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- ItemAcesso aberto (Open Access)Análise multivariada dos fatores de sobrevida e recidiva em 414 pacientes portadores de carcinoma hepatocelular transplantados em São Paulo.(Universidade Federal de São Paulo (UNIFESP), 2020-01-30) Takamatsu, Fernanda Yuri [UNIFESP]; Netto, Alcides Augusto Salzedas [UNIFESP]; Gonzalez, Adriano Miziara [UNIFESP]; http://lattes.cnpq.br/6234829429056217; http://lattes.cnpq.br/2580534578039797; http://lattes.cnpq.br/1700430753091220; Universidade Federal de São PauloObjective: To identify the risk factors involved in the survival and recurrence of patients with hepatocellular carcinoma (HCC) undergoing liver transplantation (LTx). Methods: Retrospective observational study that analyzed the medical records of 414 patients with HCC undergoing deceased donor LTx in São Paulo between January 2007 and December 2011. Multifactorial analysis of survival and recurrence was performed using clinical, laboratory and pathology data. Results: The mortality rate was 27.5%, with a mean survival time of 68.1 months (95% CI) and estimated 1-, 3- and 5-year survival probabilities of 83.8%, 75.8% and 71.5%, respectively. Altered donor blood glucose, female sex, vascular invasion, advanced age, high Model for End‐Stage Liver Disease (MELD) score and tumor size were the main risk factors determining survival in LTx recipients. Recurrence occurred in 7.2% of patients during the study period and was more frequent in women (hazard ratio [RR] 2.6). Vascular invasion increased the chance of recurrence 5.4×. Each additional 1-year increase in recipient age increased the chance of recurrence by 5.6%, and each 1-mm increase in tumor size increased the chance of recurrence by 3%. Conclusion: Risk factors for reduced survival are donor blood glucose, female recipient, older age, increased MELD score and nodule size. Tumor recurrence risk factors are vascular invasion, female sex, recipient age and nodule size.
- ItemSomente MetadadadosAvaliação dos motivos e fatores relacionados à recaída no tabagismo em função do tempo em um serviço universitário especializado em cessação de tabagismo(Universidade Federal de São Paulo (UNIFESP), 2021) Albuquerque Neto, Aldo Agra de [UNIFESP]; Jardim, Jose Roberto De Brito [UNIFESP]; Universidade Federal de São PauloIntroduction: Relapse is part of the natural history of smokers. The frequency of relapses is different over time and the relapse process appears to be different in relation to the time since cessation. The reasons and characteristics of individuals regarding relapse seem to be different in those who relapse early from those who relapse later, and may relate to these factors associated with chemical and behavioral dependence, in addition to social, economic and personal factors of smokers. Objective: To investigate self-reported factors and reasons related to relapse over time. Methods: Retrospective cross-sectional study evaluating smokers during the first assessment at a smoking cessation clinic, where they were divided into two groups regarding the longer time to relapse in a previous attempt, early and late relapse, using 6 months as the period to differentiate the groups. Univariate analysis was performed using the group with early relapse as a reference, evaluating factors related to these, such as sociodemographic characteristics, smoking history, chemical dependence on tobacco and other drugs, comorbidities, living with smokers, previous. Factors with p<0.1 were evaluated using logistic regression to assess factors associated with early relapse. Differences between reasons for relapse were evaluated according to time of relapse and sociodemographic characteristics, chemical dependency and anxiety and depression. Results: Initially 1900 smokers were evaluated, after the exclusion of patients for various reasons, 1305 individuals remained for analysis, 623 from the early relapse group and 451 from the late relapse group. After multivariate adjustment, chemical dependence (OR 1.170 95%CI 1.111-1.232) was the only factor associated with a higher risk for early relapse and having undergone smoking treatment with cognitive behavioral therapy (OR 0.528 95%CI 0.388-0.718) was the only factor protector. Self-reported reasons for relapse differed over time, with individuals with earlier relapse relating to relapse due to chemical dependency (45% vs 20.5%), anxiety (39.2% vs 27.3%) and irritation (20.5% vs 13.4%) and individuals with late relapse relating to stress from everyday problems (35.5% vs 23.1%), exposure to risky situations (19.6% vs 9, 2%) and living with smokers outside the home (10.7% vs 5.6%). Conclusion: The factor associated with early relapse was chemical dependency and the protector having performed previous behavioral therapy. The self-reported reasons for early relapse were, again, chemical dependency, in addition to anxiety and irritation, while for late relapse were stress, exposure to risky situations and living with smokers outside the home.
