Epidemiological evaluation and survival of children with acute myeloid leukemia

Objective: This study aims to describe the epidemiological characteristics and survival rates of children with acute myeloid leukemia treated in hospitals in southern Brazil and compare them with international data. Methods: A multicenter cohort study was conducted with retrospective data collection of all new patients with acute myeloid leukemia under 18 treated at five referral centers in pediatric hematology-oncology in southern Brazil between January 2005 and December 2015. Results: Of the 149 patients with acute myeloid leukemia, 63.0% (n = 94) were male. The median age at diagnosis was 10.5 years (range 0-18 years) and 40.3% (n = 60) had a white blood cell count below 50,000/mm2. The most common Franco-American-British (FAB) subtype was M3 (n = 43, 28.9%). Nine (6.0%) patients had central nervous system disease. In M3 patients, overall survival (OS) was 69.2% and 3-year event-free survival was 67.7%; in non-M3 patients, these rates were 45.3% and 36.7%, respectively. In non-M3 patients, OS was significantly different between transplanted (61.8%) and non-transplanted (38.2%) patients (p = 0.031). Conclusions: These results show a higher prevalence of the Franco-American-British M3 subtype than that reported in the international literature, as well as a decreased OS compared with that of developed countries. Further multicenter Brazilian studies with a larger sample size are encouraged to better understand the characteristics of acute myeloid leukemia, and to improve the treatment and prognosis in this population

Clinical evidence and diagnosis of temporal arteritis: a concise systematic review

Introduction: Temporal arteritis (TA), or giant cell arteritis, is a systemic autoimmune vasculitis that affects patients over 50 years of age. Temporal artery biopsy is considered the gold standard for diagnosis, although it has low sensitivity. It was shown that TA can lead to irreversible blindness in about 20% of untreated cases. Objective: A concise systematic review was carried out to contribute to the diagnosis and treatment of temporal arteritis, assessing whether a series of patients met the clinical and laboratory criteria for diagnosis, regardless of the biopsy result, as well as whether these results alter the management of these patients. Methods: The research was carried out from December 2022 to January 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, following the PRISMA rules for systematic review. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 140 articles were found, and a total of 32 articles were evaluated and 6 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 32 studies with a high risk of bias and 43 studies that did not meet GRADE. It was concluded that, regardless of the biopsy result, all patients should immediately start treatment with corticosteroids. Early diagnosis and treatment must be performed to avoid compromising the contralateral eye. In addition, it is necessary to perform other diagnostic imaging tools to increase the sensitivity and closure of the diagnosis of temporal arteritis

Ferrara ring and the nomogram as the main strategy for correcting keratoconus: a systematic review of clinical findings

Introduction: In the setting of corneal ectasias, keratoconus (KC) is a bilateral and asymmetrical disease that results in progressive thinning and tilting of the cornea, leading to irregular astigmatism and decreased visual acuity. The condition affects all ethnicities and both sexes. KC prevalence and incidence rates are close to between 0.2 and 4790 per 100,000 people and 1.5 and 25 cases per 100,000 person-years, respectively. For surgeons who implant Ferrara rings, the manufacturer has developed an online nomogram aimed at optimizing patient outcomes. Objective: The present study carried out a systematic review to present the main clinical outcomes of keratoconus treatment using the Ferrara ring. Methods: The systematic review rules of the PRISMA Platform were followed. The literature search was carried out from January to February 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. Scientific articles from the last 15 years were selected. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 60 articles were found, of which only 21 were part of this systematic review, after an eligibility analysis.It was concluded that the insertion of Ferrara rings in keratoconic eyes with previous cross-linking history using the company's nomogram results in significant improvements in visual, refractive, and tomographic results. Corneal densitometry in the anterior layer of the cornea decreases after the implantation of intrastromal corneal ring segments and correlates with corneal keratometry. Over 5 years, Ferrara-type intrastromal corneal ring segment implantation is a safe, effective, and stable procedure for restoring vision in pediatric patients with keratoconus old

Ferrara ring and the nomogram as the main strategy for correcting keratoconus: a systematic review of clinical findings

Introduction: In the setting of corneal ectasias, keratoconus (KC) is a bilateral and asymmetrical disease that results in progressive thinning and tilting of the cornea, leading to irregular astigmatism and decreased visual acuity. The condition affects all ethnicities and both sexes. KC prevalence and incidence rates are close to between 0.2 and 4790 per 100,000 people and 1.5 and 25 cases per 100,000 person-years, respectively. For surgeons who implant Ferrara rings, the manufacturer has developed an online nomogram aimed at optimizing patient outcomes. Objective: The present study carried out a systematic review to present the main clinical outcomes of keratoconus treatment using the Ferrara ring. Methods: The systematic review rules of the PRISMA Platform were followed. The literature search was carried out from January to February 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. Scientific articles from the last 15 years were selected. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 60 articles were found, of which only 21 were part of this systematic review, after an eligibility analysis.It was concluded that the insertion of Ferrara rings in keratoconic eyes with previous cross-linking history using the company's nomogram results in significant improvements in visual, refractive, and tomographic results. Corneal densitometry in the anterior layer of the cornea decreases after the implantation of intrastromal corneal ring segments and correlates with corneal keratometry. Over 5 years, Ferrara-type intrastromal corneal ring segment implantation is a safe, effective, and stable procedure for restoring vision in pediatric patients with keratoconus old