Rio de Janeiro, Brazil
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De Aguiar S.S.,National Cancer Institute | Bergmann A.,University Center Augusto Motta
Quality of Life Research | Year: 2014

Purpose: To describe quality of life (QoL) in a cohort of surviving women 4 years after breast cancer treatment and to analyze its role as a predictor of mortality within 2 years. Methods: This is a prospective cohort study of 544 women who have undergone surgical treatment, from 2001 to 2002 and who answered a questionnaire about QoL in 2006. After, we conducted a survival study to evaluate the association between QoL and mortality within 2 years with the same population. We conducted factor analysis between the variables of the scales of function and symptoms. Survival analysis was conducted by Kaplan-Meier, and differences in survival curves were assessed with the log-rank test, assuming significant statistical level of 5 %. The Cox proportional hazards regression model was used to explore the relationship between QoL variables (functional scales) and prognostic value for survival. Results: The mean age of the women was 59.1 years (SD 11.66). The mean of overall QoL score was 75.16 (SD 20.93). Using factor analysis, we identified three conditions that made up the construct of QoL in this group of patients: social, psycho-emotional, and physical. Social condition was the most important factor. After assessment of QoL, the mean survival was 23 months (SD 3.90). Women who reported worse future perspective had higher chance of death compared with women better prospect of future (HR = 3.46; 95 % CI 1.36-8.79; p value = 0.009). Conclusion: Future perspectives were predictors of mortality, which reinforce the relevance of social support and psychological aspects for these women. © 2013 Springer Science+Business Media Dordrecht.


De Souza Moura M.A.,Brazilian National Institute of Technology | Bergmann A.,Brazilian National Institute of Technology | Bergmann A.,University Center Augusto Motta | De Aguiar S.S.,Brazilian National Institute of Technology | And 2 more authors.
BMJ Open | Year: 2014

Objectives: To estimate the magnitude of association and identify the aetiological fraction (AF) attributable to smoking in the development of different types of cancers in Brazil. Setting: We conducted a case-control study, including 231 102 patients registered in the Cancer Hospital Registries (CHR) in the period from 1998 to 2011. Participants: A total of 204 131 cancer cases relating to 30 topographies were compared with 26 971 cases of non-melanoma skin cancer. Primary and secondary outcome measures: Smoking exposure was considered at the time of hospital registration. We calculated OR, unadjusted and adjusted for gender, age and alcohol consumption, with 95% CIs. Results: After adjustment, the risk of developing cancer associated with smoking was very high (piriform sinus, bronchi and lung, larynx, hypopharynx, oropharynx and oral cavity), high (oesophagus and bladder), moderate (anus and anal canal stomach, nasal cavity, middle ear and paranasal sinuses, pancreas, nasopharynx, other parts of the biliary tract and kidney and low (liver, gall)). There was no association between smoking and cancers of the central nervous system and myeloid leukaemia. For thyroid cancer there was a decreased risk of developing the disease. The AF was higher than 50% for hypopharynx, larynx, bronchi and lung, oropharynx, oral cavity and oesophagus cancers. Conclusions: This study confirms a high risk of developing cancer of the hypopharynx, bronchi and lung, larynx, oropharynx and oral cavity, oesophagus and bladder cancer among smokers and establishes the AF attributable to smoking in the development of different types of cancer in Brazil.


Waissman F.Q.B.,Federal University of Fluminense | Waissman F.Q.B.,State University of Rio de Janeiro | Orsini M.,Federal University of Fluminense | Orsini M.,University Center Augusto Motta | And 4 more authors.
Neurology International | Year: 2013

The aim of this article is to evaluate if body awareness is important to improve the writing ability before using the splints. Twelve patients with writer's cramp were evaluated by a specialist in movement disorders. The Burke-Fahn-Marsden Scale (BFM), the Jedynak Protocol and the Analog Pain Scale were used. The rehabilitation training was administered over an eight-week period, in two phases of four weeks each, twice a week. Each session would last 60 minutes. A significant improvement was shown, not only in the motor, but also in the pain perception, through the BFM scale, the Jedynak Protocol and the Analog Pain Scale. Therefore, we conclude that the motor training, thanks to the body awareness and immobilization by splints of the affected dystonic musculature, led to an important improvement in the writer's cramp writing. © Quadros Boisson Waissman et al., 2013 Licensee PAGEPress, Italy.


