von Willebrand factor (vWF) is a protein that mediates platelet adherence to the subendothelium during primary hemostasis. High plasma vWF concentrations have been reported in patients with various types of cancer, such as head and neck, laryngeal and prostatic cancer, probably representing an acute phase reactant. In the present study we determined the plasma levels of vWF antigen (vWF:Ag) by quantitative immunoelectrophoresis in 128 female patients with breast cancer as well as in 47 women with benign breast disease and in 27 healthy female controls. The levels of vWF:Ag were 170.7 ± 78 U/dl in patients with cancer, 148.4 ± 59 U/dl in patients with benign disease and 130.6 ± 45 U/dl in controls (P<0.005). We also detected a significant increase in the levels of vWF:Ag (P<0.0001) in patients with advanced stages of the disease (stage IV = 263.3 ± 113 U/dl, stage IIIB = 194.0 ± 44 U/dl) as compared to those with earlier stages of the disease (stage I = 155.3 ± 65 U/dl, stage IIA = 146.9 ± 75 U/dl). In conclusion, vWF levels were increased in plasma of patients with malignant breast disease, and these levels correlated with tumor progression.

OBJETIVO: Avaliar a associação entre o resultado do teste CAGE aplicado em pacientes internados num hospital geral universitário (Hospital de Clínicas de Porto Alegre - HCPA) e a percepção e registro de abuso de álcool e de doenças relacionadas pelas equipes de saúde. PACIENTES E MÉTODOS: O delineamento envolveu três fases: a) aplicação do teste CAGE aos 385 pacientes adultos e adolescentes internados considerados elegíveis para o estudo; b) revisão dos prontuários dos pacientes CAGE-positivo e de um número igual de pacientes CAGE-negativo, estratificados por área de internação e sorteados, para identificar hábitos alcoólicos e a presença de doenças relacionadas ao uso de álcool; c) entrevista com os membros das equipes médicas responsáveis para avaliar sua percepção sobre o hábito alcoólico em seu paciente. As diferenças encontradas foram analisadas através do teste Qui-quadrado e do teste t de Student, com significância estatística em nível de 5% bicaudal. RESULTADOS: Foram encontrados 51 pacientes CAGE-positivo (13%). A equipe médica registrou abuso de álcool no prontuário de 51% dos pacientes CAGE-positivo e 10% dos CAGE-negativo, e a equipe de enfermagem fez este registro no prontuário de 31% dos pacientes CAGE-positivo e 8% dos CAGE-negativo (p=.724). Não houve diferença entre o registro e a percepção da equipe médica (p=.184). A prevalência de doenças relacionadas ao abuso de álcool foi 27% quando se examinou os prontuários médicos e 26% quando se entrevistou a equipe médica (p=.861), sendo maior entre os pacientes CAGE-positivo (43%) do que entre os CAGE-negativo (10%) (p=.0003). CONCLUSÕES: O abuso de bebidas alcoólicas e a presença de doenças associadas ao mesmo são condições prevalentes nos pacientes admitidos ao HCPA. Entretanto, mais de metade dos casos não foram detectados pela equipe de saúde, havendo correspondência entre os registros de prontuário e a entrevista.

BACKGROUND: The high frequency of alcohol related problems highlights the importance of its approach. The association of both the alcohol-abuse and alcohol related diseases has been pointed in the literature and are often the main reason for hospitalization. Physicians use different tools to detect abusive drinkers, and one of them is the CAGE-test, validated by Mayfield et al. in 1974. OBJECTIVES: To study the association between the result of the CAGE-test and the perception and registration of alcohol abuse by the medical staff and the nurses in charge of inpatients of Hospital de Clínicas de Porto Alegre, southern Brazil. MATERIAL AND METHOD: The design involved three phases. First, the application of the CAGE-test to the 385 eligible patients. Second, review of all 51 CAGE-positive patients' records as well the controlled evaluation of 51 randomized CAGE-negative patients, to seek alcoholic habits and alcohol-related diseases. Third, interview with the medical staff to find out their perception about these subjects. RESULTS: We found 51 patients CAGE-positive (prevalence = 13%). When evaluated through the registration and through a standardized interview, medical staff and nurses were not aware of more than half of CAGE-positive patients. No significant differences were found between medical staff registration and perception; the prevalence of alcohol related diseases was the same for both: 26 and 27% (p = .861). The prevalence of alcohol related diseases was higher among CAGE-positive patients (p = .0003). CONCLUSIONS: In spite of the high prevalence among our patients, alcohol abuse is not pursued by our health teams as it should be. As for the future, there is reason to envision a continuing alcoholism rapprochement.