O câncer de pulmão é atualmente a neoplasia mais frequentemente diagnosticada, considerando ambos os sexos, e a principal causa de óbito por câncer em todo o mundo. A incidência e a mortalidade do câncer de pulmão vêm sendo influenciadas ao longo do tempo pela história do tabagismo e seus aspectos sócio-demográficos. Este estudo tem como objetivo analisar a sobrevida e fatores prognósticos em mulheres com câncer de pulmão assistidas em uma clínica especializada no Rio de Janeiro no período de 2000 a 2009. Foram analisadas 193 mulheres com diagnóstico de câncer de pulmão confirmado por exame histopatológico. Os dados foram obtidos diretamente do sistema informatizado de registros médicos do referido serviço. A idade do diagnóstico foi categorizada em quatro faixas etárias: até 49 anos, 50 a 59 anos, 60 a 69 anos e maior de 70anos. O tabagismo foi categorizado como não fumante, ex-fumante, fumante e fumante passiva. O estado nutricional foi avaliado pelo Índice de Massa Corpórea (IMC). A classificação histológica seguiu a divisão entre tumores de células não-pequenas (CPCNP) e tumores de pequenas células (CPCP). O estadiamento clínico se baseou na classificação do American Joint Committee on Cancer (AJCC) e Veterans Administration Lung Cancer Study Group (VALCSG) para os tumores de células não-pequenas e tumores de células pequenas, respectivamente. A modalidade de tratamento foi categorizada pela intenção da abordagem terapêutica em quatro grupos: controle, neoadjuvância, adjuvância e paliativa. Foram calculadas funções de sobrevida pelo método de Kaplan-Meier. Para os fatores prognósticos de risco, foram calculados os hazards ratios brutos e ajustados com intervalos de confiança de 95%, através do modelo de riscos proporcionais de Cox. A idade média das pacientes foi de 63 anos. Destas, 47,7% eram fumantes, 26,9% não fumantes, 19,7% ex-fumantes e 3,6% fumantes passivas. Em relação ao estado nutricional, 2,6% das pacientes apresentavam IMC baixo peso, 52,8% normal, 29,5% sobrepeso e 15% obesidade. A maioria dos casos, 169 (87,6%) pacientes, foi classificado como câncer de pulmão de células não-pequenas (CPCNP). Apenas 24 casos (12,4%) foram de câncer de pequenas células (CPCP). Durante o período estudado ocorreram 132 óbitos; 114 por CPCNP e 18 por CPCP. O tempo mediano de sobrevida para toda a coorte foi de 23,2 meses (IC95%: 16,9-33,5). Quando os dados foram estratificados por classificação tumoral, a sobrevida mediana nas pacientes com diagnóstico de CPCNP foi de 18,2 meses (IC95%: 15,6-25,5) e para aquelas com CPCP foi de 10,3 meses (IC95%: 8,4-19,3). A sobrevida encontrada em 24 meses foi de 49% (IC95%: 42,25-56,9), sendo 22,95 (IC95%: 0,6-49,3) para os tumores de pequenas células e 50,29% (IC95%: 43,1-58,7) para os tumores de células não- pequenas. Para o total das pacientes, as curvas de sobrevida estratificadas pelas variáveis selecionadas mostraram diferenças em relação à idade do diagnóstico (p=0,0023) nas faixas etárias intermediárias de 50-59 anos e 60-69 anos, se comparadas com os limites extremos (as mais idosas e as mais jovens). Não houve diferenças para o status de tabagismo (p=0,1484) nem para o IMC (p=0,6230). Na análise multivariada para todos os tumores, nenhum fator prognóstico influenciou no risco de morte. A idade nas categorias intermediárias (50-59 anos e 60-69 anos) e o IMC na categoria sobrepeso mostraram uma tendência à proteção, porém, não houve significância estatística. Para o grupo de mulheres com CPCNP, o modelo de riscos proporcionais apontou diferença em relação ao estadiamento clínico, especificamente o estádio IV (HR=3,36, IC95%: 1,66-6,8; p=0,001). As pacientes com idade entre 50-59 anos e sobrepeso mostraram uma tendência à diminuição do risco, embora sem significância estatística. Esses resultados mostram a necessidade de conhecer melhor o perfil das mulheres que desenvolvem câncer de pulmão e de realizar pesquisas que investiguem de forma mais aprofundada as condições que influenciam a evolução clínica dos casos e assim contribuir para o aprimoramento da abordagem terapêutica. / Lung cancer is currently the most frequently diagnosed cancer, considering both sexes, and the leading cause of cancer death worldwide. Incidence and mortality of lung cancer have been influenced over time by smoking history and their socio-demographic.This study aims to assess the survival and prognostic factors, smoking and body mass index, adjusted for aging, histologic classification and TNM Stating System among women with lung cancer at a clinic in Rio de Janeiro, Brazil, between 2000-2009. The information was obtained from the database of the clinic. The main variables analysed were age at diagnosis, categorized