ObjectiveTo determine the prevalence of hyperglycemia during induction therapy in adult patients with acute leukemia and its effect on complicated infections and mortality during the first 30 days of treatment.
MethodsAn analysis was performed in a retrospective cohort of 280 adult patients aged 18 to 60 years with previously untreated acute leukemia who received induction chemotherapy from January 2000 to December 2009 at the Hemocentro de Pernambuco (HEMOPE), Brazil. Hyperglycemia was defined as the finding of at least one fasting glucose measurement > 100 mg/dL observed one week prior to induction therapy until 30 days after. The association between hyperglycemia and complicated infections, mortality and complete remission was evaluated using the Chi-square or Fisher's exact tests by the Statistical Package for Social Sciences (SPSS) in the R software package version 2.9.0.
ResultsOne hundred and eighty-eight patients (67.1%) presented hyperglycemia at some moment during induction therapy. Eighty-two patients (29.3%) developed complicated infections. Infection-related mortality during the neutropenia period was 20.7% (58 patients). Mortality from other causes during the first 30 days after induction was 2.8%. Hyperglycemia increased the risk of complicated infections (OR 3.97; 95% confidence interval: 2.08 - 7.57; p-value < 0.001) and death (OR 3.55; 95% confidence interval: 1.77-7.12; p-value < 0.001) but did not increase the risk of fungal infections or decrease the probability of achieving complete remission.
ConclusionThis study demonstrates an association between the presence of hyperglycemia and the development of complicated infections and death in adult patients during induction therapy for acute leukemia.
Background: Liver metastases of colorectal cancer are frequent and potentially fatal event
in the evolution of patients with these tumors. Aim: In this module, was contextualized the clinical situations and parameterized
epidemiological data and results of the various treatment modalities established.
Method: Was realized deep discussion on detecting and staging metastatic colorectal
cancer, as well as employment of imaging methods in the evaluation of response to
instituted systemic therapy. Results: The next step was based on the definition of which patients would have their
metastases considered resectable and how to expand the amount of patients elegible
for modalities with curative intent. Conclusion: Were presented clinical, pathological and molecular prognostic factors,
validated to be taken into account in clinical practice.
BackgroundKaposi's sarcoma continues to be the most common human immunodeficiency virus
- associated neoplasm with considerable morbidity and mortality.ObjectiveTo describe the clinical and laboratory characteristics, initial staging, and
outcomes of aids patients with Kaposi's sarcoma at an university hospital of
Recife, Pernambuco.MethodsThis is a descriptive study with analytic character, retrospective, of a case
series between 2004 and 2014.ResultsOf the 22 patients included in the study, 20 were aged <40 years (72.7%).
The majority had CD4+ T lymphocyte counts of <200 cells/mm3
(77.3%) and human immunodeficiency virus loads of <100,000 copies/mL
(78.9%). Lesions were most commonly observed on the skin (90%), and internal
organs were affected in 11 of the 22 patients. Only 7 (31.8%) of the 22
patients were undergoing antiretroviral therapy (ART) at the time of Kaposis
sarcoma diagnosis, and the initial disease staging classification was high
risk (Aids Clinical Trials Group Oncology Committee) in 19 of the 22
patients (86.4%). Regarding Kaposi's sarcoma treatment, 17 of 22 patients
(77.3%) underwent systemic chemotherapy + ART and 5 were treated exclusively
with ART. Eight of the 22 patients died (36.5%); of these, 87.5% had died
within one year of Kaposi's sarcoma diagnosis.Limitation of the studyWithout a control group, this study cannot be used to generate
hypotheses.ConclusionsDespite the association between aids and late Kaposi's sarcoma diagnosis in
the study population, including an unfavorable risk at the time of staging,
a lower mortality rate was observed relative to other studies; this might be
related to access to a specialized health service.
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