Outcomes of patients with non-small cell lung cancer and poor performance status treated with immune checkpoint inhibitors in the real-world setting

International Journal of Clinical Oncology - Immune-checkpoint inhibitors (ICIs) are standard treatments for metastatic non-small cell lung cancer (NSCLC). Patients with poor performance status...     

Utility of point-of-care haemoglobin measurement in the HemoCue-B haemoglobin for the initial diagnosis of anaemia

Measurement of haemoglobin (Hb) concentration provides a reliable indication of the presence and severity of anaemia. However, other laboratory parameters are usually requested as well, leading to an increase in socio-sanitary costs. Accordingly, this study was undertaken to ascertain the reliability of point-of-care Hb determination with the portable photometer HemoCue-B haemoglobin (HBH) and to evaluate its utility for the initial diagnosis of anaemia. Hb was measured (x3) in 20 venous blood samples diluted with saline (v/v; 1 : 0, 2 : 1, 1 : 1, 2 : 1 and 3 : 1) to obtain a wide range of Hb and in venous and capillary blood samples from 247 primary health care patients. All HBH results were compared with those yielded by the reference cell counter Pentra 120 Retic (ABX). In diluted samples, Hb values obtained with either method were not significantly different (ABX-HBH, -0.01 +/- 0.32 g/dl; 95% CI, -0.04 to 0.028 g/dl) and showed an excellent Pearson's coefficient of correlation (r = 0.992; P < 0.01). HBH provides accurate values if at least 4 mul of blood is loaded into the cuvette. There were no significant differences between Hb measured in venous (v) and capillary (c) blood samples in primary care patients. Eighteen anaemic patients were detected by ABX measurements (7.3%; 15 female/3 male), 18 by HBHv (specificity, 100%; sensitivity, 100%) and 25 by HBHc (eight false positives; one false negative; specificity, 94.4%; sensitivity, 96.5%). Compared with ABX, HBH provides accurate and precise measurements for a wide range of Hb and its use in primary health care seems to be a good method for the initial diagnosis of anaemia.     

Amino acids in amniotic fluid in the 15th–16th weeks of gestation and preterm labor

Objective. To investigate amino acids in amniotic fluid collected at the time of genetic amniocentesis.

Methods. We analyzed 128 fluids from the 15^th week of gestation and 53 from the 16^th week of gestation from normal pregnancies, and eight in the 15^th week and seven in the 16^th week from pregnancies that lead to preterm deliveries. We calculated the mean values for each week and the ratios between each pair of amino acids. The data for both groups (normal and preterm delivery) were compared.

Results. The most abundant amino acid in both groups was alanine. The comparisons of the groups showed significant differences for isoleucine in the 15^th gestational week (p < 0.05). Some amino acids had different evolutions between both gestational ages on comparing the normal group and preterm group. Eighteen ratios in the 15^th week showed significant differences (mainly in the ratios of arginine and taurine), and three in the 16^th week.

Conclusions. The amino acid profiles in amniotic fluid, particularly in the 15^th week of gestation, showed differences in the pregnancies that lead to preterm delivery.     

Tratamiento quirúrgico conservador del síndrome de HELLP (ELLP) asociado a hematoma hepático subcapsular

Severe hemorrhagic complications associated with pregnancy usually occur within the third trimester and are frequently linked to preeclampsia and HELLP syndrome.     

Factors associated with low bone mineral density among white women

OBJECTIVE: To analyze whether the factors causing low bone mineral density among elderly women are the same as those observed in other age groups. METHODS: A cross-sectional study was carried out on the medical records of a random sample of 413 white women seen at an imaging diagnostics service in a city of Southern Brazil, in 2003. Femoral bone mineral densities with adjustment using T-scores were used. The following variables were investigated: age, body mass index, tobacco smoking, alcohol consumption, milk consumption, physical activity and hormone replacement therapy. Univariate and multivariate unconditional logistic regression were used. RESULTS: In the sample, 52.5% were up to 59 years old and 47.5% were 60 or over. The mean bone mineral density was 0.867 g/cm2 (SD=0.151) for the femoral neck. Significant age-adjusted values were obtained for physical activity (adjusted OR=0.47; 95% CI: 0.23;0.97), body mass index greater than or equal to 30.0 kg/m2 (adjusted OR=0.10; 95% CI: 0.05;0.21), alcohol consumption (adjusted OR=7.90; 95% CI: 2.17;28.75), low milk consumption (adjusted OR=3.29; 95% CI: 1.91;5.68) and hormone replacement (adjusted OR = 0.44; 95% CI: 0.21;0.90). Among the elderly women, body mass, milk consumption and physical activity were independent protection factors. CONCLUSIONS: Advanced age, body mass, physical activity, milk and alcohol consumption were important factors in bone mass regulation. The influence of behavioral factors was maintained among the women of advanced aged, thus reinforcing the role of preventive measures in medical practice and public health promotion policies aimed at healthy aging.