into four levels on the basis of age (<=49, 50-59, 60-69 and >=70), smoking history (never smoking, former smoking and current smoking), nutritional status based on Body Mass Index (BMI), histological classification, designated as non-small cell carcinoma (NSLC) and small cell carcinoma (SCLC), Staging System based on American Joint Committee on Câncer (AJCC) for NSLC and Veterans Administration Lung Study Group (VALSG) for SCLC and treatment modality. They were considered as treatment modality, observation, neoadjuvant and adjuvant therapies, prolongation of survival by chemotherapy. Survival curves were calculated by the Kaplan-Meier (KM) method. We used the porportional hazards modelo of Cox for evaluation of prognostic factors. We analysed 193 women, diagnosed with lung cancer confirmed by histopathology, 169 (87.6%) patient with tumors of non-small cell and 24 (12.4%) patients with smallcell tumors. The average age of patients was 63 years. Median survival for the entire cohort was 23.2 months (95% CI, 16.5 to 32.9). When data were stratified by tumor classification, the median survival in patients with NSLC was 25.5 months (95% CI, 18.3 to 36.4) and 10.5 (95% CI, 8.6 to 20.4) those with SCLC. The overall survival rate at 5 years was found to be 28.9% (95% CI, 2.4 to 37.1) and 68.3% (95% CI, 60.5 to 75.0) for NSLC and 17.2% (95% CI, 4.8 to 35.9) for SCLC. The survival curves differentiated by the classification of tumors showed a significant worsening of the median survival in patients with small-cell lung cancer, 10.3 months (95% CI, 8.4 to 19.3) when compared with non small cell lung cancer, 18.2 months (95% CI, 15.6 to 25.5). Median survival for the entire sample was 16.5 months (95% CI, 13.8 to 23.2). The survival functions stratified by prognostic factors showed differences in age at diagnosis (p= 0.00597) but showed no differences for smoking (p=0.11) nor BMI (p=0.383). The multivariate analysis showed clinical staging as the main independent prognostic factor. The age at diagnosis and BMI exerted a protective factor in at least one of the categories studied. The smoking status did not influence survival. These results show the need to better understand the profile of women who develop lung cancer and identify new prognostic factors to contribute to the improvement of the therapeutic approach.

O câncer de pulmão é atualmente a neoplasia mais frequentemente diagnosticada, considerando ambos os sexos, e a principal causa de óbito por câncer em todo o mundo. A incidência e a mortalidade do câncer de pulmão vêm sendo influenciadas ao longo do tempo pela história do tabagismo e seus aspectos sócio-demográficos. Este estudo tem como objetivo analisar a sobrevida e fatores prognósticos em mulheres com câncer de pulmão assistidas em uma clínica especializada no Rio de Janeiro no período de 2000 a 2009. Foram analisadas 193 mulheres com diagnóstico de câncer de pulmão confirmado por exame histopatológico. Os dados foram obtidos diretamente do sistema informatizado de registros médicos do referido serviço. A idade do diagnóstico foi categorizada em quatro faixas etárias: até 49 anos, 50 a 59 anos, 60 a 69 anos e maior de 70anos. O tabagismo foi categorizado como não fumante, ex-fumante, fumante e fumante passiva. O estado nutricional foi avaliado pelo Índice de Massa Corpórea (IMC). A classificação histológica seguiu a divisão entre tumores de células não-pequenas (CPCNP) e tumores de pequenas células (CPCP). O estadiamento clínico se baseou na classificação do American Joint Committee on Cancer (AJCC) e Veterans Administration Lung Cancer Study Group (VALCSG) para os tumores de células não-pequenas e tumores de células pequenas, respectivamente. A modalidade de tratamento foi categorizada pela intenção da abordagem terapêutica em quatro grupos: controle, neoadjuvância, adjuvância e paliativa. Foram calculadas funções de sobrevida pelo método de Kaplan-Meier. Para os fatores prognósticos de risco, foram calculados os hazards ratios brutos e ajustados com intervalos de confiança de 95%, através do modelo de riscos proporcionais de Cox. A idade média das pacientes foi de 63 anos. Destas, 47,7% eram fumantes, 26,9% não fumantes, 19,7% ex-fumantes e 3,6% fumantes passivas. Em relação ao estado nutricional, 2,6% das pacientes apresentavam IMC baixo peso, 52,8% normal, 29,5% sobrepeso e 15% obesidade. A maioria dos casos, 169 (87,6%) pacientes, foi classificado como câncer de pulmão de células não-pequenas (CPCNP). Apenas 24 casos (12,4%) foram de câncer de pequenas células (CPCP). Durante o período estudado ocorreram 132 óbitos; 114 por CPCNP e 18 por CPCP. O tempo mediano de sobrevida para toda a coorte foi de 23,2 