- ItemSomente MetadadadosSex with Animals (SWA): Behavioral Characteristics and Possible Association with Penile Cancer. A Multicenter Study(Wiley-Blackwell, 2012-07-01) Zequi, Stenio de Cassio; Guimaraes, Gustavo Cardoso; Fonseca, Francisco Paulo da; Ferreira, Ubirajara; Matheus, Wagner Eduardo de; Reis, Leonardo Oliveira; Aita, Giuliano Amorim; Glina, Sidney; Soares Fanni, Victor Silvestre; Cardenuto Perez, Marjo Denisson; Montez Guidoni, Luiz Renato; Ortiz, Valdemar [UNIFESP]; Nogueira, Lucas; Almeida Rocha, Luis Carlos de; Cuck, Gustavo; Costa, Walter Henriques da; Moniz, Ravendra Ryan; Dantas, Jose Hipolito; Soares, Fernando Augusto; Lopes, Ademar; Hosp AC Camargo Fund Antonio Prudente; Universidade Estadual de Campinas (UNICAMP); Hosp Sao Marcus; Hosp Ipiranga; FCMSCSP; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Minas Gerais (UFMG); Universidade Federal do Paraná (UFPR); Hosp Aeronaut São Paulo; Urol Serv Hosp; Univ Fed Rio Grande do NorteIntroduction. Zoophilia has been known for a long time but, underreported in the medical literature, is likely a risk factor for human urological diseases. Aim. To investigate the behavioral characteristics of sex with animals (SWA) and its associations with penile cancer (PC) in a case-control study. Methods. A questionnaire about personal and sexual habits was completed in interviews of 118 PC patients and 374 controls (healthy men) recruited between 2009 and 2010 from 16 urology and oncology centers. Main Outcome Measures. SWA rates, geographic distribution, duration, frequency, animals involved, and behavioral habits were investigated and used to estimate the odds of SWA as a PC risk factor. Results. SWA was reported by 171 (34.8%) subjects, 44.9% of PC patients and 31.6% of controls (P < 0.008). the mean ages at first and last SWA episode were 13.5 years (standard deviation [SD] 4.4 years) and 17.1 years (SD 5.3 years), respectively. Subjects who reported SWA also reported more venereal diseases (P < 0.001) and sex with prostitutes (P < 0.001), and were more likely to have had more than 10 lifetime sexual partners (P < 0.001) than those who did not report SWA. SWA with a group of men was reported by 29.8% of subjects and SWA alone was reported by 70.2%. Several animals were used by 62% of subjects, and 38% always used the same animal. the frequency of SWA included single (14%), weekly or more (39.5%), and monthly episodes (15%). Univariate analysis identified phimosis, penile premalignancies, smoking, nonwhite race, sex with prostitutes, and SWA as PC risk factors. Phimosis, premalignant lesions, smoking, and SWA remained as risk factors in multivariate analysis. However, SWA did not impact the clinicopathological outcomes of PC. Conclusion. SWA is a risk factor for PC and may be associated with venereal diseases. New studies are required in other populations to test other possible nosological links with SWA. Zequi SC, Guimaraes GC, da Fonseca FP, Ferreira U, de Matheus WE, Reis LO, Aita GA, Glina S, Fanni VSS, Perez MDC, Guidoni LRM, Ortiz V, Nogueira L, Rocha LCA, Cuck G, da Costa WH, Moniz RR, Dantas Jr. JH, Soares FA, and Lopes A. Sex with animals (SWA): Behavioral characteristics and possible association with penile cancer. A multicenter study. J Sex Med 2012;9:18771884.