Correlation between the proportion of healthy mammary tissue versus tumor size in breast-conserving surgeries

Objective: To evaluate the proportion of excised healthy tissue in breast-conserving surgeries and to identify possible tendency toward excision in healthy tissue beyond the ideal for oncological safety. Methods: Data from patients who underwent breastconserving surgery at the Hospital Geral de Caxias do Sul from January 2010 to December 2016 were analyzed. For statistical purposes, means, standard deviations, Student's t-test, and linear regression were used for numerical variables. Risk estimate by odds ratio (OR) was performed through logistic regression with 95% CI. A significance level (alpha) of 5% was adopted. Results: A total of 124 cases were analyzed. The mean tumor size observed by ultrasonography was 1.7 ± 0.95 cm. The tumor size was 1.9 ± 1.12 cm. The mean size of the resected surgical specimens was 7.8 ± 3.4cm. When comparing the tumor size in the anatomopathological examination and the size in ultrasonography, the mean differences accounted for 0.6 cm (95%CI -0.10­ 0.44; p = 0.2). Conversely, the difference in the size of the total surgical specimen versus tumor size in the anatomopathological examination was 5.8 cm (95%CI 5.2­6.5; p < 0.001). There was no statistical difference regarding the tumor location nor size of the surgical specimen. Conclusion: It was observed that there is a tendency toward excising a large amount of healthy tissue in breastconserving surgeries far beyond what is recommended in order to consider the oncological safety of excised margins.

Avaliação dos fatores associados à ocorrência de prematuridade em um hospital terciário de ensino / Evaluation of the factors associated to prematurity in a tertiary hospital of education

INTRODUÇÃO: Na atualidade, o nascimento de recém-nascidos prematuros tem constituído um crescente problema obstétrico e de saúde pública, posto que taxas elevadas têm contribuído significativamente com a mortalidade perinatal e a morbidade infantil de longo prazo. O objetivo deste estudo é analisar os fatores de exposição associados à prematuridade em um hospital terciário de ensino. MÉTODOS: Trata-se de um estudo caso-controle, com seleção de casos incidentes e controles consecutivos, em que foram analisadas variáveis maternas e perinatais. Para se verificar a presença ou não de associação entre as variáveis independentes e o nascimento pré-termo, estimou-se a Odds Ratio bruta para cada associação de interesse. Na análise univariada, foi aplicado o teste t de Student para as variáveis contínuas e o teste do qui-quadrado para as variáveis dicotômicas. Em todos os testes, se considerou significante um p<0,05. RESULTADOS: De um total de 1.093 nascimentos, foram identificados 117 recém-nascidos pré-termo (10,7%). Os fatores de exposição identificados foram a falta de pré-natal, malformações congênitas, ruptura da membrana amniótica por mais de 12h e episódios de sangramento vaginal de qualquer etiologia durante a gestação. Não se observou associação ao uso de fumo, síndromes hipertensiva e diabética e pH no sangue da artéria umbilical <7,1. CONCLUSÃO: O percentual de prematuridade no estudo foi de 10,7% e o de óbito perinatal, de 13,7%. Os fatores de exposição identificados foram: falta de pré-natal, malformações congênitas, ruptura da membrana amniótica por mais de 12h e episódios de sangramento vaginal de qualquer etiologia durante a gestação

INTRODUCTION: At present, the birth of premature infants has become a growing problem in obstetrics and public health, since high rates have contributed significantly to perinatal mortality and long term infant morbidity. Aims: To assess the exposure factors associated with prematurity in a tertiary care teaching hospital. METHODS: This is a case-control study, with selection of consecutive incident cases and controls, in which maternal and perinatal variables were analyzed. In order to determine the presence or absence of association between independent variables and pre-term birth, the crude odds ratio was estimated for each association of interest. In univariate analysis, the Student's t test for continuous variables and chi-square test for dichotomous variables were applied. In all tests, p<0.05 was considered as significant. RESULTS: Of a total of 1,093 births, 117 (10.7%) were identified as pre-term newborns. The exposure factors identified were lack of prenatal care, birth defects, amniotic membrane rupture for more than 12h, and episodes of vaginal bleeding of any cause during pregnancy. There was no association with smoking, hypertensive and diabetic syndromes, and pH in umbilical artery <7.1. CONCLUSION: The percentage of pre-term births in the study was 10.7%, and perinatal mortality was 13.7%. The exposure factors identified were: lack of prenatal care, birth defects, amniotic membrane rupture for more than 12h, and episodes of vaginal bleeding of any cause during pregnancy