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de Mattos R.A.,Hospital do Servidor Publico Estadual | Kadunc B.V.,University of Sao Paulo | Toschi A.,Instituto Brasileiro Of Controle Do Cancer Ibcc | Peixoto S.M.,TI da Sociedade Brasileira de Dermatologia Rio de Janeiro RJ | Andriolo A.C.,Hospital do Servidor Publico Estadual
Surgical and Cosmetic Dermatology | Year: 2011

Introduction: An online questionnaire on the use of lasers and other technologies for treating cutaneous disorders or unattractive conditions was sent to 6517 members of the Brazilian Society of Dermatology. Objective: To quantify the use of those technologies by dermatologists by region, in order to identify regional needs in Brazil. Methods: The survey included 17 questions about the devices, relating to topics such as the place of application, ownership or rental equipment status, number of devices used, indications and types, and the member's region. The respondents used the Society's website to submit answers between February and March 2011. The answers were coded in graphs with percentages. Results: The response rate was 859: 68% of Brazilian dermatologists perform the procedures at their private offices, 32% are owners of the equipment and 80% live in the southeast/south of Brazil. Conclusions: While some results met the expectations -the Brazilian Southeast region had the greatest number of dermatologists who answered the questionnaire and use the technologies in question-, others were surprising -variety of equipment used-. This survey allowed the Brazilian Society of Dermatology to analyze how Brazilian dermatologists employ those devices, as well as the geographical locations that have a greater need for their use.

Carraro D.M.,Ac Camargo Hospital | Carraro D.M.,National Institute of Science and Technology in Oncogenomics INCITO | Koike Folgueira M.A.A.,University of Sao Paulo | Garcia Lisboa B.C.,Ac Camargo Hospital | And 16 more authors.
PLoS ONE | Year: 2013

Germline mutations in BRCA1, BRCA2 and TP53 genes have been identified as one of the most important disease-causing issues in young breast cancer patients worldwide. The specific defective biological processes that trigger germline mutation-associated and -negative tumors remain unclear. To delineate an initial portrait of Brazilian early-onset breast cancer, we performed an investigation combining both germline and tumor analysis. Germline screening of the BRCA1, BRCA2, CHEK2 (c.1100delC) and TP53 genes was performed in 54 unrelated patients <35 y; their tumors were investigated with respect to transcriptional and genomic profiles as well as hormonal receptors and HER2 expression/amplification. Germline mutations were detected in 12 out of 54 patients (22%) [7 in BRCA1 (13%), 4 in BRCA2 (7%) and one in TP53 (2%) gene]. A cancer familial history was present in 31.4% of the unrelated patients, from them 43.7% were carriers for germline mutation (37.5% in BRCA1 and in 6.2% in the BRCA2 genes). Fifty percent of the unrelated patients with hormone receptor-negative tumors carried BRCA1 mutations, percentage increasing to 83% in cases with familial history of cancer. Over-representation of DNA damage-, cellular and cell cycle-related processes was detected in the up-regulated genes of BRCA1/2-associated tumors, whereas cell and embryo development-related processes were over-represented in the up-regulated genes of BRCA1/2-negative tumors, suggesting distinct mechanisms driving the tumorigenesis. An initial portrait of the early-onset breast cancer patients in Brazil was generated pointing out that hormone receptor-negative tumors and positive familial history are two major risk factors for detection of a BRCA1 germline mutation. Additionally, the data revealed molecular factors that potentially trigger the tumor development in young patients. © 2013 Carraro et al.

Barbosa E.M.,Instituto Brasileiro Of Controle Do Cancer Ibcc | Francisco A.A.R.F.,Instituto Brasileiro Of Controle Do Cancer Ibcc | Araujo Neto J.T.,Instituto Brasileiro Of Controle Do Cancer Ibcc | Alves E.M.F.,Instituto Brasileiro Of Controle Do Cancer Ibcc | And 2 more authors.
Revista Brasileira de Ginecologia e Obstetricia | Year: 2010

