Cancer incidence in alcoholics cared for in a public university hospital: a report of case series

OBJECTIVE: To evaluate the incidence of cancer in patients treated in the Alcoholism Outpatient Clinic of the Clinical Hospital of the Federal University of Uberlândia, in the city of Uberlândia, MG, Brazil. METHODS: Medical records of 490 out of 511 patients, treated between January 1995 and December 2006, were reviewed. This search was conducted in the hospital's Medical Archive Service and in the Mortality Information System of the city of Uberlândia's Civil Registry Office.RESULTS: No patients were referred with a confirmed or suspected diagnosis of cancer. Among the 490 patients, 23 (4.7%) developed some form of cancer during the study period. All these were men, with a mean age of 48.7 ± 9.6 years (33 to 65 years), and 18 (78.3%) were smokers. Upper aerodigestive tract cancer was the most frequent (10/23 - 43.5%) and in all of them, the histological type was squamous cell carcinoma; 5 (21.7%) had gastric cancer (adenocarcinoma); 2 (8.7%), lung (carcinoma); 2 (8.7%), liver cancer (hepatocellular carcinoma and cholangiocarcinoma); 2 (8.7%), central nervous system cancer; 1 (4.3%), acute myeloid leukemia (FAB M2); 1 (4.3%), rhabdomyosarcoma; and 1 (4.3%), poorly differentiated carcinoma with undefined primary site.CONCLUSIONS: During the study period, at least 4.7% of patients developed some form of cancer, predominantly in the upper aerodigestive tract. This is an alarming fact, considering that 12.3% of Brazilians aged over 12 years may be dependent on alcohol and another 24% make heavy and/or frequent use of alcoholic beverages.

Estudo da gravidade dos pacientes vítimas de acidentes de trânsito atendidos pelo hospital de clínicas de Uberlândia de dezembro de 2005 a março de 2006 segundo índices de trauma / Traffic victims and their injuries, as treated in the emergency room of the university hospital of Uberlândia (HCU), from december, 2005 through march, 2006 based on trauma scales

Calculamos os índices Injurity Severity Score (ISS), Revised Trauma Score (RTS) e Escala de Coma de Glasgow (ECG) dos pacientes vítimas de acidentes de trânsito atendidas no Hospital de Clínicas de Uberlândia (HCU) aos sábados dos meses de dezembro de 2005 a março de 2006, além de analisar os dados epidemiológicos referentes ao acidente, aos pacientes e ao atendimento pré e intra-hospitalar (primeiro atendimento). As informações foram obtidas nos prontuários das vítimas. A maioria dos pacientes apresentou lesões na superfície externa do corpo (58; 53,7 por cento), seguida por lesões em extremidades e ossos da pelve (30; 27,8 por cento) e por cabeça e face (15; 13,9 por cento). O sexo masculino foi o mais acometido (53; 58,2 por cento) e os acidentes motociclísticos foram os mais freqüentes (29; 31,9 por cento). Quanto ao ISS, os pacientes em geral apresentaram baixos escores, não excedendo a 16. Todas as vítimas tiveram escores altos na escala de coma de Glasgow, sendo que 60 (65,9 por cento) apresentaram escore igual a 15. Para 17 pacientes (18,7 por cento) foi possível o cálculo do índice RTS. Destes, 15 (88,2 por cento) obtiveram escore final 12. Concluímos que a maioria dos pacientes atendidos no HCU por acidentes de trânsito apresentou trauma leve, sendo que valores RTS e ECG altos correlacionaram-se com escores ISS baixos, indicadores de bom prognóstico e baixo risco de vida, o que em um hospital de atendimento de nível terciário congestiona o serviço e demanda ônus monetário e de pessoal, podendo interferir no bom atendimento de casos de maior complexidade.

The authors applied three different measurement tools to analyze patients, victims of traffic accidents, at the Emergency Room of the Hospital de Clínicas in Uberlândia, Minas Gerais (HCU). The measures used were: the Injury Severity Score (ISS), Revised Trauma Score (RTS) and the Glasgow Coma Scale (GCS). The data, including epidemiological factors, were collected from patients’ charts as they were treated, on Saturdays from December, 2005 through March of the following year. Most of the patients presented superficial lesions or abrasions to the body (58 patients; 53.7 percent), followed by lesions to the extremities and hips (30; 27.8 percent) and head and face injuries (15; 13.9 percent). Most of the injured were male (53; 58.2 percent) and accidents involving motorcycles were very frequent (29; 31.9 percent). Regarding the Injury Severity Score (ISS) patients demonstrated relatively low scores, not exceeding 16. All victims scored high on the Coma Glasgow Scale; of these, 60 (65.9 percent), presented a score of 15. Seventeen patients (18,7 percent) were assessed using the RTS scale. Of these, fifteen (88,2 percent), were given a final score of 12. It was concluded that the majority of the victims of traffic accidents admitted to the HCU Emergency Room during the period of the study demonstrated minimal trauma. High values for RTS and GCS correlated with lower ISS scores, indicating an adequate prognosis and a reduced risk to the patients’ lives. Unfortunately the services and costs involved with their treatment led to a congested situation prejudicial to adequate assistance for more serious cases.