Objective. The aim of the present study was to investigate the usefulness of the CA-125 area under the curve (AUC) as a new kinetic parameter for predicting overall survival in patients with ovarian cancer. In addition, the relationship of CA-125 AUC with other prognostic factors of ovarian cancer was evaluated.Methods. Ninety-two patients that underwent primary line chemotherapy within 4 months after submission to cytoreductive surgery were included. For each patient, CA-125 AUC was calculated and a statistical analysis was conducted to compare CA-125 AUC behavior among patients according to several covariates.Results. The mean age at diagnostic time was found to be 55.5 (16.1-82.4) years with a mean survival of 39.2 (3.5-100.1; SE = 2.6) months. Across FIGO stage I, II, III, and IV patients had a mean CA-125 AUC of 18.2, 24.6, 147.8, and 574.6 IU/ml*days, respectively ( P b 0.05). At the evaluation date, living patients had a mean CA-125 AUC of 40.1 in contrast to 234.1 IU/ml*days ( P b 0.05) for deceased ones. Patients with a complete response to primary chemotherapy had a mean CA-125 AUC of 48.8, while patients with a partial response had a mean of 251.7 IU/ml*days, and patients with no response or disease progression had a mean of 316.5 IU/ml*days ( P b 0.05). The best CA-125 AUC performance is in predicting patient complete response to chemotherapy with a cut-off of 100 IU/ml*days and an accuracy of 82%.Conclusions. Despite CA-125 AUC high correlation with the FIGO stage, residual disease, and patient final outcome, the main interest of CA-125 AUC calculation is to evaluate the treatment efficacy and to foresee a full chemotherapy response. Further studies should be carried out before extrapolating these results to other data sets. D
Compreender o processo de enfrentamento do câncer e as consequências psicossociais dessa patologia no cotidiano das crianças. Metodologia: Trata-se de uma revisão de literatura acerca dos aspectos psicológicos de pacientes pediátricos acometidos pelo câncer. Utilizou-se a estratégia PICO para a elaboração da pergunta norteadora. Ademais, realizou-se o cruzamento dos descritores "impacto psicossocial"; "pacientes pediátricos", "diagnosticados com câncer"; "tratamento oncológico", nas bases de dados Biblioteca Virtual de Saude (BVS); Scientific Eletronic Library Online (SCIELO); Google Scolar e EbscoHost. Resultados e Discussão: O diagnóstico e o tratamento oncológico são fatores prejudiciais no desenvolvimento infantil. Os sintomas inespecíficos e a escassez de informação retardam o reconhecimento da patologia. Assim, as crianças iniciam o tratamento em estágios avançados e são submetidas a procedimentos invasivos, o que justifica o grande impacto psicológico delas e de seus familiares. Evidenciou-se alterações no relacionamento e na rotina dos membros da família, menor sociabilidade, maior busca por espiritualidade, atraso escolar, minimização da independência já adquirida pela criança, gastos financeiros exacerbados e o surgimento de sentimentos como medo, angústia e ansiedade. Conclusão: As pesquisas selecionadas reafirmam os impactos negativos na saúde mental infantil. Portanto, é imprescindível fomentar a realização de pesquisas científicas referentes à neoplasia pediátrica e o fornecimento de informações para os cuidadores desses pacientes, com o objetivo de minimizar a passividade atribuída às crianças em tratamento.
In diesem Bericht wird unter anderem anhand von Dokumenten des Nationalen Ethikrates für Lebenswissenschaften und einschlägigen statistischen Daten ein Portrait des Schwangerschaftsabbruchs in Portugal unter Berücksichtigung der gegenwärtig geltenden gesetzlichen Regelungen gezeichnet.
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