos de 150 pacientes de un hospital peruano entre los años 2010 al 2020. Se describieron las características y supervivencia (método de Kaplan-Meier). La media de edad fue 48,3 años, 130 (86,7%) fueron mujeres y el tipo histológico más frecuente fue el papilar 94,6%. El 74,2% tenían estadio TNM I, 70,7% tiroidectomía total y 68,7% recibió yodo radiactivo. La supervivencia global a los 5 años fue 89,3%, siendo menor en aquellos con estadio TNM IV y mayor en los que usaron yodo radiactivo. En conclusión, en un hospital de Cusco, el cáncer diferenciado de tiroides fue más frecuente en mujeres y la supervivencia fue menor en comparación con reportes de otros países.
ABSTRACT This study aimed at studying the clinical and anatomopathological characteristics, treatment and survival of patients with differentiated thyroid cancer. A retrospective cohort study was conducted with data from 150 patients from a Peruvian hospital between the years 2010 to 2020. Characteristics and survival (Kaplan-Meier method) were described. The mean age was 48.3 years, 130 participants (86.7%) were women and the most frequent histologic type was papillary 94.6%. Of the participants, 74.2% had TNM stage I, 70.7% had total thyroidectomy and 68.7% received radioactive iodine. Overall survival at 5 years was 89.3%, being lower in those with TNM stage IV and higher in those who used radioactive iodine. In conclusion, in a hospital in Cusco, differentiated thyroid cancer was more frequent in women and survival was lower compared to reports from other countries.
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Objetivo: refletir sobre os cuidados paliativos em oncopediatria, desenvolvido por enfermeiros, a partir do referencial teórico proposto por Jean Watson. Método: estudo teórico-reflexivo, realizado em agosto de 2023, durante a elaboração de Tese de Doutorado, embasado em publicações científicas nacionais e internacionais sobre a Teoria do Cuidado Humano de Jean Watson e sobre cuidados paliativos em oncopediatria. Resultados: observou-se que a presente teoria pode subsidiar o enfermeiro a superar a filosofia do cuidado direcionado apenas as necessidades físicas, visto que os principais conceitos da teoria despertam reflexões relevantes sobre as dimensões biopsicossocioespirituais da criança com câncer em assistência paliativa. Considerações finais: a abordagem holística contribui com a promoção do bem-estar e da qualidade de vida, independente do prognóstico da doença. A utilização dos 10 elementos do Processo Caritas, favorece a assistência efetivada por meio de um processo dinâmico, permeado pelo carinho, atenção, respeito, lúdico e comunicação efetiva.
Objective: to reflect on palliative care in pediatric oncology, developed by nurses, based on the theoretical framework proposed by Jean Watson. Method: theoretical-reflective study, carried out in August 2023, during the preparation of the Doctoral Thesis, based on national and international scientific publications on Jean Watson's Theory of Human Care and on palliative care in pediatric oncology. Results: it was observed that the present theory can support nurses to overcome the philosophy of care directed only to physical needs, since the main concepts of the theory awaken relevant reflections on the biopsychosocial-spiritual dimensions of children with cancer undergoing palliative care. Final considerations: the holistic approach contributes to promoting well-being and quality of life, regardless of the prognosis of the disease. The use of the 10 elements of the Caritas Process favors assistance provided through a dynamic process, permeated by affection, attention, respect, fun and effective communication.
