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1.
Medisur ; 19(3): 508-517, 2021. graf
Article in Spanish | LILACS | ID: biblio-1287332

ABSTRACT

RESUMEN El pseudotumor orbitario es la tercera causa de oftalmoplejía dolorosa; constituye un desafío diagnóstico pues obliga a descartar enfermedades de etiología muy diversa que lo provocan. Se presenta el caso de una paciente femenina, de color de piel blanca, de procedencia urbana, ama de casa, fumadora, que no practica ejercicios ni lleva dieta, con antecedentes de hipertensión arterial y artritis reumatoidea, que acudió al Servicio de Oftalmología por presentar síntomas inflamatorios anexiales: edema palpebral, quemosis conjuntival, vasos conjuntivales dilatados, que se acompañaban de proptosis, oftalmoplejía dolorosa con diplopía y de una masa tumoral palpable a nivel de la porción supero-externa de la órbita. Se ingresó y se le realizaron estudios imagenológicos e histológicos, que solo aportaron signos inflamatorios y una pansinusitis. Se concluyó como un pseudotumor orbitario en su forma aguda de aparición, asociada a la artritis reumatoidea, cuyo diagnóstico se realizó por exclusión sobre la base de los resultados negativos de los estudios imagenológicos y de la biopsia. Llevó tratamiento con antibióticos parenterales y altas dosis de esteroides orales con regresión del cuadro y mejoría clínica. Se decidió la presentación del caso porque en la provincia no existen reportes sobre esta entidad, y por el énfasis en cómo llegar al diagnóstico y su correcto manejo, evitando con ello secuelas en el órgano visual.


ABSTRACT Orbital pseudotumor is the third cause of painful ophthalmoplegia; it constitutes a diagnostic challenge as it forces us to rule out diseases of very diverse etiology that cause it. A female patient, of white skin color, of urban origin, housewife, smoker, who does not practice exercises or is not on a diet, with a history of high blood pressure and rheumatoid arthritis, who attended the Ophthalmology service for presenting Adnexal inflammatory symptoms: eyelid edema, conjunctival chemosis, dilated conjunctival vessels, which were accompanied by proptosis, painful ophthalmoplegia with diplopia and a palpable tumor mass at the level of the superior-external portion of the orbit was presented. She was admitted and imaging and histological studies were performed, which only revealed inflammatory signs and pansinusitis. It was concluded as an orbital pseudotumor in its acute onset form, associated with rheumatoid arthritis, the diagnosis of which was made by exclusion on the basis of the negative results of imaging studies and biopsy. She was treated with parenteral antibiotics and high doses of oral steroids with regression of the symptoms and clinical improvement. The presentation of the case was decided because in the province there are no reports on this entity, and because of the emphasis on how to reach the diagnosis and its correct management, thereby avoiding effects in the visual organ.


Subject(s)
Humans , Female , Steroids/therapeutic use , Orbital Pseudotumor/therapy , Orbital Pseudotumor/diagnostic imaging , Antibiotics, Antineoplastic/therapeutic use
2.
Braz. arch. biol. technol ; 64: e21190750, 2021. tab, graf
Article in English | LILACS | ID: biblio-1249207

ABSTRACT

Abstract In this paper, the antibacterial activity of triazole functionalized cyclodextrin (CD.Click) and cyclodextrin-triazole-titanium based nanocomposite (CD.COM) was evaluated. The results indicated that CD.Click and CD.COM perform a wide range of antibacterial activity against both gram positive (Staphylococcus aureus and Bacillus subtilis) and gram negative (Escherichia coli and Pseudomonas aeruginosa) bacteria. The cytotoxic effect of CD.COM was investigated in vitro on cancerous cell lines (cervical cancer, breast carcinoma and sarcoma osteogenic) and fibroblast cells by MTT assay. The cell viability evaluation confirmed that the growth of cancerous cells is inhibited in a dose and time dependent way without any significant effect on the normal fibroblast cells.


Subject(s)
Triazoles/chemical synthesis , beta-Cyclodextrins/chemical synthesis , In Vitro Techniques/instrumentation , Antibiotics, Antineoplastic
3.
Arq. bras. cardiol ; 115(5): 885-893, nov. 2020. tab, graf
Article in Portuguese | LILACS, SES-SP | ID: biblio-1142279

ABSTRACT

Resumo Fundamento: A cardiotoxicidade pode ser uma consequência do tratamento com doxorrubicina (DOX). Objetivos: Verificar o efeito do exercício aeróbio na prevenção da disfunção cardíaca de murinos expostos à DOX. Método: Uma busca abrangente foi realizada em nove bases de dados, em dezembro de 2017. Estudos que avaliaram a função cardíaca de murinos expostos à DOX foram incluídos. O nível de significância adotado foi de 5%. Resultados: Na comparação entre 230 murinos submetidos a exercício aeróbio mais DOX e 222 controles (tratados somente com DOX), a fração de encurtamento mostrou uma melhora de 5,33% a favor do grupo experimental (p = 0,0001). A pressão desenvolvida no ventrículo esquerdo também mostrou um aumento de 24,84 mmHg a favor do grupo de 153 murinos que realizaram exercício em comparação com o grupo controle de 166 murinos (p = 0,00001). Conclusão: Estudos pré-clínicos incluídos nesta metanálise indicaram que o exercício é uma boa estratégia não farmacológica para preservar a função cardíaca pós-DOX.


Abstract Background: Cardiotoxicity may be a consequence of treatments with doxorubicin (DOX). Objectives: To investigate the effect of aerobic exercise on the prevention of cardiac dysfunction in murines exposed to DOX. Method: A comprehensive search was conducted in 9 databases in December 2017. Studies that evaluated the cardiac function of murines exposed to DOX were included. The significance level adopted was 5%. Results: In a comparison between 230 murines that underwent aerobic exercise plus DOX treatment and 222 control murines (DOX treatment only), fractional shortening showed an improvement of 5.33% in favor of the experimental group (p = 0.00001). Left ventricle developed pressure also showed an increase of 24.84 mm Hg in favor of the group of 153 murines that performed exercise in comparison to the control group of 166 murines (p = 0.00001). Conclusion: Preclinical studies included in this meta-analysis indicated that exercise is a good nonpharmacological strategy for preserving post-DOX cardiac function.


