A leucemia mielóide aguda ainda apresenta altos índices de mortalidade em adultos, exceção feita à leucemia promielocítica. A otimização dos protocolos de tratamento tem sido muito discutida há 3 décadas, com resultados ainda insatisfatórios. Fatores prognósticos como idade, cariótipo e tolerância à consolidação com altas doses de citarabina guardam relação com a melhor sobrevida. Com o objetivo de avaliar diferentes protocolos de tratamento e validar estes e outros fatores prognósticos, conduzimos um estudo retrospectivo no Hospital das Clínicas da Universidade de São Paulo, analisando prontuários médicos e os eventos relacionados à leucemia mielóide aguda, de 1978 a 2007. Analisamos 400 pacientes tratados curativamente e achamos que idade abaixo de 60 anos (27% vs 7%), cariótipo favorável (53% vs 28% vs 5%) e administração de doses totais de citarabina, principalmente se acima da mediana de 45,45 gramas (68% vs 44% vs 21%) tem impacto positivo na sobrevida global em 5 anos, sendo o uso de altas doses de citarabina um fator independente. A positividade para mieloproxidase, classificação FAB e protocolo de tratamento não mostraram associação estatisticamente significante para melhores índices de sobrevida. Pudemos concluir que, se os protocolos de indução não apresentam diferenças estatísticas, a consolidação intensiva com altas doses de citarabina em pacientes abaixo de 60 anos tem impacto independente na sobrevida global, com resultados ainda melhores quando a dose total é maior ou igual a 45,45 gramas. O cariótipo também foi validado em nossa população / Acute myeloid leukemia in adults is still a highly fatal disease, except for acute promyelocitic leukemia. The optimization of treatment protocols has been debated for three decades, without satisfactory results. Prognostic factors like age, kariotype and consolidation with cytarabine in high dosis seem to correlact with a better overall survival. We conducted a retrospective study in the General Hospital of University of Sao Paulo analyzing medical records and acute myeloid leukemia outcomes to compare different treatment protocols used through 1978 to 2007. We also intended to validate international prognostic factors as the ones cited in our population. We analyzed 400 patients treated with curative intention and found better overall survival in 5 years regarding age less than 60 years (27% vs 7%), favorable karyotipe (53% vs 28% vs 5%) and high dosis cytarabine in consolidation, meanly if total dose was at least the median of 45,45 g (68% vs 44% vs 21%). Consolidation with high dosis cytarabine was an independent predictor of better overall survival. No estatistical differences were seen regarding myeloperoxidase positivity, induction protocol and FAB classification. We concluded that, if the induction protocols seem to be no different in results, consolidation with high dosis cytarabine for patients under 60 years has impact in overall survival, being even better when the total dosis is at least 45,45 g. Karyotipe has also been validated in our study population

Submitted by Roberta Lorenzon (roberta.lorenzon@fgv.br) on 2011-05-30T14:26:15Z No. of bitstreams: 1 63080100015.pdf: 781749 bytes, checksum: 32dd660d87d63789ab4a0ee0600ce50d (MD5) / Approved for entry into archive by Gisele Isaura Hannickel(gisele.hannickel@fgv.br) on 2011-05-30T14:47:36Z (GMT) No. of bitstreams: 1 63080100015.pdf: 781749 bytes, checksum: 32dd660d87d63789ab4a0ee0600ce50d (MD5) / Approved for entry into archive by Gisele Isaura Hannickel(gisele.hannickel@fgv.br) on 2011-05-30T14:48:59Z (GMT) No. of bitstreams: 1 63080100015.pdf: 781749 bytes, checksum: 32dd660d87d63789ab4a0ee0600ce50d (MD5) / Made available in DSpace on 2011-05-31T15:39:00Z (GMT). No. of bitstreams: 1 63080100015.pdf: 781749 bytes, checksum: 32dd660d87d63789ab4a0ee0600ce50d (MD5) Previous issue date: 2010-05-28 / The present work aims to study the macroeconomic factors influence in credit risk for installment autoloans operations. The study is based on 4.887 credit operations surveyed in the Credit Risk Information System (SCR) hold by the Brazilian Central Bank. Using Survival Analysis applied to interval censured data, we achieved a model to estimate the hazard function and we propose a method for calculating the probability of default in a twelve month period. Our results indicate a strong time dependence for the hazard function by a polynomial approximation in all estimated models. The model with the best Akaike Information Criteria estimate a positive effect of 0,07% for males over de basic hazard function, and 0,011% for the increasing of ten base points on the operation annual interest rate, toward, for each R$ 1.000,00 on the installment, the hazard function suffer a negative effect of 0,28% , and an estimated elevation of 0,0069% for the same amount added to operation contracted value. For de macroeconomics factors, we find statistically significant effects for the unemployment rate (-0,12%) , for the one lag of the unemployment rate (0,12%), for the first difference of the industrial product index(-0,008%), for one lag of inflation rate (-0,13%) and for the exchange rate (-0,23%). We do not find statistic significant results for all other tested variables. / The present work aims to study the macroeconomic factors influence in credit risk for installment autoloans operations. The study is based on 4.887 credit operations surveyed in the Credit Risk Information System (SCR) hold by the Brazilian Central Bank. Using Survival Analysis applied to interval censured data, we achieved a model to estimate the hazard function and we propose a method for calculating the probability of default in a twelve month period. Our results indicate a strong time dependence for the hazard function by a polynomial approximation in all estimated models. The model with the best Akaike Information Criteria estimate a positive effect of 0,07% for males over de basic hazard function, and 0,011% for the increasing of ten base points on the operation annual interest rate, toward, for each R$ 1.000,00 on the installment, the hazard function suffer a negative effect of 0,28% , and an estimated elevation of 0,0069% for the same amount added to operation contracted value. For de macroeconomics factors, we find statistically significant effects for the unemployment rate (-0,12%) , for the one lag of the unemployment rate (0,12%), for the first difference of the industrial product index(-0,008%), for one lag of inflation rate (-0,13%) and for the exchange rate (-0,23%). We do not find statistic significant results for all other tested variables.