Objetivo: reflexionar sobre los cuidados paliativos en oncología pediátrica, desarrollados por enfermeros, a partir del marco teórico propuesto por Jean Watson. Método: estudio teórico-reflexivo, realizado en agosto de 2023, durante la elaboración de la Tesis Doctoral, basado en publicaciones científicas nacionales e internacionales sobre la Teoría del Cuidado Humano de Jean Watson y sobre cuidados paliativos en oncología pediátrica. Resultados: se observó que la presente teoría puede apoyar al enfermero a superar la filosofía del cuidado dirigido sólo a las necesidades físicas, ya que los principales conceptos de la teoría despiertan reflexiones relevantes sobre las dimensiones biopsicosocial-espirituales de los niños con cáncer sometidos a cuidados paliativos. Consideraciones finales: el enfoque holístico contribuye a promover el bienestar y la calidad de vida, independientemente del pronóstico de la enfermedad. El uso de los 10 elementos del Proceso Cáritas favorece la asistencia brindada a través de un proceso dinámico, permeado por el cariño, la atención, el respeto, la diversión y la comunicación efectiva.
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Background: Pain in patients with oral cancers can limit the normal functioning and quality of life. Neuropathic pain raises the anxiety and depression levels, increases the morbidity and decreases the efficiency to work. Neuropathic pain is frequently diagnosed as a complication of cancer pain due to direct invasion of nerves, plexus or compression, and side effect of chemotherapy, radiation injury or surgery. Methods: A total of 60 patients were divided randomly into two groups based on treatment: group P (pregabalin) and group G (gabapentin). The intensity of pain was measured using visual analog scale (VAS) and DN4 questionnaire (Douleur Neuropathique 4) was used to evaluate neuropathic component. Changes in pain score and neuropathic component was assessed at 2nd and 4th week of follow up. Data was collected and analysed using SPSS 20.0 software at level of significance being p<0.05. Results: At baseline, the mean±SD of VAS score in group P was 7.20±0.79; in group G was 7.13±0.66. At 2nd week, the mean±SD of VAS score in group P was 4.5±0.91; in group G was 4.46±0.88. At 4th week, the mean±SD of VAS score in group P was 3.66±0.69; in group G was 3.83±0.85. At baseline, the mean±SD of DN4 score in group P was 7.13±0.80; in group G was 6.93±0.85. At 2nd week, the mean±SD of DN4 score in group P was 4.73±0.92; in group G was 4.46±0.82. At 4th week, the mean±SD of DN4 score in group P was 3.73±0.42; in group G was 3.93±0.62. Conclusions: Pregabalin was found to be more effective with lesser side effects than gabapentin
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Background: Cervical cancer is a common gynecological malignancy and public health problem that can be prevented, but the utilization of screening is just 2.6%-5% in India. Healthcare providers mainly nursing personnel are crucial and play a vital role in raising awareness and educating the public about implementation of low-cost cervical cancer screening approaches in low-resource settings. Objectives were to determine baseline information about knowledge of cervical cancer and explore attitude and practice of pap smear screening among staff nurses. Methods: The questionnaire containing mostly recognition and some recall type questions about demographics, knowledge about cervical cancer, its risk factors, screening techniques, attitudes towards cervical cancer screening and its practices and their knowledge was tested. Results: Analyses of knowledge showed that majority of nurses recognized the risk factors and symptoms associated with carcinoma of cervix. A considerable lack of knowledge was observed on the treatment of cervical cancer but a significant portion of nurses knew about prevention. A positive attitude was observed on all aspects of cervical cancer and its prevention. Conclusions: This study demonstrates a good knowledge and positive attitude about carcinoma of cervix and its prevention amongst the nurses which plays a key role in the campaign to prevent cervical malignancy. Poor practice seen in this study emphasizes the need to translate the awareness to practice. Easier availability of HPV testing and better distribution of HPV vaccine is paramount to successfully prevent cervical cancer in future.