Subject(s)
Animals , Rats , Physical Conditioning, Animal , Heart Diseases , Exercise , Doxorubicin/adverse effects , Cardiotoxicity/etiology , Antibiotics, Antineoplastic
4.
Arq. odontol ; 56: 1-10, jan.-dez. 2020. ilus, tab
Article in Portuguese | LILACS, BBO | ID: biblio-1145405

ABSTRACT

Objetivo: Avaliar e comparar os efeitos antimicrobiano e antibiofilme, e a citotoxicidade promovida pela associação do hidróxido de cálcio ao óleo essencial de Melaleuca alternifolia (MA), em diferentes concentrações, e ao propilenoglicol (PG). Métodos: As seguintes medicações compuseram os grupos experimentais: G1) HC/MA 1%; G2) HC/MA 5%; G3) HC/MA 10%; G4) HC/MA 20%; e G5) HC/PG. Solução salina 0,85% e meio DMEM serviram como controle nos testes antimicrobianos e de citotoxidade em fibroblastos do ligamento periodontal humano (FbLP), respectivamente. A atividade antimicrobiana (n = 12) foi avaliada por meio do teste de difusão em ágar. O efeito antibiofilme (n = 12) imediato das medicações foi avaliado por meio do teste de viabilidade bacteriana em biofilmes de 72 horas de E. faecalis, formados sobre discos de dentina e tratados por sete dias com as medicações. Após a coleta microbiológica do biofilme remanescente, os discos de dentina foram imersos em meio estéril e armazenados por mais sete dias, para a análise do efeito antibiofilme residual das medicações, quando nova coleta microbiológica foi realizada. A atividade metabólica de FbLP foi avaliada por meio do ensaio colorimétrico MTS (n = 9). Os valores médios dos halos de inibição, em mm, das unidades formadoras de colônia, e o percentual de atividade metabólica celular foram analisados pelos testes Kruskal-Wallis e post hoc Dunn (α = 5%). Resultados:Todas as medicações experimentais apresentaram superior ação antimicrobiana e antibiofilme comparadas ao controle, solução salina (p < 0,05), e mantiveram viáveis os FbLP, semelhante ao controle DMEM (p > 0,05). Conclusão: A associação do óleo essencial de Melaleuca alternifolia, nas concentrações de 1%, 5%, 10% e 20%, ao hidróxido de cálcio promoveu excelente ação antimicrobiana, antibiofilme e biocompatibilidade com fibroblastos, de forma semelhante à associação com propilenoglicol.


Aim:To evaluate and compare the antimicrobial and antibiofilm effect, as well as the cytotoxicity of calcium hydroxide (CH) associated with the Melaleuca alternifolia (MA)essential oil, in different concentrations, and with propylene glycol. Methods: The following medications composed the experimental groups: G1) CH/MA 1%; G2) CH/MA 5%; G3) CH/MA 10%; G4) CH/MA 20%; and G5) CH/PG. Saline solution and culture medium DMEM were used as a control in antimicrobial and cytotoxicity tests in human periodontal ligament fibroblasts (PDLF), respectively. The antimicrobial activity (n = 12) was evaluated by the disk-diffusion agar method. The immediate antibiofilm effect (n = 12) of the medications was evaluated for bacterial viability in 72 hours-biofilms of E. faecalis, formed on the dentin disc surface and treated for seven days with medications. After microbiological sampling of the remaining biofilm, the dentin discs were immersed in sterile culture medium and stored for another seven days, for analysis of the residual antibiofilm effect of the medications, when a new microbiological sampling was performed. PDLF viability was evaluated by MTS colorimetric assay (n = 9). The mean values of the inhibition halos, in mm, the colony forming units, and the metabolic cell activity percentage were analyzed by means of Kruskal-Wallis and post hoc Dunn (α = 5%) tests. Results:All of the experimental medications presented higher antimicrobial and antibiofilm effects, when compared to the saline solution control (p < 0.05), and maintained the PDLF feasible, similar to the DMEM control (p > 0.05). Conclusions:The association of the Melaleuca alternifolia essential oil, at concentrations of 1%, 5%, 10%, and 20%, with calcium hydroxide promoted an excellent antimicrobial and antibiofilm activity, and biocompatibility with fibroblasts, similarly to the association with propylene glycol.


Subject(s)
Calcium Hydroxide/analysis , Oils, Volatile/therapeutic use , Endodontics , Anti-Infective Agents/analysis , Antibiotics, Antineoplastic , Enterococcus faecalis , Fibroblasts , Regenerative Endodontics
5.
Chinese Journal of Oncology ; (12): 617-623, 2020.
Article in Chinese | WPRIM | ID: wpr-826582

ABSTRACT

As a new type of anthracyclines, pegylated liposomal doxorubicin (PLD) is widely used in the treatment of a variety of malignant tumors, including soft tissue sarcoma, ovarian cancer, breast cancer, multiple myeloma, and so on. Compared with traditional anthracyclines, PLD can significantly decrease the incidences of adverse events such as cardiac toxicity and alopecia. However, the use of PLD will be accompanied with toxic side effects such as hand-foot syndrome, oral mucositis, and infusion reaction. This consensus will mainly focus on the mechanism, prevention and treatment of adverse events of PLD, in order to improve the therapeutic efficacy of PLD and life quality of patients.


Subject(s)
Antibiotics, Antineoplastic , Therapeutic Uses , Consensus , Doxorubicin , Therapeutic Uses , Drug-Related Side Effects and Adverse Reactions , Female , Hand-Foot Syndrome , Humans , Neoplasms , Drug Therapy , Polyethylene Glycols , Therapeutic Uses , Practice Guidelines as Topic , Stomatitis
6.
J. bras. nefrol ; 41(4): 451-461, Out.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1056616

ABSTRACT

ABSTRACT Hypertension and Diabetes mellitus are the two main causes of chronic kidney disease that culminate in the final stage of kidney disease. Since these two risk factors are common and can overlap, new approaches to prevent or treat them are needed. Macitentan (MAC) is a new non-selective antagonist of the endothelin-1 (ET-1) receptor. This study aimed to evaluate the effect of chronic blockade of ET-1 receptor with MAC on the alteration of renal function observed in hypertensive and hyperglycemic animals. Genetically hypertensive rats were divided into control hypertensive (HT-CTL) group, hypertensive and hyperglycemic (HT+DIAB) group, and hypertensive and hyperglycemic group that received 25 mg/kg macitentan (HT-DIAB+MAC25) via gavage for 60 days. Kidney function and parameters associated with oxidative and nitrosative stress were evaluated. Immunohistochemistry for neutrophil gelatinase-associated lipocalin (NGAL), ET-1, and catalase in the renal cortex was performed. The HT+DIAB group showed a decrease in kidney function and an increase in NGAL expression in the renal cortex, as well as an increase in oxidative stress. MAC treatment was associated with attenuated ET-1 and NGAL production and increases in antioxidant defense (catalase expression) and nitric oxide production. In addition, MAC prevented an increase in oxidant injury (as measured by urinary hydroperoxide and lipid peroxidation), thus improving renal function. Our results suggest that the antioxidant effect of the ET-1 receptor antagonist MAC is involved in the improvement of kidney function observed in hypertensive and hyperglycemic rats.