PURPOSE: to evaluate which clinical, pathological or immunohistochemical factors may be predictive of metastatic involvement of other lymph nodes in patients with breast carcinoma undergoing sentinel lymph node biopsy (SLNB). METHODS: a retrospective study carried out with 1,000 successive patients with SLNB from 1998 to 2008. Age, tumor size, histological grade, lymphovascular invasion, hormone receptor status and HER-2, size of metastasis and number of positive SLN were evaluated. The associations between the characteristics of the tumors and the types of metastases were evaluated through χ2 corrected likelihood ratio tests for insufficient samples. RESULTS: mean age was 57.6 years and mean tumor size was 1.85 cm. A total of 72.2% SLN were negative and 27.8% were positive, but in 61.9% of the cases, the SLN was the only positive one, with 78.4% having macrometastases, 17.3% micrometastases and 4.3% isolated tumor cells (CTI). Tumor size was predictive of metastases in non-sentinel lymph nodes. After 54 months of follow-up, there were no recurrences in patients with CTI, but one local recurrence and two systemic recurrences were observed in the micrometastasis group, as well as four local and 30 distant metastases in the macrometastasis group. CONCLUSIONS: among the clinical parameters studied, only tumor size was correlated with metastatic involvement in axillary lymph nodes. The size of the metastases and the number of positive SLN also directly increased the possibility of systemic recurrence. The different rates of recurrence indicate that the biological significance of these types of metastases is different and that patients with SLN metastases may also have different risks of metastatic involvement of other axillary lymph nodes.

Tacani P.M.,Instituto Brasileiro Of Controle Do Cancer Ibcc | Kasawara K.T.,University of Campinas | Tacani R.E.,Centro Universitario Sao Camilo | Machado A.F.P.,University of Sao Paulo | And 2 more authors.
Mundo da Saude | Year: 2014

Advances in cancer treatment has been favoring higher survival rates, increasing demand of rehabilitation of cancer patients, being physical therapy one of the areas in a higher growth. However, this population has very different profiles, demands and realities, requiring the knowledge of its features to better develop action strategies and conducts in the area of physical therapy in oncology. The objective of this study was to identify the clinical profile of patients assisted in a physical therapy outpatient in Oncology. One hundred five medical records were analyzed for demographic and clinical data collection in a outpatient physiotherapy service of Sao Paulo city, from August 2008 to July 2010, being 11(10.5%) excluded. Statistical analysis was performed using the test for equality of two proportions to evaluate the relative distribution of variables, which were compared using the Mann-Whitney test. Among those 94 medical records, 63.8% (n = 60) were female (p < 0.001), with a mean age of 56.3 ± 13.3 years and they had a BMI of 27.09 ± 5.88 kg/m2. The most prevalent medical diagnosis was breast cancer in 44.4% (n = 44; p < 0.05). Most patients were between the second and the fifth year (33%; n = 31) of disease evolution. Surgery was the most common treatment (94.7%; n = 89; p < 0.001). The most frequent physiotherapeutic diagnosis included vascular and lymphatic dysfunctions (87.2%; n = 82; p < 0.001) with complaints of pain (55.3%; n = 52) and swelling (51.1%; n = 48; p = 0.559). It was concluded that the clinical profile of patients was characterized by woman, over 50 years old, overweight in late postoperative breast cancer, exhibiting lymphedema and pain in the limbs.

Baiocchi G.,Hospital Do Cancer A C Camargo | Duprat J.P.,Hospital Do Cancer A C Camargo | Neves R.I.,Pennsylvania State University | Fukazawa E.M.,Hospital Do Cancer A C Camargo | And 3 more authors.
Sao Paulo Medical Journal | Year: 2010

Context and objective: Vulvar melanoma is a rare disease. We describe the experience of a single institution and review the literature. design and setting: Retrospective study at the Department of Gynecology, Hospital do Cancer A. C. Camargo. Methods: Eleven patients with vulvar melanoma attended between January 1987 and December 2006 were reviewed regarding clinicopathological characteristics, surgical therapy and follow-up. Results: The initial symptoms were vulvar lesions, pruritus, pain and bleeding. The median age was 64.8 years. The median depth of invasion was 3.08 mm. The staging ranged from IB to IIIC (American Joint Committee on Cancer, 2002). All the patients underwent vulvectomy. Two patients did not undergo primary elective lymphadenectomy. Bilateral inguinal lymphadenectomy was performed on five patients, and one had unilateral inguinal lymphadenectomy. Sentinel lymph node investigation was performed on three patients. Five patients had locoregional recurrence. Prolonged survival was only achieved in the absence of lymph node involvement. The median follow-up was 56 months. The median disease-free survival was 15 months and the median overall survival was 29 months. Conclusions: The prognosis for patients with vulvar melanoma is generally poor, with a high tendency towards regional and distant recurrence. Depth of invasion and lymph node involvement are the most important prognostic factors. In most cases, resection of the lesion with adequate margins may replace vulvectomy. Elective inguinal femoral lymphadenectomy remains the standard lymph node staging procedure. Sentinel lymph node investigation is feasible and should be performed by a multidisciplinary team with experience of this method.

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