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1.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 661-665, jan.-dez. 2021. ilus
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1178716

ABSTRACT

Objetivo: Identificar os estudos que descrevem a prevalência de xerostomia em pacientes com câncer de mama e em quimioterapia. Método: Revisão integrativa, partindo da questão norteadora << Quais as evidências científicas sobre a prevalência de xerostomia em pacientes com câncer de mama e em quimioterapia? >>. Foi realizada uma busca nas bases de dados: US National Library of Medicine and National Institute of Health, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Scientific Electronic Library Online por meio dos Descritores em Ciências da Saúde. Foram encontrados 63 artigos, analisados por dois pesquisadores seguindo os critérios de inclusão e exclusão. Resultados: A prevalência de xerostomia foi descrita em 10 artigos que utilizaram como método de avaliação escalas, questionários com respostas dicotômicas e sialometria. Conclusão: Identificou-se uma prevalência de 47% a 77,3% de xerostomia durante a quimioterapia


Objective: To identify studies describing the prevalence of xerostomia in breast cancer patients undergoing chemotherapy. Method: Integrative review based on the guiding question << What is the scientific evidence on the prevalence of xerostomia in breast cancer patients undergoing chemotherapy? >>. We searched the US National Library of Medicine and National Institute of Health, Latin American and Caribbean Health Sciences Literature and Scientific Electronic Library Online databases using the Health Sciences Descriptors. We found 63 articles, which were analyzed by two researchers, following the inclusion and exclusion criteria. Results: The prevalence of xerostomia was described in 10 articles that used scales, questionnaires with dichotomous answers, and sialometry as evaluation methods. Conclusion: A prevalence of 47% to 77.3% of xerostomia during chemotherapy was identified


Objetivo: Identificar estudios que describen la prevalencia de xerostomía en pacientes con cáncer de mama y quimioterapia. Método: Revisión integradora, basada en la pregunta guía << ¿Cuál es la evidencia científica sobre la prevalencia de xerostomía en pacientes con cáncer de mama y quimioterapia? >>. Se realizaron búsquedas en las bases de datos US National Library of Medicine and National Institute of Health, Literatura Latino-Americana y del Caribe en Ciencias de la Salud y Scientific Electronic Library Online utilizando los Descriptores de Ciencias de la Salud. Encontramos 63 artículos, que fueron analizados por dos investigadores siguiendo los criterios de inclusión y exclusión. Resultados: La prevalencia de xerostomía se describió en 10 artículos que utilizaron escalas, cuestionarios con respuestas dicotómicas y sialometría como método de evaluación. Conclusión: Se identificó una prevalencia de xerostomía del 47% al 77,3% durante la quimioterapia


Subject(s)
Humans , Male , Female , Xerostomia/etiology , Breast Neoplasms/complications , Chemotherapy, Adjuvant/adverse effects , Prevalence , Antineoplastic Agents/adverse effects
2.
Rev. Col. Bras. Cir ; 47: e20202460, 2020. tab, graf
Article in English | LILACS | ID: biblio-1143691

ABSTRACT

ABSTRACT Objectives: to analyze the survival in juvenile melanoma. Methods: retrospective study conducted by hospital record review and cancer records of patients aged 0 to 19 years, with histologically proven melanoma and treated between 1997 and 2017 at the Erasto Gaertner Hospital in Curitiba-PR. Results: the sample comprised 24 patients, female (62.5%), mean 14.14 ± 4.72 years old, with head and neck melanoma (37.5%), chest (25%) and extremities. (20.8%). Signs and symptoms at diagnosis were increased lesion size (25%), bleeding (20.8%) and pruritus (16.6%). There was a Breslow II and IV index and Clark IV level, with a statistical tendency between Breslow IV and death (p = 0.127), and significance between Clark V and death (p = 0.067). Nine (37.5%) patients had metastases, six (25%) with distant metastases died (p = 0.001), five were girls (20.8%). Surgery was the standard treatment and chemotherapy the most used adjuvant (37.5%). The average time between diagnosis and death was 1.3 ± 1.2 years and survival were 3.7 ± 3.2 years. Conclusion: there was a delay in diagnosis, high morbidity and mortality and average survival less than five years.


RESUMO Objetivos: analisar a sobrevida no Melanoma Infantojuvenil. Métodos: estudo retrospectivo realizado mediante revisão de prontuários e registros hospitalares de câncer, de pacientes na faixa etária de 0 a 19 anos, com melanoma comprovado histologicamente e atendidos entre 1997 e 2017 no Hospital Erasto Gaertner em Curitiba-PR. Resultados: amostra composta por 24 pacientes, sexo feminino (62,5%), média de 14,12 ± 4,72 anos de idade, com melanoma em cabeça e pescoço (37,5%), tórax (25%) e extremidades (20,8%). Os sinais e sintomas ao diagnóstico foram aumento do tamanho da lesão (25%), sangramento (20,8%) e prurido (16,6%). Ocorreu Índice de Breslow II e IV e Nível de Clark IV, com tendência estatística entre Breslow IV e óbito (p=0,127) e significância entre Clark V e óbito (p=0,067). Nove (37,5%) pacientes apresentaram metástases, seis (25%) com metástases à distância morreram (p=0,001), cinco eram meninas (20,8%). A cirurgia foi o tratamento padrão e a quimioterapia o adjuvante mais utilizado (37,5%). A média de tempo entre diagnóstico e óbito foi de 1,3 ± 1,2 anos e de sobrevida foi 3,7 ± 3,2 anos. Conclusão: houve atraso no diagnóstico, alta morbimortalidade e média de sobrevida menor do que cinco anos.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Young Adult , Skin Neoplasms/mortality , Melanoma/mortality , Prognosis , Survival Analysis , Survival Rate , Retrospective Studies , Chemotherapy, Adjuvant/adverse effects , Sentinel Lymph Node , Head and Neck Neoplasms/surgery , Melanoma/pathology , Melanoma/therapy , Neoplasm Metastasis , Neoplasm Staging
3.
São Paulo; s.n; 2020. 33 p.
Thesis in Portuguese | LILACS, Inca | ID: biblio-1178933

