Objetivo Avaliar o efeito do tempo de espera (TE) até radioterapia na sobrevida global de pacientes com glioblastoma como um fator prognóstico confiável. Método Estudo retrospectivo de 115 pacientes com glioblastoma, que foram submetidos à radioterapia pós-operatória, em dois serviços diferentes no Brasil (um público e outro privado). Resultados Mediana de TE para radioterapia foi de 6 semanas (variação, 1,3-17,6). A mediana de sobrevida para TE ≤ 6 semanas foi de 13,5 meses (IC95%, 9,1-17,9) e para TE > 6 semanas foi de 14,2 meses (IC95%, 11,2-17,2) (HR 1,165, 0,770-1,762; p = 0,470). Na análise multivariada, as variáveis associadas à sobrevida foram perfomance status (p < 0,001), extensão da ressecção (p = 0,009) e tratamento adjuvante (p = 0,001). Conclusão Não se observou impacto prognóstico para TE até a radioterapia na sobrevida. Diante de outros fatores prognósticos, é possível assegurar de que o espaço de tempo até a radioterapia não parece influenciar o controle da doença.

Objective To evaluate the effect of waiting time (WT) to radiotherapy (RT) on overall survival (OS) of glioblastoma (GBM) patients as a reliable prognostic variable in Brazil, a scenario of medical disparities. Method Retrospective study of 115 GBM patients from two different health-care institutions (one public and one private) in Brazil who underwent post-operative RT. Results Median WT to RT was 6 weeks (range, 1.3-17.6). The median OS for WT ≤ 6 weeks was 13.5 months (95%CI , 9.1-17.9) and for WT > 6 weeks was 14.2 months (95%CI, 11.2-17.2) (HR 1.165, 95%CI 0.770-1.762; p = 0.470). In the multivariate analysis, the variables associated with survival were KPS (p < 0.001), extent of resection (p = 0.009) and the adjuvant treatment (p = 0.001). The KPS interacted with WT to RT (HR 0.128, 95%CI 0.034-0.476; p = 0.002), showing that the benefit of KPS on OS depends on the WT to RT. Conclusion No prognostic impact of WT to RT could be detected on the OS. Although there are no data to ensure that delays to RT are tolerable, we may reassure patients that the time-length to initiate treatment does not seem to influence the control of the disease, particularly in face of other prognostic factors.

OBJETIVO: Investigar se artigos brasileiros sobre câncer são publicados em periódicos de fator impacto e/ou repercussão (medida pelo número de citações) inferiores aos oriundos de instituições estrangeiras MÉTODOS: Pesquisou-se, no PubMed, o MeSH Term "neoplasm" com os limitadores: clinical trial, afiliação de autor(es) brasileira e intervalo de 1º de julho de 2009 a 30 de junho de 2010. Foram selecionados para pareamento artigos relacionados, não brasileiros, publicados entre três meses antes e três meses depois da data de publicação do estudo brasileiro. Foram obtidos os números de citações, em duas bases de dados, assim como o fator de impacto para as revistas nas quais os artigos foram publicados. RESULTADOS: Identificaram-se 43 artigos nacionais e 876 internacionais relacionados. Os brasileiros apresentaram fator de impacto médio de 3.000 contra 3.430 dos internacionais (p=0,041). Não houve diferença estatisticamente significativa quanto ao número de citações entre os grupos. A afiliação do primeiro autor à instituição brasileira ou estrangeira também não influenciou significativamente no número de citações nem no fator de impacto. CONCLUSÃO: Artigos brasileiros são significativamente menos aceitos em revistas de maior impacto sem aparente comprometimento de sua repercussão na comunidade científica.

OBJECTIVE: To investigate whether Brazilian articles on cancer are published in journals with an impact factor and/or repercussion (measured by the number of citations) inferior to those that come from foreign organizations. METHODS: A search was carried out in PubMed for the MeSH term "neoplasm" with the limits clinical trial, affiliation of the Brazilian author(s), and interval from July 1st, 2009 to June 30, 2010. Selected for matching were non-Brazilian related articles published from three months prior to three months after the date of publication of the Brazilian study. The numbers of citations were obtained from two databases, as well as the impact factor for the journals in which the articles were published. RESULTS: Forty-three national and 876 related international articles were identified. The Brazilian publications had a mean impact factor of 3.000 versus 3.430 of the international ones (p=0.041). There was no statistically significant difference as to the number of citations between the two groups. The affiliation of the first author with a Brazilian or foreign organization did not significantly influence the number of citations or the impact factor. CONCLUSION: Brazilian articles are significantly less accepted in journals with higher impact factors, although it does not compromise its repercussion on the scientific community.

62 axillas, 32 on the right upper limb and 30 on the left one were analyzed aiming a more detailed study of the topographic relationship between the brachial plexus' (BP) cords and the second part of the axillary artery (Aa). Once the second part of the Aa was determined (retropectoral part of the axilla) the authors observed that some of the BP's cords lost their identity during the length of the above-mentioned part of the axilla, so, the analysis of these cords and their relationship with the Aa was effected on the beginning of the retropectoral region. It was verified that in 27,42% of the cases, PB's cords surrounded the 2nd part of the Aa positioned according to their names lateral cord (LC), medial cord (MC) and posterior cord (PC) being this the most mentioned disposition in literature. In 16,13% of the cases, it was observed that MC and PC were disposed posteriorly to the Aa, while LC was situated laterally to the artery. In 3,23 % of the cases, LC and MC were found anteriorly, and PC posteriorly to the Aa; in the same percentage of cases, all the cords were situated laterally to the Aa. Only in 1,62%, MC and PC were situated according to their names, and the LC was anterior to the Aa. The majority of cases in which the cords were present, they disposed themselves differently of what the analyzed literature shows

Analizamos 62 axilas, 32 derechas y 30 izquierdas de cadáveres humanos, con el objetivo de hacer un estudio detallado de las relaciones topográficas de los cordones del plexo braquial (PB) en relación a la 2 parte de la arteria axilar (Aa) (parte retropectoral de la axila). Notamos que algunos cordones del PB pierden su identidad a lo largo de dicha porción, por este motivo, el análisis de ellos fue hecha en el comienzo de la región retropectoral y se limitó a los casos en que se presentaban al mismo tiempo los tres cordones (36 casos, 58%). Se comprobó que en el 27,42% de los casos, los cordones del PB circundaban la 2 parte de la Aa y estaban situados en conformidad con sus nombres lateral (CL), medial (CM) y posterior (CP) siendo ésta la disposición más citada en la literatura. En 16,13% de los casos, se observó el CM y el CP dispuestos posteriormente a la Aa, estando el CL lateral. En 6,46% de los casos, el CP estaba ubicado postero-lateral, el CM estaba posterior y el CL se ubicaba lateralmente a la Aa. En 3,23% de los casos, el CL y el CM estaban situados anteriormente, y el CP posteriormente a la Aa; en el mismo porcentaje todos los cordones del PB estaban ubicados lateralmente a la Aa. Sólo en el 1,62%, fueron encontrados los CM y CP relacionados con la Aa conforme a sus nombres, y el CL ubicado anteriormente a la Aa. En la mayoría de los casos donde los cordones estaban presentes, éstos se ubicaban de modo diferente a como se presenta en la literatura analizada