meses (IC95%: 16,9-33,5). Quando os dados foram estratificados por classificação tumoral, a sobrevida mediana nas pacientes com diagnóstico de CPCNP foi de 18,2 meses (IC95%: 15,6-25,5) e para aquelas com CPCP foi de 10,3 meses (IC95%: 8,4-19,3). A sobrevida encontrada em 24 meses foi de 49% (IC95%: 42,25-56,9), sendo 22,95 (IC95%: 0,6-49,3) para os tumores de pequenas células e 50,29% (IC95%: 43,1-58,7) para os tumores de células não- pequenas. Para o total das pacientes, as curvas de sobrevida estratificadas pelas variáveis selecionadas mostraram diferenças em relação à idade do diagnóstico (p=0,0023) nas faixas etárias intermediárias de 50-59 anos e 60-69 anos, se comparadas com os limites extremos (as mais idosas e as mais jovens). Não houve diferenças para o status de tabagismo (p=0,1484) nem para o IMC (p=0,6230). Na análise multivariada para todos os tumores, nenhum fator prognóstico influenciou no risco de morte. A idade nas categorias intermediárias (50-59 anos e 60-69 anos) e o IMC na categoria sobrepeso mostraram uma tendência à proteção, porém, não houve significância estatística. Para o grupo de mulheres com CPCNP, o modelo de riscos proporcionais apontou diferença em relação ao estadiamento clínico, especificamente o estádio IV (HR=3,36, IC95%: 1,66-6,8; p=0,001). As pacientes com idade entre 50-59 anos e sobrepeso mostraram uma tendência à diminuição do risco, embora sem significância estatística. Esses resultados mostram a necessidade de conhecer melhor o perfil das mulheres que desenvolvem câncer de pulmão e de realizar pesquisas que investiguem de forma mais aprofundada as condições que influenciam a evolução clínica dos casos e assim contribuir para o aprimoramento da abordagem terapêutica. / Lung cancer is currently the most frequently diagnosed cancer, considering both sexes, and the leading cause of cancer death worldwide. Incidence and mortality of lung cancer have been influenced over time by smoking history and their socio-demographic.This study aims to assess the survival and prognostic factors, smoking and body mass index, adjusted for aging, histologic classification and TNM Stating System among women with lung cancer at a clinic in Rio de Janeiro, Brazil, between 2000-2009. The information was obtained from the database of the clinic. The main variables analysed were age at diagnosis, categorized into four levels on the basis of age (<=49, 50-59, 60-69 and >=70), smoking history (never smoking, former smoking and current smoking), nutritional status based on Body Mass Index (BMI), histological classification, designated as non-small cell carcinoma (NSLC) and small cell carcinoma (SCLC), Staging System based on American Joint Committee on Câncer (AJCC) for NSLC and Veterans Administration Lung Study Group (VALSG) for SCLC and treatment modality. They were considered as treatment modality, observation, neoadjuvant and adjuvant therapies, prolongation of survival by chemotherapy. Survival curves were calculated by the Kaplan-Meier (KM) method. We used the porportional hazards modelo of Cox for evaluation of prognostic factors. We analysed 193 women, diagnosed with lung cancer confirmed by histopathology, 169 (87.6%) patient with tumors of non-small cell and 24 (12.4%) patients with smallcell tumors. The average age of patients was 63 years. Median survival for the entire cohort was 23.2 months (95% CI, 16.5 to 32.9). When data were stratified by tumor classification, the median survival in patients with NSLC was 25.5 months (95% CI, 18.3 to 36.4) and 10.5 (95% CI, 8.6 to 20.4) those with SCLC. The overall survival rate at 5 years was found to be 28.9% (95% CI, 2.4 to 37.1) and 68.3% (95% CI, 60.5 to 75.0) for NSLC and 17.2% (95% CI, 4.8 to 35.9) for SCLC. The survival curves differentiated by the classification of tumors showed a significant worsening of the median survival in patients with small-cell lung cancer, 10.3 months (95% CI, 8.4 to 19.3) when compared with non small cell lung cancer, 18.2 months (95% CI, 15.6 to 25.5). Median survival for the entire sample was 16.5 months (95% CI, 13.8 to 23.2). The survival functions stratified by prognostic factors showed differences in age at diagnosis (p= 0.00597) but showed no differences for smoking (p=0.11) nor BMI (p=0.383). The multivariate analysis showed clinical staging as the main independent prognostic factor. The age at diagnosis and BMI exerted a protective factor in at least one of the categories studied. The smoking status did not influence survival. These results show the need to better understand the profile of women who develop lung cancer and identify new prognostic factors to contribute to the improvement of the therapeutic approach.

