Cesar Uehara

Câncer de pulmão: comparação entre os sexos

A importância dos fatores de prognostico na analise de estudos clinicos de câncer de pulmao ja e bem definida. Neste artigo, varios fatores de prognostico foram avaliados, assim como a comparacao entre ambos os sexos foi realizada. Nao houve diferenca estatisticamente significante entre os dois sexos para a presenca de sintomas no momento do diagnostico. Os pacientes do sexo feminino apresentaram incidencia de tabagismo menor que os do masculino. O carcinoma espinocelular (40,6%) foi o tipo histologico mais comum entre os pacientes ao sexo masculino enquanto o adenocarcinoma (57,1%) foi o mais frequente no feminino. Em media, 45% dos pacientes apresentaram-se com doenca disseminada no momento do diagnostico. Pacientes do sexo masculino (40%) foram classificados como desnutridos mais frequentemente que as do feminino.

Estudo comparativo dos fatores prognósticos entre os pacientes com maior e menor sobrevida em portadores de carcinoma broncogênico

Apesar dos avancos no tratamento, ha pouca melhora na sobrevida dos pacientes com câncer do pulmao. Atualmente, e importante o conhecimento dos fatores que intervem na sobrevida. Objetivos: Verificar possiveis diferencas de fatores prognosticos em duas populacoes de pacientes com câncer de pulmao, uma com pequena sobrevida (menos de seis meses) e outra com maior sobrevida (acima de 24 meses). Metodos: De 1997 a 1999 foram estudados 52 pacientes com diagnostico histopatologico de carcinoma homogenico, sendo colhidos dados demograficos, clinicos, parametricos, habitos tabagicos, indice de Karnofsky, estadiamento da doenca e dosagem laboratorial de desidrogenase latica, fosfatase alcalina, antigeno carcinoembrionario e calcio. Resultados: 29 pacientes tiveram sobrevida menor do que seis meses e 23, superior a 24 meses. Os tres fatores mais importantes que influenciaram o tempo curto de sobrevida foram baixo indice de Karnofsky inicial, reducao do apetite e alto nivel serico de DHL. Conclusao: Os tres componentes do prognostico sao o estado fisico atual, o estado fisico previo e o estado atual da doenca. (J Pneumol 2002;28(5):245-9) Comparative study of prognostic factors among longer and shorter survival patients with bronchogenic carcinoma Despite the improvements seen in the treatment of lung cancer, little has improved in the survival of these patients, and a great importance is attributed to the factors that have a role to play in such survival. Purpose: To check for possible prognostic factor differences in two populations of lung cancer patients, one of them with short survival (less than six months), and the other with longer survival (more than 24 months). Methods: From 1997 to 1999, 52 patients with histopathologic diagnosis of homogenous carcinoma were studied, and demographics, clinical parameters, smoking pattern, Karnofsky’s index, disease staging, and laboratory dosing of lactic dehydrogenase, alkaline phosphatase, carcinoembryonic antigen, and calcium data were surveyed. Results: 29 patients had less than six month survival, and 23 had more than 24 month survival. The three most important factors for short survival were the low initial Karnofsky’s index, loss of appetite, and high serum LDH levels. Conclusion: The three prognosis components are: current physical status, prior physical status, and current status of the disease.

Avaliação do risco de contaminação por bactérias, no paciente submetido à broncoscopia, após o reprocessamento do broncoscópio *

Introduction: Bronchoscopic is a diagnostic and therapeutic procedure performed by introducing a flexible tube in the airways that allows for the visualization even of the smallest airways. In order to prevent or reduce the risk of infection, the bronchoscope must be adequately disinfected with at least high level disinfection. Purpose: Check for the risk of bacterial contamination for patients submitted to bronchoscopy at the Hospital Sao Paulo of Unifesp University, State of Sao Paulo. Methods: From 1997 to 1998, bronchoscope reprocessing included cleaning, rinsing with sterile or potable water, followed by rinsing with 2% glutaraldehyde for 20 minutes, rinsing again with sterile or potable water, and rinsing with 70% ethyl alcohol, and forced-air drying through the suction channel. Samples of 65 patients were collected for microbiologic tests by instilling sterile saline solution through the suction channel of the bronchoscope. Results: After reprocessing, the following were found in the samples: Staphylococcus epidermidis, Enterobacter sp, Acinetobacter baumanni, Streptococcus viridans, Staphylococcus aureus, Streptococcus beta hemoliticus A, Staphylococcus coagulase negative, and mycobacterial growth was found in the culture of five samples. Conclusions: Bronchoscope disinfection with 2% glutaraldehyde was not sufficient to assured disinfection of the scope and the presence of Staphylococcus epidermidis shows that there was bronchoscope contamination due to handling after disinfection.