Characterization of occupational exposure to pesticides and its impact on the health of rural women

Objective: To characterize the profile of occupational exposure to pesticides and its impact on women's health. Method: This is a prospective and descriptive study with a quantitative approach. The study population included all patients attended at Francisco Beltrao Cancer Hospital (Ceonc) from May 2015 to December 2018 (n=315). The characterization of their exposure profile was obtained through an interview using a form applied by trained researchers contained 60 questions related to women's pesticide exposure and their health status. The questions referred to past and current occupational pesticide exposure profile, intoxication, and health history from women and their families. All collected data were analyzed in the Statistical Package for the Social Sciences package (SPSS 25.0). Results: A total of 265 individuals (84.2%) have lived some part of their life in the countryside, and 70% were categorized as occupationally exposed to pesticides. Most of them (57%) were directly exposed, mainly by washing pesticide-contaminated clothes and personal protective equipment used in pesticide pulverization without glove protection. Cancer cases in the family were the main disease reported (68.3%). Further, 57% of interviewed women had a breast cancer diagnosis but no significance between breast cancer occurrence and pesticide exposure was observed. Conclusion: The form allowed us to characterize the profile of occupational pesticide exposition in rural women, alerting them to their severe contamination. This approach can be useful to characterize the occupational exposure profiles of rural workers living in other rural regions of Brazil that use pesticides.

Carcinoma de Células de Merkel Metastático: Relato de Caso / Metastatic Merkel cell Carcinoma: Case Report / Carcinoma de Células de Merkel Metastásico: Relato de Caso

Introdução: O carcinoma de células de Merkel é um raro tumor neuroendócrino cutâneo, que se origina das células responsáveis pela sensibilidade tátil, possui caráter agressivo, evolução rápida e difícil tratamento. Relato do caso: Paciente do sexo masculino, 49 anos, caucasiano, que, ao atendimento dermatológico, apresentou nódulo indolor, infiltrando tecidos profundos, não ulcerado e localizado na região do braço esquerdo. O resultado da biópsia incisional foi positivo para carcinoma de células de Merkel. Após ressecção da lesão, os exames complementares evidenciaram doença metastática na axila e parede torácica. Com o tratamento quimioterápico, houve um benefício inicial com redução tumoral, porém, não durável, uma vez que foram reveladas novas áreas com metástases tumorais em regiões superiores do corpo, sendo submetido a novo procedimento cirúrgico, o qual, após novo regime quimioterápico, não obteve sucesso. Conclusão: Na ocasião do tratamento desse paciente, os anticorpos monoclonais, como o avelumab, não estavam disponíveis. O diagnóstico precoce com cirurgia de exérese da lesão imediata, antes do acometimento de outras regiões, permanece sendo a melhor opção para um prognóstico favorável ao paciente. Contudo, a despeito disso, com as limitações à época do tratamento, o paciente evoluiu a óbito.

Introduction: The Merkel cell carcinoma is a rare cutaneous neuroendocrine tumor that originates from cells responsible for tactile sensitivity, it has an aggressive character, fast evolution and difficult treatment. Case report: 49 years Caucasian male patient, with a painless nodule, infiltrating deep tissue, not ulcerated and located in left arm identified during the dermatological consultation. The result of the incisional biopsy was positive for Merkel cell carcinoma. After resection of the lesion, complementary exams revealed metastatic disease in the axilla and chest wall. The chemotherapy treatment brought an initial improvement with tumor reduction, however, it was not durable, because new areas with tumor metastases in upper regions of the body were revealed, the patient was submitted to an another surgical procedure, after which a new chemotherapy regimen failed. Conclusion:At the time of the treatment of this patient, monoclonal antibodies, such as avelumab, were not available. Early diagnosis with immediate lesion excision surgery, before the involvement of other regions, remains the best option for a better prognosis. However, regardless of this, because of the limitations at the time of the treatment, the patient died.