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Proteostasis, the intricate balance of protein synthesis, folding, trafficking, and degradation, is a fundamental cellular process crucial for maintaining cellular health and homeostasis. Imbalances in proteostasis are implicated in various diseases, including neurodegenerative disorders, cancer, aging, type 2 diabetes mellitus, cataract, huntington's disease, heart disease, sarcopenia, ischemic disorders, diabetic neuropathy and other metabolic conditions. We delve in to the proteostasis mechanisms and highlight the significance of proteostasis in the context of protein misfolding diseases that have broadened our understanding of proteostasis network. Further, we explore the relevance of proteostasis in cancer, shedding light on the interplay between the ubiquitin-proteasome system and oncoproteins. Furthermore, we also address therapeutic approaches aimed at modulating proteostasis to combat protein misfolding diseases. The mysteries of protein balance continue to captivate researchers, and the evolving landscape of proteostasis research promises insights into novel therapeutic strategies and a deeper understanding of its role in human health. This review offers a comprehensive perspective on the ever-expanding frontiers of proteostasis research, with the hope of inspiring further exploration and innovation in this dynamic field.
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Background: Concurrent chemoradiation is one of the major treatments for locally advanced rectal cancer. As radiation therapy suppresses the bone marrow, it is essential to quantify the dose received by the pelvic bone marrow (PBM), which constitutes about 50% of the hematopoietic bone marrow. Methods: A prospective study conducted in 50 patients with locally advanced rectal cancer treated with long course concurrent chemoradiation. All the patients were followed up with weekly complete blood count for assessing hematological toxicities and were graded. PBM was contoured and subdivided into ilium bone marrow (IBM), lower pelvis bone marrow (LPBM) and lumbosacral bone marrow (LSBM). Volumes of bone marrow receiving different doses were quantified. Results: Among the 50 patients, 40 (80%) developed acute bone marrow toxicity, during the course of treatment. Highest grade of bone marrow toxicity developed in 20 (40%) patients which was grade 2. Compared to grade 1, grade 2 neutropenia patients exhibited significantly higher levels of V10 to V40 (p<0.05) in PBM and significantly higher levels of V20 in IBM and LSBM. In LPBM, compared to grade 1 leukopenia and neutropenia, grade 2 leukopenia and neutropenia exhibited significantly higher levels of V10 and V20 (p<0.05). Conclusions: Increased PBM V10 to V40, IBM V20, LSBM V20, LPBM V10 and V20 were significantly related to the higher grades of neutropenia in locally advanced rectal cancer patients undergoing long course concurrent chemoradiation. Increased LPBM V10 and V20 were also significantly related with higher grades of leukopenia.
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Background: Objective of the study was to compare the effectiveness of VIA and pap smear for screening of premalignant lesions of cervix and to compare the performance of VIA used alone and combined with pap smear for screening of premalignant lesions of cervix.Methods: VIA and Pap smear were performed in 260 patients attending routine gynaecology OPD. Positive cases of either or both screening tests were subjected to colposcopy and biopsy if indicated. The reports of histopathology were correlated with the pap smear and VIA findings and thereby sensitivity, specificity, positive and negative predictive values of each of the screening methods were calculated and results were analysed.Results: 260 patients were screened for premalignant lesions of cervix by VIA and pap smear both, 37 of 260 patients, (14.2%) were VIA positive, 30 of 260 patients (11.5%) were pap smear positive, 20 of 260 patients (7.69%) were positive for VIA as well as pap smear, 25 of 260 patients (9.6%) were confirmed of premalignant lesions on histopathology, 24 patients were diagnosed CIN and one patient was diagnosed with CIS.Conclusions: VIA has lower sensitivity and specificity compared to Pap smear but the results are comparable. Both the tests are fairly accurate. A combination of VIA and Pap smear increased the sensitivity and specificity to 100%.
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Introduction: Thyroid cancer, considered one of the most frequent malignant tumors of the endocrine system, accounts for 80%-90% of cases. The most common histological type observed in most studies is papillary cancer. Objective: To determine the frequency of thyroid cancer in patients undergoing total thyroidectomy at the Otorhinolaryngology Department of the Hospital de Clínicas between the period 2018-2022. Methodology: This retrospective study included 260 patients treated during the study period. Data were obtained from the patients' medical records, and sociodemographic and clinical variables related to thyroid cancer were analyzed. Data were analyzed with the SPSS v25 program, using descriptive statistics. Results: The frequency of thyroid cancer was 48.1%. The mean age of the cancer patients was 42.10±13.10 years. A higher frequency was observed in females 34.2%, n=89) and among those aged 25-44 years 20.0%, n=52). The most frequent were papillary (36.9%), follicular (2.7%), medullary (1.5%), and anaplastic (1.2%) types. Discussion: The frequency of thyroid cancer is high; it is more common in women and as age increases.
