Valor prognóstico de células TCD8+ E natural killer em carcinoma epidermóide oral e orofaringeano tratado com radioterapia e quimioterapia

The most common malignant neoplasm of the oral cavity and oropharynx are squamous cell carcinoma. Injuries to the same stage and subjected to the same treatment protocol have sometimes different evolutionary courses. The scope of this study was to investigate, through a retrospective cohort, associations between the number of CD8 + T cells and natural killer, identified immunohistochemically in the inflammatory infiltrate in a series of cases of oral squamous cell carcinoma and orofaringeano, and the level of tumor response to radiotherapy and chemotherapy, overall survival and relapse-free survival of patients. We identified 54 patients with unresectable disease were treated exclusively with radiotherapy and chemotherapy. The median follow-up was 22 months. The sample was characterized by the predominance of male subjects, median age 60 years, all were smokers. The most frequent site was the tongue and 81.5% were in stage IV. Patients with disease in the oral cavity had a worse response to treatment (p = 0.006), worse relapse-free survival (p = 0.007), worse overall survival (p = 0.007). The advanced T stage was shown a negative prognostic factor (p= 0.006) for the clinical treatment response made. Immunohistochemistry was performed to select CD8 + cells (anti-CD8) and NK cells (anti-CD57). Lymphocytes positive and negative markings were counted using the program ImageJ ®. Two groups were created for each marking evaluated: Group I patients with more than 50% cells positive, Group II: less than 50% of labeled cells. For CD8 + cells detected in 38 (70.3%) of Group I were CD8 + and 16 (29.7%) Group II CD8 +. For NK cells, 26 (48.15%) Group I NK and 28 (51.85%) Group II NK. Regarding the clinical response to treatment, we observed that 39% of patients achieved a complete response and 25.9% remained without recurrence at the end of follow-up. These results were better in Group I CD8 + (p = 0.2). Identified that 72.2% of patients progressed to death, this finding had no association with the immunohistochemical data. There was no statistically significant differences between the number of CD8 + and NK cells and the ability of tumor response to radiotherapy and chemotherapy, or with overall survival and relapse-free survival of patients. However, especially in relation to a learned response, we found that this group of patients with advanced disease have a low count of CD8 + T cells active. Believing in the role that the immune response plays in the local fight against neoplastic cells, however, our results do not support the use of quantitative analysis of CD8 + T cells and NK cells as a prognostic factors for oral squamous cell carcinoma and oropharynx

Perfil de mortalidade de idosos no Rio Grande do Norte: estudo comparativo entre duas faixas etárias e fatores relacionados

Measures of mortality represent one of the most important indicators of health conditions. For comprising the larger rate of deaths, the study of mortality in the elderly population is regarded as essential to understand the health situation. In this sense, the present study aims to analyze the mortality profile of the population from 60 to 69 (young elders) and older than 80 years old (oldest old) in the Rio Grande do Norte state (Brazil) in the period 2001 to 2011, and to identify the association with contextual factors and variables about the quality of the Mortality Information System (SIM). For this purpose, Mortality Proportional (MP) was calculated for the state and Specific Mortality Rate by Age (CMId) , according to chapters of ICD- 10, to the municipalities of Rio Grande do Norte , through data from the Mortality Information System (SIM) and the Brazilian Institute of Geography and Statistics (IGBE). In order to identify groups of municipalities with similar mortality profiles, Nonhierarchical Clustering K-means method was applied and the Factor Analysis by the Principal Components Analysis was resort to reduce contextual variables. The spatial distribution of these groups and the factors were visualized using the Spatial Analysis Areas technique. During the period investigated, 21,813 younger elders deaths were recorded , with a predominance of deaths from circulatory diseases (32.75%) and neoplasms (22.9 %) . Among the oldest old, 50,637 deaths were observed, which 35.26% occurred because of cardiovascular diseases and 17.27% of ill-defined causes. Clustering Analysis produced three clusters to the two age groups and Factor Analysis reduced the contextual variables into three factors, also the sum of the factor scores was considered. Among the younger elders, the groups are called misinformation profile, development profile and development paradox, which showed a statistically significant association with education and poverty and extreme poverty factors, factorial sum and the variable related to underreporting of deaths. Misinformation profile remained in the oldest old group, accompanied by the epidemiological transition profile and the epidemiological paradox, that were statistically associated with the development and health factor, as well as with the variables that indicate the SIM quality: proportion of blank fields about the schooling and underreporting. It proposed that the mortality profiles of the younger elders and oldest old differ on the importance of the basic causes and that are influenced by different contextual aspects , observing that 60 to 69 years group is more affected by such aspects. Health inequalities can be reduced by measures aimed to improve levels of education and poverty, especially in younger elders, and by optimizing the use of health services, which is more associated to the oldest old health situation. Furthermore, it is important to improve the quality of information for the two age groups