Introducción: El carcinoma de células de Merkel es un tumor neuroendocrino cutáneo raro, que se origina en células responsables de la sensibilidad táctil, tiene un carácter agresivo, una evolución rápida y un tratamiento difícil. Relato del caso: Paciente masculino, de 49 años, caucásico, que en atención dermatológica encontró nódulo indoloro, infiltrando tejidos profundos, no ulcerados y ubicados en la región del brazo izquierdo. El resultado de la biopsia incisional fue positivo para el carcinoma de células de Merkel. Después de la resección de la lesión, los exámenes complementarios mostraron enfermedad metastásica en la axila y la pared torácica. Con el tratamiento de quimioterapia, hubo un beneficio inicial con la reducción del tumor, sin embargo, no es duradero, ya que se revelaron nuevas áreas con metástasis tumorales en las regiones superiores del cuerpo, que se sometieron a un nuevo procedimiento quirúrgico, que después de un nuevo régimen de quimioterapia no tuvo éxito. Conclusión: En el momento del tratamiento de este paciente, los anticuerpos monoclonales, como avelumab, no estaban disponibles. El diagnóstico temprano con cirugía para la escisión de la lesión inmediata, antes de la participación de otras regiones, sigue siendo la mejor opción para un pronóstico favorable para el paciente. Sin embargo, a pesar de esto, con las limitaciones al momento del tratamiento, el paciente falleció.

Hereditary Breast and Ovarian Cancer Screening Syndrome Profile in Women Diagnosed with Breast Cancer from Paraná State Southwest / Perfil do rastreamento da síndrome hereditária de câncer de mama e ovário em mulheres diagnosticadas com câncer de mama na região sudoeste do Paraná

Abstract Objective This study evaluated the risk of the hereditary breast and ovarian cancer (HBOC) syndrome in patients with breast cancer by using the Family History Screening 7 (FHS-7) tool, a validated low-cost questionnaire with high sensitivity able to screen the HBOC risk in the population. Methods Women diagnosed with breast cancer (n=101) assisted by the Unified Health System at the 8th Regional Health Municipal Office of the state of Paraná answered the FHS-7, and the results were analyzed using IBM SPSS Statistics for Windows, Version 25.0. software (IBM Corp., Armonk, NY, USA). Results The risk of HBOC was 19.80% (n=20). Patients at risk exhibited aggressive tumor characteristics, such as high-grade tumors (30%), presence of angiolymphatic emboli (35%), and premenopausal at diagnosis (50%). Significant associations between the prevalence of high-grade tumors were observed inwomen younger than 50 years at diagnosis with HBOC (p=0.003). Conclusion Our findings suggest a possible family inheritance associated with worse clinical features in women with breast cancer in this population, indicating that HBOC investigation can be initially performed with low-cost instruments such as FHS-7.

Resumo Objetivo Este estudo avaliou o risco da síndrome hereditária de câncer de mama e ovário (HBOC, na sigla em inglês) em pacientes com câncer de mama utilizando a ferramenta Familial History Screening 7 (FHS-7), um questionário validado de baixo custo e com alta sensibilidade capaz de rastrear o risco de HBOC na população. Métodos Mulheres diagnosticadas com câncer de mama (n=101) assistidas pelo Sistema Único de Saúde da 8ª Regional de Saúde do estado do Paraná responderam ao questionário FHS-7, e os resultados foram analisados pelo software IBM SPSS for Windows, Version 25.0. (IBM Corp., Armonk, NY, EUA). Resultados A ocorrência do risco de HBOC foi de 19,80% (n=20). Pacientes em risco exibiram características agressivas do tumor como tumores de alto grau (30%), presença de êmbolos angiolinfáticos (35%) e pré-menopausa ao diagnóstico (50%). Associações significantes foram observadas entre a prevalência de tumores de alto grau e diagnóstico abaixo de 50 anos no grupo HBOC (p=0.003). Conclusão Nossos achados sugerem uma possível herança familiar associada a piores características clínicas em mulheres com câncer de mama nessa população, indicando que a investigação de HBOC pode ser realizada, inicialmente, com instrumentos de baixo custo, como o FHS-7.