RESUMO Hipertensão e Diabetes Mellitus figuram como as duas principais causas de doença renal crônica que culmina em doença renal terminal. Uma vez que os dois fatores de risco são comuns e podem se sobrepor, novas abordagens preventivas e terapêuticas se fazem necessárias. O macitentan (MAC) é um novo antagonista não-seletivo dos receptores da endotelina-1 (ET-1). O presente estudo teve como objetivo avaliar os efeitos do bloqueio crônico dos receptores da ET-1 com MAC sobre a alteração da função renal em animais hipertensos e hiperglicêmicos. Ratos geneticamente hipertensos foram divididos em grupos com animais hipertensos de controle (HT-CTL), hipertensos e hiperglicêmicos (HT+DIAB) e hipertensos e hiperglicêmicos tratados com 25 mg/kg de macitentan (HT-DIAB+MAC25) via gavagem por 60 dias. Foram avaliados função renal e parâmetros associados ao estresse oxidativo e nitrosativo. Exames de imunoistoquímica foram realizados para lipocalina associada à gelatinase neutrofílica (NGAL), ET-1 e catalase no córtex renal. O grupo HT+DIAB exibiu diminuição da função renal e aumento na expressão de NGAL no córtex renal, bem como estresse oxidativo aumentado. O tratamento com MAC foi associado a atenuação da produção de ET-1 e NGAL e maior ativação das defesas antioxidantes (expressão de catalase) e elevação da produção de óxido nítrico. Além disso, o MAC evitou exacerbação da lesão oxidante (medida por hidroperóxidos urinários e peroxidação lipídica), melhorando assim a função renal. Nossos resultados sugerem que o efeito antioxidante do antagonista dos receptores da ET-1 MAC esteja imbricado no aprimoramento da função renal observada em ratos hipertensos e hiperglicêmicos.


Subject(s)
Humans , Animals , Male , Hyperglycemia/complications , Kidney/drug effects , Antioxidants/pharmacology , Rats/genetics , Risk Factors , Endothelin-1/metabolism , Administration, Intravenous , Endothelin Receptor Antagonists/administration & dosage , Endothelin Receptor Antagonists/therapeutic use , Hyperglycemia/chemically induced , Hypertension/complications , Hypertension/physiopathology , Kidney/physiopathology , Kidney/injuries , Antibiotics, Antineoplastic/administration & dosage
7.
Rev. chil. pediatr ; 90(6): 662-667, dic. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058198

ABSTRACT

INTRODUCCIÓN: El síndrome de CLOVES se caracteriza por sobrecrecimiento lipomatoso asociado a malformaciones vasculares, representando un desafío diagnóstico y terapéutico. La rapamicina, un inhibidor de la vía mTOR, ha demostrado ser una buena alternativa terapéutica en un grupo de anomalías vasculares. Reportamos dos casos de síndrome de CLOVES con buena respuesta al tratamiento con rapamicina oral. OBJETIVO: Reportar la experiencia del uso de rapamicina oral en el tratamiento de dos pacientes con síndrome de CLOVES. CASOS CLÍNICOS: Caso 1: preescolar femenino de tres años de edad con sín drome de CLOVES e historia de hospitalizaciones reiteradas por infección severa de malformaciones linfáticas macroquísticas y episodios trombóticos. Evoluciona con mala calidad de vida, múltiples hospitalizaciones, riesgo quirúrgico y progresión de las lesiones, por lo que se indicó rapamicina oral. A los 6 meses de tratamiento se evidenció reducción clínica y radiológica del tamaño de las masas lipomatosas y linfáticas, ausencia de linforrea cutánea y mejoría significativa de la calidad de vida, sin requerir nuevas hospitalizaciones. Caso 2: escolar femenino de diez años de edad, portadora de síndrome de CLOVES, que desarrolló escoliosis y deterioro de su capacidad motora, haciéndose dependiente del uso de silla de ruedas. Se indicó rapamicina oral, evidenciándose a los cuatro meses de tratamiento mejoría en su capacidad física, independencia y autovalencia, con desaparición de la linforrea. CONCLUSIÓN: Proponemos la rapamicina oral para el tratamiento de pacientes con sín drome de CLOVES que presenten complicaciones y deterioro de la calidad de vida producto de su enfermedad.


INTRODUCTION: CLOVES syndrome is characterized by lipomatous overgrowth associated with vascular malforma tions, representing a diagnostic and a therapeutic challenge. Rapamycin, an mTOR inhibitor, has proved to be a good therapeutic option in some vascular anomalies. In this article, we report two ca ses of CLOVES syndrome with good response to oral rapamycin treatment. OBJECTIVE: To report the outcome of two patients with CLOVES syndrome treated with oral rapamycin. CLINICAL CASES: Case 1: A three-year-old female preschooler with CLOVES syndrome and history of repeated hospita lizations due to severe infections resulting from macrocystic lymphatic malformations and due to thrombotic episodes. The patient evolved with poor quality of life, multiple hospitalizations, surgical risk and progression of the lesions, therefore, oral rapamycin was indicated. After six months of treatment, clinical and radiological reduction in the size of the lipomatous and lymphatic masses, cutaneous lymphorrhea absence and a significant improvement of her quality of life were observed, without requiring new hospitalizations. Case 2: a ten-year-old female schooler with CLOVES syndro me, who developed scoliosis and deterioration of her motor skills, becoming wheelchair-dependent. Oral rapamycin was indicated, showing improvement in her physical capacity, independence and au tonomy, and absence of lymphorrhea after four months of treatment. CONCLUSION: We propose oral rapamycin for the treatment of patients with CLOVES syndrome who present with complications and deterioration in the quality of life as a result of the disease.


Subject(s)
Humans , Female , Child, Preschool , Child , Sirolimus/therapeutic use , Vascular Malformations/drug therapy , Lipoma/drug therapy , Antibiotics, Antineoplastic/therapeutic use , Musculoskeletal Abnormalities/drug therapy , Nevus/drug therapy , Administration, Oral , Sirolimus/administration & dosage , Antibiotics, Antineoplastic/administration & dosage
8.
Rev. costarric. cardiol ; 21(1): 7-13, ene.-jun. 2019. tab
Article in Spanish | LILACS | ID: biblio-1042858

ABSTRACT

Resumen La Cardio-oncología es una nueva disciplina que busca enfocarse en el tamizaje, monitoreo y tratamiento de los pacientes con cáncer que presentan enfermedad cardiaca durante o después de recibir tratamiento. Esto debido a que el efecto cardiotóxico asociado a los quimioterapéuticos es ampliamente conocido y respaldado por abundantes estudios clínicos. Sin embargo, no es hasta épocas recientes que en Costa Rica se desarrollaron por primera vez Unidades Cardio-oncológicas, los cuales actualmente se ubican en diversos centros médicos de nuestro sistema de salud público. A continuación, se presenta un resumen de las manifestaciones clínicas de las diversas terapias oncológicas diferentes a las antraciclinas que tenemos a disposición en la Caja Costarricense del Seguro Social (CCSS).


Abstract Cardio-oncology is a new discipline that looks to focus on the screening, monitoring and treatment of patients withcancer that show up with heart disease during and after their treatment. This is due to the fact that the cardiotoxic effectsassociated to chemotherapeutics is widely known and backed up with abundant clinical trials. Nevertheless, it is not untilrecently that in Costa Rica the Cardio-oncologic Units were created for the first time, which now can be found in multiplemedical centers of our public health system. Up next, we present a summary of the clinical manifestations of the diversenon-anthracycline oncologic therapies that are available in the "Caja Costarricense del Seguro Social".