Introducción: El cáncer de tiroides, considerado uno de los tumores malignos más frecuentes del sistema endocrino, representa entre el 80% y el 90% de los casos. El tipo histológico más común observado en la mayoría de los estudios es el cáncer papilar. Objetivo: Determinar la frecuencia de cáncer de tiroides en pacientes sometidos a tiroidectomía total en la Cátedra y Servicio de Otorrinolaringología del Hospital de Clínicas durante el período 2018-2022. Metodología: se realizó un estudio retrospectivo con un total de 260 pacientes atendidos en el período de estudio. Los datos fueron tomados de las historias clínicas de los pacientes, en el cual se analizan variables sociodemográficas y clínicas relacionadas con el cáncer de tiroides. Los datos se analizaron con el programa SPSS v25, mediante estadística descriptiva. Resultados: La frecuencia del cáncer de tiroides fue del 48.1%. El promedio de edad de los pacientes con cáncer fue de 42.10±13.10 años. se observó una mayor frecuencia en las personas del sexo femenino 34.2% (n=89) y entre quienes tuvieron de 25-44 años 20.0% (n=52). El más frecuente fue el tipo papilar 36.9%, el folicular 2.7%, el medular 1.5% y el anaplásico 1.2%. Discusión: la frecuencia de cáncer de tiroides es alta, es más frecuente en las mujeres y a medida que aumenta la edad.
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Resumen Introducción : La inspección visual con ácido acé tico (IVAA) es una alternativa primaria para mer mar la incidencia y mortalidad por cáncer de cuello uterino (CaCu). El objetivo del estudio es conocer la proporción de mujeres de 30 a 49 años que usaron el test de IVAA en los últimos dos años y los factores asociados con el uso de la prueba, en el ámbito de la atención primaria. Métodos : Estudio transversal y multicéntrico, partici paron 706 mujeres de 30 a 49 años, usuarias de centros de atención primaria en una región del Perú. La variable dependiente fue el uso del test de IVAA, en los últimos dos años y las independientes los factores sociodemo gráficos, sociosanitarios, de información y actitud. Resultados : La proporción de mujeres que usaron el test de IVAA, fue del 30.6%. Se asociaron con mayor uso de la prueba, el área de residencia urbana, haber recibido recomendación para realizarse la IVAA, sentir preocupación por adquirir CaCu, haber oído hablar del CaCu y del virus del papiloma humano, el considerar tener mayor o igual probabilidad de desarrollar CaCu respecto a mujeres de su edad y con menor uso de la prueba, el proceder de la sierra y considerar riesgoso realizarse la IVAA. Conclusión : El programa de tamizaje del CaCu, me diante IVAA no estaría logrando el impacto deseado. Se requiere fortalecer estrategias e intervenciones en atención primaria, para mejorar las conductas y tasas del cribado.
Abstract Introduction : Visual inspection with acetic acid (VIA) is a primary alternative to reduce cervical cancer (CaCu) incidence and mortality. The study aimed to determine the proportion of women aged 30-49 years who used VIA in the last two years and the factors associated with the use of the test in the primary care setting. Methods : Cross-sectional, multicenter study. Seven hundred and six women aged 30 to 49 years partici pated, users of primary health care centers in a region of Peru. The dependent variable was the use of the VIA test in the last two years and the independent variables were sociodemographic, socio-health, information and attitudinal factors. Results : The proportion of women who used the VIA test was 30.6%. The following factors were associated with greater use of the test: urban area of residence, having received a recommendation for VIA, feeling worried about acquiring CaCu, having heard about CaCu and the human papilloma virus. Also, considering having a greater or equal probability of developing CaCu compared to women of the same age, and with lower use of the test, coming from the highlands and considering it risky to undergo VIA. Conclusion : The VIA screening program for CaCu would not be achieving the desired impact. There is a need to strengthen strategies and interventions in primary care to improve screening behaviors and rates.
