Sindemia de Covid-19 e tuberculose pulmonar durante período pandêmico: impactos na saúde pública brasileira / Covid-19 syndemic and pulmonary tuberculosis during the pandemic period: impacts on brazilian public health / Tuberculosis pulmonar y sindrome covid-19 durante el periodo pandémico: impactos en la salud pública brasileña

Objetivo: Examinar e mapear as evidências científicas sobre o impacto da sindemia de COVID-19 e tuberculose pulmonar durante período pandêmico no Brasil. Metodologia: Scoping Review, baseado nos procedimentos recomendados pelo Instituto Joanna Briggs. Estabeleceu-se a pergunta norteadora: "Qual o impacto da pandemia de COVID-19 e fatores associados ao aumento de casos de Tuberculose Pulmonar no Brasil durante período pandêmico?". Foram realizadas buscas em três bases de dados nacionais e internacionais, sobre trabalhos publicados até dezembro de 2022. Dos 819 estudos encontrados, 20 foram selecionados para leitura na íntegra, resultando em uma amostra final de 11 estudos analisados. Resultados: As 11 publicações analisadas foram publicadas de 2020 a 2022 durante período pandêmico, de âmbito nacional e internacional com delineamento de estudos experimentais, do tipo ensaio clínico com randomização. A maioria dos estudos incluídos, 7 (70%) foram publicados no ano de 2022. Quanto ao tipo de estudo, 40% eram estudos transversais, 03 estudos (30%) eram do tipo estudo retrospectivo, observacional. Apenas 3 eram estudos ecológico de série temporal no qual estes evidenciaram que o Brasil e suas macrorregiões apresentaram tendência temporal crescente para a notificação de TB no período pré-pandêmico. Segundo Berra et al. (2022) apenas a Região Nordeste apresentou tendência temporal decrescente de casos curados. Para o abandono do tratamento, todas as regiões, exceto o Nordeste, apresentaram um aumento nos números de casos, e em relação ao óbito, o Brasil e a Região Nordeste apresentaram tendência temporal crescente.

Objective: To examine and map the scientific evidence on the impact of the COVID-19 syndemic and pulmonary tuberculosis during the pandemic period in Brazil. Methodology: Scoping Review, based on procedures recommended by the Joanna Briggs Institute. The guiding question was established: "What is the impact of the COVID-19 pandemic and factors associated with the increase in cases of Pulmonary Tuberculosis in Brazil during the pandemic period?". Searches were carried out in three national and international databases, on works published until December 2022. Of the 819 studies found, 20 were selected for full reading, resulting in a final sample of 11 analyzed studies. Results: The 11 analyzed publications were published from 2020 to 2022 during the pandemic period, nationally and internationally with experimental study design, of the clinical trial type with randomization. Most of the studies included, 7 (70%) were published in the year 2022. As for the type of study, 40% were cross-sectional studies, 03 studies (30%) were retrospective, observational studies. Only 3 were ecological time series studies in which they showed that Brazil and its macro-regions showed an increasing temporal trend for TB notification in the pre-pandemic period. According to Berra et al. (2022) only the Northeast Region showed a decreasing temporal trend of cured cases. For treatment abandonment, all regions, except the Northeast, showed an increase in the number of cases, and in relation to death, Brazil and the Northeast Region showed an increasing temporal trend. KEYWORDS: Pulmonary Tuberculosis; COVID-19; Impact.

Objetivo: Examinar y mapear la evidencia científica sobre el impacto de la epidemia de COVID-19 y de la tuberculosis pulmonar durante el período pandémico en Brasil. Metodología: Scoping Review, basado en los procedimientos recomendados por el Instituto Joanna Briggs. Se estableció la pregunta guía "¿Cuál es el impacto de la pandemia de COVID-19 y los factores asociados al aumento de casos de Tuberculosis Pulmonar en Brasil durante el período pandémico?". Se realizaron búsquedas en tres bases de datos nacionales e internacionales, sobre trabajos publicados hasta diciembre de 2022. De los 819 estudios encontrados, 20 fueron seleccionados para lectura completa, resultando en una muestra final de 11 estudios analizados. Resultados: Las 11 publicaciones analizadas fueron publicadas entre 2020 y 2022 durante el periodo pandémico, a nivel nacional e internacional con diseño de estudio experimental, del tipo ensayo clínico con aleatorización. La mayoría de los estudios incluidos, 7 (70%) fueron publicados en el año 2022. En cuanto al tipo de estudio, 40% fueron estudios transversales, 03 estudios (30%) fueron retrospectivos, observacionales. Solamente 3 fueron estudios de series temporales ecológicas en los cuales mostraron que Brasil y sus macrorregiones presentaron una tendencia temporal creciente para la notificación de TB en el período prepandémico. Según Berra et al. (2022) sólo la Región Nordeste mostró una tendencia temporal decreciente de casos curados. Para el abandono del tratamiento, todas las regiones, excepto la Nordeste, mostraron un aumento en el número de casos, y en relación a la muerte, Brasil y la Región Nordeste mostraron una tendencia temporal creciente. PALABRAS CLAVE: Tuberculosis Pulmonar; COVID-19; Impacto.

