甲地孕酮联合化疗对晚期非小细胞肺癌生活质量的影响

目的:比较甲地孕酮联合NP方案和单用NP方案化疗对晚期非小细胞肺癌生活质量的影响,评价甲地孕酮的临床疗效。方法:将60例晚期非小细胞肺癌患者随机分为治疗组与对照组。治疗组30例,于化疗前2天口服甲地孕酮160 mg,2次/d,同时予NP方案化疗。对照组30例仅接受NP方案化疗。于化疗4周期后评价患者的食欲、体重变化、KPS评分及不良反应。结果:经过4个周期后治疗组食欲、体重、KPS评分改善情况与对照组相比差异有统计学意义(P<0.05)。治疗组主要不良反应为高血压、便秘、血糖升高、皮疹、阴道流血、踝部水肿等反应,经对症处理后可缓解。结论:甲地孕酮可改善晚期非小细胞肺癌患者的生活质量,减轻其不良反应,不良反应可耐受。     

急性白血病完全缓解后患乳腺癌1例

1 病例报告女,51岁. 因发热、关节疼痛、齿龈胀痛、左下肺感染20 d,抗生素治疗无效,于2001-11-29入我院血液科治疗. 查体:T 37.5℃,P 120次/min,R 18次/min,BP 110/50 kPa,贫血外观,巩膜无黄染,皮肤黏膜无出血,右颌下可触及一黄豆粒大小淋巴结,触痛(±),胸骨压痛( ),心率120次/min,律齐,无病理性杂音. 双肺未闻及干湿啰音. 腹软,肝脾未触及,四肢运动正常. 既往史:曾于1992年行"乳腺小叶切除术",1999年因子宫肌瘤行"子宫次全切除术". 家族史:其姐姐1982年患乳腺癌,因肺转移已于1983年病故.     

High prevalence of suicide risk in people living with HIV: who is at higher risk?

A cross-sectional study was developed to evaluate suicide risk and associated factors in HIV/AIDS patients at a regional reference center for the treatment of HIV/AIDS in southern Brazil. We assessed 211 patients in regard to suicide risk, clinical and sociodemographic characteristics, drug use, depression, and anxiety. Suicide risk was assessed with Mini International Neuropsychiatric Interview, Module C. Multivariate analysis was performed using Poisson regression. Of the total sample, 34.1% were at risk of suicide. In the multivariate analysis, the following variables were independently associated with suicide risk: female gender; age up to 47 years; unemployment; indicative of anxiety; indicative of depression; and abuse or addiction on psychoactive substances. Suicide risk is high in this population. Psychosocial factors should be included in the physical and clinical evaluation, given their strong association with suicide risk.     

Protein Oxidative Stress and Dyslipidemia in Dialysis Patients

Our aim was to investigate and determine the associations between oxidative stress (OS), dyslipidemia and inflammation in patients treated with continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) using observational cross‐sectional study. Twenty patients in CAPD and 48 in HD for at least 8 weeks and aged ≥18 years were included in the study. Individuals with malignant or acute inflammatory disease were excluded. A control group of 17 healthy individuals was also recruited. The biochemical parameter evaluations were analyzed using colorimetric kits for albumin, serum glucose, total cholesterol (TC) and lipid fractions. To determine the inflammatory status, CRP, IL‐6 and TNF‐α were analyzed by automated chemiluminescence kits. Plasma advanced oxidation protein products (AOPP) were determined by spectrophotometry. Mean AOPP levels were significantly higher for the HD group compared to the control, and there was no difference in AOPP concentrations between the control and CAPD groups. Dialysis patients had levels of inflammatory parameters higher than controls, and showed a high prevalence of patients with dyslipidemia, especially in CAPD. In the HD group, AOPP was positively correlated with triglycerides (TG) and inversely associated with HDL. Also the HD group was observed to have negative associations between TNF‐α and HDL, LDL and TC. In the CAPD group, CRP was inversely correlated with HDL. Hemodialysis patients had increased protein OS and associations of inflammation and dyslipidemia were also observed in these dialysis groups. A more detailed characterization of the relations between oxidative stress and other more traditional risk factors has therapeutic importance, since cardiovascular diseases are the leading cause of death among dialysis patients.     

Quality of Life in Rural and Urban Adults 65 Years and Older: Findings From the National Health and Nutrition Examination Survey

Purpose: The proportion of people over 65 years of age is higher in rural areas than in urban areas, and their numbers are expected to increase in the next decade. This study used Andersen's behavioral model to examine quality of life (QOL) in a nationally representative sample of community‐dwelling adults 65 years and older according to geographic location. Specifically, associations between 3 dimensions of QOL (health‐related QOL [HQOL], social functioning, and emotional well‐being) and needs and health behaviors were examined. Methods: The 2005‐2006 National Health and Nutrition Examination survey was linked with the 2007 Area Resources File via the National Center for Health Statistics’ remote access system. Frequencies and distribution patterns were assessed according to rural, adjacent, and urban locations. Findings: Older adults reported high levels of QOL; however, rural older adults had lower social functioning than their urban counterparts. Older blacks and Hispanics had lower scores than whites on 2 dimensions of QOL. Associations between QOL and needs and health behaviors varied. Although activities of daily living were associated with all 3 dimensions, others were associated with 1 or 2 dimensions. Conclusions: The lower scores on social functioning in rural areas suggest that rural older adults may be socially isolated. Older rural adults may need interventions to maintain physical and mental health, strengthen social relationships and support, and increase their participation in the community to promote QOL. In addition, older blacks and Hispanics seem more vulnerable than whites and may need more assistance.