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Resumen La neumatosis intestinal y el neumoperitoneo no son entidades patológicas en sí mismas, son signos radio lógicos que resultan de alguna condición subyacente. En general, estos se asocian con procesos graves intra-abdominales que resultan en cirugías de urgencias con resecciones de intestino. A continuación, presentamos el caso de una mujer de 80 años, con diagnóstico de cáncer de mama estadio IV en tratamiento con ful vestrant y ribociclib, que ingresó a nuestro centro por dolor abdominal y vómitos. Se diagnosticó neumatosis intestinal y neumoperitoneo por lo que se procedió a laparotomía exploradora por sospecha de isquemia intestinal. No hubo evidencia de necrosis o perforación intestinal por lo que no se realizó resección. Evolucionó durante la internación de forma satisfactoria y en el control tomográfico al mes del egreso hubo resolución completa del cuadro. Si bien está descrito esta afectación en relación a los episodios de aumento de presión intraabdominal, como en la emesis, también se describió en pacientes con neoplasias, principalmente del tubo digestivo, ya sea por daño local o por toxicidad asociada a la quimioterapia. No encontramos reportes en la literatura de neumatosis intestinal vinculada a esta medicación antineoplásica en humanos. Probablemente en nuestro caso la etiolo gía haya sido multifactorial. Es posible que el ribociclib haya jugado un rol, ya sea por un mecanismo indirecto asociado a los vómitos y la inmunosupresión o directo sobre el enterocito debido a su mecanismo de acción celular no específico.
Abstract Pneumatosis intestinalis and pneumoperitoneum are not pathological entities in themselves, they are radiological signs that result from some underlying condition. In general, these are associated with serious intra-abdominal processes that result in emergency surgeries with bowel resections. Below, we present the case of an 80-year-old woman, diagnosed with stage IV breast cancer under treatment with fulvestrant and ribociclib, who was admitted to our center due to abdominal pain and vomiting. She was diagnosed with intestinal pneumatosis and pneumoperitoneum, so she underwent exploratory laparotomy for sus pected intestinal ischemia. There was no evidence of intestinal necrosis or perforation, so resection was not performed. She progressed satisfactorily during hospitalization and in the tomographic control one month after discharge there was complete resolution of the condition. Although this condition has been described in relation to episodes of increased intra-abdominal pressure, such as emesis, it has also been described in patients with neoplasms, mainly of the digestive tract, either due to lo cal damage or toxicity associated with chemotherapy. We found no reports in the literature of pneumatosis intesti nalis linked to this antineoplastic medication in humans. Probably in our case the etiology was multifactorial. It is possible that ribociclib played a role, either through an indirect mechanism associated with vomiting and im munosuppression or directly on the enterocyte due to its non-specific cellular mechanism of action.