The aim of this study was to investigate the factors affecting the survivability of goat kids to weaning, in a small-scale communal grazing system. Goat kids are the most vulnerable component of communal goat flocks and increasing their survival could increase productivity. Some of the main factors which contributed towards kid survivability were evaluated and ranked and cost benefit analysis was done. Initially 20 farmers in Jericho District, North West Province, were subjected to a structured interview. The mean age of farmers was 68.9 years and the mean number of does was 11. Thirteen farmers remained in the trial throughout and were visited once a month. The average number of does for farmers remained in the trial was 13. Body condition scores of does were estimated, kids were weighed, faecal samples were collected and the veld evaluated. Management and socio-economic aspects were observed and informal discussions were conducted with farmers. Goat housing was evaluated using a housing checklist. Monthly precipitation and temperature data were recorded. Survivability to weaning of 63% of kids was recorded from the total number of kids born (131) from 170 does of the 13 farmers who remained in the trial. The flocks of goats examined were parasitised by Haemonchus contortus, Trichuris globulosa, Coccidia as well as Moniezia. Although faecal egg counts were relatively low, there was a significant correlation with kid mortalities. Three of the six goats submitted for necropsy also died of internal parasites. The species of ticks were Amblyoma, Hyalomma and Rhipicephalus spp. Lice species found were identified as Bovicola caprae, Bovicola limbatus and Linognathus africanus using scanning electron microscopy. Flea infestation was observed in three flocks, the flea species was identified as Ctenocephalides felis felis. Management was found to be suboptimal and in 92.31% of flocks, housing was inadequate. Build-up of faeces and poor drainage probably contributed to internal parasites. Other factors such as climate and feeding could not be correlated to kid mortalities. Cost benefit analysis suggested that strategic de-worming and improvement of hygiene and drainage in the housing would be the most affordable and effective way to reduce mortalities in kids. / Dissertation (MSc (Veterinary Sciences))--University of Pretoria, 2002. / Paraclinical Sciences / unrestricted

Survival of transplanted neural stem/progenitor cells (NSPC) is limited after spinal cord injury (SCI). This thesis tested whether ephrin-B3 could enhance the survival of spinal cord derived NSPC because ephrin-B3 enhanced the survival of endogenous NSPC in the mouse brain. Preclustered ephrin-B3-Fc was tested, and preclustered Fc fragments and phosphate-buffered saline (PBS) were used as controls. This study showed that spinal cord derived NSPC and normal and injured rat spinal cord expressed EphA4 receptors. In culture, ephrin-B3-Fc increased the survival of NSPC at 1µg/mL (p<0.05), but Fc fragments reduced NSPC survival dose-dependently. In the injured spinal cord, infusion of ephrin-B3-Fc increased the proliferation of endogenous ependymal cells compared with infusion of PBS (p<0.05). However, in the injured cord, infusion of either ephrin-B3-Fc or Fc fragments caused a 20-fold reduction in the survival of transplanted NSPC (p<0.001). Thus, after SCI, ephrin-B3-Fc and Fc fragments are toxic to transplanted NSPC.

Survival of transplanted neural stem/progenitor cells (NSPC) is limited after spinal cord injury (SCI). This thesis tested whether ephrin-B3 could enhance the survival of spinal cord derived NSPC because ephrin-B3 enhanced the survival of endogenous NSPC in the mouse brain. Preclustered ephrin-B3-Fc was tested, and preclustered Fc fragments and phosphate-buffered saline (PBS) were used as controls. This study showed that spinal cord derived NSPC and normal and injured rat spinal cord expressed EphA4 receptors. In culture, ephrin-B3-Fc increased the survival of NSPC at 1µg/mL (p<0.05), but Fc fragments reduced NSPC survival dose-dependently. In the injured spinal cord, infusion of ephrin-B3-Fc increased the proliferation of endogenous ependymal cells compared with infusion of PBS (p<0.05). However, in the injured cord, infusion of either ephrin-B3-Fc or Fc fragments caused a 20-fold reduction in the survival of transplanted NSPC (p<0.001). Thus, after SCI, ephrin-B3-Fc and Fc fragments are toxic to transplanted NSPC.