ABSTRACT

Introdução: A quimioterapia perioperatória e cirurgia são o padrão de tratamento para pacientes com câncer gastroesofágico avançado, entretanto, seu impacto entre aqueles tratados com cirurgia radical carece de avaliação mais detalhada. Apresentamos os resultados desta abordagem de tratamento multimodal em uma coorte de pacientes com câncer gástrico tratados com linfadenectomia D2. Objetivo: identificar fatores prognósticos associados à melhora da sobrevida e resposta patológica associados ao tratamento neoadjuvante. Pacientes e métodos. Este estudo de coorte retrospectivo envolveu pacientes tratados com quimioterapia perioperatória e ressecção em um único centro oncológico no Brasil entre 2006 e 2016. Indivíduos com tumores do coto gástrico, tumores de esôfago ou tratados com quimioterapia intra-peritoneal foram excluídos. A análise de sobrevivência com intenção de tratar foi realizada para todos os indivíduos que iniciaram a quimioterapia neoadjuvante, e os fatores prognósticos foram determinados entre aqueles que tiveram ressecção R0. Resultados. Este estudo incluiu 239 pacientes, dos quais 198 tiveram ressecção R0. A média de idade foi de 59,9 anos e a maioria apresentava doença em estágio clínico IIB ou III (88%). Entre os 239 pacientes que iniciaram quimioterapia neoadjuvante, 207 (86,6%) completaram todos os ciclos de tratamento neoadjuvante, e a ressecção cirúrgica foi realizada em 225 indivíduos (94,1%). As taxas gerais de morbidade e mortalidade em 60 dias foram de 35,6% e 4,4%, respectivamente. Para toda a coorte, a sobrevida mediana foi de 78 meses e a taxa de sobrevida em 5 anos foi de 55,3%. Os fatores associados à pior sobrevida foram estágio ypT3­4, ypN, estágio, ressecção estendida e sem quimioterapia adjuvante. Conclusões. A quimioterapia perioperatória resultou em resultados muito bons para pacientes tratados com cirurgia radical, e o downstaging após a quimioterapia mostrou ser um determinante principal do prognóstico


Background. Perioperative chemotherapy and surgery are the standard of care in advanced gastroesophageal cancer patients, but its impact among those treated with radical surgery still needs further assessment. We present the results of this multimodality treatment approach in a gastric cancer patients cohort treated with D2 lymphadenectomy. We aimed to identify prognostic factors associated with improved survival. Patients and Methods. This retrospective cohort study enrolled patients treated with perioperative chemotherapy and resection in a single cancer center in Brazil between 2006 and 2016. Subjects presenting tumors of the gastric stump, esophageal tumors, or treated with intraperitoneal chemotherapy were excluded. Intention-to-treat survival analysis was performed for all subjects who started neoadjuvant chemotherapy, and prognostic factors were determined among those who had R0 resection. Results. This study included 239 patients, of whom 198 had R0 resection. The mean age was 59.9 years, and most had clinical stage IIB or III disease (88%). Among the 239 patients who started neoadjuvant chemotherapy, 207 (86.6%) completed all neoadjuvant treatment cycles, and surgical resection was performed in 225 subjects (94.1%). Overall 60-day morbidity and mortality rates were 35.6% and 4.4%, respectively. For the entire cohort, median survival was 78 months and the 5-year survival rate was 55.3%. Factors associated with worse survival were ypT3­4 stage, ypN stage, extended resection, and no adjuvant chemotherapy. Conclusions. Perioperative chemotherapy resulted in very good outcomes for patients treated with radical surgery, and downstaging after chemotherapy was shown to be a major determinant of prognosis


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Prognosis , Stomach Neoplasms/therapy , Survival , Chemotherapy, Adjuvant/adverse effects
4.
Arq. bras. cardiol ; 107(1): 40-47, July 2016. tab, graf
Article in English | LILACS | ID: lil-792490

ABSTRACT

Abstract Background: Cardiotoxicity is an important side effect of trastuzumab therapy and cardiac surveillance is recommended. Objectives: The aim of our study was to prospectively assess baseline patients' characteristics, level of N-terminal pro-brain natriuretic peptide (NT-proBNP) and echocardiographic parameters as possible predictors of trastuzumab-related cardiac dysfunction. Methods: In a prospective cohort study, clinical, echocardiographic and neurohumoral assessment was performed at baseline, after 4, 8 and 12 months in breast cancer patients undergoing post-anthracycline (3-4 cycles) adjuvant therapy with trastuzumab. Trastuzumab-related cardiac dysfunction was defined as a decline of ≥ 10% in left ventricular ejection fraction (LVEF). Results: 92 patients (mean age, 53.6 ± 9.0 years) were included. Patients who developed trastuzumab-related LVEF decline ≥ 10% (20.6%) during treatment had significantly higher baseline LVEF (70.7 ± 4.4%) than those without (64.8 ± 5.5%) (p = 0.0035). All other measured baseline parameters (age, body mass index, arterial hypertension, level of NT-proBNP and other echocardiographic parameters) were not identified as significant. Conclusions: Our findings suggest that baseline patient' characteristics, level of NT-proBNP and echocardiographic parameters, as long as they are within normal range, are not a reliable tool to predict early trastuzumab-related cardiac dysfunction in patients undergoing post-low dose anthracycline adjuvant trastuzumab therapy. A LVEF decline in patients with high-normal baseline level although statistically significant is not clinically relevant.


Resumo Fundamento: Cardiotoxicidade é um importante efeito colateral da terapia com trastuzumabe, recomendando-se vigilância cardíaca. Objetivos: Avaliar prospectivamente as características basais de pacientes, nível de fração N-terminal do pró-peptídeo natriurético cerebral (NT-proBNP) e parâmetros ecocardiográficos como possíveis preditores de disfunção cardíaca relacionada ao trastuzumabe. Métodos: Em um estudo clínico prospectivo de coorte, realizou-se avaliação ecocardiográfica e neuro-humoral basal, aos 4, 8 e 12 meses em pacientes com câncer de mama submetidas a terapia adjuvante com trastuzumabe após antraciclina (3-4 ciclos). Definiu-se disfunção cardíaca relacionada ao trastuzumabe como uma redução na fração de ejeção ventricular esquerda (FEVE) ≥ 10%. Resultados: Este estudo incluiu 92 pacientes (idade média, 53,6 ± 9,0 anos). Pacientes que desenvolveram redução na FEVE ≥ 10% (20,6%) relacionada ao trastuzumabe durante tratamento tinham FEVE basal significativamente maior (70,7 ± 4,4%) do que aqueles sem (64,8 ± 5,5%) (p = 0,0035). Todos os demais parâmetros basais medidos (idade, índice de massa corporal, hipertensão arterial, nível de NT-proBNP e outros parâmetros ecocardiográficos) não foram identificados como significativos. Conclusões: Nossos achados sugerem que as características basais das pacientes, nível de NT-proBNP e parâmetros ecocardiográficos, contanto que dentro da variação normal, não são ferramentas confiáveis para predição precoce de disfunção cardíaca relacionada ao trastuzumabe em pacientes submetidas a terapia adjuvante com trastuzumabe após baixa dose de antraciclina. Uma redução na FEVE em pacientes com FEVE basal alta-normal, ainda que estatisticamente significativa, não é clinicamente relevante.