Subject(s)
Humans , Abnormalities, Radiation-Induced , Doxorubicin , Anthracyclines , Costa Rica , Cyclophosphamide , Drug Therapy , Cardiotoxicity , Trastuzumab , Sorafenib , Antibiotics, Antineoplastic , Antineoplastic Agents
9.
Braz. j. med. biol. res ; 52(12): e8467, 2019. tab, graf
Article in English | LILACS | ID: biblio-1055474

ABSTRACT

The aim of our study was to assess the efficacy, safety, and prognostic factors of drug-eluting bead transarterial chemoembolization (DEB-TACE) in Chinese hepatocellular carcinoma (HCC) patients. Patients (n=102) diagnosed as primary HCC were consecutively enrolled in this retrospective cohort study. Treatment responses were assessed following the modified Response Evaluation Criteria in Solid Tumors. Progression-free survival (PFS) and overall survival (OS) were evaluated, and adverse events (AEs) as well as liver function-related laboratory indexes of all DEB-TACE records (N=131) were assessed. Complete response (CR) rate, objective response rate, and disease control rate were 51.0, 87.3, and 95.1%, respectively, at 1-3 months post DEB-TACE. The mean PFS and OS were 227 (95%CI: 200-255) days and 343 (95%CI: 309-377) days, respectively. Multivariate logistic regression revealed that portal vein invasion and abnormal total protein (TP) were independent predictive factors for worse CR, and multivariate Cox's regression analysis showed that multifocal disease independently correlated with shorter PFS. Most of the liver function-related laboratory indexes worsened at 1 week but recovered at 1-3 months post-treatment, only the percentage of patients with abnormal ALP increased at 1-3 months. In addition, 112 (85.5%), 84 (64.1%), 53 (40.5%), 40 (30.5%), and 16 (12.2%) patients had pain, fever, nausea, vomiting, and other AEs, respectively. DEB-TACE is efficient and safe in Chinese HCC patients, and portal vein invasion, abnormal TP level as well as multifocal disease could be used as unfavorable prognostic factors to DEB-TACE treatment.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Epirubicin/administration & dosage , Chemoembolization, Therapeutic/methods , Carcinoma, Hepatocellular/therapy , Liver Neoplasms/therapy , Antibiotics, Antineoplastic/administration & dosage , Prognosis , Survival Analysis , Retrospective Studies , Cohort Studies , Treatment Outcome
10.
Rev. Soc. Bras. Clín. Méd ; 16(1): 64-69, 20180000.
Article in Portuguese | LILACS | ID: biblio-885011

ABSTRACT

O linfoma folicular é um tipo de linfoma não Hodgkin de células B indolente. Apenas 30% dos pacientes apresentam doença em fase inicial ao diagnóstico. Os pacientes com estadiamento III-IV estão entre a maioria dos diagnósticos da doença e apresentam altas taxas de recaída ou refratariedade ao tratamento. O linfoma folicular recaído ou refratário permanece um desafio para a prática clínica. O transplante de células-tronco hematopoéticas autólogo vem sendo utilizado há muito tempo nesse perfil de pacientes, com altos índices de complicações como segunda neoplasia e curto período de remissão. O transplante de células-tronco hematopoéticas alogênico com regime de condicionamento mieloablativo apresenta resultados pouco aceitáveis, devido ao aumento da mortalidade relacionada ao tratamento sem benefícios em sobrevida global, da sobrevida livre de doença ou da taxa de recaída que sustentem tal indicação O transplante de células-tronco hematopoéticas alogênico com regime de condicionamento com intensidade reduzida parece ser uma alternativa promissora, inclusive como primeiro transplante. Alguns estudos comparando os resultados dos três tipos de transplantes em pacientes com linfoma folicular recaído ou refratário, com enfoque principal no transplante de células-tronco hematopoéticas alogênico de condicionamento com intensidade reduzida, são descritos neste artigo de revisão.(AU)


Follicular Lymphoma is a type of indolent B-cell non-Hodgkin´s lymphoma. Only 30% of the patients present with an early phase of the disease at diagnosis. Patients with stage III-IV are among the majority of the diagnoses of the disease, and these have high rates of relapse or refractoriness to treatment. Relapsed or refractory follicular lymphoma remains a challenge for clinical practice. Autologous hematopoietic stem cell transplantation has been used for a long time in this profile of patients, with high rates of complications, such as second neoplasia and short remission period. The allogenic hematopoietic stem cell transplantation with myeloablative conditioning regimen presents poorly acceptable results due to increased treatment-related mortality with no overall survival benefits, disease-free survival, or relapse rate to warrant it. Allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning regimen seems to be a promising alternative, even as the first transplant. Some studies comparing the results of the three types of transplants in patients with relapsed or refractory follicular lymphoma , with a main focus on hematopoietic stem cell transplantation allogenic with reduced-intensity conditioning regimen, will be described in this review article.(AU)


Subject(s)
Humans , Male , Female , Antibiotics, Antineoplastic/administration & dosage , Hematopoietic Stem Cell Transplantation/methods , Lymphoma, Follicular/pathology , Lymphoma, Follicular/therapy , Transplantation, Autologous/methods
11.
Electron. j. biotechnol ; 32: 13-18, Mar. 2018. ilus, graf
Article in English | LILACS | ID: biblio-1022495

ABSTRACT

Background: The suppression of cancer cell growth and invasion has become a challenging clinical issue. In this study, we used nanotechnology to create a new drug delivery system to enhance the efficacy of existing drugs. We developed layered double hydroxide by combing Au nanosol (LDH@Au) and characterized the compound to prove its function as a drug delivery agent. The anti-cancer drug Doxorubicin was loaded into the new drug carrier to assess its quality. We used a combination of apoptosis assays, cell cycle assays, tissue distribution studies, cell endocytosis, transwell invasion assays, and immunoblotting to evaluate the characteristics of LDH@Au as a drug delivery system. Results: Our results show that the LDH@Au-Dox treatment significantly increased cancer cell apoptosis and inhibited cell invasion compared to the control Dox group. Additionally, our data indicate that LDH@Au-Dox has a better target efficiency at the tumor site and improved the following: cellular uptake, anti-angiogenesis action, changes in the cell cycle, and increased caspase pathway activation. Conclusions: Our findings suggest the nano drug is a promising anti-cancer agent and has potential clinical applications.