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Abstract Metastases to the thyroid gland from nonthyroidal malignant tumors are rare but significant. They are often asymptomatic, indicating advanced-stage primary tumors and poor prognosis. Although infrequently, breast cancer (BC) can metastasize to the thyroid gland. We present the case of a 56-year-old woman with a history of BC who pre sented with a nodular goiter. Physical examination and im aging revealed a thyroid nodule and cervical lymph nodes with suspicious features. Fine-needle aspiration biopsy (FNAB) confirmed the presence of atypical epithelial cells in the thyroid nodule and lymph nodes. Further evaluation, including positron emission tomography, histological biop sy, and immunohistochemistry, supported the diagnosis of metastatic BC to the thyroid gland. Due to the local extent of the disease, total thyroidectomy was not feasible. The treatment with ribociclib and letrozole was initiated, but unfortunately, the patient had an unfavorable progression with the development of metastasis in the nervous system. Metastatic carcinoma to the thyroid gland is rare but has increased due to improved diagnostic techniques. BC can metastasize to the thyroid. Diagnosis involves imaging, FNAB, and immunohistochemistry. Treatment options include surgery, radiotherapy, and chemotherapy, but the prognosis is generally poor.
Resumen Las metástasis en la glándula tiroides a partir de tu mores malignos no tiroideos son raras pero significativas. A menudo son asintomáticas, lo que indica tumores primarios en etapas avanzadas y un mal pronóstico. Aunque infrecuentemente, el cáncer de mama puede metastatizar en la glándula tiroides. Presentamos el caso de una mujer de 56 años con antecedente de cáncer de mama que consultó por bocio nodular. El examen físico y las imágenes revelaron un nódulo tiroideo y ganglios linfáticos cervicales con características sospechosas. La punción aspiración con aguja fina confirmó la presencia de células epiteliales atípicas en el nódulo tiroideo y los ganglios linfáticos. Una evaluación adicional, que incluyó tomografía por emisión de positrones, biopsia histológica e inmunohistoquímica, respaldó el diagnóstico de cáncer de mama metastásico en la glándula tiroides. Debido a la extensión local de la enfermedad, no fue factible realizar una tiroidectomía total. Se inició el tratamiento con ri bociclib y letrozol, pero desafortunadamente la paciente tuvo una progresión desfavorable con el desarrollo de metástasis en el sistema nervioso. El carcinoma metas tásico en la glándula tiroides es raro, pero ha aumentado debido a las técnicas de diagnóstico mejoradas. El cáncer de mama puede metastatizar en la tiroides. El diagnóstico implica imágenes, punción aspiración con aguja fina e in munohistoquímica. Las opciones de tratamiento incluyen cirugía, radioterapia y quimioterapia, pero el pronóstico generalmente es desfavorable.
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Abstract To establish the prevalence of oral mucosal lesions and normal variations in a population of older adults. This observational study was conducted from 2015 to 2016 and involved 156 participants from Los Guido (San José, Costa Rica). The participants' sociodemographic information, risk factors, comorbidity, and clinical examination were evaluated and analyzed descriptively and qualitatively. Findings in oral mucosa were found to preferentially affect women (n=111; 71%) and individuals between the ages of 60 and 69 years (n=65; 42%), having smoking as a risk factor (n=67; 43%), and suffering from arterial hypertension (n=101; 65%). Intraoral findings were mainly presented together with variations from normal and pathology (n=71; 46%), predominantly one variation from normal (n=67; 33%) and one pathology (n=51; 43%). The most prevalent normal variations were the saburral tongue, lingual varicose veins, and cryptic tonsils. Infectious diseases (n=33; 21%), potentially malignant disorders (n=30; 19%), and physical and chemical injuries (n=18; 12%) were the most prevalent groups. The four most predominant lesions were prosthetic stomatitis, actinic cheilitis, frictional keratosis, and atrophic glossitis. The differences in pathological groups were not statistically significant (p=0.392) when comparing the frequency ratio by sex. Variations of the normal anatomy are the predominant ones, the saburral tongue being the most prevalent individually; among the pathologies, the most remarkable group was the infectious diseases, and prosthetic stomatitis was the most frequent. The information about this subject in Costa Rica is limited. So it is important to conduct more studies that contribute to the oral health of the elderly population in this area.