A leucemia mielóide aguda ainda apresenta altos índices de mortalidade em adultos, exceção feita à leucemia promielocítica. A otimização dos protocolos de tratamento tem sido muito discutida há 3 décadas, com resultados ainda insatisfatórios. Fatores prognósticos como idade, cariótipo e tolerância à consolidação com altas doses de citarabina guardam relação com a melhor sobrevida. Com o objetivo de avaliar diferentes protocolos de tratamento e validar estes e outros fatores prognósticos, conduzimos um estudo retrospectivo no Hospital das Clínicas da Universidade de São Paulo, analisando prontuários médicos e os eventos relacionados à leucemia mielóide aguda, de 1978 a 2007. Analisamos 400 pacientes tratados curativamente e achamos que idade abaixo de 60 anos (27% vs 7%), cariótipo favorável (53% vs 28% vs 5%) e administração de doses totais de citarabina, principalmente se acima da mediana de 45,45 gramas (68% vs 44% vs 21%) tem impacto positivo na sobrevida global em 5 anos, sendo o uso de altas doses de citarabina um fator independente. A positividade para mieloproxidase, classificação FAB e protocolo de tratamento não mostraram associação estatisticamente significante para melhores índices de sobrevida. Pudemos concluir que, se os protocolos de indução não apresentam diferenças estatísticas, a consolidação intensiva com altas doses de citarabina em pacientes abaixo de 60 anos tem impacto independente na sobrevida global, com resultados ainda melhores quando a dose total é maior ou igual a 45,45 gramas. O cariótipo também foi validado em nossa população / Acute myeloid leukemia in adults is still a highly fatal disease, except for acute promyelocitic leukemia. The optimization of treatment protocols has been debated for three decades, without satisfactory results. Prognostic factors like age, kariotype and consolidation with cytarabine in high dosis seem to correlact with a better overall survival. We conducted a retrospective study in the General Hospital of University of Sao Paulo analyzing medical records and acute myeloid leukemia outcomes to compare different treatment protocols used through 1978 to 2007. We also intended to validate international prognostic factors as the ones cited in our population. We analyzed 400 patients treated with curative intention and found better overall survival in 5 years regarding age less than 60 years (27% vs 7%), favorable karyotipe (53% vs 28% vs 5%) and high dosis cytarabine in consolidation, meanly if total dose was at least the median of 45,45 g (68% vs 44% vs 21%). Consolidation with high dosis cytarabine was an independent predictor of better overall survival. No estatistical differences were seen regarding myeloperoxidase positivity, induction protocol and FAB classification. We concluded that, if the induction protocols seem to be no different in results, consolidation with high dosis cytarabine for patients under 60 years has impact in overall survival, being even better when the total dosis is at least 45,45 g. Karyotipe has also been validated in our study population

Drawing on the theoretical influences of Mad and Disability Studies; philosophical conceptualizations of epistemic injustice (Fricker, 2007), ethical loneliness (Stauffer, 2015), and psycho-emotional disablism (Reeve, 2012; Thomas, 1999; 2007); disability/service user/feminist ethics; a decade of Mad Movement community organizing; as well as autobiographical illustrations and empirical data from two collaborative research projects, this thesis describes my efforts to live a Mad politics in the community, academy, and social work education. Central to this politics, and to the overall contribution of the thesis, is its focus on (1) the recognition and redress of affective-epistemic harms that are often ignored by legislative/social welfare approaches to in/justice; and (2) the generation and refinement of Mad knowledge/ways of knowing that respond to our own priorities as Mad people, rather than those of mental health systems. It contributes to these areas of Mad Studies theory in several ways: First, by recognizing and politicizing the often ignored affective-epistemic effects of abandonment and neglect Mad people experience from society, including loneliness, anger, resentment, distrust, low expectations of others and lack of confidence. Second, by seeking new conceptualizations (such as epistemic loneliness) and contributing to existing ones (like expectations of just treatment, psycho-emotional disablism) in order to more adequately interpret and attest to these harms and call for their redress. Third, by affirming emergent Mad moral and epistemological frameworks, especially those that manifest in the aftermath of harm and account for ontologies of knowing. Fourth, by developing Survivor/Service User Research approaches to analysis (listening for resonance, everyday forms of service user resistance, and ‘quiet’ data) that value affective engagements with data and perceive and respond to Mad onto-ethico-epistemologies in and on their own terms. Ultimately, this work calls for greater relational justice, and an expansion of what we owe each other. / Thesis / Doctor of Philosophy (PhD) / This thesis contributes to Mad theory by recording some of the things I learned while trying to survive in the world, community organizing, the academy, and social work education as a Mad person. To do so, I reflect on the existential and ethical questions I brought to my doctoral studies, the people, texts, and concepts that I found particularly good company during this time, and my Mad methods of living/doing/knowing. Three separate but interconnected articles then follow. These are about (1) moving with loneliness as a Mad student; (2) resisting unmet expectations as service user ethics, and (3) how pedagogical partnerships between students and faculty/staff can cultivate marginalized students’ confidence in their knowledge. The thesis ends with a discussion of its overall contributions to how we conceptualize the psycho-emotional harms produced through sanism/disablism and the ways we understand what Mad knowledge is and how it is generated.