Subject(s)
Stomach Neoplasms/drug therapy , Doxorubicin/administration & dosage , Apoptosis/drug effects , Nanoparticles/administration & dosage , Antibiotics, Antineoplastic/administration & dosage , Doxorubicin/pharmacology , Cell Cycle/drug effects , Blotting, Western , Drug Delivery Systems , Nanotechnology , Cell Line, Tumor , Microscopy, Electron, Transmission , Cell Proliferation/drug effects , Endocytosis/drug effects , Hydroxides , Antibiotics, Antineoplastic/pharmacology , Neoplasm Invasiveness/prevention & control
13.
Arq. bras. cardiol ; 110(3): 219-228, Mar. 2018. tab, graf
Article in English | LILACS | ID: biblio-888028

ABSTRACT

Abstract Background: Anthracycline generates progressive left ventricular dysfunction associated with a poor prognosis. Objectives: The purpose of this study was to evaluate whether layer-specific strain analysis could assess the subclinical left ventricular dysfunction after exposure to anthracycline. Methods: Forty-two anthracycline-treated survivors of large B-cell non-Hodgkin lymphoma, aged 55.83 ± 17.92 years (chemotherapy group) and 27 healthy volunteers, aged 51.39 ± 13.40 years (control group) were enrolled. The cumulative dose of epirubicin in chemotherapy group was 319.67 ± 71.71mg/m2. The time from last dose of epirubicin to the echocardiographic examination was 52.92 ± 22.32 months. Global longitudinal (GLS), circumferential (GCS) and radial strain (GRS), subendocardial, mid and subepicardial layer of longitudinal (LS-ENDO, LS-MID, LS-EPI) and circumferential strain (CS-ENDO, CS-MID, CS-EPI) values were analyzed. Transmural strain gradient was calculated as differences in peak systolic strain between the subendocardial and subepicardial layers. A value of p < 0.05 was considered significant. Results: Conventional parameters of systolic and diastolic function showed no significant difference between two groups. Compared with controls, patients had significantly lower GCS and GLS. Multi-layer speckle tracking analysis showed significant reduction of circumferential strain of subendocardial layer, transmural CS gradient and longitudinal strain of all three layers. In contrast, the two groups did not differ in transmural longitudinal strain gradient and radial strains. Conclusions: It proved the preferential impairment of subendocardial deformation in long-term survivors after exposure to anthracycline. Multi-layer speckle tracking echocardiography might facilitate the longitudinal follow-up of this at-risk patient cohort.


Resumo Fundamentos: A antraciclina gera uma disfunção ventricular esquerda progressiva associada a um prognóstico ruim. Objetivos: O propósito deste estudo foi avaliar se a análise layer específico de strain poderia avaliar disfunção ventricular esquerda subclínica após exposição a antraciclina. Métodos: Foram inscritos quarenta e dois sobreviventes tratados com antraciclina por linfoma não Hodgkin de células B grandes, de 55,83 ± 17,92 anos (grupo de quimioterapia) e 27 voluntários saudáveis, de 51,39 ± 13,40 anos (grupo controle). A dose cumulativa de epirrubicina no grupo de quimioterapia foi de 319,67 ± 71,71 mg/m2. O tempo desde a última dose de epirrubicina até o exame ecocardiográfico foi de 52,92 ± 22,32 meses. Analisaram-se o strain longitudinal global (GLS), o circunferencial (GCS) e o strain radial (GRS), os valores das camadas subendocárdica, média e subepicárdica so strain longitudinal (LS-ENDO, LS-MID, LS-EPI) e do strain circunferencial (CS-ENDO, CS-MID, CS-EPI). O gradiente de strain transmural foi calculado como a diferença no strain sistólico pico entre as camadas subendocárdicas e subepicárdicas. Um valor de p < 0,05 foi considerado significativo. Resultados: Os parâmetros convencionais da função sistólica e diastólica não mostraram diferenças significativas entre dois grupos. Comparados aos controles, os pacientes apresentaram GCS e GLS significativamente menores. A análise de speckle tracking multi-layer mostrou uma redução significativa no strain circunferencial da camada subendocárdica, o gradiente transmural CS e o strain longitudinal das três camadas. Em contraste, os dois grupos não diferiram no gradiente de strain longitudinal transmural e de strain radiais. Conclusões: Provou-se a deterioração preferencial do strain subendocárdico em sobreviventes de longa duração após exposição à antraciclina. O ecocardiograma de speckle tracking multi-layer pode facilitar o acompanhamento longitudinal dessa coorte de pacientes em risco. (Arq Bras Cardiol. 2018; 110(3):219-228)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Echocardiography/methods , Lymphoma, B-Cell/drug therapy , Ventricular Dysfunction, Left/chemically induced , Ventricular Dysfunction, Left/diagnostic imaging , Anthracyclines/adverse effects , Antibiotics, Antineoplastic/adverse effects , Reference Values , Stroke Volume/drug effects , Stroke Volume/physiology , Epirubicin/therapeutic use , Case-Control Studies , Observer Variation , Cross-Sectional Studies , Risk Factors , Analysis of Variance , Follow-Up Studies , Ventricular Dysfunction, Left/physiopathology , Statistics, Nonparametric , Cardiotoxicity/etiology , Cardiotoxicity/diagnostic imaging , Heart/drug effects , Heart/physiopathology , Myocardium/pathology
14.
Sierra Leone j. biomed. res. (Online) ; 10(2): 47-57, 2018. ilus
Article in French | AIM | ID: biblio-1271996

ABSTRACT

The aim of this research was to determine the role of door handles in the proliferation of microorganisms in staff offices within University of Benin, Benin City. Isolation and characterization of isolates was carried out using standard methods. The results of this study showed that surfaces of door handles of Plant Biology and Biotechnology, Microbiology and Chemistry Departments had high bacterial count, which ranged from 6.17 ± 0.75 × 104 cfu/cm2 - 7.45 ± 0.67 × 104 cfu/cm2, while Geology, Physics and Adult Education had low counts (3.31 ± 0.64 × 104 cfu/cm2 - 3.55 ± 0.80 × 104 cfu/cm2). The bacterial isolates were: Staphylococcus epidermidis, Citrobacter sp., Escherichia coli, Enterobacter sp., Staphylococcus aureus, Klebsiella sp., Streptococcus pyogenes, Corynebacterium sp., Bacillus subtilis, Pseudomonas aeruginosa and Proteus vulgaris, while the fungal isolates were Rhizopus sp., Aspergillus niger, Fusarium sp., Penicillium sp. and Mucor sp. The most predominant bacterial isolate was Staphylococcus aureus (25.22%), while Citrobacter sp. (1.74%) was the least. Plasmid profile revealed plasmid fragments in all the bacterial isolates, with most of the isolates, being multi-drug resistant. Results showed that door handles harbor pathogenic organisms. Therefore, everyone is encouraged to have good personal hygiene, use of hand-sanitizers, hand-washing before and after the use of door handles and routine surface disinfection of door handles in order to prevent cross-contamination


Subject(s)
Antibiotics, Antineoplastic , Nigeria , Public Health , Universities
15.
Chinese Medical Journal ; (24): 1917-1925, 2018.
Article in English | WPRIM | ID: wpr-773949