Resumen Establecer la prevalencia de lesiones de la mucosa oral y variaciones de lo normal en una población de adultos mayores. Estudio observacional en 156 participantes de Los Guido (San José, Costa Rica) del 2015 a 2016. Se evaluaron y analizaron de forma descriptiva y cualitativa información sociodemográfica, factores de riesgo, comorbilidad y exploración clínica. Los hallazgos en mucosa oral afectaron preferentemente a las mujeres (n=111; 71%), el rango de edad entre 60 y 69 años (n=65; 42%) y con el tabaco como factor de riesgo (n=67; 43%) e hipertensión arterial (n=101; 65%). Los hallazgos intraorales se presentaron preferentemente de forma conjunta variaciones de lo normal y patologías (n=71; 46%), predominantemente una variación de lo normal (n=67; 33%) y una patología (n=51; 43%). Las variaciones de lo normal más prevalentes fueron lengua saburral, várices linguales y amígdalas criptodónticas. Las enfermedades infecciosas (n=33; 21%), los desórdenes potencialmente malignos (n=30; 19 %) e injurias físicas y químicas (n=18; 12%) fueron los grupos más prevalentes. Las cuatro lesiones más predominantes fueron estomatitis protésica, queilitis actínica, queratosis friccional y glositis atrófica. No hubo diferencia estadísticamente significativa (p=0.392) al comparar la proporción de frecuencia por sexo. Las variaciones de la anatomía normal predominaron; siendo en forma individual la lengua saburral la más frecuente; de las patologías destacaron las enfermedades infecciosas principalmente la estomatitis protésica. Existe poca información en esta área en Costa Rica, es importante generar más estudios que permitan contribuir con la salud oral de la población adulta mayor.
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RESUMEN Introducción: El Índice de Severidad del Embolismo Pulmonar (PESI) se utiliza para categorizar el riesgo de mortalidad en el tromboembolismo pulmonar agudo (TEP). Por definición, los pacientes con cáncer siempre presentarán un puntaje PESI simplificado alto y serán considerados de mayor riesgo. Existe información limitada respecto de si los pacientes con PESI intermedio o alto (≥86 puntos) y cáncer activo, tienen mayor riesgo de presentar una evolución desfavorable respecto de aquellos sin cáncer. Objetivos: Determinar si, en pacientes con TEP y un puntaje PESI ≥86 puntos, la presencia de cáncer activo se asocia a una evolución desfavorable respecto de aquellos sin cáncer. Material y métodos: Análisis retrospectivo en pacientes con TEP y un puntaje PESI ≥86, entre los años 2008 y 2022. Se evaluó la ocurrencia de muerte intrahospitalaria (MIH), uso de drogas vasopresoras (DV) y necesidad de asistencia respiratoria mecánica (ARM) en los pacientes con vs. sin cáncer. Resultados: Se analizaron 209 pacientes. La población con cáncer, respecto de aquella sin cáncer, resultó ser más joven (65 vs. 70 años; p=0,006), presentó valores de PESI simplificado altos con mayor frecuencia (100 % vs. 84 %; p<0,001), tuvo menor requerimiento de ARM (9 % vs. 34 %; p=0,005) y menor uso de DV (11 % vs. 23 %; p=0,019), aunque no se observaron dife rencias en las tasas de MIH (12,7 % vs. 8 %; p=NS). Conclusiones: Los pacientes con TEP y un puntaje PESI ≥86 con cáncer no presentaron mayor MIH e incluso tuvieron menor requerimiento de ARM y DV. En la población estudiada, los pacientes con TEP y cáncer no tuvieron mayor riesgo de presentar una evolución desfavorable.
