ABSTRACT Introduction: Improving survival of Acute Lymphoblastic Leukemia (ALL) in adult patients has been a challenge. Despite intensive chemotherapy treatment, overall survival is poor. However, several studies demonstrate that young adult patients have better survival when treated with pediatric-based intensive regimens. Considering these results, We decided to treat newly diagnosed ALL patients according to age and risk factors. The goal of this study was to describe the results of this intensive chemotherapy treatment approach for ALL adult patients diagnosed at our institution. Methods: Fifty-eight ALL patients, diagnosed from 2004 to 2013, were included in the analysis. Patients were assigned to either the St. Jude Total Therapy XIIIB high-risk arm (St Jude) or the CALGB 8811 (CALGB). The Kaplan-Meier survival curve was used for the survival analyses and the Cox proportional hazard regression, for multivariable analysis. Results: The overall survival was 22.9% at 10 years. The St. Jude improved survival, compared to the CALGB (p = 0.007), with 32.6% vs. 7.4% survival rate at 10 years. However, no survival benefit was found for patients younger than 20 years old (p = 0.32). The multivariable analysis demonstrated that undetectable minimal residual disease (MRD) and hematopoietic stem cell transplantation (HSCT) had beneficial impact on survival (p = 0.0007 and p = 0.004, respectively). Conclusion: ALL is a disease of poor prognosis for adults. The joint effort to standardize treatment and seek solutions is the way to start improving this scenario.

OBJETIVO: Avaliar o estado nutricional e a ingestão alimentar de mulheres adultas sadias durante o ciclo menstrual. MÉTODOS: Quarenta e cinco voluntárias foram acompanhadas durante três meses. A avaliação do estado nutricional foi baseada no índice de massa corporal, porcentagem de gordura e água corporal. Foram aplicados seis registros alimentares para análise da ingestão dos grupos de alimentos, usando como base o guia alimentar da pirâmide. Para a observação do sintoma "desejos alimentares", foram utilizados três "mapas de sintomas diários". RESULTADOS: Os valores médios de índice de massa corporal e de porcentagem de gordura corporal apresentaram-se normais em ambas as fases, entretanto foi observado maior percentual de mulheres com água corporal acima do padrão na fase lútea (77%). O consumo de alimentos do grupo complementar foi maior na fase lútea. Todos os outros grupos de alimentos, com exceção do grupo de carnes, apresentaram consumo inferior às recomendações, em ambas as fases. A intensidade do sintoma "desejos alimentares" foi leve durante o ciclo menstrual, não sendo observada diferença significativa entre as fases. O sintoma "desejos alimentares" associou-se positivamente com o aumento da ingestão do grupo complementar na fase lútea. CONCLUSÃO: O ciclo menstrual influencia o comportamento alimentar e leva à retenção hídrica, na fase lútea, em mulheres adultas sadias.

OBJECTIVE: This study assessed the nutritional status and food intake of healthy young women during the menstrual cycle. METHODS: Forty-five volunteers were followed for three months. Their nutritional status was determined by body mass index, body fat and total body water. Six food recall instruments were used to evaluate food group intake according to the food guide pyramid. Food cravings were detected by three daily symptom charts. RESULTS: The mean body mass index and body fat were normal in both phases; however, there was a higher percentage of women with above-average body water during the luteal phase (77%). The consumption of foods from the complementary group was higher during the luteal phase. The consumption of foods from all other groups during both phases was below the recommended levels, except for meats. Food cravings were mild during the entire menstrual cycle and there were no significant differences between the phases. Food cravings were positively associated with increased intake of foods from the complementary group. CONCLUSION: In healthy women, the menstrual cycle influences food consumption and the luteal phase causes water retention.

Esta pesquisa, realizada com agentes comunitários de saúde (ACS), objetivou: (1) avaliar a saúde mental em ACS; (2) descrever os eventos vitais vivenciados no último ano por ACS; (3) averiguar o nível de ansiedade apresentado por ACS; (4) correlacionar saúde mental, ansiedade e eventos vitais em ACS. Participaram 116 ACS. Instrumentos: questionário sociodemográfico, Questionário de Saúde Geral de Goldberg, Escala de Eventos Vitais, Inventário de Ansiedade Traço-Estado. A maioria dos ACS apresentou grau de ansiedade moderado e saúde mental positiva e relatou ter vivenciado poucos eventos estressantes no último ano, embora a maioria tenha tido problemas de saúde. O fato de estarem presentes níveis de ansiedade, mesmo moderados, sugere uma provável interferência de características específicas da profissão. Entretanto, o fato de a pessoa identificar subjetivamente a ansiedade e classificá-la em um determinado nível pressupõe que esteja usando estratégias de controle, fato esse que auxilia a manter a saúde mental.

The scope of this research, carried out together with community-based health workers (ACS) was: (1) to evaluate the mental health of the ACS; (2) to describe the vital events in the last year of the ACS; (3) to inquire about the level of anxiety of the ACS; (4) to correlate mental health, vital events and anxiety of the ACS. Participants: 116 ACS. Measurements: socio-demographic questionnaire, Goldberg General Health Questionnaire, The Life Events Inventory, State-Trait Anxiety Inventory. The majority of the ACS presented a moderate degree of anxiety and positive mental health; they reported having experienced few stressful events in the past year, even though the majority had experienced health problems. The fact that most of the ACS reported having experienced moderate anxiety levels suggests a probable interference of specific characteristics of the profession. However, the fact that the persons subjectively identified the presence of anxiety and classified it at a given level presupposes that they are using control strategies, which is a factor that assists in maintaining mental health.

Esta pesquisa, realizada com agentes comunitários de saúde (ACS), objetivou: (1) avaliar a saúde mental em ACS; (2) descrever os eventos vitais vivenciados no último ano por ACS; (3) averiguar o nível de ansiedade apresentado por ACS; (4) correlacionar saúde mental, ansiedade e eventos vitais em ACS. Participaram 116 ACS. Instrumentos: questionário sociodemográfico, Questionário de Saúde Geral de Goldberg, Escala de Eventos Vitais, Inventário de Ansiedade Traço-Estado. A maioria dos ACS apresentou grau de ansiedade moderado e saúde mental positiva e relatou ter vivenciado poucos eventos estressantes no último ano, embora a maioria tenha tido problemas de saúde. O fato de estarem presentes níveis de ansiedade, mesmo moderados, sugere uma provável interferência de características específicas da profissão. Entretanto, o fato de a pessoa identificar subjetivamente a ansiedade e classificá-la em um determinado nível pressupõe que esteja usando estratégias de controle, fato esse que auxilia a manter a saúde mental.

The scope of this research, carried out together with community-based health workers (ACS) was: (1) to evaluate the mental health of the ACS; (2) to describe the vital events in the last year of the ACS; (3) to inquire about the level of anxiety of the ACS; (4) to correlate mental health, vital events and anxiety of the ACS. Participants: 116 ACS. Measurements: socio-demographic questionnaire, Goldberg General Health Questionnaire, The Life Events Inventory, State-Trait Anxiety Inventory. The majority of the ACS presented a moderate degree of anxiety and positive mental health; they reported having experienced few stressful events in the past year, even though the majority had experienced health problems. The fact that most of the ACS reported having experienced moderate anxiety levels suggests a probable interference of specific characteristics of the profession. However, the fact that the persons subjectively identified the presence of anxiety and classified it at a given level presupposes that they are using control strategies, which is a factor that assists in maintaining mental health.