Caracterização de processos morfodinâmicos e hidrodinâmicos do cinturão lacustre meridional da Reserva Biológica do Lago Pirituba, Amapá

The Amapá State has an important natural lake system, known as The Amapá Lakes Region . Most of these lakes are on the southern part of Amapá s coastal plain, which has 300 km of extension and it s composed by holocenic sediments deposited at the northern part of Amazon River to the Orange Cape located on the northern part of Amapá state. This region is under influence of the Amazon River discharge which is the largest liquid discharge of about 209.000 m³/s and biggest sediment budget discharged on the ocean in the order 6.108 ton per day. The climate is influenced by the Intertropical Convergence Zone and El Niño Southern Oscillation which act mainly under precipitation, nebulosity, local rivers and tidal hidrology. In this region lake belts are Ocidental, Oriental and Meridional Lake Belts. The last one is formed by the by the lakes Comprido de Cima, Botos, Bacia, Lodão, Ventos, Mutuco and Comprido de Baixo. These lakes are the closest to the Araguari River and are characterized by pelitic sedimentation associated with fluvial and estuarine flood plains under influence of tides. The lakes are interconnected, suffer influence of flood pulses from the Tartarugal, Tartarugalzinho and Araguari rivers and the hydrodynamic and morphodynamic know edge is poor. Volume and area reduction, natural eutrophication, anthophic influence, hidrodynamic alterations, morphological changes and are factors which can contribute to the closing of such lakes on the Meridional Lake Belt. This belt is inside the boundaries of the Biological Reserve of Piratuba Lake, created in 1980 for integral protection. Due to the fragility of the environment together with the poor knowledge of the system and with the study area relevancy it is necessary to know the hydrodynamic and geoenvironmental processes. This work aims the characterization of morphodynamic and hydrodynamic processes in order to understand the geoambiental context of the Meridional Lake Belt, from the Comprido de Baixo Lake to the dos Ventos Lake, including the Tabaco Igarape. Methodology was based on the hydrodynamic data acquisition: liquid discharge (acoustic method), tides, bathymetry and the interpretation of multitemporal remote sensing images, integrated in a Geographic Information System (GIS). By this method charts of the medium liquid discharges of Lake Mutuco and Tabacco Igarape the maximum velocity of flow were estimated in: 1.1 m/s, 1.6 m/s and 1.6 m/s (rainy season) and 0.6 m/s, 0.6 m/s and 0.7 m/s (dry period), the maximum flow in: 289 m³/s, 297 m³/s and 379 m³/s (rainy season) and 41 m³/s , 79 m³/s and 105 m³/s (dry period), respectively. From the interpretation of multitemporal satellite images, maps were developed together with the analysis of the lakes and Tobaco Igarape evolution from 1972 to 2008, and were classified according to the degree of balance in the area: stable areas, eutrophic areas, areas of gain, and eroded areas. Troughout analysis of the balance of areas, it was possible to quantify the volume of lake areas occupied by aquatic macrophytes. The study sought to understand the hydrodynamic and morphodynamic processes occurring in the region, contributing to the elucidation of the processes which cause and/or favor geoenvironmental changes in the region; all such information is fundamental to making the management of the area and further definition of parameters for environmental monitoring and contributing to the development of the management plan of the Biological Reserve of Lake Piratuba. The work activities is a part of the Project "Integration of Geological, geophysical and geochemical data to Paleogeographic rebuilding of Amazon Coast, from the Neogene to the Recent