ABSTRACT Background: The Pulmonary Embolism Severity Index (PESI) is used to categorize the risk of death in acute pulmonary em bolism (PE). By definition, cancer patients will always have a high simplified PESI score and will be considered at high risk. There is limited information regarding whether patients with an intermediate or high PESI score (≥86 points) and cancer are at greater risk of an unfavorable progression versus those without cancer. Objectives: To determine whether the presence of active cancer in patients with a PESI score ≥86 points is associated with an unfavorable progression versus those without cancer. Methods: A retrospective analysis in patients with PE and a PESI score ≥86, between 2008 and 2022. The occurrence of in-hospital mortality (IHM) the use of vasopressor drugs (VDs), and the need for mechanical ventilatory support (MVS) were evaluated in patients with vs. without cancer. Results: 209 patients were analyzed. The population with cancer was younger than patients without cancer (65 vs 70 years; p=0.006), showed high simplified PESI values more frequently (100% vs 84%; p<0.001), had lower MVS requirement (9% vs 34%; p=0.005), and used fewer VDs (11% vs 23%; p=0.019). However, no difference was observed in IHM rates (12.7% vs 8%; p=NS). Conclusions: Patients with PE and a PESI score ≥86 who have cancer did not show higher IHM and also had lower MVS and VDs requirement. Therefore, in the studied population, patients with PE and cancer had no greater risk of having an unfavorable progression.
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RESUMEN Antecedentes: La medición de la calidad en cirugía, a través de las intervenciones de mejora, favorece mejores resultados para los pacientes y menos costos institucionales. Los resultados de libro quirúrgico (RLq) y los de libro oncológico (RLo) son una forma organizada de medir la calidad de la actividad quirúrgica. Objetivo: Estimar el cumplimiento de los parámetros de los RLq y RLo en una serie de pacientes con cáncer de recto bajo operados con amputación abdominoperineal por un mismo equipo. Material y métodos: Se realizó un estudio observacional descriptivo a partir de la revisión retrospectiva de los parámetros de los RLq y RLo en pacientes sometidos a una amputación abdominoperineal por cáncer de recto, entre agosto de 2015 y marzo de 2023, y se estimaron los porcentajes de cumplimiento en ambos libros. Resultados: Se incluyeron 26 pacientes cuyo promedio de edad fue de 52,07 años, y de ellos 18 (69,2%) fueron varones. En 25 casos (96 %) se realizó neoadyuvancia. Los RLq se cumplieron en 20 pacientes (76,9%), mientras que los RLo en 14 (53,8%), y ambos juntos en 13 (50%). Los ítems que más se presentaron para no llegar al 100% de cualquiera de los resultados fueron las complicaciones y el número de ganglios resecados igual a 12 o mayor, y, en menor medida, la resección R0, los días de estadía y la readmisión. Conclusión: Se lograron RLq y RLo adecuados en el 50% de los pacientes con amputaciones abdominoperineales. El análisis permite conocer dónde debemos actuar para mejorar la calidad de nuestros resultados.
ABSTRACT Background: Measuring quality in surgery through improvement interventions favors better patient outcomes and lower institutional costs. Textbook surgical outcome (TSO) and textbook oncologic outcome (TOO) are an organized way to measure the quality of surgical activity. Objective: The aim of the present study was to evaluate the proportion of patients with low rectal cancer who underwent abdominoperineal amputation by the same surgical team and achieved the TSO and TOO. Material and methods: We conducted a descriptive observational study based on the retrospective review of TSO and TOO parameters in patients undergoing abdominoperineal amputation for rectal cancer, between August 2015 and March 2023. The percentage of patients who achieved the TSO and TOO was estimated. Results: A total of 26 patients were included; mean age was 52.07 years and 18 (69.2%) were men and 25 patients (96%) received neoadjuvant therapy. The TSO was achieved in 20 patients (76.9%); 14 patients (53.8%) achieved the TOO and 13 patients (59%) achieved both textbook outcomes. The presence of complications and < 12 lymph nodes resected were the most common reasons for not achieving 100% of both textbook outcomes; other items were R0 resection, length of hospital stay and readmission. Conclusion: Fifty percent of patients with abdominoperineal amputations achieved an adequate TSO and TOO. The analysis allows us to understand where we must take action in order to improve the quality of our results.