Subject(s)
Humans , Animals , Female , Adult , Middle Aged , Aged , Peptide Fragments/blood , Breast Neoplasms/drug therapy , Anthracyclines/adverse effects , Natriuretic Peptide, Brain/blood , Heart Failure/chemically induced , Antineoplastic Agents/adverse effects , Reference Values , Stroke Volume/drug effects , Time Factors , Blood Pressure/drug effects , Echocardiography, Doppler , Body Mass Index , Logistic Models , Predictive Value of Tests , Prospective Studies , Risk Factors , Treatment Outcome , Chemotherapy, Adjuvant/adverse effects , Receptor, ErbB-2 , Cardiotoxicity/etiology , Trastuzumab/adverse effects
5.
Rev. bras. cancerol ; 61(3): 227-234, jul.-set. 2015.
Article in Portuguese | LILACS | ID: biblio-833860

ABSTRACT

Introdução: A quimioterapia aparece como promotora do aumento no peso e no percentual de gordura, os quais estão em conexão com o desenvolvimento da carcinogênese mamária. Objetivo: Avaliar a influência do tratamento antineoplásico sobre a composição corporal e vetores de impedância bioelétrica em mulheres com neoplasia da mama. Método: Estudo observacional, tipo antes e depois, realizado de março de 2012 a junho de 2013, no Hospital Geral de Fortaleza (Ceará, Brasil), com 30 mulheres com tumor na mama, avaliadas após o diagnóstico e antes do tratamento antineoplásico (M1), e após o tratamento antineoplásico (M2). Coletaram-se dados antropométricos, de composição corporal e valores de resistência (R) e reactância (Xc) para análise vetorial de impedância bioelétrica (BIVA). Resultados: Os percentuais de gordura corporal estiveram acima do recomendado nos dois momentos [M1= 35,6% (4,9) e M2= 35,3% (4,7)] e os valores de massa magra foram, respectivamente, 64,3% (4,9), 64,6% (4,7) sem diferenças significativas. A Reactância (p=0,001) e o ângulo de fase (p=0,000) apresentaram-se diminuídos no M2. Os vetores de impedância, quando comparados M1 e M2, não mostraram deslocamento significativo (p=0,053). Entretanto, ao serem comparados com o vetor médio de uma população de referência, apresentaram deslocamento significativo antes (T2=95,2; p=0,000) e após (T2=53,2; p=0,000) o tratamento antineoplásico, indicando alterações nas propriedades elétricas dos tecidos, retenção hídrica e perda de massa celular. Conclusão: A composição corporal não se alterou após o tratamento antineoplásico. As modificações nos vetores de impedância foram sugestivas de alterações nas propriedades elétricas dos tecidos, indicando pior prognóstico clínico.


Introduction: Chemotherapy appears to promote increased weight and fat percentage, which are in connection with the development of mammary carcinogenesis. Objective: To evaluate the influence of the anti-cancer treatment on body composition and bioelectrical impedance vectors in women with breast cancer. Method: Observational study, both before and after, held from March 2012 to June 2013 at the General Hospital of Fortaleza (Ceará, Brazil), with 30 women with breast tumors, assessed after diagnosis and before the anti-cancer treatment (M1), and after the anticancer treatment (M2). The study collected anthropometric data, body composition and resistance values (R) and reactance (Xc) for vector analysis of bioelectrical impedance (BIVA). Results: The percentage of body fat was above the recommended levels in both instances [M1 = 35.6% (4.9) and M2 = 35.3% (4.7)] and lean body mass values were, respectively, 64 3% (4.9) 64.6% (4.7), without significant differences. The reactance (p=0.001) and the phase angle (p = 0.000) had become reduced in M2. The impedance vectors, when M1 and M2 were compared, showed no significant shift (p=0,053). However, when compared with the mean vector of a reference population, it presented a significant displacement before (T2=95,2; p=0,000) and after (T2=53,2; p=0,000) the antineoplastic treatment, indicating alterations in the electrical properties of the tissue, fluid retention and loss of cell mass. Conclusion: Body composition did not change after the anti-cancer treatment. Changes in impedance vectors were suggestive of changes in the electrical properties of tissue, indicating a poorer clinical prognosis.


Introducción: Quimioterapia promueve el aumento en porcentaje en peso y la grasa corporal que están en conexión con el desarrollo de la carcinogénesis mamaria. Objetivo: Evaluar la influencia del tratamiento antineoplásico en la composición corporal y en la bioimpedancia vectorial eléctrica en mujeres con cáncer de mama. Método: Estudio observacional incluyendo el antes y el después, llevado de marzo de 2012 a junio de 2013 en el Hospital Geral de Fortaleza (Ceará, Brasil), con 30 mujeres con tumores de mama, evaluadas después del diagnóstico y antes del tratamiento antineoplásico (M1) y después del tratamiento antineoplásico (M2). Fueron recogidos los datos antropométricos, la composición corporal y valores de resistencia (R) y de reactancia (Xc) para Análisis de Bioimpedancia Vectorial Eléctrica (BIVA). Resultados: Los porcentajes de grasa corporal estuvieron por encima de los niveles recomendados en ambos momentos [M1=35,6%(4,9) y M2=35,3%(4,7)] y los valores de masa corporal magra fueron, respectivamente, 64,3% (4,9) 64,6% (4,7), sin diferencias significativas. La reactancia (p=0,001) y el ángulo de fase (p=0,000) se redujeron en M2. Los vectores de impedancia cuando se comparan M1 y M2 no mostraron cambio significativo (p = 0,053). Sin embargo, cuando se compara con el vector medio de una población de referencia, dichos vectores mostraron un cambio significativo antes (T2=95,2; p=0,000) y después (T2=53,2; p=0,000) del tratamiento antineoplásico, lo que indica cambios en las propiedades eléctricas del tejido, retención de líquidos y la pérdida de masa celular. Conclusión: La composición corporal no cambió después del tratamiento antineoplásico. Los cambios en los vectores de impedancia son indicadores de los cambios en las propiedades eléctricas de los tejidos, lo que indica un peor pronóstico clínico.


