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Nogueira L.A.C.,Rio de Janeiro State Federal University | Nogueira L.A.C.,Federal University of Rio de Janeiro | dos Santos L.T.,Federal University of Rio de Janeiro | Sabino P.G.,Rio de Janeiro State Federal University | And 3 more authors.
Arquivos de Neuro-Psiquiatria | Year: 2013

Purpose: We analysed the cognitive influence on walking in multiple sclerosis (MS) patients, in the absence of clinical disability. Method: A case-control study was conducted with 12 MS patients with no disability and 12 matched healthy controls. Subjects were referred for completion a timed walk test of 10 m and a 3D-kinematic analysis. Participants were instructed to walk at a comfortable speed in a dual-task (arithmetic task) condition, and motor planning was measured by mental chronometry. Results: Scores of walking speed and cadence showed no statistically significant differences between the groups in the three conditions. The dual-task condition showed an increase in the double support duration in both groups. Motor imagery analysis showed statistically significant differences between real and imagined walking in patients. Conclusion: MS patients with no disability did not show any influence of divided attention on walking execution. However, motor planning was overestimated as compared with real walking.

Thuler L.C.S.,Instituto Nacional Of Cancer Jose Alencar Gomes Da Silva Inca | Thuler L.C.S.,Federal University of Rio de Janeiro | Bergmann A.,National Cancer Institute Jose Alencar Gomes da Silva INCA | Bergmann A.,University Center Augusto Motta
Aging Male | Year: 2015

Purpose: To describe the clinical-epidemiological features of male patients with breast cancer in Brazil. Methods: Data from male patients with breast cancer treated from 2000 through 2009 were obtained from the Brazilian Hospital Cancer Register databases. Descriptive statistics were performed. Results: A total of 1189 male patients were included. The mean age at diagnosis was 59.6 years (±13.6). Tumours were categorised as clinical stage I (14.3%), stage II (38.3%), stage III (34.1%) and stage IV (13.3%). The most frequent histological type was invasive ductal carcinoma (83.7%). The first course treatment (alone or combined) consisted of chemotherapy in 53.2%, surgery in 49.2, radiation therapy in 36.8 and hormonal therapy in 21.0%; 3.4% of cases did not receive treatment. Treatment modality varies according to the tumor-node-metastasis (TNM) stage. The inadequate response rate was 15.9%, and 7.4% of patients died after the first course of treatment. Adequate response according to the first-course cancer treatment, after adjusted for clinical stage, was associated with being Caucasian (odds ratio (OR)=2.50; 95% confidence interval (95% CI): 1.35-4.65) and submitted to chemotherapy (OR=0.46; 95% CI: 0.28-0.74). Conclusions: Male breast cancer diagnosis is often made in the advanced stage. Consequently, patients were subjected to more aggressive treatments, with poorer clinical response. © 2014 Informa UK Ltd.

Fonseca T.C.,Instituto Nacional Of Cancer Jose Alencar Gomes Da Silva Inca | Eisenberg A.L.A.,Instituto Nacional Of Cancer Jose Alencar Gomes Da Silva Inca
Jornal Brasileiro de Patologia e Medicina Laboratorial | Year: 2015

Introduction: Lesions of the salivary glands are uncommon, representing 2% to 6.5% of all neoplasms of head and neck, and because of the difference in treatment between them, an accurate diagnosis is essential. The cytological study by fine-needle aspiration (FNA) biopsy is a highly accurate method used to diagnose lesions of the salivary glands. Intraoperative consultation (IOC), in its turn, is a test that provides diagnosis during surgery, aiming to differentiate malignant from benign lesions and to enable the most appropriate surgical approach. Objective: To evaluate the accuracy of IOC in salivary gland lesions. Material and methods: A survey was conducted in the database of Instituto Nacional de Câncer (Inca) into IOC for diagnosis of salivary gland lesions from January 2001 to December 2012, and found 748 cases. Diagnosis made at IOC (IOCD) was compared with the gold standard histopathological diagnosis and classified into: 1) consenting; 2) discordant; and 3) indeterminate. From these data, sensitivity, specificity and accuracy were calculated. Results: Among the 748 IOCs, results were concordant in 656 cases (88%), discordant in 56 (7%), and indeterminate in 36 (5%). Sensitivity was 78%, specificity 99% and accuracy 92%. Conclusion: Our results indicate that IOC in salivary gland lesions is highly accurate and can contribute to the surgical approach.

