Qualidade de vida de cuidadores de idosos vinculados ao Programa Saúde da Família - Teixeiras, MG / Quality of life elderly caregivers of link to the family health Program- Teixeiras, MG

O estudo teve como objetivo avaliar a associação entre a percepção subjetiva da qualidade de vida dos cuidadores domiciliares de idosos vinculados ao Programa Saúde da Família (PSF) e as características sociodemográficas e de saúde, grau de sobrecarga percebida e grau de independência funcional do idoso. Foram entrevistados 66 cuidadores, de agosto a dezembro de 2008, utilizando os instrumentos WHOQOL-bref; Zarit Burden Interview e a Medida de Independência Funcional para os idosos. Houve o predomínio de mulheres cuidadoras, donas de casa e em média com 50,5 anos. A média da medida de independência funcional foi 57,82, classificando a amostra de idosos em dependência modificada. A escala Zarit correlacionou-se negativamente A todos os domínios do WHOQOL-bref. As variáveis independentes estatisticamente relacionadas à qualidade de vida geral, no modelo múltiplo, foram: a escala de sobrecarga, a presença de companheiro e a presença de doença no cuidador, considerando, em especial, o fato de que o baixo nível de escolaridade e de renda pode afetar a forma como o cuidado é realizado.

Granulocytic sarcoma of the stomach: relapse after hematopoietic stem-cell transplantation for chronic myeloid leukemia

An 18-year-old male underwent an allogeneic hematopoietic stem cell transplantation [allo-HSCT] for chronic myeloid leukemia [CML] in the first late chronic phase. On day 132, he was readmitted to the hospital with nausea, vomiting and nodular lesions on endoscopy. A diagnosis of granulocytic sarcoma of the stomach was made. Bone marrow cytogenetic analysis for the Philadelphia chromosome and nested polymerase chain reaction for BCR-ABL1 were both negative. Immunosuppression was abruptly discontinued, and by day 180, all gastric lesions had completely disappeared. However, there were histological signs of graft-versus-host disease. The patient developed progressive anorexia and elevated hepatic enzymes, which prompted the reintroduction of cyclosporine. Considering the risk of another relapse, imatinib mesylate [IM] 600 mg/day was started. The patient's condition improved, and there was no evidence of disease recurrence at 36 months after relapse. Relapse of CML is the commonest cause of treatment failure after allo-HSCT. On rare occasions, a localized extramedullary presentation is seen. Unless properly treated, other extramedullary relapse sites and/or marrow infiltration usually occur. Withdrawal of immunosuppression, along with IM therapy seems to be an acceptable approach in this setting

retrospective comparison of allogeneic peripheral blood stem cell versus bone marrow transplantation

Disease evolution depends in part on the source of transplanted cells. Therefore, we compared outcomes after allogeneic bone marrow [BM] and peripheral blood stem cell [PBSC] transplantation in patients who underwent transplant at Hospital das Clinicas of the Federal University of Minas Gerais, Brazil. We studied 364 patients who received allogeneic BM [n=142] or PBSC transplanttation [n=222] between July 1995 and May 2005. The median age of the patients was 31 years [range, 3.1-58 years]. Chronic myeloid leukemia was the predominant diagnosis [41.2%]. A conditioning regimen with cycclosphosphamide and busulfan was used in 79.4% [n=289] and graft-versus-host disease [GVHD] prophylaxis was cyclosporine/methotrexate in 95.9% [n=349] of cases. The patients in the PBSC group had faster neutrophil [P<.001] and platelet engraftment [P=.03] but increased rates of acute GVHD [P < .001] vs. those in the BM group. There was no significant difference between the groups in chronic GVHD, transplant-related mortality, relapse and survival rates. Although allogeneic PBSC transplant results in a faster hematopoietic engraftment, there was an increase in acute GVHD. There was no clear benefit in relapse rate and no evidence that transplantation with PBSC benefits patient survival in our institution

O uso do ligamento sintético nas lesôes ligamentares agudas graves do joelho / Use of synthetic ligament in cruciate ligament reconstruction of the knee

Os autores descrevem 26 casos de reconstruçäo simultânea dos ligamentos cruzados anterior e posterior do joelho, realizados no período de maio de 1989 a setembro de 1993, usando o ligamento sintético (Artrolig). Mostram as vantagens decorrentes da técnica utilizada, os resultados obtidos e as complicaçöes.