de Almeida C.R.,State University of Rio de Janeiro | Carneiro K.,State University of Rio de Janeiro | Fiorelli R.,State University of Rio de Janeiro | Orsini M.,University Center Augusto Motta | Alvarenga R.M.P.,State University of Rio de Janeiro
Neurology International | Year: 2013

The aim of the present study is to describe the type and frequency of bladder dysfunction in a series of female patients with multiple sclerosis (MS) from Rio de Janeiro, and analyze the role of the urologist in the multidisciplinary team. A team of urologists and a neurologist from the Hospital da Lagoa, Rio de Janeiro, Brazil, interviewed female patients with MS about illness onset, urologic follow-up since diagnosis, current stage of the disease and current urological symptoms. The interview was followed by an urodynamic testing, ultrasound of the urinary tract and urinalysis. Data resulting from the interviews and exam results were gathered and submitted to statistical evaluation. Sixty one patients were evaluated, with average age of 41.4 years. Urinary symptoms such as urinary incontinence, urinary hesitancy, urinary retention, urinary urgency and incomplete bladder emptying were reported in 44% of patients as initial signs of MS disease. Mean disease duration was 8 years and all patients (100%) with the primary progressive form of the disease and 63.5% with the relapsing- remitting presentation had urological symptoms. Analysis of complementary exams showed that 37.7% of urinalysis, 8.2% of the urinary tract ultrasound exams and 66.7% of the urodynamic evaluations were abnormal and the most frequent abnormality were overactive neurogenic bladder. Only 4 patients (6.6%) had seen an urologist during the course of their disease and only 1.6% had performed an urodynamic evaluation. This study shows a high prevalence (68%) of urinary dysfunction in a female population with MS. Urologic care should be part of the multidisciplinary team since the beginning of the disease. An urodynamic evaluation and simple urinalysis should be included in the routine testing during disease follow-up due to the high incidence of neurogenic bladder and other urologic complications. © C. Rodrigues de Almeida et al., 2013.


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.


Abrahao K.D.S.,University Center Augusto Motta | Bergmann A.,University Center Augusto Motta | Aguiar S.S.D.,University Center Augusto Motta | Thuler L.C.S.,Federal University of Rio de Janeiro
Maturitas | Year: 2015

Background Breast cancer is commonly diagnosed at an advanced stage in Brazil. Aim Analyze the determinants of advanced staging in Brazilian women with breast cancer. Methods Crosssectional study, including women diagnosed with breast cancer in Brazil, between 2000 and 2009. Results A total of 59,317 women were included, 53.5% being classified as advanced stage (≥IIB). Younger age (18 to 49 years old) (OR = 1.61 95% CI 1.51 to 1.72) or between 40 and 49 years old (OR = 1.08 95% CI 1.03 to 1.14), having low educational level (OR = 1.53 95% CI 1.48 to 1.58), living in less developed geographical regions (OR = 1.27 95% CI 1.21 to 1.33), having invasive ductal carcinoma (OR = 2.70 95% CI 2.56 to 2.84) and invasive lobular carcinoma (OR = 2.63 95% CI 2.42 to 2.86) were associated with advanced breast cancer. Conclusion We conclude that future interventions should focus on these high risk groups. © 2015 Elsevier Ireland Ltd. All rights reserved.