Impacto da infodemia na hesitação vacinal contra a covid-19: uma ameaça compartilhada / Impact of the infodemia on vaccine hesitation against covid-19: a shared threat / Impacto de la infodemia en las dudas sobre la vacuna contra el covid-19: una amenaza compartida

Objetivo: Examinar e mapear as evidências científicas sobre o compartilhamento de desinformações relacionadas a vacinação contra a COVID-19 entre usuários das redes sociais. Metodologia: Scoping Review, baseado nos procedimentos recomendados pelo Instituto Joanna Briggs. Estabeleceu-se a pergunta norteadora: "Qual o comportamento dos usuários de redes sociais quanto ao compartilhamento de informações e desinformações em saúde relacionados à vacinação contra COVID-19?". A coleta dos dados foi realizada em abril de 2023 nas bases de dados PubMed, Biblioteca Virtual em Saúde, Scopus, Web of Science e EMBASE. Foram excluídos textos publicados antes de 2020, protocolos de revisão sistemática ou meta análise e estudos fora do recorte temático. Resultados: Os 9 estudos tiveram delineamento de pesquisas experimentais do tipo análise netnográfica. Quanto a plataforma de disseminação, é possível observar que o Facebook é a mídia social que mais veicula fake news relacionadas à vacinação de COVID-19 seguido do Twitter (33,3%) e Instagram (22,2%). Evidencia-se a forte propensão de engajamento a publicações de cunho antivacina e disseminação de eventos adversos e/ou efeitos colaterais dos imunizantes com ênfase na Pfizer-BioNTech. O perfil dos disseminadores está associado a figuras públicas e jovens de 18 a 44 anos, que também possuem maior propensão de crença na fidedignidade das informações encontradas. Os estudos associam a queda nas taxas de imunização pelo medo dos efeitos colaterais, incluindo hospitalização, miocardites, coágulos sanguíneos e óbito, bem como a desconfiança governamental. Conclusão: o compartilhamento de fake news é um forte fator de hesitação vacinal gerando medo, insegurança e preocupação.

Objective: To examine and map scientific evidence on the sharing of misinformation related to COVID-19 vaccination among social media users. Methodology: Scoping Review, based on procedures recommended by the Joanna Briggs Institute. The guiding question was established: "What is the behavior of users of social networks regarding the sharing of health information and misinformation related to vaccination against COVID-19?". Data collection was carried out in April 2023 in the PubMed, Virtual Health Library, Scopus, Web of Science and EMBASE databases. Texts published before 2020, systematic review or meta-analysis protocols and studies outside the thematic scope were excluded. Results: The 9 studies had the design of experimental researches of the netnographic analysis type. As for the dissemination platform, it is possible to observe that Facebook is the social media that most conveys fake news related to the COVID-19 vaccination followed by Twitter (33.3%) and Instagram (22.2%). There is evidence of a strong tendency to engage with anti-vaccine publications and the dissemination of adverse events and/or side effects of immunizations, with an emphasis on Pfizer-BioNTech. The profile of disseminators is associated with public figures and young people aged 18 to 44, who are also more likely to believe in the reliability of the information found. Studies associate the drop in immunization rates with fear of side effects, including hospitalization, myocarditis, blood clots and death, as well as government distrust. Conclusion: The sharing fake news is a strong factor in vaccine hesitancy, generating fear, insecurity and concern.

