OBJETIVO: verificar se há alguma relação entre o estado histopatológico do linfonodo sentinela, a recorrência e a mortalidade decorrente do melanoma espesso em pacientes submetidos à BLS ao longo de um seguimento significante. MÉTODOS: Oitenta e seis pacientes portadores de melanoma espesso submetidos à BLS foram selecionados de um banco de dados prospectivo. A linfocintilografia, o mapeamento linfático e a detecção gama intraoperatória foram realizados em todos pacientes. O linfonodo sentinela (LS) foi analisado por HE e por imunoistoquímica. Linfadenectomia total foi indicada para os pacientes com LS positivo. O estado histopatológico do LS foi relacionado à taxa de recorrência e de mortalidade por melanoma. RESULTADOS: Cento e sessenta e seis LS foram retirados dos 86 pacientes. As idades variaram de 18 a 73 anos. Havia 47 mulheres e 39 homens. Micrometástases foram encontradas em 44 pacientes. Quarenta e dois pacientes foram submetidos à linfadenectomia total. Sete pacientes tiveram outro linfonodo positivo. Entre os 44 pacientes com LS positivo houve 20 recorrências e 15 mortes. Houve 18 recidivas e 12 mortes no grupo de LS negativo. A espessura de Breslow não apresentou correlação com o estado histopatológico do LS. O estado histopatológico do LS não interferiu nas taxas de recorrência e de mortalidade (teste de Fisher, p=1.00). A mediana de seguimento foi 69 meses. CONCLUSÃO: Considerando a falta de evidência de benefício, a BLS não deve ser indicada para pacientes com melanoma espesso fora de estudos clínicos.
Introduction: Benign idiopathic tonsillar hypertrophy (HBI) may affect a child's quality of life and sleep. Several studies have sought to relate the clinical features of HBI with the infectious and/or immunologic changes that occur. Objective: To increase the knowledge of the etiology of HBI. Data Synthesis: From 2012 to 2013 we conducted a retrospective observational study of 101 children with HBI who underwent tonsillectomies at Ambulatory ENT General Hospital of the East Zone of São Paulo City, a region with a poor socioeconomic population. Preoperative serologic results were available to confirm mononucleosis, cytomegalovirus, anti-streptolysin O (ASLO) and immunoglobulins. The mean patient age was 5.8 years (55% male, 45% female). Using the Mann-Whitney U test, we identified significant gender differences in the parameters of immunoglobulins (Ig) M (IgM), IgA, and IgE. Forty-seven percent of the patients had increased ASLO levels, and 37% had increased IgE levels. Conclusion: An evaluation of a patient's serologic parameters and laboratory results may be relevant to the etiology and prevention of HBI. Based on the results obtained from the study sample, the identification of etiologic agents and causative factors remain a public health challenge that affects the quality of life of children.
Background: Knowledge of first aid and cardiopulmonary resuscitation (CPR) is very important in schools, where children, teens and even employees are subject. Our objective was to evaluate the knowledge of teachers and employees of public schools in São Paulo on first aid and CPR with automated external defibrillator (AED). Methods: A questionnaire on the content that is covered in the course of First Aid from the American Heart Association was applied to faculty and staff of public schools in São Paulo. After answering the questionnaire, all volunteers took the course First Aid with CPR and AED. Results: The study included 563 volunteers: 227 (40%) teachers and 336 (60%) school staff. The mean age was 42 ± 12 years, 101 (18%) were male and 80 participants (14%) had already done a course in First Aid and / or CPR. The mean number of correct answers was 6.5 (46%) in a total of 14 questions. The questions with the greatest number of errors were: frequency of chest compressions (82%), depth of chest compressions (78%), handling of automated external defibrillator (77%), what to do with an unconscious victim (64%), compression ratio and ventilation (61%), conduct on a victim with nosebleed (53%) and conduct on a victim with convulsion (52%). When asked if they were interested in doing a course in first aid, 95% answered yes, 89% believe that the contents of first aid should be placed in the grade of students albeit in a simplified manner. Conclusion: We conclude that the degree of knowledge of teachers and employees of public schools in São Paulo is quite insufficient, although the vast majority has an interest in pursuing a course that addresses the topic of first aid and CPR with AED. It would therefore be very interesting that the government underscored the importance of the subject and stimulate training for teachers, school staff and students.
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