COVID-19 in patients with obesity: clinicopathological features and immunological mechanisms associated with adverse clinical outcome / COVID-19 em pacientes com obesidade: características clínico-patológicas e mecanismos imunológicos associados a desfechos clínicos desfavoráveis / COVID-19 en pacientes con obesidad: características clínico-patológicas y mecanismos inmunológicos asociados con resultados clínicos adversos

Justificativa e Objetivos: A infecção pelo novo coronavírus (Sars-CoV-2), causador da COVID-19, ocorre de forma mais grave em pacientes que apresentam fatores de risco, entre os quais se destaca a obesidade, o que os torna mais suscetíveis à ventilação mecânica e à mortalidade. Neste contexto, este trabalho revisa a epidemiologia da obesidade e os possíveis mecanismos imunológicos que fazem dela um dos piores cenários clínicos para a COVID-19. Métodos: Este estudo é uma revisão bibliográfica narrativa de caráter exploratório em que, na coleta de dados, consideraram-se, entre as publicações científicas do tema estudado, artigos publicados nas bases eletrônicas PubMed e Biblioteca Virtual em Saúde (BVS) em inglês, espanhol e português, no período de junho de 2015 a junho de 2020. Os descritores adotados foram: "Sars-CoV-2", "Obesity", "COVID-19" e "Risk Factors". Conteúdo: A obesidade é uma pandemia e sua condição inflamatória crônica é fator de risco para diversas patologias, incluindo pior desfecho em infecções respiratórias virais. A análise imunológica desse estado e seu respectivo papel na imunopatologia do Sars-CoV-2 revelam uma resposta pró-inflamatória desregulada, com acentuado aumento de diversas citocinas, como TNF-α, IL-6 e IL-1ß. Tais mecanismos geram um grande fluxo de citocinas, com consequente piora da resposta imune à infecção pelo novo coronavírus, o que tem sido associado à forma grave da doença. Conclusão: A obesidade é um fator de risco global relevante para a infecção do Sars-CoV-2, pois desregula a resposta imune pró-inflamatória, causando pior desfecho clínico, o que merece atenção especial por parte das políticas de combate à pandemia.(AU)

Background and objectives: The infection with the new coronavirus (SARS-CoV-2), which causes COVID-19, is more severe in patients with risk factors, increasing these patients' susceptibility to mechanical ventilation and mortality, among them, obesity stands out. This study reviews the epidemiology of obesity and the possible immunological mechanisms that make it one of the worst clinical scenarios in COVID-19. Methods: This study consists of an exploratory narrative review. Data collection considered articles in English, Spanish and Portuguese, published between June 2015 and June 2020, in the electronic databases PubMed and Virtual Health Library (BVS). The indexing terms used were "SARS-CoV-2," "Obesity," "COVID-19," "Risk Factors." Content: Obesity is a pandemic and its chronic inflammatory condition is a risk factor for several pathologies, including worse outcome in viral respiratory infections. The immunological analysis of this risk factor and its role in the immunopathology of SARS-CoV-2 reveals a deregulated pro-inflammatory response, with a marked increase in several cytokines, such as TNF-α, IL-6 and IL-1ß. Such mechanisms result in a cytokine storm, with a consequent deterioration of the immune response for the new coronavirus infection that have been linked to the severe form of disease. Conclusion: Obesity is a global relevant risk factor for SARS-CoV-2 infection because it disrupts the pro-inflammatory immune response, resulting in a worse clinical outcome, which deserves special attention in the fight against the pandemic.(AU)