Subject(s)
Humans , Female , Body Composition/drug effects , Breast Neoplasms , Chemotherapy, Adjuvant/adverse effects , Drug-Related Side Effects and Adverse Reactions , Electric Impedance , Observational Study
6.
Rev. bras. cancerol ; 61(3): 235-242, jul.-set. 2015.
Article in Portuguese | LILACS | ID: biblio-833863

ABSTRACT

Introdução: A Avaliação Subjetiva Global Produzida pelo Próprio Paciente é recomendada durante a assistência nutricional em oncologia para detecção precoce do risco nutricional ou desnutrição. A localização do tumor e o esquema quimioterápico podem por si só auxiliar na detecção do risco nutricional. Objetivo: Descrever a classificação do estado nutricional, segundo método subjetivo, e os indicadores de risco nutricional no paciente oncológico em quimioterapia. Método: Estudo descritivo do tipo série de casos, realizado no setor de quimioterapia de um hospital universitário, de agosto a dezembro de 2014. Participaram da pesquisa indivíduos adultos e idosos, de ambos os sexos, com idade ≥20 anos, diagnosticados com câncer, acompanhados ambulatorialmente e que haviam iniciado o primeiro ciclo de quimioterapia. A localização do tumor e a terapia antineoplásica foram utilizadas como indicadores de risco nutricional. A avaliação nutricional foi realizada pela Avaliação Subjetiva Global Produzida pelo Próprio Paciente. Resultados: Foram estudados 30 pacientes, com idade média de 49,1±16,4 anos. Vinte e cinco entrevistados (83%) eram tratados exclusivamente com quimioterapia. Segundo a localização do tumor e o esquema quimioterápico, 67% e 100%, respectivamente, foram considerados de médio a alto risco nutricional. Pela avaliação subjetiva, 17 (56,7%) apresentaram risco nutricional ou desnutrição moderada (grau B) e seis (20%) desnutrição grave (grau C).Pela pontuação obtida no formulário subjetivo, a necessidade de intervenção nutricional foi verificada em 23 (76,7%). Conclusão: Na amostra estudada, foram elevadas as frequências de tumores e terapias agressivas de risco nutricional/desnutrição, assim como de necessidade de indicação de terapia nutricional.


Introduction: The Subjective Global Assessment produced by the patient is recommended for during the nutritional care in oncology, for the early detection of nutritional risk or malnutrition. The location of the tumor and the chemotherapy course may, in themselves, aid in the detection of nutritional risk. Objective: To describe the classification of nutritional status according to the subjective method, together with nutritional risk factors in cancer patients undergoing chemotherapy. Method: This is a case series study held at the chemotherapy unit of a university hospital, from August to December 2014. The participants were adult and elderly outpatients of both sexes, aged≥20 years, diagnosed with cancer, and who had begun the first cycle of chemotherapy. The location of the tumor and the antineoplastic therapy were used as indicators of nutritional risk. Nutritional assessment was performed via the Subjective Global Assessment produced by the patient themselves. Results: 30 patients were studied, with an average age of 49.1 ± 16.4 years. Twenty-five respondents (83%) were treated solely with chemotherapy. According to the location of the tumor and the course of chemotherapy, 67% and 100% of the cases, respectively, were classified as medium to high nutritional risk. By subjective assessment, 17 (56.7%) presented a nutritional risk or moderate malnutrition (Grade B) and 6 (20%) severe malnutrition (Grade C). By way of the score via subjective assessment, the need for nutritional intervention was detected in 23 cases (76.7%). Conclusion: The sample studied revealed high frequencies of tumors and aggressive therapies that could cause nutritional risk/malnutrition, highlighting the necessity of nutritional therapy.


Introducción: La Valoración Subjetiva Global Generada por el Paciente es recomendada durante la asistencia nutricional en oncología para la detección precoz del riesgo nutricional o desnutrición. La localización del tumor y del esquema quimioterápico pueden por si solo auxiliar en la detección del riesgo nutricional. Objetivo: Describir la clasificación del estado nutricional según el método subjetivo y los indicadores de riesgo nutricional en el paciente con cáncer en quimioterapia. Método: Estudio del tipo serie de casos, realizado en el sector de quimioterapia de un hospital universitario, de agosto a diciembre de 2014. Participaron de la investigación individuos adultos y ancianos, de ambos los sexos, con edad ≥20 años, diagnosticados con cáncer, acompañados ambulatoriamente y que habían iniciado el primer ciclo de quimioterapia. La localización del tumor y la terapia antineoplásica fueron utilizadas como indicadores de riesgo nutricional. La evaluación nutricional fue realizada por la Valoración Subjetiva Global Generada por el Paciente. Resultados: Fueron estudiados 30 pacientes, con edad media de 49,1±16,4 años. 25 encuestados (83%) fueron tratados únicamente con quimioterapia. Segundo la localización del tumor y el esquema quimioterápico, 67% y 100%, respectivamente, fueron considerados de medio a alto riesgo nutricional. A través de la evaluación subjetiva, 17 (56,7%) presentaron riesgo nutricional o desnutrición moderada (Grado B) y 6 (20%) desnutrición grave (Grado C). A través de la puntuación obtenida del formulario subjetivo, la necesidad de intervención nutricional fue verificada en 23 (76,7%) pacientes. Conclusión: En la muestra estudiada fueron altas las frecuencias de tumores y terapias agresivas de riesgo nutricional/desnutrición, así como se observó la necesidad de indicación de terapia nutricional.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Drug-Related Side Effects and Adverse Reactions/prevention & control , Nutrition Assessment , Nutritional Status , Chemotherapy, Adjuvant/adverse effects , Epidemiology, Descriptive , Neoplasms
7.
Rev. bras. cancerol ; 61(2): 115-121, abr./jun. 2015.
Article in Portuguese | LILACS | ID: biblio-833809

