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Biomedical subjects

F Cortez

Publications and source records attributed to F Cortez.

7 recordsLinked to original sources
PubMed1999

Surgical treatment of lung metastases: prognostic factors for long-term survival.

BACKGROUND AND OBJECTIVES: Surgical resection of lung metastases is an established therapy for a large number of primary tumors, but there is some controversy about prognostic factors for long-term survival. METHODS: From 1968 to 1996, we performed a retrospective review of a series of 85 patients (100 operations) that have been operated for resection of lung metastases. The Kaplan-Meier method was used to estimate the probabilities of survival, the log-rank test for the univariate analysis of prognostic factors for survival, and the Cox model in the subsequent multivariate analysis. RESULTS: The operative mortality was 4% and the morbidity 18%. The mean follow-up after lung resection was 22.13 months (1-146). The actuarial 5-year survival rate was 29.2%. By univariate analysis, the following factors were associated with survival after resection: location and histology of the primary tumor, greatest dimension of the largest metastasis, radicality of the resection, involvement of the resection margins, and use of adjuvant therapy (P < 0.05). After multivariate analysis, only the dimension of the metastases and involvement of surgical margins have been found to be independently associated with survival. CONCLUSIONS: Surgical excision is a safe and effective therapy for lung metastases from a large number of primary tumors, provided a complete resection is feasible.

Adolescent↗
PubMed1995

Mucinous carcinoma of the breast: a pathologic study of 82 cases.

A series of 82 consecutive cases of mucinous carcinomas of the female breast was investigated for their clinical, morphological, and histochemical features and for the influence of some tumor characteristics on its prognosis. Two groups, a "pure" subtype (n = 58) and a "mixed" subtype (n = 24), were considered, according to the absence or the presence of concomitant areas with typical infiltrating ductal carcinoma. Eighty patients were followed with an average of 7.4 years. The actuarial survival was 58.5% at 10 years. The group of pure mucinous carcinomas showed a statistically significant better prognosis (P = 0.0007) than that of the group of mixed tumors, as well as a lower percentage of axillary nodal metastasis. Tumor dimension of both pure and mixed mucinous carcinomas influenced the prognosis, since patients with T1 tumors had longer survival than those with T2 tumors (P = 0.05) and the latter showed less mortality than T3 tumor cases (P = 0.036). Node-negative patients also had a more favorable outcome with lower mortality than node positive patients (P = 0.007). None of the T1 pure mucinous carcinomas had axillary metastasis, which may have implications for the surgical protocols. The evaluation of quantitative and qualitative content in mucosubstances did not correlate with the prognosis. However, sulfomucins were demonstrated in 30.5% of cases; this fact points to add breast carcinoma to the group of neoplasms that may present as a metastatic sulfomucin-producing adenocarcinoma.

Actuarial Analysis↗
PubMed1991

QA systems must balance functionality with data security.

Confidentiality of patient records has been a critical focus of automated clinical systems since their inception. The added dimension of quality assurance studies, however, greatly broadens the area of confidentiality and liability, heightening security concerns for quality-assurance professionals.

Confidentiality↗
PubMedDate not supplied

Quality assurance system must balance functionality with data security.

The evaluation and selection of a QA system should include scrutiny of its security mechanisms. When the system is implemented, evaluate access by all users, establish security policies, and, most importantly, enforce them. Security features should not overburden the system to the point that it becomes cumbersome. As many security features as possible should be inherent in its day-to-day operations. After all, automation is intended to provide access to clinical and financial information easily and quickly. QA professionals must weigh security issues against the need for patient and physician-specific performance information. Finally, include medical staff in the early stages of system implementation so they are aware of the security precautions you have taken. They will be assured that you are protecting confidential information while meeting the needs of both the medical staff and the quality management team.

Confidentiality↗