ABSTRACT

Background@#Follistatin-like 1 (FSTL1) is a novel profibrogenic factor that induces pulmonary fibrosis (PF) through the transforming growth factor-beta 1 (TGF-β1)/Smad signaling. Little is known about its effects on PF through the non-Smad signaling, like the mitogen-activated protein kinase (MAPK) pathway. Therefore, this study aimed to investigate the role of FSTL1 in PF through the MAPK signaling pathway and its mechanisms in lung fibrogenesis.@*Methods@#PF was induced in Fstl1and wild-type (WT) C57BL/6 mice with bleomycin. After 14 days, the mice were sacrificed, and lung tissues were stained with hematoxylin and eosin; the hydroxyproline content was measured to confirm PF. The mRNA and protein level of FSTL1 and the change of MAPK phosphorylation were measured by quantitative polymerase chain reaction and Western blotting. The effect of Fstl1 deficiency on fibroblasts differentiation was measured by Western blotting and cell immunofluorescence. MAPK signaling activation was measured by Western blotting in Fstl1 and WT fibroblasts treated with recombinant human FSTL1 protein. We pretreated mouse lung fibroblast cells with inhibitors of the extracellular signal-regulated kinase (ERK), p38, and Jun N-terminal kinase (JNK) signaling and analyzed their differentiation, proliferation, migration, and invasion by Western blotting, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide analysis, and transwell assays. The Student's t-test was used to compare the differences between two groups.@*Results@#Fstl1 deficiency attenuated phosphorylation of the ERK, p38, and JNK signaling in bleomycin-induced fibrotic lung tissue 14 days after injury (0.67 ± 0.05 vs. 1.22 ± 0.03, t = 14.92, P = 0.0001; 0.41 ± 0.01 vs. 1.15 ± 0.07; t = 11.19; P = 0.0004; and 0.41 ± 0.01 vs. 1.07 ± 0.07, t = 8.92, P = 0.0009; respectively), compared with WT lungs at the same time and in primary lung fibroblasts (0.82 ± 0.01 vs. 1.01 ± 0.04, t = 4.06, P = 0.0150; 1.04 ± 0.03 vs. 1.24 ± 0.03, t = 4.44, P = 0.0100; and 0.76 ± 0.05 vs. 0.99 ± 0.05, t = 4.48, P = 0.0100; respectively), compared with TGF-β1-stimulated WT group. Recombinant human FSTL1 protein in lung fibroblasts enhanced TGF-β1-mediated phosphorylation of the ERK (1.19 ± 0.08 vs. 0.55 ± 0.04, t = 6.99, P = 0.0020), p38 (1.18 ± 0.04 vs. 0.66 ± 0.03, t = 11.20, P = 0.0020), and JNK (1.11 ± 0.01 vs. 0.84 ± 0.04, t = 6.53, P = 0.0030), compared with the TGF-β1-stimulated WT group. Fstl1-deficient fibroblasts showed reduced alpha-smooth muscle actin (α-SMA) expression (0.70 ± 0.06 vs. 1.28 ± 0.11, t = 4.65, P = 0.0035, compared with the untreated WT group; 1.40 ± 0.05 vs. 1.76 ± 0.02, t = 6.31, P = 0.0007; compared with the TGF-β1-treated WT group). Compared with the corresponding condition in the control group, the TGF-β1/FSTL1-mediated α-SMA expression was significantly suppressed by pretreatment with an inhibitor of p38 (0.73 ± 0.01 vs. 1.13 ± 0.10, t = 3.92, P = 0.0078) and JNK (0.78 ± 0.03 vs. 1.08 ± 0.06, t = 4.40, P = 0.0046) signaling. The proliferation of mouse lung fibroblast cells (MLgs) significantly decreased after treatment of an inhibitor of p38 (0.30 ± 0.01 vs. 0.46 ± 0.03, t = 4.64, P = 0.0009), JNK (0.30 ± 0.01 vs. 0.49 ± 0.01, t = 12.84, P = 0.0001), and Smad2/3 (0.18 ± 0.02 vs. 0.46 ± 0.02, t = 12.69, P = 0.0001) signaling compared with the dimethylsulfoxide group. The migration and invasion cells of MLgs significantly decreased in medium pretreated with an inhibitor of p38 (70.17 ± 3.28 vs. 116.30 ± 7.11, t = 5.89, P = 0.0042 for the migratory cells; 19.87 ± 0.84 vs. 32.70 ± 0.95, t = 10.14, P = 0.0005 for the invasive cells), JNK (72.30 ± 3.85 vs. 116.30 ± 7.11, t = 5.44, P = 0.0056 for the migratory cells; 18.03 ± 0.94 vs. 32.70 ± 0.95, t = 11.00, P = 0.0004 for the invasive cells), and Smad2/3 (64.76 ± 1.41 vs. 116.30 ± 7.11, t = 7.11, P = 0.0021 for the migratory cells; 18.03 ± 0.94 vs. 32.70 ± 0.95, t = 13.29, P = 0.0002 for the invasive cells) signaling compared with the corresponding condition in the dimethylsulfoxide group.@*Conclusion@#FSTL1 affects lung fibroblast differentiation, proliferation, migration, and invasion through p38 and JNK signaling, and in this way, it might influence the development of PF.


Subject(s)
Animals , Antibiotics, Antineoplastic , Bleomycin , Cells, Cultured , Fibroblasts , Follistatin , Follistatin-Related Proteins , Physiology , Humans , Mice , Mice, Inbred C57BL , Pulmonary Fibrosis , Transforming Growth Factor beta , Transforming Growth Factor beta1 , Physiology , p38 Mitogen-Activated Protein Kinases
16.
An. bras. dermatol ; 92(4): 484-491, July-Aug. 2017. tab, graf
Article in English | LILACS | ID: biblio-887013

ABSTRACT

Abstract: Background: Varicose veins and the complications of venous disease are common disorders in humans. Objective: To study the effects of bleomycin as a potential new sclerosing agent and its adverse events in treating varicose veins. Methods: Bleomycin-loaded liposomes 0.1ml was injected in the dorsal ear veins of white New Zealand rabbits. Sodium tetradecyl sulfate was used as a positive control. Normal saline was used as negative control. The blood vessels of the treated ears were photographed before and at one hour and two, eight and 45 days after treatment. Biopsies from the treated areas were obtained for histological examination. Blood samples were collected to determine any possible toxicity. Results: Bleomycin by itself was ineffective; therefore, liposomes were used as a vector to deliver bleomycin to the vein lumen. Subsequently, bleomycin started showing its sclerosing effects. Toxicity monitoring showed no apparent hematologic, pulmonary, hepatic or renal toxicities. This study revealed that bleomycin induced vasculitis, which led to vascular occlusion, which was observed on day 1 and day 8. No bleomycin-related injury was noted by histopathological examination of lung sections. The calculation of the lung/body weight coefficient indicated that edema was present in the experimental groups compared with the negative and positive controls. Study limitations: Relatively small number of experimental animals used. Conclusions: This study showed that bleomycin-loaded liposomes were able to induce vasculitis and vascular occlusion without any toxicity or complications. It might be useful, hence, to treat patients suffering from Varicose veins and other ectatic vascular diseases with this agent.


