Recommendations from national regulatory agencies for ongoing cancer trials during the COVID-19 pandemicthe Birmingham Environment for Academic Research local Cloud. 10 UKCCMP delivers meaningful real-time data to all UK cancer centres and clinicians to allow more personalised approaches to individual patient care and inform clinical decision making. This initiative will improve cancer care in the UK and beyond at this time of unprecedented global turmoil and reliance on health-care resources.We declare no other competing interests. We thank the oncologists, acute physicians, and health-care staff working tirelessly on the frontlines of the COVID-19 pandemic. The UK Coronavirus Monitoring Project team donated time and resources to support the project. The project was initially funded through the donation of time and resources from the supporters and advocates of the project. The University of Birmingham initiated this process, with the Pro-Vice-Chancellor dedicating the computational and human resources of the University's Centre for Computational Biology, the Institute of Translational Medicine, and scientists from the Institute of Cancer and Genomic Sciences. Other academic institutions dedicating time and staff to the project include the
BackgroundRecent studies have suggested that B-type Natriuretic Peptide (BNP) is an important predictor of ischemia and death in patients with suspected acute coronary syndrome. Increased levels of BNP are seen after episodes of myocardial ischemia and may be related to future adverse events.ObjectivesTo determine the prognostic value of BNP for major cardiac events and to evaluate its association with ischemic myocardial perfusion scintigraphy (MPS).MethodsThis study included retrospectively 125 patients admitted to the chest pain unit between 2002 and 2006, who had their BNP levels measured on admission and underwent CPM for risk stratification. BNP values were compared with the results of the MPS. The chi-square test was used for qualitative variables and the Student t test, for quantitative variables. Survival curves were adjusted using the Kaplan-Meier method and analyzed by using Cox regression. The significance level was 5%.ResultsThe mean age was 63.9 ± 13.8 years, and the male sex represented 51.2% of the sample. Ischemia was found in 44% of the MPS. The mean BNP level was higher in patients with ischemia compared to patients with non-ischemic MPS (188.3 ± 208.7 versus 131.8 ± 88.6; p = 0.003). A BNP level greater than 80 pg/mL was the strongest predictor of ischemia on MPS (sensitivity = 60%, specificity = 70%, accuracy = 66%, PPV = 61%, NPV = 70%), and could predict medium-term mortality (RR = 7.29, 95% CI: 0.90-58.6; p = 0.045) independently of the presence of ischemia.ConclusionsBNP levels are associated with ischemic MPS findings and adverse prognosis in patients presenting with acute chest pain to the emergency room, thus, providing important prognostic information for an unfavorable clinical outcome.
Objetivo: Avaliar a incidência de neoplasias malignas do esôfago na população de Volta Redonda, através de um estudo retrospectivo em 10 anos nos registros de diagnósticos histopatológicos. Método: foram obtidos 10.000 registros, pertencentes ao acervo da disciplina de Patologia Geral do Curso de Odontologia do UniFOA, oriundos do extinto Hospital da Companhia Siderúrgica Nacional na cidade de Volta Redonda, Rio de Janeiro, Brasil, registrados no período compreendido entre os anos de 1990 a 2000. Foram selecionados os casos diagnosticados como de neoplasias malignas que apresentaram o esôfago como sítio primário. Neoplasias metastáticas não foram consideradas. Resultados: Foram encontrados 1280 casos diagnosticados como de neoplasias malignas no referido serviço. Dentre esses, 3,90% (n=50) apresentaram como sitio primário o esôfago. A idade variou de 42 a 76 anos, com média de 65,6 anos, com predominância na faixa etária entre 60 e 69 anos (n=29). Ocorreram 38 casos no gênero masculino (76%) e 12 no feminino (24%). Em relação ao diagnostico histopatológico, a maioria dos casos foi de carcinomas epidermóides (n=35, 70%), tendo sido encontrados 15 casos (30%) de adenocarcinomas. Conclusões: A incidência encontrada foi de 3,9%, com maior ocorrência na faixa etária entre 60 e 69 anos e no gênero masculino. O principal tipo histológico foi o Carcinoma epidermóide.
Aiming to avoid a health system collapses due to the COVID-19 pandemic; social distancing measures are taken broadly.1 The very high or high-risk population is of specific concern, once expected to have an increase rate of admission.2 Besides criticised, the strategy seems to be working properly and now brings the discussion about when the measures will be relaxed with safety.Comparisons with other pandemics are not entirely appropriate, but it seems reasonable to look back at the past and consider valuable lessons learned. The direct association between death and age as well as for comorbidities or clinical risk is observed in other viral infections similarly to the current outbreak.3-13 Age is also a known as an independent survival factor. On the other hand, it should be highlighted that young children are the exception once have an immature immune system, main reasons why we generally see a “J-like” curve shape as schematically represented by the Figure 1. Although, age-mortality rate seems to be similar amongst world regions, the poor healthcare and quality index is associate with increase death rate.14Unfortunately, we were relying on certainties that are fragile for the moment. There is no solid evidence about herd immunity in patients with asymptomatic disease. Moreover, we all expect that the patients that recovered from the infection are hopefully immune or at least have a mild disease in case of re-infection but the knowledge about the immune response and anti-bodies nature is currently imature15, 16. There is also scare evidence about mass use disposable barrier methods, such as face masks or gloves, will diminish the viral transmission.17 Although community use of personal protection equipment might give a sensation of safety in some cultures, the misuse or re-use could be dangerous and there is no evidence assuring the benefit provided by community manufactured masks.18,19Therefore, once the evidence is being gathered and a vaccine, probably the most reliable scientific based way out of this crisis, will take at least some months to be available, we should consider relax social distancing measures based on age adjusted by comorbidities as a first step whilst continuing with hand washing associated with high standards of self-hygiene when possible.
Objetivo: Avaliar a incidência de neoplasias malignas do esôfago na população de Volta Redonda, através de um estudo retrospectivo em 10 anos nos registros de diagnósticos histopatológicos. Método: foram obtidos 10.000 registros, pertencentes ao acervo da disciplina de Patologia Geral do Curso de Odontologia do UniFOA, oriundos do extinto Hospital da Companhia Siderúrgica Nacional na cidade de Volta Redonda, Rio de Janeiro, Brasil, registrados no período compreendido entre os anos de 1990 a 2000. Foram selecionados os casos diagnosticados como de neoplasias malignas que apresentaram o esôfago como sítio primário. Neoplasias metastáticas não foram consideradas. Resultados: Foram encontrados 1280 casos diagnosticados como de neoplasias malignas no referido serviço. Dentre esses, 3,90% (n=50) apresentaram como sitio primário o esôfago. A idade variou de 42 a 76 anos, com média de 65,6 anos, com predominância na faixa etária entre 60 e 69 anos (n=29). Ocorreram 38 casos no gênero masculino (76%) e 12 no feminino (24%). Em relação ao diagnostico histopatológico, a maioria dos casos foi de carcinomas epidermóides (n=35, 70%), tendo sido encontrados 15 casos (30%) de adenocarcinomas. Conclusões: A incidência encontrada foi de 3,9%, com maior ocorrência na faixa etária entre 60 e 69 anos e no gênero masculino. O principal tipo histológico foi o Carcinoma epidermóide.
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