ABSTRACT

Introdução: Náuseas e vômitos estão entre os efeitos mais frequentes da quimioterapia antineoplásica, afetando cerca de 70% a 80% dos pacientes. A terapia antiemética objetiva prevenir o surgimento desses efeitos. Objetivo: Verificar a conformidade das prescrições de antieméticos, em uma unidade oncológica, de acordo com as diretrizes internacionais. Método: Estudo retrospectivo-descritivo a partir da coleta de dados das prescrições de quimioterapia do serviço de oncologia de um hospital universitário de Belém. Foram analisadas as prescrições dos pacientes ambulatoriais atendidos durante o período de um ano. Para a classificação do nível emetogênico de quimioterápicos isolados, utilizaram-se as classificações adotadas pela Multinational Association of Suportive Care in Cancer, American Society of Clinical Oncology e National Comprehensive Cancer Network; e, para associações de quimioterápicos, o algoritmo de Hesketh e colaboradores. Resultados: Entre as 143 prescrições analisadas, 27,3% apresentaram nível emetogênico baixo, 0,7% moderado e 72% alto. O estudo demonstrou que houve variabilidade entre as prescrições de antieméticos analisadas e as principais diretrizes. Quanto às não conformidades observadas, 53,8% ocorreram no manejo da terapia de nível emetogênico baixo, envolvendo associação ou dose; 100% no nível moderado e 27,2% no nível alto, relacionados à dose.Conclusão: A prevenção adequada das náuseas e vômitos é essencial para preservar a qualidade de vida dos pacientes oncológicos. Dessa forma, é necessário um protocolo intra-hospitalar para prescrição de antieméticos conforme as diretrizes internacionais. Esta pesquisa também alerta para a necessidade da intervenção farmacêutica em tempo real a fim de contribuir para o uso racional de medicamentos.


Subject(s)
Humans , Male , Female , Antiemetics/therapeutic use , Chemotherapy, Adjuvant/adverse effects , Nausea/drug therapy , Nausea/prevention & control , Vomiting/prevention & control
8.
Einstein (Säo Paulo) ; 12(4): 502-504, Oct-Dec/2014. graf
Article in Portuguese | LILACS | ID: lil-732464

ABSTRACT

O câncer de bexiga é um importante problema de saúde mundial, tanto pelas elevadas taxas de prevalência, quanto pelos custos relacionados ao tratamento. Desde a introdução da imunoterapia intravesical adjuvante com bacilo Calmette-Guérin, vem sendo observada diminuição na taxa de recorrência. As principais complicações são de pequeno porte e simples resolução a partir de medidas locais e orientações. A bexiga contraída, uma complicação local rara e grave, mas incapacitante em alguns casos, é observada principalmente em doentes com um programa de manutenção. Relatamos aqui o caso de um paciente masculino submetido a ressecção transuretral da bexiga por um carcinoma urotelial T1 de alto grau, que desenvolveu tal complicação durante tratamento com bacilo Calmette-Guérin, sendo portanto submetido à cistoprostatectomia com realização de neobexiga ortotópica ileal.


Bladder cancer is an important health problem worldwide due to high prevalence rates and costs related to treatment. A reduction in recurrence rates has been observed since the introduction of adjuvant intravesical immunotherapy with bacillus Calmette-Guerin. There are mild complications that are easily solved by local measures and orientations. Bladder contracture, a rare and severe local complication, in some cases leading to disability, is observed primarily in patients in a maintenance program. In this article we reported the case of a male patient who underwent transurethral resection of the bladder because of a high-grade T1 urothelial carcinoma and developed this complication during treatment with bacillus Calmette-Guerin. For this reason he was submitted to cystoprostatectomy with orthotopic ileal neobladder reconstruction.


Subject(s)
Humans , Male , Middle Aged , Adjuvants, Immunologic/adverse effects , BCG Vaccine/adverse effects , Carcinoma/therapy , Contracture/surgery , Cystectomy/methods , Urinary Bladder , Urinary Bladder Diseases/surgery , Urinary Bladder Neoplasms/therapy , Administration, Intravesical , Carcinoma/complications , Chemotherapy, Adjuvant/adverse effects , Contracture/etiology , Cystitis/surgery , Ileum/surgery , Treatment Outcome , Urinary Bladder Diseases/etiology , Urinary Bladder Neoplasms/complications , Urinary Diversion/methods
9.
Hist. ciênc. saúde-Manguinhos ; 21(4): 1301-1322, Oct-Dec/2014. graf
Article in Portuguese | LILACS | ID: lil-732508

ABSTRACT

A história da anatomia humana, de sua pesquisa e seu ensino no Brasil é tema pouco explorado academicamente. Observa-se a quase inexistência de uma visão mais abrangente do percurso da anatomia contextualizada pelas contingências nacionais, o que gera insegurança entre os pesquisadores que buscam aprofundar-se nessa temática, majorada pelo fato de que muitos dos dados disponíveis nem sempre se apresentam suficientemente apurados. Este texto visa retraçar o desenvolvimento da disciplina anatômica – de sua pesquisa e seu ensino no contexto paulista e nacional –, em muito sintetizada pela ação da autoproclamada escola boveriana de anatomia, fundada pelo médico italiano Alfonso Bovero, por ocasião da criação da Faculdade de Medicina da Universidade de São Paulo.


There is little scholarly research on the history, teaching and research of human anatomy in Brazil. A broader vision of the progress of anatomy under different circumstances in the country is virtually non-existent, leaving researchers keen to study the subject insecure. This is compounded by the fact that the data available are not always reliable. This text retraces the development of the discipline of anatomy and its research and education in Brazil in general and São Paulo state in particular, which can largely be reduced to the action of the self-proclaimed Boverian school of anatomy, founded by Italian physician Alfonso Bovero at the same time as the Medical Faculty of the University of São Paulo.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Antineoplastic Agents/therapeutic use , Carcinoma, Hepatocellular/drug therapy , Embolization, Therapeutic/methods , Floxuridine/therapeutic use , Combined Modality Therapy , Chemotherapy, Adjuvant/adverse effects , Embolization, Therapeutic/adverse effects , Floxuridine/adverse effects , Multivariate Analysis , Prospective Studies , Survival Rate , Treatment Outcome
10.
Rev. cuba. med. mil ; 43(3): 352-369, jul.-set. 2014. Ilus
Article in Spanish | LILACS, CUMED | ID: lil-731007

