ABSTRACT
BACKGROUND: There is growing evidence that the subventricular zone (SVZ) may be involved in both the initiation and progression of glioblastoma (GB). We aimed to assess tumor proximity to the SVZ as a potential prognostic factor in GB. METHOD: Retrospective study of 133 patients diagnosed with primary GB who underwent surgery followed by temozolomide-based chemoradiation between 2010 and 2016. All lesions were classified according to their anatomic relation with the SVZ. We determined the effect of tumor contact with the SVZ on progression-free survival (PFS), overall survival (OS), type, and patterns of recurrence. RESULTS: At a median follow-up of 18.6 months (95% CI 15.9-21.2), PFS and OS were 7.5 (95% CI 6.7-8.3) and 13.9 (95% CI 10.9-16.9) months, respectively. On the univariate analyses, initial contact with the SVZ was a factor for poor prognosis for both PFS (6.1 vs. 8.7 months; p = 0.006) and OS (10.6 vs. 17.9 months; p = 0.037). On the multivariate analysis, tumor contact with the SVZ remained statistically significant for PFS, but not OS. Patients with SVZ-contacting tumors presented a higher rate of aggressive clinical progression (30.9% vs. 11.3%; p = 0.007) and contralateral relapse patterns (23.4% vs. 9.1%; p = 0.048). CONCLUSIONS: Our results suggest that glioblastoma contact with the SVZ appears to be an independent prognostic factor for poor PFS. The presence of an SVZ-contacting tumor was associated with more aggressive recurrences and a higher rate of contralateral relapses. These findings suggest that this variable may be a new prognostic factor in glioblastoma.
Subject(s)
Brain Neoplasms/pathology , Glioblastoma/pathology , Lateral Ventricles/pathology , Neoplasm Recurrence, Local , Antineoplastic Agents, Alkylating/therapeutic use , Brain Neoplasms/etiology , Brain Neoplasms/mortality , Brain Neoplasms/therapy , Chemoradiotherapy , Confidence Intervals , Female , Follow-Up Studies , Glioblastoma/etiology , Glioblastoma/mortality , Glioblastoma/therapy , Humans , Magnetic Resonance Imaging , Male , Neoplasm Recurrence, Local/diagnostic imaging , Prognosis , Progression-Free Survival , Radiotherapy Dosage , Retrospective Studies , Temozolomide/therapeutic useABSTRACT
To determine the prevalence of anemia, and iron (ID) and vitamin A deficiencies aiming at their prevention, 414 children between 6 and 24 months of age, were randomly selected from the whole province of Chaco. A sociodemographic survey was implemented, and hemoglobin (Hb), plasma ferritin and retinol were measured. Anemia prevalence (Hb < 110 g/L) was 66.4 per cent, without differences between age groups, and included 18 per cent with Hb < 90 g/L. These cases were significantly less in children 6-8 month of age (5.1 per cent) than in the others (approximately equal to 20 per cent) (P: 0.007). Mean Hb was also higher in 6-8 months old children and was associated with lower prevalence of ID (ferritin < 12 micrograms/L) (p < 0.000) but not with age (p = 0.8865). ID already present, however, in 36.6 per cent of children in this age group, reached a prevalence of 72.9 per cent in children older than 18 months. Anemia prevalence was significantly higher in males, in children whose birth weight was < 3000 g, in those who had never taken iron supplements and among the poor, both structural and by income. Retinol values < 20 micrograms/dl occurred only in 5.1 per cent of children. Iron nutrition prior to, during pregnancy and in children during the first 2 years of life must be improved by joining strategies based on community empowerment aimed at improving dietary iron, assuring effective preventive supplementation and promoting the opportune umbilical cord ligation.
Subject(s)
Humans , Male , Female , Infant , Anemia, Iron-Deficiency , Vitamin A Deficiency/epidemiology , Iron/deficiency , Anemia, Iron-Deficiency , Anemia/blood , Anemia/epidemiology , Anemia/prevention & control , Argentina/epidemiology , Vitamin A Deficiency/blood , Vitamin A Deficiency/prevention & control , Ferritins , Health Services Accessibility , Hemoglobins/analysis , Prevalence , Socioeconomic FactorsABSTRACT
Aiming at their prevention, to determine the prevalence of gestational iron deficiency and anemia, considering access to health care and associations with social and biological variables in the Province of el Chaco, Argentina. Three hundred and sixty four, randomly selected pregnant women from the whole province participated. Mean Hemoglobin (Hb) +/- SD dropped progressively from 118.4 +/- 11.0 to 112.1 +/- 11.5 g/L (p = 0.015) between the 1st and the 3rd gestational trimesters. Anemia prevalence (Hb < 110 g/L) was 17.4, 26.5 and 35.8 per cent. From the 1st to the 3rd trimesters. Second trimester prevalence was 14.1 per cent using Hb < 105 g/L as recently suggested. The ferritin geometric mean during the progressive gestational trimesters were 28.9; 16.0 and 11.1 micrograms/L. 21.7, 40.5 and 60.5 per cent had ferritins < 12 micrograms/L, and 39.1, 58.9 and 83.2 per cent had ferritins < 20 micrograms/L in these respective trimesters (p < 0.004 between trimesters in both cases). Both iron deficiency and anemia were significantly greater in women with unfinished primary education and with interpregnancy interval < 1 year. Seventy five percent of women had adequate number of antenatal visits but only 23 per cent were taking iron supplements and 10 per cent had stopped taking them. The prevention and correction of gestational iron deficiency and anemia must focus on the preconceptional period (inter-pregnancy spacing and increasing iron intake using all available means) as well as during pregnancy improving adherence to iron supplements by means of motivation of health workers and community.
Subject(s)
Humans , Female , Pregnancy , Adult , Anemia, Iron-Deficiency , Pregnancy Complications, Hematologic/epidemiology , Iron/deficiency , Anemia, Iron-Deficiency , Argentina/epidemiology , Cross-Sectional Studies , Pregnancy Complications, Hematologic/prevention & control , Ferritins , Hemoglobins/analysis , PrevalenceABSTRACT
From the clarification of the origin and historical development of two of the most impressive health campaigns of the first third of the twentieth century, those against tuberculosis and to prevent infant mortality, an evaluation is sought from a long range view. Their contribution to the modern configuration of health as well as to the genesis of several regular traits of today's community and family medicine are pointed out.
Subject(s)
Health Promotion/history , Infant Mortality , Public Health/history , Tuberculosis/history , History, 20th Century , Humans , Infant , SpainABSTRACT
El uso prolijo de citostáticos, el surgimiento de nuevas y potentes drogas y el hecho de que estén en boga las combinaciones de dos o más agentes, son factores que obligan a hacer consideraciones sobre las complicaciones de la quimioterapia, específicamente sobre una de las más frecuentes y peligrosas: la leucopenia. En una serie de 389 tratamientos citostáticos consecutivos efectuados en nuestro centro en un período de seis meses, analizamos la incidencia, mortalidad y tratamiento de las leucopenias correlacionándolas con el tipo de quimioterapia (mono o poli), agentes usados y vías de administración(AU)
Subject(s)
Humans , Antineoplastic Agents/adverse effects , Leukopenia/etiologyABSTRACT
Presentamos cuatro casos de pacientes con sarcoma hemorrágico de Kaposi, que ilustran las formas clínicas de esta enfermedad, infrecuente en nuestro país. Se realiza revisión del cuadro clínico, anatomía patológica, evolución y tratamiento de la entidad(AU)