ABSTRACT
ABSTRACT Background: Diarrhea is frequently seen in autologous stem cell transplantation. Although toxicity related to conditioning is the most common cause, infectious pathogens can play a distinctive role particularly in certain regions and environments. Methods: The role of enteropathogens was investigated in 47 patients submitted to autologous stem cell transplantation at a Brazilian center between May 2011 and May 2013. All patients who presented with diarrhea consented to stool sample analysis to identify the etiological agents including coccidia, Strongyloides sp., Clostridium difficile and other pathogenic bacteria. Results: Thirty-nine patients (83%) had diarrhea, among whom seven (17.5%) presented with coccidia, three (7.5%) with Candida sp., one (2.5%) with C. difficile, and one (2.5%) with Giardia lamblia. There was a tendency toward a higher incidence of diarrhea in older patients (p-value = 0.09) and those who received conditioning with lomustine, etoposide, cytarabine, and melphalan (p-value = 0.083). Furthermore, the number of days of neutropenia was higher in patients with diarrhea (p-value = 0.06). Conclusions: The high frequency of diarrhea caused by coccidia shows the importance of investigating and correctly identifying etiological agents and highlights the possible varieties of intestinal infections in patients who undergo autologous stem cell transplantation.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Coccidia , Stem Cell Transplantation , DiarrheaABSTRACT
O carcinoma de células renais (CCR) é uma causa crescente de morte por câncer. Melhor entendimento da biologia tumoral pode levar a terapias mais eficientes. Estudou-se a sinalização celular originada de EGFR em CCR e o efeito de um inibidor de EGFR (gefitinibe), um inibidor de MAPK (UO126) e um inibidor de mTOR (rapamicina) na fosforilação de intermediários da via de MAPK, em componentes do complexo de início de tradução (CIT) e no crescimento de culturas celulares. UO126 promoveu defosforilação de substratos de mTOR revelando comunicação entre MAPK e CIT. Gefitinibe bloqueou a sinalização entre EGFR e as vias PI3K e MAPK. Rapamicina foi um potente inibidor do crescimento na maioria das linhagens celulares e seu efeito foi frequentemente potencializado por UO126 ou gefitinibe. EGFR, MAPK e CIT são alvos promissores no tratamento do CCR / Summary Renal cell carcinoma (RCC) is a rising cause of cancer death. Better understanding of tumor biology may lead to more efficient therapy based on biological agents. We studied EGFR driven cell signaling in RCC as well as the effect of an EGFR inhibitor (gefitinib) a MAPK inhibitor (UO126) and a mTOR inhibitor (rapamycin) on phosphorylation of MAPK pathway intermediates, translation initiation complex (TIC) components and growth of cell cultures. UO126 caused dephosphorylation of downstream targets of mTOR revealing a cross talk between MAPK and TIC. Gefitinib blocked EGFR signaling though PI3K and MAPK pathways. Rapamycin was found to be a potent growth inhibitor in most cell lines and its effect was often potentiated by UO126 or gefitinib. EGFR, MAPK and TIC are suitable targets...
Subject(s)
Humans , Kidney Neoplasms/pathology , Polymerase Chain Reaction , Protein Biosynthesis , Blotting, Western , Kidney Neoplasms/genetics , SirolimusABSTRACT
OBJETIVO: Avaliar o nível de informação e as atitudes preventivas em uso corrente pelos médicos ligados à FMABC. MÉTODOS: Foram entregues questionários para 120 médicos não oncologistas que lidam diretamente com pacientes adultos. RESULTADOS: A taxa de resposta foi de 58,3 por cento. A idade média dos médicos foi de 33,9 anos, sendo 57,1 por cento mulheres e 10 por cento tabagistas. As práticas preventivas para os cânceres mais comuns (mama, colo de útero, próstata, colorretal e pele não-melanoma) foram analisadas e comparadas com as recomendadas pelos consensos adotados (INCA, Sociedade Americana de Cancerologia e Força-Tarefa Canadense). Observou-se que a maioria das práticas (45,72 por cento a 100 por cento) não se adequou a nenhum deles. Sobre possíveis barreiras para o adequado exercício da prevenção do câncer, 82,86 por cento considerou falta de agentes educadores em saúde para a população, 77,14 por cento poucos conhecimento ou treinamento e 70,15 por cento falta de verba para custear exames. Houve uma tendência ao excesso de pedidos de exames de rastreamento. CONCLUSÕES: As práticas preventivas utilizadas pelos médicos entrevistados são heterogêneas e, em sua maioria, não preconizadas pelos consensos de condutas preventivas consultados, o que pode ser relacionado tanto à sua falta de conhecimento em relação a estes consensos como às divergências entre eles. Dessa forma, faz-se necessário um esforço educativo enfatizando a importância da prevenção do câncer no aprendizado e na prática médica.
Subject(s)
Humans , Male , Female , Adult , Health Knowledge, Attitudes, Practice , Neoplasms/prevention & control , Practice Patterns, Physicians'/standards , Consensus , Mass Screening , Neoplasms/diagnosis , Practice Guidelines as Topic , Surveys and QuestionnairesABSTRACT
CONTEXT: Patients receiving adjuvant chemotherapy for breast cancer have a tendency to gain weight. This tendency has determining factors not completely defined and an unknown prognostic impact. OBJECTIVE: To evaluate weight change during chemotherapy for breast cancer in a defined population and to identify its predisposing factors and possible prognostic significance. DESIGN: Observational, retrospective cohort study. SETTING: Private clinical oncology service. PARTICIPANTS: 106 consecutive patients with breast cancer treated between June 1994 and April 2000, who received neoadjuvant (n = 8), adjuvant (n = 74) or palliative (n = 24) chemotherapy. INTERVETION: Review of medical records and gathering of clinical information, including patientsÆ body weights before treatment and at follow-up reviews. MAIN MEASUREMENTS: Body weight change, expressed as percentage of body weight per month in treatment; role of clinical data in weight change; and influence of weight change in overall survival and disease-free survival. RESULTS: There was a mean increase of 0.50 ± 1.42 percent (p = 0.21) of body weight per month of treatment. We noted a negative correlation between metastatic disease and weight gain (r = -0.447, p < 0.0001). In the adjuvant and neoadjuvant therapy groups there was a mean weight gain of 0.91 ± 1.19 percent (p < 0.00001) per month, whereas in the metastatic (palliative) group, we observed a mean loss of 0.52 ± 1.21 percent (p = 0.11) of body weight per month during the treatment. We did not observe any statistically significant correlation between weight changes and disease-free survival or overall survival. CONCLUSIONS: Women with breast cancer undergoing adjuvant or neoadjuvant chemotherapy gain weight, whereas metastatic cancer patients will probably lose weight during palliative chemotherapy. Further studies are needed in order to evaluate the prognostic significance of weight changes during chemotherapy