ABSTRACT

Los tumores del epidídimo son infrecuentes y la mayoría benignos, por lo que muchos no se informan en la literatura médica. En ocasiones, llegar al diagnóstico histológico de certeza, implica realizar múltiples exámenes al paciente y un reto al desempeño del médico. En el presente trabajo se hace un recuento anatómo-fisiológico del epidídimo, así como la actualización del tema de los tumores de dicho órgano, en lo referente al diagnóstico y tratamiento. Se efectuó una búsqueda bibliográfica, en las bases de datos de Hinari, PubMed, MEDLINE y en el motor de búsquedas de Google, en el periodo de 2009 a 2013. Se emplearon los términos del MeSH: tumores paratesticulares, tumores intraescrotales y tumores del epidídimo, en idioma español e inglés. También se revisaron libros de consulta y revistas especializadas. Se confirma el valor del interrogatorio y del examen físico minucioso, para establecer el diagnóstico topográfico y diferencial de estos tumores. Aunque el ultrasonido es el estudio imagenológico de elección para su valoración inicial, muchas veces no es concluyente, por lo que resulta necesario obtener imágenes por resonancia magnética nuclear para lograr información adicional. Cuando el cuadro clínico y los hallazgos de las imágenes suponen un tumor benigno, la citología aspirativa con aguja fina es una opción fiable para clasificarlos en benignos o malignos. No obstante, si esta no es definitoria, se recurre a la biopsia por congelación transoperatoria, la cual se obtiene mediante inguinotomía, y así se evita orquiectomías radicales innecesarias. Los tratamientos adyuvantes, para los tumores malignos, son muy particularizados según la edad del paciente, el tipo histológico y el estadio.


Epididymus tumors are rare and the majority of them are benign, so there is not much information about them in the medical literature. Reaching the final histological diagnosis implies multiple testing and represents a challenge for the physician's performance. The present paper made an anatomical and physiological review of the epididymus as well as provided updating on the tumors affecting this organ in terms of diagnosis and treatment. Literature search was made in databases Hinari, PubMed, Medline and in Goggle from 2009 to 2013. The MeSH terms were paratesticular tumors, intrascrotal tumors and epididymal tumors in Spanish and English. Reference books and specialized journals were also reviewed. This paper confirmed the value of questioning and of the detailed physical exam in order to set the topographic and differential diagnosis of these tumors. Although ultrasound is the imaging study of choice for initial assessment, it is often inconclusive; therefore, it is necessary to obtain nuclear magnetic resonance images so as to have additional information. When the clinical picture and the findings from images may indicate a benign tumor, then fine needle aspiration cytology is a reliable option to make the final classification. Nevertheless, if this technique is not conclusive, then there is the biopsy through transoperative freezing, which is taken with inguinotomy, thus avoiding unnecessary radical orchiectomies. The adjuvant treatments for malignant tumors are very customized since they depend on the patient's age, the histological type and the tumor staging.


Subject(s)
Humans , Magnetic Resonance Imaging/statistics & numerical data , Chemotherapy, Adjuvant/adverse effects , Biopsy, Fine-Needle/methods , Epididymis/injuries , Genital Diseases, Male/diagnosis , Neoplasms/pathology
11.
Rev. pediatr. electrón ; 11(1)abr. 2014.
Article in Spanish | LILACS | ID: lil-719016

ABSTRACT

Es conocido que la radiación ha sido asociada a una cicatrización disminuida de las heridas, necrosis grasa y decoloración. La quimioterapia, por otra parte, se ha descrito con efectos adversos como infección, necrosis, contractura o deformación de los colgajos. Los antecedentes previos son los causantes de cierta confusión al enfrentar pacientes oncológicos que durante su evolución requieren solucionar defectos de piel y tejidos blandos: es seguro realizar injertos o colgajos en un paciente que está siendo tratado con quimio o radioterapia? Por medio de la revisión de la literatura publicada buscamos dar respuesta a esta interrogante.


It is known that the radiation has been associated with decreased wound healing, fat necrosis and bleaching. Chemotherapy, on the other hand, has been described with side effects as infection, necrosis, contraction or deformation of the flaps. The previous history are causing some confusion that may arise when facing cancer patients that during their evolution require fix skin and soft tissue defects: is it safe do grafts or flaps in a patient being treated with chemotherapy or radiation therapy? Through the review of the published literature we seek to answer this question.


Subject(s)
Humans , Male , Female , Child , Adult , Skin Abnormalities/drug therapy , Neoplasms/surgery , Chemotherapy, Adjuvant/adverse effects , Radiotherapy, Adjuvant/adverse effects , Surgical Flaps , Transplants/abnormalities , Skin Abnormalities/radiotherapy , Neoplasms/drug therapy , Neoplasms/radiotherapy , Skin , Combined Modality Therapy/adverse effects
12.
Gut and Liver ; : 254-264, 2014.
Article in English | WPRIM | ID: wpr-163243

ABSTRACT

BACKGROUND/AIMS: The aim of this study was to evaluate the influence of recent chemotherapy on the patterns of the maximum-standardized uptake value (M-SUV) and sensitivity of 18F-fluoro-deoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in colorectal cancer. METHODS: We retrospectively analyzed the FDG-PET/CT of 509 patients who underwent surgery for colorectal cancer. Subgroup analysis was performed according to chemotherapy status; 401 patients were not treated with chemotherapy and 108 patients were treated with chemotherapy within 6 months prior to surgery. Pathologic analysis of the surgical specimen was used as the gold standard. RESULTS: The M-SUV was significantly lower in patients treated with chemotherapy than in those not treated with chemotherapy in pathologically confirmed same stages of disease. The difference in the sensitivity of the M-SUV according to chemotherapy status was greatest using a cutoff M-SUV value of 6.4 (p<0.001). The longest diameter of the primary tumor was the most important factor that correlated with M-SUV of the primary tumor irrespective of the chemotherapy effect (p<0.001). The M-SUV of the primary tumor was not an independent predictor of lymph node metastasis in colorectal cancer. CONCLUSIONS: The results indicate that the M-SUV of FDG-PET/CT should be interpreted in the context of concurrent chemotherapy.


