Diagnóstico precoce do câncer de pulmão: o grande desafio. Variáveis epidemiológicas e clínicas, estadiamento e tratamento

OBJETIVO: Avaliar casos confirmados de câncer de pulmão, revisando suas variáveis epidemiológicas, clínicas, estadiamento e tratamento. MÉTODOS: Foram estudados 263 casos provenientes do Hospital de Clínicas da Universidade Federal do Paraná e do Hospital Erasto Gaertner, instituições responsáveis por parcela significativa do atendimento a pacientes na cidade de Curitiba (PR). Realizou-se um estudo retrospectivo através de preenchimento de questionário e os dados obtidos foram analisados de forma descritiva, utilizando-se o software EPI-INFO. RESULTADOS: Houve predomínio de pacientes do sexo masculino (76%), sendo que a maioria dos pacientes era fumante ou ex-fumante por ocasião do diagnóstico (90%). Não havia referência a doença pulmonar prévia em 87% dos casos. Tosse (142 casos) e dor torácica (92 casos) foram os sintomas iniciais mais freqüentes. O câncer de pulmão tipo não pequenas células foi encontrado em 87% dos pacientes e o tipo histológico mais freqüente foi o carcinoma espinocelular, representando 49% dos casos. O tabagismo foi considerado o fator predisponente mais importante. CONCLUSÃO: As características evolutivas do câncer de pulmão, como a inespecificidade dos sintomas iniciais e o tempo e evolução do tumor, somadas à ausência de programas de rastreamento efetivos, constituem os principais fatores que contribuem para a não detecção da neoplasia pulmonar de forma precoce, o que torna difícil o tratamento e dificulta o aumento da sobrevida

sj-xlsx-1-dst-10.1177_19322968241232686 – Supplemental material for Intermittently Scanned Continuous Glucose Monitoring Performance in Patients With Liver Cirrhosis

sj-xlsx-1-dst-10.1177_19322968241232686 for Intermittently Scanned Continuous Glucose Monitoring Performance in Patients With Liver Cirrhosis by Fernanda Augustini Rigon, Marcelo Fernando Ronsoni, Alexandre Hohl, André Gustavo Daher Vianna, Simone van de Sande-Lee and Leonardo de Lucca Schiavon in Journal of Diabetes Science and Technology</p

The SAGE study: global observational analysis of glycaemic control, hypoglycaemia and diabetes management in T1DM

International audienceAims: To describe glycaemic control and diabetes management in adults with type 1 diabetes (T1DM), in a real-life global setting.Materials and methods: Study of Adults' GlycEmia (SAGE) was a multinational, multicentre, single visit, non-interventional, cross-sectional study in adult patients with T1DM. Data were collected at a single visit, analysed according to predefined age groups (26-44, 45-64, and ≥65 years), and reported across different regions. The primary endpoint was the proportion of participants achieving HbA1c <7.0 % in each age group. Secondary endpoints included incidence of hypoglycaemia, severe hypoglycaemia and severe hyperglycaemia leading to diabetic ketoacidosis (DKA), and therapeutic management of T1DM.Results: Of 3903 included participants, 3858 (98.8%) were eligible for the study. Overall, 24.3% (95% confidence interval [CI]: 22.9 to 25.6) of participants achieved the glycaemic target of HbA1c <7.0 %, with more participants achieving this target in the 26-44 years group (27.6% [95% CI: 25.5 to 29.8]). Target achievement was highest in Eastern and Western Europe, and lowest in the Middle East. The incidence of hypoglycaemia and of severe hyperglycaemia leading to DKA tended to decrease with age, and varied across regions. Age and regional differences were observed in therapeutic management, including types of device/insulin usage, frequency of insulin dose adjustment, and technology usage.Conclusions: Glycaemic control remains poor in adults with T1DM globally. Several areas of treatment may be optimised to improve outcomes, including supporting patient self-management of insulin therapy, increasing use of technologies such as CGM, and greater provision of healthcare support. This article is protected by copyright. All rights reserved