Subject(s)
Animals , Rabbits , Sclerosing Solutions/pharmacology , Sodium Tetradecyl Sulfate/administration & dosage , Varicose Veins/therapy , Bleomycin/pharmacology , Sclerotherapy/methods , Antibiotics, Antineoplastic/administration & dosage , Sclerosing Solutions/administration & dosage , Sclerosing Solutions/adverse effects , Vasculitis/chemically induced , Vasculitis/drug therapy , Veins/drug effects , Bleomycin/administration & dosage , Disease Models, Animal , Drug Evaluation, Preclinical , Injections, Intravenous , Liposomes
17.
Arq. bras. cardiol ; 108(1): 12-20, Jan. 2017. tab, graf
Article in English | LILACS | ID: biblio-838670

ABSTRACT

Abstract Background: Radionuclide ventriculography (RV) is a validated method to evaluate the left ventricular systolic function (LVSF) in small rodents. However, no prior study has compared the results of RV with those obtained by other imaging methods in this context. Objectives: To compare the results of LVSF obtained by RV and echocardiography (ECHO) in an experimental model of cardiotoxicity due to doxorubicin (DXR) in rats. Methods: Adult male Wistar rats serving as controls (n = 7) or receiving DXR (n = 22) in accumulated doses of 8, 12, and 16 mg/kg were evaluated with ECHO performed with a Sonos 5500 Philips equipment (12-MHz transducer) and RV obtained with an Orbiter-Siemens gamma camera using a pinhole collimator with a 4-mm aperture. Histopathological quantification of myocardial fibrosis was performed after euthanasia. Results: The control animals showed comparable results in the LVSF analysis obtained with ECHO and RV (83.5 ± 5% and 82.8 ± 2.8%, respectively, p > 0.05). The animals that received DXR presented lower LVSF values when compared with controls (p < 0.05); however, the LVSF values obtained by RV (60.6 ± 12.5%) were lower than those obtained by ECHO (71.8 ± 10.1%, p = 0.0004) in this group. An analysis of the correlation between the LVSF and myocardial fibrosis showed a moderate correlation when the LVSF was assessed by ECHO (r = -0.69, p = 0.0002) and a stronger correlation when it was assessed by RV (r = -0.79, p < 0.0001). On multiple regression analysis, only RV correlated independently with myocardial fibrosis. Conclusion: RV is an alternative method to assess the left ventricular function in small rodents in vivo. When compared with ECHO, RV showed a better correlation with the degree of myocardial injury in a model of DXR-induced cardiotoxicity.


Resumo Fundamento: A ventriculografia radioisotópica (VRI) é um método validado para avaliação da função sistólica do ventrículo esquerdo (FSVE) em pequenos roedores. Contudo, nenhum estudo prévio comparou os resultados obtidos com VRI com os obtidos por outros métodos de imagem neste contexto. Objetivos: Comparar os resultados de FSVE obtidos por VRI e por ecocardiografia (ECO) em modelo experimental de cardiotoxicidade por doxorrubicina (DXR) em ratos. Métodos: Ratos Wistar machos adultos controles (n = 7) e tratados com DXR (n = 22) em doses acumuladas de 8, 12 e 16 mg/kg, foram avaliados com ECO com equipamento Sonos 5500 Philips (transdutor de 12 MHz) e VRI adquirida em gama-câmara Orbiter-Siemens com colimador pinhole de 4 mm de abertura. Após eutanásia, foi realizada a quantificação histopatológica da fibrose miocárdica. Resultados: Os animais controles apresentaram valores comparáveis na análise da FSVE à ECO e à VRI (83,5 ± 5% e 82,8 ± 2,8%, respectivamente, p > 0,05). Os animais que receberam DXR apresentaram valores menores de FSVE quando comparados aos dos controles (p < 0,05); entretanto, observou-se neste grupo menores valores de FSVE obtidos por VRI (60,6 ± 12,5%) quando comparados aos obtidos pela ECO (71,8 ± 10,1%, p = 0,0004). A análise da correlação entre a FSVE e a fibrose miocárdica mostrou uma correlação moderada quando a FSVE foi estimada com a ECO (r = -0,69, p = 0,0002) e mais forte quando a FSVE foi obtida por VRI (r = -0,79, p < 0,0001). Apenas a VRI apresentou correlação de forma independente com a fibrose miocárdica à análise de regressão múltipla. Conclusão: A VRI é um método alternativo para avaliação da função ventricular esquerda in vivo em pequenos roedores, exibindo comparativamente à ECO melhor correlação com o grau de lesão miocárdica no modelo de cardiotoxicidade por DXR.


Subject(s)
Animals , Male , Echocardiography , Radionuclide Ventriculography , Ventricular Function, Left/drug effects , Ventricular Dysfunction, Left/diagnostic imaging , Reference Values , Fibrosis , Doxorubicin , Reproducibility of Results , Rats, Wistar , Ventricular Dysfunction, Left/chemically induced , Ventricular Dysfunction, Left/pathology , Statistics, Nonparametric , Disease Models, Animal , Cardiotoxicity/diagnostic imaging , Antibiotics, Antineoplastic
18.
Braz. j. med. biol. res ; 50(10): e6147, 2017. tab, graf
Article in English | LILACS | ID: biblio-888934

ABSTRACT

Chemotherapy response rates in patients with cholangiocarcinoma remain low, primarily due to the development of drug resistance. Epithelial-mesenchymal transition (EMT) of cancer cells is widely accepted to be important for metastasis and progression, but it has also been linked to the development of chemoresistance. Salinomycin (an antibiotic) has shown some potential as a chemotherapeutic agent as it selectively kills cancer stem cells, and has been hypothesized to block the EMT process. In this study, we investigated whether salinomycin could reverse the chemoresistance of cholangiocarcinoma cells to the chemotherapy drug doxorubicin. We found that combined salinomycin with doxorubicin treatment resulted in a significant decrease in cell viability compared with doxorubicin or salinomycin treatment alone in two cholangiocarcinoma cell lines (RBE and Huh-28). The dosages of both drugs that were required to produce a cytotoxic effect decreased, indicating that these two drugs have a synergistic effect. In terms of mechanism, salinomycin reversed doxorubicin-induced EMT of cholangiocarcinoma cells, as shown morphologically and through the detection of EMT markers. Moreover, we showed that salinomycin treatment downregulated the AMP-activated protein kinase family member 5 (ARK5) expression, which regulates the EMT process of cholangiocarcinoma. Our results indicated that salinomycin reversed the EMT process in cholangiocarcinoma cells by inhibiting ARK5 expression and enhanced the chemosensitivity of cholangiocarcinoma cells to doxorubicin. Therefore, a combined treatment of salinomycin with doxorubicin could be used to enhance doxorubicin sensitivity in patients with cholangiocarcinoma.