Objetivo: Examinar y mapear la evidencia científica sobre el intercambio de información errónea relacionada con la vacunación contra la COVID-19 entre los usuarios de las redes sociales. Metodología: Scoping Review, basado en los procedimientos recomendados por el Instituto Joanna Briggs. Se estableció la pregunta guía "¿Cuál es el comportamiento de los usuarios de las redes sociales con respecto al intercambio de información sanitaria y desinformación relacionada con la vacunación contra la COVID-19?". La recogida de datos se realizó en abril de 2023 en las bases de datos PubMed, Virtual Health Library, Scopus, Web of Science y EMBASE. Se excluyeron textos publicados antes de 2020, protocolos de revisión sistemática o metaanálisis y estudios fuera del ámbito temático. Resultados: Los 9 estudios tenían el diseño de investigaciones experimentales del tipo análisis netnográfico. En cuanto a la plataforma de difusión, se puede observar que Facebook es el medio social que más transmite noticias falsas relacionadas con la vacunación COVID-19 seguido de Twitter (33,3%) e Instagram (22,2%). Se evidencia una fuerte tendencia a las publicaciones antivacunas y a la difusión de eventos adversos y/o efectos secundarios de las vacunas, destacando Pfizer-BioNTech. El perfil de los divulgadores se asocia a personajes públicos y jóvenes de 18 a 44 años, que además son más propensos a creer en la fiabilidad de la información encontrada. Los estudios asocian la caída de las tasas de inmunización con el miedo a los efectos secundarios, incluyendo hospitalización, miocarditis, coágulos de sangre y muerte, así como la desconfianza del gobierno. Conclusiones: El intercambio de noticias falsas es un factor importante en la indecisión sobre las vacunas, ya que genera miedo, inseguridad y preocupación.

Effects of Bariatric Surgery in Obese Patients With Hypertension: The GATEWAY Randomized Trial (Gastric Bypass to Treat Obese Patients With Steady Hypertension).

BACKGROUND: Recent research efforts on bariatric surgery have focused on metabolic and diabetes mellitus resolution. Randomized trials designed to assess the impact of bariatric surgery in patients with obesity and hypertension are needed. METHODS: In this randomized, single-center, nonblinded trial, we included patients with hypertension (using ≥2 medications at maximum doses or >2 at moderate doses) and a body mass index between 30.0 and 39.9 kg/m2. Patients were randomized to Roux-en-Y gastric bypass plus medical therapy or medical therapy alone. The primary end point was reduction of ≥30% of the total number of antihypertensive medications while maintaining systolic and diastolic blood pressure <140 mm Hg and 90 mm Hg, respectively, at 12 months. RESULTS: We included 100 patients (70% female, mean age 43.8±9.2 years, mean body mass index 36.9±2.7 kg/m2), and 96% completed follow-up. Reduction of ≥30% of the total number of antihypertensive medications while maintaining controlled blood pressure occurred in 41 of 49 patients from the gastric bypass group (83.7%) compared with 6 of 47 patients (12.8%) from the control group with a rate ratio of 6.6 (95% confidence interval, 3.1-14.0; P<0.001). Remission of hypertension was present in 25 of 49 (51%) and 22 of 48 (45.8%) patients randomized to gastric bypass, considering office and 24-hour ambulatory blood pressure monitoring, respectively, whereas no patient submitted to medical therapy was free of antihypertensive drugs at 12 months. A post hoc analysis for the primary end point considering the SPRINT (Systolic Blood Pressure Intervention Trial) target reached consistent results, with a rate ratio of 3.8 (95% confidence interval, 1.4-10.6; P=0.005). Eleven patients (22.4%) from the gastric bypass group and none in the control group were able to achieve SPRINT levels without antihypertensives. Waist circumference, body mass index, fasting plasma glucose, glycohemoglobin, low-density lipoprotein cholesterol, triglycerides, high-sensitivity C-reactive protein, and 10-year Framingham risk score were lower in the gastric bypass than in the control group. CONCLUSIONS: Bariatric surgery represents an effective strategy for blood pressure control in a broad population of patients with obesity and hypertension. CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov. Unique identifier: NCT01784848.

Effects of bariatric surgery in obese patients with hypertension: the GATEWAY randomized trial (Gastric Bypass to Treat Obese Patients With Steady Hypertension)