Justificación y Objetivos: La infección por el SARS-CoV-2, causante de la COVID-19, se presenta de forma más grave en pacientes portadores de factores de riesgo, entre los cuales se destaca la obesidad, que los predispone a la ventilación mecánica y la mortalidad. En este contexto, el presente trabajo revisa la epidemiología de la obesidad y los posibles mecanismos inmunológicos que asocian la obesidad como uno de los peores escenarios clínicos en la COVID-19. Métodos: Este estudio consiste en una revisión bibliográfica narrativa de carácter exploratorio. En la recolección de datos, se consideraron, entre las publicaciones científicas del tema estudiado, artículos publicados en los idiomas inglés, español y portugués en el periodo de junio de 2015 a junio de 2020, en las bases electrónicas PubMed y Biblioteca Virtual de Salud (BVS). Los descriptores adoptados fueron: "SARS-CoV-2", "Obesity", "COVID-19", "Risk Factors". Contenido: La obesidad es una pandemia y su condición inflamatoria crónica es un factor de riesgo para diversas patologías, que incluye un peor desenlace en infecciones respiratorias virales. El análisis inmunológico de ese estado y su respectivo papel en la inmunopatología del SARS-CoV-2 revela una respuesta proinflamatoria desregulada, con acentuado aumento de diversas citocinas, como TNF-α, IL-6 e IL-1ß. Tal mecanismo tiene como resultado un gran flujo de citocinas, con el consecuente empeoramiento de la respuesta inmune frente a la infección por el nuevo coronavirus, lo que se ha relacionado con la forma grave de la enfermedad. Conclusión: La obesidad configura un factor de riesgo relevante global para la infección del SARS-CoV-2 por proporcionar la desregulación de la respuesta inmune proinflamatoria que resulta en un peor desenlace clínico y merece una atención especial por parte de las políticas para combatir la pandemia.(AU)

Programa Cuide-se Mais: impacto na prevenção e rastreamento do câncer no Paraná / Take More Care Program: impact on cancer prevention and tracking in Paraná

O aumento da incidência de câncer na população brasileira alerta para a necessidade de implantação de medidas de rastreamento baseadas na busca ativa de novos casos. Neste sentido, o presente trabalho avaliou o impacto de um programa itinerante de rastreamento dos cânceres de mama, colo de útero, próstata e pele realizado pelo Serviço Social da Indústria (Sesi) no período de 1 ano, em 22 municípios do estado do Paraná. O estudo é descritivo, com banco de dados secundários e abordagem quantitativa, referente ao programa Cuide-se Mais do Sesi Paraná. Através de uma unidade móvel, foram realizadas análises da superfície da pele, coleta de Papanicolau em mulheres de 25 a 69 anos, mamografia em mulheres com idade entre 40 e 69 anos e dosagem de Antígeno Prostático Específico (PSA) em homens de 45 a 69 anos de 22 municípios do Paraná. Foram atendidos 4679 trabalhadores paranaenses em 202 empresas, realizadas 4120 palestras de orientações e 1346 oficinas de prevenção. As lesões avaliadas em pele suspeitas para câncer corresponderam a 3,4% do total de 3054 exames. Foram realizadas 873 mamografias, e encaminhados 11 casos de lesões suspeitas no exame de Papanicolau de um total de 2073 coletas. O PSA esteve alterado em 8 homens de um total de 1308 exames. A instalação da unidade móvel dentro da empresa quebra duas barreiras de impedimento dos trabalhadores realizarem seus exames preventivos: a sociocultural e a institucional. Desta forma, programas e ações de rastreamento do câncer podem contribuir para o diagnóstico precoce desta patologia, especialmente na população em idade economicamente produtiva.(AU)

The increased incidence of cancer in the Brazilian population urges the need of implementing screening measures based on the active search for new cases. In this sense, the present work presents the results of the Take More Care disease-screening program. With a mobile unit, analyzes of the skin surface, Pap smear collection in women aged 25 to 69 years, mammography in women aged 40 to 69 years and specific prostatic antigen (SPA) in men aged 45 to 69 were performed in 22 municipalities of Paraná state. 4679 workers from Paraná were attended in 202 companies, 4120 orientation lectures and 1346 prevention workshops were given. Suspected skin lesions for skin cancer corresponded to 3.4% from 3054 skin assessment tests. 873 mammograms were performed, and 11 cases of suspected lesions were referred to the Pap smear, from 2073 collections. The SPA was altered in 8 men, in a total of 1308 tests performed. The installation of the mobile unit inside the company breaks two barriers preventing workers from carrying out their preventive exams: the sociocultural and the institutional. Thus, cancer screening programs and actions can contribute to the early diagnosis of this pathology, especially in the population of economically productive age.(AU)