Subject(s)
Aged , Antineoplastic Agents/adverse effects , Chemoradiotherapy, Adjuvant/adverse effects , Chemotherapy, Adjuvant/adverse effects , Colorectal Neoplasms/drug therapy , Female , Fluorodeoxyglucose F18 , Humans , Male , Neoplasm Invasiveness , Neoplasm Metastasis , Positron-Emission Tomography/methods , Radiopharmaceuticals , Retrospective Studies
13.
Rev. Hosp. Clin. Univ. Chile ; 24(2): 142-149, 2013. tab, graf
Article in Spanish | LILACS | ID: biblio-996036

ABSTRACT

Cancer is a disease that impairs health of those who suffer it, affecting their quality of life. Chemotherapy produces deterioration on functional capacity as a result of the effects of therapy. Particularly affected are those patients who have to be admitted to receive treatment, by the very effects of hospitalization and prolonged rest. The deterioration of functional capacity (quality of life indicator) is explained by the alteration of physical capacity and ability to perform activities of daily living (ADLs) in an independent fashion, constituent elements of functional capacity. Given the prevalence of this disease, and the disability associated with both the disease and treatment, it is necessary to incorporate into daily practice interventions to reduce the impact on functionality, favoring the adequate reintegration of the person into his or her environment. The aim of this review is to describe the mechanisms that alter functional capacity, and the effects of physical training programs, complementary therapies and multidimensional interventions on symptomatology, well-being and quality of life of cancer patients in medical treatment. (AU)


Subject(s)
Patient Care Team/organization & administration , Quality of Life , Interdisciplinary Communication , Oncology Service, Hospital/organization & administration , Chemotherapy, Adjuvant/adverse effects
14.
Journal of the Egyptian Society of Parasitology. 2011; 41 (3): 737-744
in English | IMEMR | ID: emr-117283

ABSTRACT

Conservative surgery with adjuvant chemotherapy has made the preservation of fertility even in patient with advanced disease. The increase in cure rate has shifted to research for the long term menstrual reproductive and gynecologic outcome in these patients. The current study is retrospective for 25 cases of ovarian malignant germ cell tumor from January 2006 to January 2011, at El Hussian and Sayed Galal University Hospitals. The uterus and contralateral ovary were retained to preserve ovarian function with or without chemotherapy, followed up for two years. The mean age of most patients ranged from 15-28 years [average 21.5 years]. According to International Federation of Gynecology and Obstetrics, the histological subtypes were ten dysgerminoma [40%]. Five immature teratoma [20%], three endodermal sinus tumor [12%], four mixed germ cell tumor [16%] three embryonic cell tumours [12%]. Stage I: tumors 15 cases [60%], Stage II: tumors one case [4%], Stage III tumors 6 cases [24%], Stage IV tumors 3 cases [12%]. Adjuvant chemotherapy was administered to 15 cases 60% and followed up for two years. There were two recurrences, one died at 7[th] day postoperative of massive pulmonary embolism with past history of D.V.T, five healthy live births in the chemotherapy group without birth defects, and one infertility case 4%


Subject(s)
Humans , Female , Chemotherapy, Adjuvant/adverse effects , Follow-Up Studies , Fertility/radiation effects , Combined Modality Therapy
15.
Rev. latinoam. enferm ; 18(4): 681-687, July-Aug. 2010. tab
Article in English | LILACS, BDENF | ID: lil-560078

ABSTRACT

This study aimed to analyze the occurrence of skin toxicity caused by drugs used in the protocol of neoadjuvant and adjuvant chemotherapy among women with breast cancer. Patient records of 72 women who were subject to this therapy between 2003 and 2006 were assessed. Of the 558 cycles of chemotherapy, 152 adverse events were registered. There were 37 registrations of dermatological toxicity, of those, 20 were extravasations that affected 17 women. Nine reports of hardened local injury, local fibrosis, pain, and hyperemia were registered during neoadjuvancy. In adjuvancy, among the 11 extravasations registered there were reports of hardened local injury, fibrosis and local pain. Lack of follow-up records for both periods was observed. Registration of the events and reports by the nursing team are essential to monitor the sites of venous puncture during the chemotherapy treatment, besides measuring and making a photographic record of the site.


O objetivo deste estudo foi analisar a ocorrência de toxicidade dermatológica, provocada por drogas utilizadas no protocolo de quimioterapia neoadjuvante e adjuvante, entre mulheres com câncer de mama. Foram avaliados 72 prontuários de mulheres submetidas a essa terapia, entre 2003 e 2006. De 558 ciclos de quimioterapia, foram registrados 152 eventos adversos, 37 de toxicidade dermatológica, e, desses, 20 eram ocorrências de extravasamento em um total de 17 mulheres. Observou-se nove ocorrências na neoadjuvância com registros nos prontuários de lesão endurecida no local, fibrose local, dor e hiperemia. Na adjuvância, dos 11 extravasamentos registrados, destacam-se lesão endurecida no local, fibrose e dor local. Houve falta de registro de seguimento e avaliação dos eventos adversos para os dois períodos. O registro das intercorrências pela equipe de enfermagem é essencial para o acompanhamento dos sítios de punções venosas, utilizados durante o tratamento quimioterápico, além da mensuração e registro fotográfico do local.


El objetivo de este estudio fue analizar la ocurrencia de toxicidad dermatológica provocada por drogas utilizadas en el protocolo de quimioterapia neoadyuvante y adyuvante entre mujeres con cáncer de mama. Fueron evaluadas 72 fichas de mujeres sometidas a esta terapia de 2003 a 2006. De 558 ciclos de quimioterapia, fueron registrados 152 eventos adversos, 37 de toxicidad dermatológica; de estos, 20 fueron ocurrencias de extravasación de líquido ocurridos en un 17 mujeres. Se observó 9 ocurrencias en la quimioterapia neoadyuvante con registros en las fichas de lesión endurecida en el local, fibrosis local, dolor e hiperemia. En la quimioterapia adyuvante, de las 11 extravasaciones registradas, se destacan lesión endurecida en el local, fibrosis y dolor local. Hubo falta de registro de seguimiento y evaluación de los eventos adversos para los dos períodos. El registro de las interocurrencias por el equipo de enfermería es esencial para el acompañamiento de los sitios de punciones venosas utilizados durante el tratamiento de quimioterapia, además de mensuración y registro fotográfico del local.