BACKGROUND: Recent research efforts on bariatric surgery have focusedon metabolic and diabetes mellitus resolution. Randomized trials designedto assess the impact of bariatric surgery in patients with obesity andhypertension are needed.METHODS: In this randomized, single-center, nonblinded trial, we includedpatients with hypertension (using ≥2 medications at maximum doses or >2 atmoderate doses) and a body mass index between 30.0 and 39.9 kg/m2. Patientswere randomized to Roux-en-Y gastric bypass plus medical therapy or medicaltherapy alone. The primary end point was reduction of ≥30% of the totalnumber of antihypertensive medications while maintaining systolic and diastolicblood pressure <140 mmHg and 90 mmHg, respectively, at 12 months. RESULTS: We included 100 patients (70% female, mean age 43.8±9.2 years,mean body mass index 36.9±2.7 kg/m2), and 96% completed follow-up.Reduction of ≥30% of the total number of antihypertensive medicationswhile maintaining controlled blood pressure occurred in 41 of 49 patientsfrom the gastric bypass group (83.7%) compared with 6 of 47 patients(12.8%) from the control group with a rate ratio of 6.6 (95% confidenceinterval, 3.1–14.0; P<0.001). Remission of hypertension was present in 25of 49 (51%) and 22 of 48 (45.8%) patients randomized to gastric bypass,considering office and 24-hour ambulatory blood pressure monitoring...

OSA and Prognosis After Acute Cardiogenic Pulmonary Edema: The OSA-CARE Study.

BACKGROUND: Acute cardiogenic pulmonary edema (ACPE) is a life-threatening condition. OSA may be a modifiable risk factor for ACPE recurrence. This study was designed to evaluate the impact of OSA on the incidence of cardiovascular events following ACPE recovery. METHODS: Consecutive patients with confirmed ACPE from 3 centers underwent a sleep study following clinical stabilization. OSA was defined as an apnea-hypopnea index (AHI) ≥ 15 events/h. The mean follow-up was 1 year, and the primary outcome was ACPE recurrence. RESULTS: A total of 104 patients were included in the final analysis; 61% of the patients had OSA. A higher rate of ACPE recurrence (25 vs 6 episodes; P = .01) and a higher incidence of myocardial infarction (15 vs 0 episodes; P = .0004) were observed in patients with OSA than in those without OSA. All 17 deaths occurred in the OSA group (P = .0001). In a Cox proportional hazards regression analysis, OSA was independently associated with ACPE recurrence (hazard ratio [HR], 3.3 [95% CI, 1.2-8.8]; P = .01), incidence of myocardial infarction (HR, 2.3 [95% CI, 1.1-9.5]; P = .02), cardiovascular death (HR, 5.4 [95% CI, 1.4-48.4]; P = .004), and total death (HR, 6.5 [95% CI, 1.2-64.0]; P = .005). When the analysis was limited only to patients with OSA, levels of AHI and hypoxemic burden and rates of sleep-onset ACPE were significantly higher in those who presented with ACPE recurrence or who died than in those who did not experience these events. CONCLUSIONS: OSA is independently associated with higher rates of ACPE recurrence and both fatal and nonfatal cardiovascular events.

OSA and prognosis after acute cardiogenic pulmonary edema: the OSA-care study

BACKGROUND: Acute cardiogenic pulmonary edema (ACPE) is a life-threatening condition. OSA may be a modifiable risk factor for ACPE recurrence. This study was designed to evaluate the impact of OSA on the incidence of cardiovascular events following ACPE recovery. METHODS: Consecutive patients with confirmed ACPE from 3 centers underwent a sleep study following clinical stabilization. OSA was defined as an apnea-hypopnea index (AHI) ≥ 15 events/h. The mean follow-up was 1 year, and the primary outcome was ACPE recurrence. RESULTS: A total of 104 patients were included in the final analysis; 61% of the patients had OSA. A higher rate of ACPE recurrence (25 vs 6 episodes; P = .01) and a higher incidence of myocardial infarction (15 vs 0 episodes; P = .0004) were observed in patients with OSA than in those without OSA. All 17 deaths occurred in the OSA group (P = .0001). In a Cox proportional hazards regression analysis, OSA was independently associated with ACPE recurrence (hazard ratio [HR], 3.3 [95% CI, 1.2-8.8]; P = .01), incidence of myocardial infarction (HR, 2.3 [95% CI, 1.1-9.5]; P = .02), cardiovascular death (HR, 5.4 [95% CI, 1.4-48.4]; P = .004), and total death (HR, 6.5 [95% CI, 1.2-64.0]; P = .005). When the analysis was limited only to patients with OSA, levels of AHI and hypoxemic burden and rates of sleep-onset ACPE were significantly higher in those who presented with ACPE recurrence or who died than in those who did not experience these events...

Obstructive Sleep Apnea and Cardiovascular Events After Percutaneous Coronary Intervention.