Critical review of cancer mortality using hospital records and potential years of life lost / Revisão crítica da mortalidade por câncer usando registros hospitalares e anos potenciais de vida perdidos

ABSTRACT Objective To determine and discuss cancer mortality rates in southern Brazil between 1988 and 2012. Methods This was a critical review of literature based on analysis of data concerning incidence and mortality of prostate cancer, breast cancer, bronchial and lung cancer, and uterine and ovarian cancer. Data were collected from the online database of the Brazil Instituto Nacional de Câncer José Alencar Gomes da Silva. Results The southern Brazil is the leading region of cancer incidence and mortality. Data on the cancer profile of this population are scarce especially in the States of Santa Catarina and Paraná. We observed inconsistency between data from hospital registers and death recorded. Conclusion Both cancer incidence and the mortality are high in Brazil. In addition, Brazil has great numbers of registers and deaths for cancer compared to worldwide rates. Regional risk factors might explain the high cancer rates.

RESUMO Objetivo Investigar e discutir os indicadores de mortalidade por câncer na Região Sul do Brasil entre 1988 e 2012. Métodos Revisão crítica da literatura baseada na análise de dados referentes às estimativas de incidência e mortalidade dos cânceres de próstata, mama feminina, brônquios e pulmões, colo de útero e ovário, realizada por meio de consulta na base de dados online do Instituto Nacional de Câncer José Alencar Gomes da Silva. Resultados A Região Sul lidera no país a incidência e a mortalidade das neoplasias estudadas. Há escassez de dados sobre o perfil do câncer nesta população, especialmente nos Estados de Santa Catarina e Paraná. Notou-se, ainda, incoerência entre os dados de registros hospitalares e registros de óbito no período estudado. Conclusão Tanto a incidência quanto a mortalidade decorrentes dos cânceres estudados ainda são muito elevadas no Brasil, com significante número de registros da doença e de óbitos, quando comparado às taxas mundiais. Fatores de risco regionais podem explicar as elevadas taxas.

Sodium nitroprusside has leishmanicidal activity independent of iNOS

Abstract: INTRODUCTION: Leishmaniasis is a zoonotic disease caused by protozoa of the genus Leishmania . Cutaneous leishmaniasis is the most common form, with millions of new cases worldwide each year. Treatments are ineffective due to the toxicity of existing drugs and the resistance acquired by certain strains of the parasite. METHODS: We evaluated the activity of sodium nitroprusside in macrophages infected with Leishmania (Leishmania) amazonensis . Phagocytic and microbicidal activity were evaluated by phagocytosis assay and promastigote recovery, respectively, while cytokine production and nitrite levels were determined by ELISA and by the Griess method. Levels of iNOS and 3-nitrotyrosine were measured by immunocytochemistry. RESULTS: Sodium nitroprusside exhibited in vitro antileishmanial activity at both concentrations tested, reducing the number of amastigotes and recovered promastigotes in macrophages infected with L. amazonensis . At 1.5µg/mL, sodium nitroprusside stimulated levels of TNF-α and nitric oxide, but not IFN-γ. The compound also increased levels of 3-nitrotyrosine, but not expression of iNOS, suggesting that the drug acts as an exogenous source of nitric oxide. CONCLUSIONS: Sodium nitroprusside enhances microbicidal activity in Leishmania -infected macrophages by boosting nitric oxide and 3-nitrotyrosine.

