Risk of cardiovascular thrombotic events after surgical castration versus gonadotropin-releasing hormone agonists in Chinese men with prostate cancer

We investigated the cardiovascular thrombotic risk after surgical castration (SC) versus gonadotropin-releasing hormone agonists (GnRHa) in Chinese men with prostate cancer. All Chinese prostate cancer patients who were treated with SC or GnRHa from year 2000 to 2009 were reviewed and compared. The primary outcome was any new-onset of cardiovascular thrombotic events after SC or GnRHa, which was defined as any event of acute myocardial infarction or ischemic stroke. The risk of new-onset cardiovascular thrombotic event was compared between the SC group and the GnRHa group using Kaplan–Meier method. Multivariate Cox regression analysis was performed to adjust for other potential confounding factors. A total of 684 Chinese patients was included in our study, including 387 patients in the SC group and 297 patients in the GnRHa group. The mean age in the SC group (75.3 ± 7.5 years) was significantly higher than the GnRHa group (71.8 ± 8.3 years) (P < 0.001). There was increased risk of new cardiovascular thrombotic events in the SC group when compared to the GnRHa group upon Kaplan–Meier analysis (P = 0.014). Upon multivariate Cox regression analysis, age (hazard ratio [HR] 1.072, 95% confidence interval [CI] 1.04–1.11, P< 0.001), hyperlipidemia (HR 2.455, 95% CI 1.53–3.93, P< 0.001), and SC (HR 1.648, 95% CI 1.05–2.59, P = 0.031) were significant risk factors of cardiovascular thrombotic events. In conclusion, SC was associated with increased risk of cardiovascular thrombotic events when compared to GnRHa. This is an important aspect to consider while deciding on the method of androgen deprivation therapy, especially in elderly men with known history of hyperlipidemia.     

CLINICAL AND EPIDEMIOLOGICAL PROFILE OF ELDERLY PATIENTS WITH CHAGAS DISEASE FOLLOWED BETWEEN 2005-2013 BY PHARMACEUTICAL CARE SERVICE IN CEARá STATE, NORTHEASTERN BRAZIL

By controlling the transmission of Chagas disease, the challenge of providingassistance to millions of infected patients that reach old age arises. In this study,the socioeconomic, demographic and comorbidity records of all elderly chagasicpatients followed at the Pharmaceutical Care Service of the Chagas Disease ResearchLaboratory were assessed. The information related to the clinical form of the diseasewas obtained from medical records provided by the Walter Cantídio UniversityHospital. The profile of the studied population was: women (50.5%); mean age of 67years; retired (54.6%); married (51.6 %); high illiteracy rate (40.2%); and familyincome equal to the minimum wage (51.5%). The predominant clinical forms of Chagasdisease were cardiac (65.3%) and indeterminate (14.7%). The main electrocardiographicchanges were the right bundle branch block (41.0%), associated or not with theanterosuperior left bundle branch block (27.4%). The average number of comorbiditiesper patient was 2.23 ± 1.54, with systemic arterial hypertension being the main onefound (67.0%). It was found that the elderly comprise a vulnerable group of patientsthat associate aging with cardiac and/or digestive disorders resulting from theevolution of Chagas disease and other comorbidities, which requires special attentionfrom health services to ensure more appropriate medical and social care.     

PREVALENCE OF PARACOCCIDIOIDOMYCOSIS INFECTION BY INTRADERMAL REACTION IN RURAL AREAS IN ALFENAS,MINAS GERAIS,BRAZIL

This study aimed to estimate the prevalence of paracoccidioidal infectionby intradermal reaction (Delayed-Type Hypersensitivity, DTH) toParacoccidioides brasiliensis in rural areas in Alfenas, SouthernMinas Gerais (MG) State, Brazil, and to assess risk factors (gender, occupation, age,alcohol intake and smoking) associated with infection. We conducted apopulation-based cross-sectional study using intradermal tests with gp 43paracoccidioidin in 542 participants, who were previously contacted by local healthagents and so spontaneously attended the test. Participants underwent an interview byfilling out a registration form with epidemiological data and were tested with anintradermal administration of 0.1 mL of paracoccidioidin in the left forearm. Thetest was read 48 hours after injection and was considered positive if induration wasgreater than or equal to 5 mm. Out of 542 participants, 46.67% were positive to theskin test. Prevalence increased in accordance with an increase of age. There wasstatistical significance only for males. Occupation, alcohol intake and smokinghabits were not significantly associated with the risk of paracoccidioidomycosisinfection. There is relevance of paracoccidioidomycosis infection in such ruralareas, which suggests that further epidemiological and clinical studies on thismycosis should be done in the southern part of Minas Gerais State.     

Reliability evaluation of alumina-blasted/acid-etched versus laser-sintered dental implants

Step-stress accelerated life testing (SSALT) and fractographic analysis were performed to evaluate the reliability and failure modes of dental implant fabricated by machining (surface treated with alumina blasting/acid etching) or laser sintering for anterior single-unit replacements. Forty-two dental implants (3.75?×?10 mm) were divided in two groups (n?=?21 each): laser sintered (LS) and alumina blasting/acid etching (AB/AE). The abutments were screwed to the implants and standardized maxillary central incisor metallic crowns were cemented and subjected to SSALT in water. Use-level probability Weibull curves and reliability for a mission of 50,000 cycles at 200 N were calculated. Polarized light and scanning electron microscopes were used for failure analyses. The Beta (β) value derived from use-level probability Weibull calculation of 1.48 for group AB/AE indicated that damage accumulation likely was an accelerating factor, whereas the β of 0.78 for group LS indicated that load alone likely dictated the failure mechanism for this group, and that fatigue damage did not appear to accumulate. The reliability was not significantly different (p?>?0.9) between AB/AE (61 %) and LS (62 %). Fracture of the abutment and fixation screw was the chief failure mode. No implant fractures were observed. No differences in reliability and fracture mode were observed between LS and AB/AE implants used for anterior single-unit crowns.