BACKGROUND: There is a paucity of data from large cohort studies examining the prognostic significance of obstructive sleep apnea (OSA) in patients with coronary artery disease. We hypothesized that OSA predicts subsequent major adverse cardiac and cerebrovascular events (MACCEs) in patients undergoing percutaneous coronary intervention. METHODS AND RESULTS: The Sleep and Stent Study was a prospective, multicenter registry of patients successfully treated with percutaneous coronary intervention in 5 countries. Between December 2011 and April 2014, 1748 eligible patients were prospectively enrolled. The 1311 patients who completed a sleep study within 7 days of percutaneous coronary intervention formed the cohort for this analysis. Drug-eluting stents were used in 80.1% and bioresorbable vascular scaffolds in 6.3% of the patients, and OSA, defined as an apnea-hypopnea index of ≥15 events per hour, was found in 45.3%. MACCEs, a composite of cardiovascular mortality, nonfatal myocardial infarction, nonfatal stroke, and unplanned revascularization, occurred in 141 patients during the median follow-up of 1.9 years (interquartile range, 0.8 years). The crude incidence of an MACCEs was higher in the OSA than the non-OSA group (3-year estimate, 18.9% versus 14.0%; p=0.001). Multivariate Cox regression analysis indicated that OSA was a predictor of MACCEs, with an adjusted hazard ratio of 1.57 (95% confidence interval, 1.10-2.24; P=0.013), independently of age, sex, ethnicity, body mass index, diabetes mellitus, and hypertension. CONCLUSIONS: OSA is independently associated with subsequent MACCEs in patients undergoing percutaneous coronary intervention. Evaluation of therapeutic approaches to mitigate OSA-associated risk is warranted. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01306526.

Potential underdiagnosis of obstructive sleep apnoea in the cardiology outpatient setting.

INTRODUCTION: Consistent evidence suggests that obstructive sleep apnoea (OSA) is associated with increased cardiovascular risk. However, it is unclear whether OSA is underdiagnosed in the cardiology outpatient setting. In the present study, we prospectively evaluated the potential underdiagnosis of OSA in several subspecialties from a tertiary cardiology university hospital. METHODS: Consecutive outpatients from five subspecialties (hypertension, coronary, arrhythmia, heart failure (HF), valvular heart disease) were studied. We performed anthropometric measurements, assessed the risk of OSA using the Berlin Questionnaire and evaluated the prior diagnosis and treatment for OSA. In a subset of patients randomly selected, we performed portable sleep monitoring to objectively evaluate the presence of OSA (defined by an apnoea-hypopnoea index ≥15 events/h of sleep). RESULTS: We evaluated 500 patients (100 from each subspecialty). The mean age and body mass index (BMI) were 59±13 years and 28.2±5.3 kg/m(2), respectively. We found that 51.6% (258 patients) had a high risk for OSA (Berlin Questionnaire). However, only 13 (3.1%) of these patients had a previous diagnosis of OSA. Of those, only six patients were receiving specific OSA treatment. Fifty patients (10 from each specialty) participated in sleep studies. No differences were found in patients who underwent sleep monitoring and those who did not. We found a high frequency of OSA (66%), varying from 50% (hypertension group) to 80% (HF group). CONCLUSIONS: Despite significant scientific evidence pointing to OSA as an emerging cardiovascular risk factor, OSA is still underdiagnosed in several cardiology subspecialties.

Impact of OSA on cardiovascular events after coronary artery bypass surgery.

BACKGROUND: The impact of OSA on new cardiovascular events in patients undergoing coronary artery bypass graft (CABG) surgery is poorly explored. METHODS: Consecutive patients referred for CABG underwent clinical evaluation and standard polysomnography in the preoperative period. CABG surgery data, including percentage of off-pump and on-pump CABG, number of grafts, and intraoperative complications, were collected. The primary end point was major adverse cardiac or cerebrovascular events (MACCEs) (combined events of all-cause death, myocardial infarction, repeated revascularization, and cerebrovascular events). Secondary end points included individual MACCEs, typical angina, and arrhythmias. Patients were evaluated at 30 days (short-term) and up to 6.1 years (long term) after CABG. RESULTS: We studied 67 patients (50 men; mean age, 58 ± 8 years; mean BMI, 28.5 ± 4.1 kg/m2). OSA (apnea-hypopnea index ≥ 15 events/h) was present in 56% of the population. The patients were followed for a mean of 4.5 years (range, 3.2-6.1 years). No differences were observed in the short-term follow-up. In contrast, MACCE (35% vs 16%, P = .02), new revascularization (19% vs 0%, P = .01), episodes of typical angina (30% vs 7%, P = .02), and atrial fibrillation (22% vs 0%, P = .0068) were more common in patients with than without OSA in the long-term follow-up. OSA was an independent factor associated with the occurrence of MACCE, repeated revascularization, typical angina, and atrial fibrillation in the multivariate analysis. CONCLUSIONS: OSA is independently associated with a higher rate of long-term cardiovascular events after CABG and may have prognostic and economic significance in CABG surgery.