Thuler L.C.S.,Instituto Nacional Of Cancer Jose Alencar Gomes Da Silva Inca | Thuler L.C.S.,Rio de Janeiro State Federal University | De Aguiar S.S.,Instituto Nacional Of Cancer Jose Alencar Gomes Da Silva Inca | Bergmann A.,Centro Universitario Augusto Motta
Revista Brasileira de Ginecologia e Obstetricia | Year: 2014

PURPOSE: To assess the determinants of late stage in women with cervical cancer in Brazil. METHODS: A cross-sectional study of secondary basis. Women with invasive cervical cancer enrolled in the Cancer Hospital Registry between January 2000 and December 2009 were included. Late clinical stage (≥IIB) was the outcome considered. The following variables were studied: age at diagnosis, race or ethnicity, years of education, marital status, alcohol consumption, smoking status, place of residence, year of diagnosis, initial treatment received, and status after the first treatment. Odds ratio (OR) with 95% confidence intervals (95%CI) and a logistic regression model were used. P values<0.05 were considered statistically significant. Results: 37,638 cases were included, with a mean age of 52.4±14.1 years. Late clinical stages were observed in 70.6% of cases and were associated with the presence of squamous cell carcinoma (OR=1.8; 95%CI 1.7-2.0), age ≥50 years (OR=1.5; 95%CI 1.4-1.6), living with a partner (OR=1.3; 95%CI 1.2-1.4), black skin color (OR=1.2; 95%CI 1.1-1.4), and low educational level (OR=1.2; 95%CI 1.1-1.3). CONCLUSION: In Brazil, the diagnosis of cervical cancer is a delayed event. Although the main factor associated with late stage of cervical cancer identified in this study is a biological factors (histological type) and, consequently, not eligible for intervention, it was confirmed that socioeconomic disparities in the country are associated with late stage disease.

Ferreira E.E.,Instituto Nacional Of Cancer Jose Alencar Gomes Da Silva Inca | Guerra D.C.,Instituto Nacional Of Cancer Jose Alencar Gomes Da Silva Inca | Baluz K.,Instituto Nacional Of Cancer Jose Alencar Gomes Da Silva Inca | De Resende Furtado W.,University of Sao Paulo | Da Silva Bouzas L.F.,Instituto Nacional Of Cancer Jose Alencar Gomes Da Silva Inca
Revista Brasileira de Hematologia e Hemoterapia | Year: 2014

OBJECTIVE: This study aimed to describe and compare the nutritional status of adult patients submitted to allogeneic hematopoietic stem cell transplantation at two different time points (admission and discharge). METHODS: A retrospective, descriptive and quantitative study was performed based on clinical, laboratory and nutritional data obtained from medical records of adult patients of both genders submitted to allogeneic hematopoietic stem cell transplantation in a bone marrow transplantation reference center in Rio de Janeiro in the period from 2010 to 2013. Statistical analysis was performed using the SPSS software (version 22.0). RESULTS: Sixty-four patients were evaluated. The mean age was 42.1±3.2 years and the most prevalent disease was acute myeloid leukemia (39%). There was a high prevalence of gastrointestinal symptoms including nausea (100%), vomiting (97%) and mucositis (93%). Between admission and discharge there was a significant decrease in the median weight (-2.5kg; 71.5 vs. 68.75kg; p-value<0.001), body mass index (-0.9kg/m2; 24.8 vs. 24.4kg/m2; p-value<0.001), and serum albumin levels (-0.2g/dL; 3.7 vs. 3.6g/dL; p-value=0.024). The survival time after hematopoietic stem cell transplantation correlated negatively with C-reactive protein at discharge (CC=-0.72; p-value<0.001) and positively with serum albumin levels (CC=0.56; p-value=0.004) and with high total protein level at discharge (CC=0.53; p-value=0.006). CONCLUSION: Our results suggest that patients submitted to allogeneic hematopoietic stem cell transplantation have compromised nutritional status during the hospital stay for transplantation. © 2014 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. All rights reserved.

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