Non-AIDS defining cancers in the D:A:D Study-time trends and predictors of survival : a cohort study

BACKGROUND:Non-AIDS defining cancers (NADC) are an important cause of morbidity and mortality in HIV-positive individuals. Using data from a large international cohort of HIV-positive individuals, we described the incidence of NADC from 2004-2010, and described subsequent mortality and predictors of these.METHODS:Individuals were followed from 1st January 2004/enrolment in study, until the earliest of a new NADC, 1st February 2010, death or six months after the patient's last visit. Incidence rates were estimated for each year of follow-up, overall and stratified by gender, age and mode of HIV acquisition. Cumulative risk of mortality following NADC diagnosis was summarised using Kaplan-Meier methods, with follow-up for these analyses from the date of NADC diagnosis until the patient's death, 1st February 2010 or 6 months after the patient's last visit. Factors associated with mortality following NADC diagnosis were identified using multivariable Cox proportional hazards regression.RESULTS:Over 176,775 person-years (PY), 880 (2.1%) patients developed a new NADC (incidence: 4.98/1000PY [95% confidence interval 4.65, 5.31]). Over a third of these patients (327, 37.2%) had died by 1st February 2010. Time trends for lung cancer, anal cancer and Hodgkin's lymphoma were broadly consistent. Kaplan-Meier cumulative mortality estimates at 1, 3 and 5 years after NADC diagnosis were 28.2% [95% CI 25.1-31.2], 42.0% [38.2-45.8] and 47.3% [42.4-52.2], respectively. Significant predictors of poorer survival after diagnosis of NADC were lung cancer (compared to other cancer types), male gender, non-white ethnicity, and smoking status. Later year of diagnosis and higher CD4 count at NADC diagnosis were associated with improved survival. The incidence of NADC remained stable over the period 2004-2010 in this large observational cohort.CONCLUSIONS:The prognosis after diagnosis of NADC, in particular lung cancer and disseminated cancer, is poor but has improved somewhat over time. Modifiable risk factors, such as smoking and low CD4 counts, were associated with mortality following a diagnosis of NADC

Taxonomia do gênero Euploca Nutt. (Heliotropiaceae) no Brasil Taxonomy of the genus Euploca Nutt. [Heliotropiaceae] in Brazil

O presente trabalho trata do estudo taxonômico do gênero Euploca (Heliotropiaceae) no Brasil, sendo registradas 17 espécies. É apresentada chave para o reconhecimento, descrições, ilustrações e comentários, além de dados de distribuição, habitat, floração e frutificação para as espécies.<br>This work deals with a taxonomic study of the genus Euploca (Heliotropiaceae) in Brazil; seventeen species are recorded. A keyfor identification, descriptions, illustrations and comments, besides distribution, habitat, flowering and fruiting data for the species are presented

Taxonomia do gênero Heliotropium L. (Heliotropiaceae) no Brasil Taxonomy of the genus Heliotropium L. (Heliotropiaceae) in Brazil

Este trabalho trata do estudo taxonômico do gênero Heliotropium L. no Brasil. Foram encontradas nove espécies e duas variedades: H. amplexicaule Vahl, H. angiospermum Murray, H. curassavicum L., H. curassavicum var. argentinum I.M. Johnst., H. elongatum (Lehm.) I.M. Johnst., H. elongatum var. burchellii I.M. Johnst., H. indicum L., H. leiocarpum Morong, H. nicotianaefolium Poir.,H. phylicoides Cham. e H. transalpinum Vell. São apresentadas descrições, ilustrações, comentários sobre afinidades baseados na morfologia e dados de distribuição para as espécies.<br>The taxonomy of the genus Heliotropium L. in Brazil was studied, revealing nine species and two varieties: H. amplexicaule Vahl, H. angiospermum Murray, H. curassavicum L., H. curassavicum var. argentinum I.M. Johnst., H. elongatum (Lehm.) I.M. Johnst., H. elongatum var. burchellii I.M. Johnst., H. indicum L., H. leiocarpum Morong, H. nicotianaefolium Poir., H. phylicoides Cham. and H. transalpinum Vell. Descriptions, illustrations, comments on relationships based on morphology and data on species distribution are presented