Tratamento com radio e quimioterapia do carcinoma epidermóide do canal anal: experiência do hospital Barão de Lucena / Radiochemotherapy for squamous cell carcinoma of the anal canal: Barao de Lucena hospital experience

Objetivos: Apresentar os resultados e analisar as variáveis implicadas no tratamento e prognóstico do carcinoma epidermóide do canal anal tratado através da radio e quimioterapia no Hospital Barão de Lucena-SUS-PE. Metodologia: Análise dos prontuários de pacientes com diagnóstico de câncer do canal anal submetidos a tratamento radioquimioterápico. O período de acompanhamento foi de junho de 1989 a junho de 2005. Foram incluídos os pacientes com diagnóstico histológico de câncer de canal anal, enquadrados nos estadios I, II, IIIa e IIIb, submetidos a dois ciclos de quimioterapia com 5-fluorouracil (5-FU) na dose de 1g/m²/dia em infusão contínua de 96 horas e cisplatino na dose de 100mg/m² administrado em 6 horas no segundo dia de infusão de cada ciclo, administrados na primeira e terceira semanas do esquema de tratamento radioterápico. Resultados: Avaliamos 108 prontuários de pacientes que preencheram os critérios do protocolo. O tempo médio de seguimento foi de 51 meses (1-182 meses). Houve predomínio do gênero feminino (81,5 por cento dos pacientes). A idade variou de 33 a 83 anos (média de 59 anos). O tipo histológico mais freqüente foi o carcinoma de células escamosas (80,6 por cento dos casos). Em 21 pacientes, foi diagnosticado carcinoma basalóide. Quanto ao grau de diferenciação, prevaleceu o tipo moderadamente diferenciado (61 por cento dos pacientes com carcinoma de células escamosas). O índice de resposta inicial completa foi de 89,8 por cento. Onze pacientes persistiram com tumor após o tratamento radio e quimioterápico. O índice de resposta inicial completa foi menor nos estadios IIIa e IIIb em relação aos estadios I e II com significância estatística (p<0,05). 14 pacientes evoluíram com recidiva tumoral, oito com recidiva local (7,4 por cento) e seis (5,5 por cento) com recidiva linfática e à distância. CONCLUSÕES: O tratamento radioquimioterápico exclusivo do carcinoma epidermóide do canal anal, tem índice de resposta completo bastante elevado co...

Objectives: To present the results and analyze the variables involved in the treatment and prognosis of squamous cell carcinoma of the anal canal treated by radiotherapy and chemotherapy at the Hospital Barao de Lucena-SUS-PE. Methodology: Analysis of medical records of patients diagnosed with anal cancer treated by chemoradiation. The monitoring period was from June 1989 to June 2005. We included patients with histologically confirmed cancer of the anal canal, framed in stages I, II, IIIa and IIIb, underwent two cycles of chemotherapy with 5-fluorouracil (5-FU) at a dose of 1g / m² / day continuous infusion 96 hours and cisplatin at a dose of 100 mg / m² administered at 6 hours the second day of infusion of each cycle, administered on the first and third weeks of radiotherapy treatment regimen. Results: We evaluated records of 108 patients who met the criteria of the protocol. The mean follow-up was 51 months (1-182 months). There were more females (81.5 percent of patients). The age ranged from 33 to 83 years (mean 59 years). The most common histological type was squamous cell carcinoma (80.6 percent of cases). In 21 patients, was diagnosed Basaloid carcinoma. Regarding the degree of differentiation, the most prevalent type was moderately differentiated (61 percent of patients with squamous cell carcinoma). The rate of initial complete response was 89.8 percent. Eleven patients had persistent tumor after radiotherapy and chemotherapy. The initial response rate was lower in complete stages IIIa and IIIb compared to stages I and II with statistical significance (p <0.05). 14 patients developed recurrence, eight with local recurrence (7.4 percent) and six (5.5 percent) with lymphatic recurrence and distance. CONCLUSIONS: The chemoradiation treatment of unique cell carcinoma of the anal canal, have complete response rate very high with acceptable morbidity. Surgical treatment still has its value in cases of persistent injury and / or local recurrence, with sati...