Subject(s)
Humans , AMP-Activated Protein Kinases/drug effects , Antibiotics, Antineoplastic/pharmacology , Doxorubicin/pharmacology , Epithelial-Mesenchymal Transition/drug effects , Pyrans/pharmacology , AMP-Activated Protein Kinases/metabolism , Cell Line, Tumor , Cell Survival/drug effects , Cholangiocarcinoma/metabolism , Cholangiocarcinoma/pathology , Drug Synergism , Gene Expression Regulation, Neoplastic
19.
Rev. panam. salud pública ; 39(6): 358-365, Jun. 2016. tab
Article in English | LILACS | ID: lil-795369

ABSTRACT

ABSTRACT Objectives To better understand the role that health care plays in breast cancer survival by investigating the effects that hormone therapy adherence and other select health care variables, adjusted for clinical and sociodemographic factors, had among a population of women in Rio de Janeiro, Brazil. Methods This was a longitudinal study based on secondary data of 5 861 women treated with hormone therapy (tamoxifen or aromatase inhibitors) at the National Cancer Institute of Brazil (INCA), from 1 January 2004 – 29 October 2010. Four different sources of data were integrated for analysis: INCA Pharmacy Sector Dispensation System; Hospital-based Cancer Registry; Integrated Hospital System and INCA Absolute System; and Mortality Information System. Analyses explored the effects of adherence to hormone therapy, disease care aspects, and sociodemographic, behavioral, and clinical variables, on the time of survival, using Kaplan-Meier and Cox proportional hazards models. Results The general survival rate was 94% in the first year after initiation of hormone therapy, and 71% in the fifth year. The Cox model indicated a higher hazard of death among women smokers, with more hospitalizations, more exams, and, among those who used, who used only aromatase inhibitors, as hormone therapy modality. The hazard was lower among women with a partner (stable relationship), a high school or college education a family history of cancer, and those who were treated by a mastologist, oncologist, and/or psychotherapist, who underwent surgery, and who adhered to hormone therapy. Conclusions The study indicated more vulnerable sub-groups and the aspects of care that provide best results, bringing new knowledge to improve assistance to this group of women.


RESUMEN Objetivo Conocer mejor la función que desempeña la atención de salud en la supervivencia del cáncer de mama, investigando los efectos que tienen el cumplimiento de la hormonoterapia y otras variables relativas a la atención de salud, ajustados según los factores clínicos y sociodemográficos, en una población de mujeres de la ciudad brasileña de Río de Janeiro. Métodos Estudio longitudinal realizado a partir de los datos secundarios de 5 861 mujeres tratadas con hormonoterapia (tamoxifeno o inhibidores de la aromatasa) en el Instituto Nacional del Cáncer del Brasil (INCA), desde el 1 de enero del 2004 hasta el 29 de octubre del 2010. Se combinaron para el análisis cuatro fuentes de datos: el sistema de dispensación al sector farmacéutico del INCA; el registro oncológico hospitalario; el sistema integrado hospitalario y el sistema absoluto del INCA; y el sistema de información sobre mortalidad. Los análisis exploraron los efectos del cumplimiento terapéutico de la hormonoterapia, de determinados aspectos de la atención a la enfermedad y de las variables sociodemográficas, conductuales y clínicas sobre el tiempo de supervivencia, con la metodología de Kaplan-Meier y los modelos de riesgos instantáneos proporcionales de Cox. Resultados La tasa de supervivencia general fue del 94% al año de iniciar la hormonoterapia y del 71% a los cinco años. El modelo de Cox indica que el riesgo de muerte es mayor para las mujeres fumadoras, para las que fueron hospitalizadas más veces, para las que se sometieron a más exploraciones y para las que solo toman un inhibidor de la aromatasa como hormonoterapia. El riesgo es menor para las mujeres con pareja (relación estable), con estudios secundarios o universitarios y con antecedentes familiares de cáncer, así como para las atendidas por un mastólogo, oncólogo o psicoterapeuta, para las intervenidas quirúrgicamente y para las que cumplieron la hormonoterapia. Conclusiones El estudio señala los subgrupos más vulnerables y los aspectos de la atención de salud que se corresponden con resultados más favorables, aportando datos nuevos para mejorar la asistencia dispensada a este grupo de mujeres.


Subject(s)
Breast Neoplasms/diagnosis , Survival Analysis , Antibiotics, Antineoplastic/administration & dosage , Brazil
20.
Article in English | LILACS | ID: lil-785826

ABSTRACT

ABSTRACT INTRODUCTION: Local progression of papillary thyroid carcinoma (PTC) after failure of standard therapies may cause pain, ulceration, and bleeding. As patients are fully aware of the tumor growth, they might suffer high grade anxiety. Electrochemotherapy (ECT) is a new local palliative treatment for skin metastases of malignant melanoma or other tumors, including squamous head e neck cancer patients. OBJECTIVE: To evaluate the impact of ECT in patients with local progression of PTC. METHODS: Four patients with local progression of PTC were treated with ECT based on Bleomycin, and evaluated according to tumor response, local pain and side effects. RESULTS: In all cases, some grade of tumor response was observed, lasting 6, 7, 12 and 8 months, respectively. Also, reduction of local pain and anxiety was registered in all patients. Tumor infiltrated skin necrosis was the only collateral effect of the treatment. ECT induced a tumor response in all PTC patients with improvement of symptoms. CONCLUSIONS: ECT may be an option for local palliative treatment in PTC patients with local tumor progression.


Resumo Introdução: A progressão local do carcinoma papilífero de tireoide (CPT) após a falha da terapia de rotina pode causar dor, ulceração e sangramento. Considerando que os pacientes estão perfeitamente cientes do crescimento tumoral, podem apresentar um alto grau de ansiedade. A eletroquimioterapia (EQT) é um novo tratamento paliativo para metástases de pele de melanoma maligno ou de outros tumores, inclusive em pacientes com carcinoma escamoso de cabeça e pescoço. Objetivo: Avaliar o impacto da EQT em pacientes com progressão local de CPT. Método: Quatro pacientes com progressão local de CPT foram tratados com EQT com base em bleomicina, e avaliados em relação ao grau de resposta tumoral, dor local, efeitos colaterais. Resultados: Em todos os casos, foi observado algum grau de resposta tumoral, que perdurou por 6, 7, 12 e 8 meses, respectivamente. Da mesma forma, foi registrada diminuição da dor local e da ansiedade em todos os pacientes. Necrose cutânea na infiltração tumoral foi o único efeito colateral do tratamento. EQT induziu resposta tumoral em todos os pacientes com CPT, com melhora dos sintomas. Conclusões: EQT pode ser uma opção para o tratamento paliativo tópico em pacientes com CPT com progressão tumoral local.


Subject(s)
Humans , Male , Female , Middle Aged , Palliative Care , Bleomycin/administration & dosage , Thyroid Neoplasms/drug therapy , Carcinoma/drug therapy , Electrochemotherapy , Antibiotics, Antineoplastic/administration & dosage , Carcinoma, Papillary , Treatment Outcome , Thyroid Cancer, Papillary , Neoplasm Recurrence, Local
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