Role of leptin in the pathogenesis of breast cancer / Papel da leptina na patogênese do câncer de mama

A leptina é um pequeno polipeptídeo codificado pelo gene OB, profundamente relacionado com a massa de gordura corporal e o balanço energético. Devido aos seus diversos efeitos biológicos e transdutores de sinal regulados, múltiplas classificações biológicas tem sido atribuídas à leptina, incluindo hormônio,citocina, adipocina, fator de crescimento, e fator de desenvolvimento, dentre outros. Este cenário nos dá uma idéia do tamanho do potencial de efeitos biológicos gerados por esta molécula. A concentração de leptina no corpo é determinada pela quantidade de tecido adiposo; portanto, hiperleptinemia é um achado comum em indivíduos obesos. Além disso, níveis elevados de leptina circulante pode conferirum pior prognóstico para qualquer condição patológica. Apesar da história da leptina ter sido reportada por mais de 20 anos, sua relação com o câncer ganhou notoriedade nos últimos 10 anos, quando estudos focaram e discutiram o papel da obesidade com um forte fator de risco para o desenvolvimento de câncer.Adicionalmente, evidências crescentes apontam a leptina como mediador primordial da resposta imune, oque agrava o cenário da ocorrência de câncer na presença de obesidade. Assim, a leptina pode apresentar pelo menos duas faces na patogênese do câncer, agindo através de mecanismos imunológicos e não imunológicos.Neste trabalho, revisamos a dinâmica do eixo leptina no câncer de mama e discutimos seu papel na doença, imunopatogênese e prognóstico.

Leptin is a small polypeptide codified by the Obese Gene (OB), deeply related with the body fat massand energetic balance. Due to its diverse biological effects and downstream signal transducers, multipleclassifications have been attributed to leptin, as hormone, cytokine, adypokine, growth factor, anddevelopmental factor, among others. This scenario gives us an idea of the size of the potential biological effects generated by this molecule. The concentration of leptin in the body is determined by the amountof adipose tissue; the refore, hyperleptinemia is a common finding in obese individuals. In addition, highlevels of circulating leptin may confer a poor prognosis for any pathological condition. Although leptin history has been reported for more than 20 years, its relationship with cancer has gained notoriety in the past ten years, where studies focused on discussing the issue of obesity as a strong risk factor for cancer developing. Further, growing evidences have pointed leptin as a pivotal mediator of immune response, which aggravates the scenario of cancer occurrence in the presence of obesity. Therefore, leptin can present at least two faces in the pathogenesis of breast cancer, acting by immune and non-immune mechanisms. In this paper we review the dynamic of the leptin axis in breast cancer and further discussits role in disease, immunopathogenesis and prognosis.

Chronic psychological stress and its impact on the development of aggressive breast cancer / Estresse psicológico crônico e seu impacto no desenvolvimento de neoplasia mamária agressiva

Objective To investigate the clinicopathological findings of women diagnosed with breast cancer and study the impact of chronic psychological stress on the pathological characteristics of these tumors.Methods We investigated a cohort composed of women diagnosed with breast cancer and divided into two groups. One group was categorized as presenting with chronic psychological stress (by using the Self-Reporting Questionnaire − SRQ-20). Another group of women with breast cancer, but with no previous history of chronic psychological stress, comprised the Control Group. Clinical and pathological data were assessed.Results Women presenting with a history of chronic distress were significantly overweight when compared to the Control Group. Furthermore, it was observed that these stressed women also had a significant percentage of aggressive breast cancer subtype, the HER2 amplified tumor, which could be putatively associated with the loss of immunosurveillance.Conclusion Our findings suggested an interaction among chronic psychological stress, overweight, and the development of more aggressive breast tumors.