Nogueira-Rodrigues A.,Federal University of Minas Gerais | Nogueira-Rodrigues A.,Brazilian National Cancer Institute | Ferreira C.G.,Brazilian National Cancer Institute | Bergmann A.,Brazilian National Cancer Institute | And 4 more authors.
Gynecologic Oncology | Year: 2014

Background Most cancers of the uterine cervix are SCC, but the relative and absolute incidence of ACA has risen in recent years, and ACA now accounts for approximately 20% of invasive cervical cancers in the screened populations worldwide. Objective To compare the epidemiological, clinical characteristics, and treatment outcomes of ACA with those of SCC of the cervix in a sub-optimally screened population.Methods Data from cervical cancer patients with SCC and ACA treated from 2000 through 2009 were obtained from the Brazilian Hospital Cancer Register databases. The summary odds ratios and chi-square tests were estimated.Results A total of 51,842 patients including 45,540 (87.8%) cases of SCC and 6302 (12.2%) of ACA were analyzed. Compared with the ACA patients, the SCC patients were younger and more frequently black and had a higher degree of illiteracy and alcohol and tobacco consumers. The tumor stage at the time of diagnosis was also significantly different between the two groups. However, initial therapeutic response and death rate after the first course of treatment were similar in both groups.Conclusions Differences between ACA and SCC were observed for all demographic and clinical variables analyzed but not for responses to treatment and death at the end of the first course of treatment. Irrespective of the histological subtype, the quality of screening and treatment must be improved in developing countries, since initial therapeutic response of ACA and SCC is similar. © 2014 Elsevier Inc. All rights reserved.


De Paula Lima P.O.,Federal University of Ceará | Reboucas N.S.,Federal University of Ceará | Chaves S.F.,Federal University of Ceará | Lemos E Silva R.,Federal University of Ceará | And 2 more authors.
Isokinetics and Exercise Science | Year: 2013

This study aimed to analyze the influence of holographic bracelets on body balance and peak torque in soccer athletes through a quintuple-blind, placebo-controlled, crossover randomized trial. Twenty-eight male athletes were evaluated in a stabilometric baropodometer (DIASU®) and performed a protocol involving concentric contractions of the knee at 60°/s. Athletes were evaluated in three situations: no bracelet (baseline), with a placebo bracelet (PB) and holographic bracelet (HB). Comparing the mean torque peak at 60°/s during knee extension, there was no statistical difference for the dominant limb (p=0.713) and non-dominant (p=0.996) between the baseline, PB and HB groups. No statistical difference was found comparing the mean oscillation ellipses from the right foot with eyes open (p=0.359) and with eyes closed (p=0.173), as well as from the left foot with eyes open (p=0.891) and with eyes closed (p=0.778). In conclusion, holographic bracelet has no influence on either body balance or knee muscle performance in athletes. © 2013 - IOS Press and the authors. All rights reserved.


PubMed | Federal University of Rio de Janeiro, Brazilian National Cancer Institute, University Center Augusto Motta and Federal University of Minas Gerais
Type: Comparative Study | Journal: Gynecologic oncology | Year: 2014

Most cancers of the uterine cervix are SCC, but the relative and absolute incidence of ACA has risen in recent years, and ACA now accounts for approximately 20% of invasive cervical cancers in the screened populations worldwide.To compare the epidemiological, clinical characteristics, and treatment outcomes of ACA with those of SCC of the cervix in a sub-optimally screened population.Data from cervical cancer patients with SCC and ACA treated from 2000 through 2009 were obtained from the Brazilian Hospital Cancer Register databases. The summary odds ratios and chi-square tests were estimated.A total of 51,842 patients including 45,540 (87.8%) cases of SCC and 6302 (12.2%) of ACA were analyzed. Compared with the ACA patients, the SCC patients were younger and more frequently black and had a higher degree of illiteracy and alcohol and tobacco consumers. The tumor stage at the time of diagnosis was also significantly different between the two groups. However, initial therapeutic response and death rate after the first course of treatment were similar in both groups.Differences between ACA and SCC were observed for all demographic and clinical variables analyzed but not for responses to treatment and death at the end of the first course of treatment. Irrespective of the histological subtype, the quality of screening and treatment must be improved in developing countries, since initial therapeutic response of ACA and SCC is similar.

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