Objective: Patients with lung cancer experience different feelings and reactions, based on their family, social, cultural, and religious backgrounds, which are a source of great distress, not only for the patients but also for their family caregivers. This study aimed to evaluate the impact that lung cancer stage and quality of life (QoL) of lung cancer patients have on caregiver burden. Methods: This was a prospective cross-sectional study. Consecutive patient-caregiver dyads were selected and asked to complete the Hospital Anxiety and Depression Scale and the Medical Outcomes Study 36-item ShortForm Health Survey (SF-36). Family caregivers also completed the Caregiver Burden Scale. Group-based modeling was used in order to identify patients with early- or advanced-stage cancer (IA to IIIA vs. IIIB to IV) plus non-impaired or impaired QoL (SF36 total score > 50 vs. ≤ 50). Patient-caregiver dyads were stratified into four groups: early-stage cancer+non-impaired QoL; advanced-stage cancer+non-impaired QoL; early-stage cancer+impaired QoL; and advanced-stage cancer+impaired QoL. Results: We included 91 patient-caregiver dyads. The majority of the patients were male and heavy smokers. Family caregivers were younger and predominantly female. The burden, QoL, level of anxiety, and level of depression of caregivers were more affected by the QoL of the patients than by their lung cancer stage. The family caregivers of the patients with impaired QoL showed a higher median burden than did those of the patients with non-impaired QoL, regardless of disease stage. Conclusions: Caregiver burden is more affected by patient QoL than by lung cancer stage.

In order to determine the contribution of a-thalassemia to microcytosis and hypochromia, 339 adult outpatients seen at Unicamp University Hospital (with the exception of the Clinical Hematology outpatient clinics), who showed normal hemoglobin (Hb) levels and reduced mean corpuscular volume and mean corpuscular hemoglobin, were analyzed. Ninety-eight were Blacks (28.9%) and 241 were Caucasians (71.1%). In all cases, Hb A 2 and F levels were either normal or low. The most common deletional and nondeletional forms of a-thalassemia [-a 3.7 , -a 4.2 , --MED , -(a) 20.5 , a HphI a, a NcoI a, aa NcoI and a TSAUDI ] were investigated by PCR and restriction enzyme analyses. A total of 169 individuals (49.9%) presented a-thalassemia: 145 (42.8%) were heterozygous for the -a 3.7 deletion (-a 3.7 /aa) and 18 (5.3%) homozygous (-a 3.7 /-a 3.7 ), 5 (1.5%) were heterozygous for the nondeletional form a HphI a (a HphI a/aa), and 1 (0.3%) was a --MED carrier (--MED /aa). Among the Blacks, 56 (57.1%) showed the -a 3.7 / aa genotype, whereas 12 (12.2%) were -a 3.7 /-a 3.7 and 1 (1.0%) was an a HphI a carrier; among the Caucasians, 89 (36.9%) were -a 3.7 /aa, 6 (2.5%) had the -a 3.7 /-a 3.7 genotype, 4 (1.7%) presented the nondeletional form (a HphI a/aa), and 1 (0.4%) was a --MED carrier. These results demonstrate that a-thalassemia, mainly through the -a 3.7 deletion, is an important cause of microcytosis and hypochromia in individuals without anemia. These data are of clinical relevance since these hematological alterations are often interpreted as indicators of iron deficiency.

Seven unrelated patients with hemoglobin (Hb) H disease and 27 individuals with a -chain structural alterations were studied to identify the a -globin gene mutations present in the population of Southeast Brazil. The -a 3.7 , --MED and -(a) 20.5 deletions were investigated by PCR, whereas non-deletional a -thalassemia (a Hph a , a NcoI

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O carcinoma bronquioloalveolar (CBA) é um subtipo de adenocarcinoma, representa menos de 5% dos tumores primários do pulmão, e possui características patológicas próprias. Poucos trabalhos foram publicados no Brasil. Objetivo: Estudar as características do carcinoma bronquioloalveolar em pacientes com diagnóstico de carcinoma broncogênico. Métodos: Estudo retrospectivo com levantamento de dados dos prontuários de pacientes do ambulatório de Oncopneumologia da UNIFESP (São Paulo). Resultados: Dos 1.617 pacientes com diagnóstico de carcinoma broncogênico, 45 (2,8%) eram CBA. Predominou o sexo feminino (53,3%), a cor branca (>70%) e 64,4% dos pacientes apresentaram história de tabagismo. Os principais sintomas foram: tosse (80%), expectoração (68,9%) e dispnéia (60%). Os pacientes levaram em média 10,27 meses para procurar o ambulatório. As imagens radiológicas predominantes foram de padrão difuso. O método diagnóstico mais utilizado foi a broncoscopia (71,2%). Conclusão: Os resultados encontrados são semelhantes aos da literatura mundial. No Serviço de Oncopneumologia da UNIFESP, se faz mais diagnósticos pela biópsia por broncoscopia.

Objetivo: verificar as diferenças dos fatores prognósticos de dois grupos distintos de portadores de carcinoma não pequenas células de pulmão: sobrevida superior a cinco anos e sobrevida inferior ou igual a um ano. Métodos: vinte e oito pacientes com maior sobrevida e 182 pacientes com menor sobrevida avaliados dos prontuários do ambulatório de Onco-Pneumologia da Unifesp. Foram avaliados dados clínicos, hábito tabágico, peso, estádio, tratamento e laboratoriais (CEA e DHL). Resultados: os fatores que influenciaram a sobrevida foram a capacidade funcional, doença localizada, perda de peso, DHL, CEA e a cirurgia. Conclusão: a avaliação destes fatores permite a escolha do melhor tratamento para cada paciente.

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