OBJECTIVES: To analyze the occurrence and types of neoplasias that have developed in patients submitted to orthotopic heart transplantation in the Cardiac Transplantation Program of the Paulista School of Medicine, Federal University of São Paulo. METHODS: The present study presents an observational analysis of 106 patients submitted to orthotopic heart transplantation from November 1986 to September 2002, who survived for more than 30 days after the procedure. The immunosuppressive regimen consisted of triple therapy with cyclosporin A, azathioprine and corticosteroid. Only two patients received, in addition to triple therapy, the addition of orthoclone OKT-3. The mean follow-up period was 61.4 months. (variation from two months to 192 months). RESULTS: Twenty-three patients (21.3%) developed neoplasias, of which 56.5% had skin neoplasms, 30.1% had solid tumors and 13.4% had post-transplantation lymphoproliferative disease (PTLD). The mean interval between transplantation and the diagnosis of neoplasia was: skin - 54.9 months, solid tumors - 24.8 months and DLPT - 70.3 months. CONCLUSIONS: The occurrence of malignant neoplasms was relatively common in the analyzed population. Skin cancer prevailed in relation to other neoplasms and solid tumors were more diagnosed than lymphoproliferative diseases in this series of patients.
<em>Ember's current storerooms were so dark and their was no natural light.</em> <em>They children's were also frightened because they suspected that the lights may go off and the generator may also fail that would leave them helpless in the dark surroundings of the storerooms.</em>
Through many of the early chapters of Little Women, the March girls make reference to the allegorical Pilgrim’s Progress. Explain how one of the girls, or the family as a whole, relates to the characters and themes. My answer would be the family and meg can not relate becuase they had nothing to do with it.