Objetivo Investigar os achados clínico-patológicos de mulheres diagnosticadas com câncer de mama e estudar o impacto do estresse psicológico crônico nas características patológicas desses tumores.Métodos Investigamos uma coorte composta por mulheres diagnosticadas com câncer de mama divididas em dois grupos. O primeiro foi classificado pela apresentação de estresse psicológico crônico (por meio do Self-Reporting Questionnaire− SRQ-20). Outro grupo de mulheres com câncer de mama, mas sem história prévia de estresse psicológico crônico, foi denominado Grupo Controle. Os dados clínicos e patológicos foram avaliados.Resultados As mulheres com histórico de estresse crônico apresentaram-se significativamente acima do peso quando comparadas com o Grupo Controle. Além disso, verificou-se que estas mulheres estressadas apresentaram um porcentual significativo de um subtipo de câncer de mama agressivo, o HER2, o que poderia estar associado à possível perda da imunovigilância.Conclusão Nossos resultados sugeriram uma ligação entre o estresse psicológico crônico, o excesso de peso e o desenvolvimento de tumores de mama com maior agressividade.

Smoking as a risk factor for the development of breast cancer

INTRODUCTION: Smoking is considered a public health problem and in many cases is responsible for the development of lung diseases and cancer. One of the mechanisms by which tobacco can induce cancer is through the generation of free radicals, establishing an oxidative stress status in smokers. With increasing smoking among women, much evidence in the literature has shown a relation between smoking and breast cancer development. OBJECTIVE: The aim of this review was to analyze the available studies in literature that demonstrate the association between smoking and the risk of breast cancer development. METHODS: We performed a review from the literature based on the search results in PubMed and Scielo. The selected works were composed by current articles according to their relevance and human application. RESULTS: The literature revealed several published studies linking smoking to oxidative stress through the action of free radicals that are generated by toxic compounds found in cigarettes. There are few studies relating smoking with breast cancer, which is a relatively more recent research line, where the vast majority of works includes epidemiological and controversial studies. CONCLUSIONS: The selected works show that, although controversial, smoking is considered a risk factor for developing breast cancer.

Aspects related to oxidative stress-mediated toxicity of doxorubicin during chemotherapy treatment

OBJECTIVE: This study aimed to describe the main toxic effects mediated by oxidative stress associated with treatment with doxorubicin in scientific research articles available in the literature. MATERIAL AND METHODS: This study employed a descriptive review methodology applied to the literature. For the theoretical scientific background, we used the electronic PubMed search engines. CONCLUSION: The toxicity of chemotherapy treatment with doxorubicin causes damage in various organs of patients who are in uninterrupted treatment with this antineoplastic agent. Anthracycline-induced cardiotoxicity has been investigated to a great degree and is especially indicated as the principal side effect. Therefore, care needs to be given to other damage caused by this medication as important as myocardial toxicity, such as renal, pulmonary and liver toxicity, among others. There is a need for further studies to prevent or even encounter a way to control the damage caused by these toxicities in various tissues.

Breast cancer and oxidative stress in chemotherapy

Objective: This revision characterizes the biomarkers used for analysis of the development of oxidative stress produced during breast cancer chemotherapy. Materials and methods: A search of articles indexed in digital databases (Lilacs, Bireme, PubMed, Scielo and digital libraries), along with publications printed as books, periodicals and articles not available online, in the period from 1979 to 2009. Conclusion: Reactive oxygen and nitrogen species are produced, principally, during aerobic metabolism; however, its synthesis can be exacerbated or antioxidant defense reduced or more usually, both conditions can occurr in many pathophysiologic situations, leading to a net reactive species yelded. This unbalance is defined as oxidative stress. Stress biomarkers can be defined as predictive indicators able to detect in vivo oxidative damage and can be subdivided into antioxidant and pro-oxidants. To verify the antioxidant system, it is possible to analyze the superoxide dismutase enzymes, catalase and glutathione, along with vitamins A, E, C and glutathione among others. The analysis of pro-oxidants can be made through the verification of protein nitration and oxidation, heat shock proteins, lipoperoxidation, formation of aldehydes for malondialdehyde tests, 4-hydroxynonenal, oxidized LDL and isoprostanes or for chemiluminescent techniques. Advances in cancer detection through the identification of potential biomarkers consist of a promising strategy for the prevention and early identification of this pathology.