Subject(s)
Adult , Female , Humans , Middle Aged , Breast Neoplasms/drug therapy , Breast Neoplasms/nursing , Chemotherapy, Adjuvant , Extravasation of Diagnostic and Therapeutic Materials , Neoadjuvant Therapy , Skin/drug effects , Blacks , Chemotherapy, Adjuvant/adverse effects , Racial Groups , Whites , Neoadjuvant Therapy/adverse effects , Photography , Punctures
16.
Rev. otorrinolaringol. cir. cabeza cuello ; 70(2): 133-138, ago. 2010. tab
Article in Spanish | LILACS | ID: lil-577236

ABSTRACT

Introducción: El hipotiroidismo es una de las complicaciones del tratamiento del cáncer de cabeza y cuello, con incidencias que varían desde 7 por ciento a 57 por ciento. Objetivo: Estimar frecuencia de hipotiroidismo en pacientes con cáncer faringo laríngeo y determinar factores de riesgo. Material y método: Se realizó un estudio transversal, midiendo la función tiroidea de todos los pacientes diagnosticados y tratados por carcinoma escamoso de orofaringe, hipofaringe y laringe en el Servicio de Otorrinolaringología del Hospital San Juan de Dios entre enero de 2006 y diciembre de 2007. Resultados: El 55,5 por ciento presentó una función tiroidea alterada en la evaluación posterior al tratamiento. La modalidad de tratamiento es crucial, variando de 35 por ciento de alteración en el grupo tratado con radioterapia v/s 83 por ciento de afección cuando ésta se asoció a cirugía. La quimioterapia no mostró efectos. Conclusiones: El hipotiroidismo es una complicación frecuente, pero poco reconocida, que ocurre en más del 50 por ciento de los pacientes tratados por cáncer de orofaringe, hipofaringe y laringe.


Introduction: Hypothyroidism is a complication of head and neck cancer treatment, it incidence goes from 7 percent to 57 percent. Aim: To estímate frequency of hipothyroidism in patients with cáncer ofpharynxand larynx and to dertermine factor of risk. Material and method: Transversal study Thyroid function measurement in patients diagnosed and treated for oropharyngeal, hypophariyngeal and laryngeal squamous cell carcinoma at San Juan de Dios's Hospital since January 2006 to December 2007. Results: 55,5 percent presented an altered thyroid function after treatment. The treatment modality is crucial, on it's frequency, changing from 35 percent with radiotherapy, v/s 83 percent when this one was associated with surgery. The chemotherapy did not show effects. Conclusions: The hypothyroidism is a frequent, but slightly recognized complication, which happens in more than 50 percent of patients treated for for oropharyngeal, hypophariyngeal and laryngeal squamous cell carcinoma.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged, 80 and over , Carcinoma, Squamous Cell/therapy , Hypothyroidism/epidemiology , Pharyngeal Neoplasms/therapy , Oropharyngeal Neoplasms/therapy , Combined Modality Therapy , Cross-Sectional Studies , Carcinoma, Squamous Cell/complications , Factor Analysis, Statistical , Hypothyroidism/etiology , Hypothyroidism/physiopathology , Laryngectomy/adverse effects , Neoplasm Staging , Pharyngeal Neoplasms/complications , Oropharyngeal Neoplasms/complications , Chemotherapy, Adjuvant/adverse effects , Risk Factors , Radiotherapy/adverse effects
17.
Rev. enferm. UERJ ; 17(4): 575-580, out.-dez. 2009. tab
Article in Portuguese | LILACS, BDENF | ID: lil-550109

ABSTRACT

Estudo descritivo-exploratório de abordagem quantitativa, cujos objetivos foram conhecer e avaliar as práticas de autocuidado das mulheres com diagnóstico de câncer de mama submetidas à quimioterapia num ambulatório público de oncologia de Sergipe. A coleta de dados foi realizada com 58 mulheres cadastradas no ambulatório de oncologia do Hospital Cirurgia, no período de junho a dezembro de 2008, através de um roteiro de entrevista estruturada, aplicado durante a consulta de enfermagem. Os resultados evidenciaram que 30 (51,72%) mulheres realizavam três refeições diárias; 52 (89,85%) ingeriam de 5 a 10 copos de líquido por dia; 9 (15,52%) faziam escovação dentária a cada refeição; 37 (63,8%) hidratavam a pele; 2 (3,84%) não protegiam o couro cabeludo; 41 (95,36%) controlavam as náuseas e vômitos com medicação prescrita; 5 (8,62%) frequentavam ambientes fechados e lotados. Constatou-se que, durante o tratamento, nenhuma das entrevistadas aderiu corretamente às ações de autocuidado orientadas através da consulta de enfermagem.


Descriptive-exploratory study of quantitative approach, The goal of this study was to know and to evaluate the self care practices by women with a breast cancer diagnosis undergoing chemotherapy in a state-owned oncology ambulatory of Sergipe, Brazil. Data collection was carried through with 58 women registered at the oncology ambulatory of Hospital Cirurgia, from July to December, 2008, on the basis of a script for a structured interview, applied during the nursing consultation. Results showed that 30 (51.72%) women had 3 meals daily; 52(89.85%) take in from 5 to 10 glasses of liquid per day; 9(15.52%) had dental brushing after each meal; 37(63.8%) hydrated their skin; 2(3.84%) did not protect their scalps; 41(95.36%) controlled nausea and vomits with prescribed medication; 5(8.62%) were regularly in closed in and crowded places. There was evidence that during their treatment, none of the interviewees abided by the self-care actions recommended through nursing assistance sessions.


Estudio descriptivo-exploratorio de abordaje cuantitativo, cuyos objetivos fueron conocer y evaluar las prácticas de autocuidado de las mujeres con diagnóstico de cáncer de mama que realizan quimioterapia en un ambulatorio público de oncología de Sergipe-Brasil. La recopilación de datos fue realizada con 53 mujeres registradas en la clínica del oncología del Hospital Cirugía a través de un guión de entrevistas estructuradas utilizadas, en el período de julio el diciembre de 2008, durante la consulta de enfermería. Los resultados evidenciaron que 30(51.72%) mujeres realizan tres comidas diariamente; 52(89.85%) injieren de 5 a 10 tazas de líquido por día; 9 (15.52%) hacían el cepillado después de cada comida; 37(63.8%) hidrataban la piel; 2 (3.84%) no protegían el cuero cabeludo; 41(95.36%) controlaban náuseas y vomitos con medicación prescrita; 5 (8,62%) frecuentaban lugares cerrados y llenados. Se constató que, durante la quimioterapia, ninguna de las entrevistadas hizo adhesión correcta a las acciones de autocuidado orientadas a través de la consulta de enfermería.


Subject(s)
Humans , Female , Self Care/statistics & numerical data , Breast Neoplasms/nursing , Breast Neoplasms/drug therapy , Brazil , Data Interpretation, Statistical , Chemotherapy, Adjuvant/adverse effects
18.
Rev. cuba. cir ; 48(4)sept.-dic. 2009.
Article in Spanish | LILACS, CUMED | ID: lil-547058

ABSTRACT

El pesquizaje del cáncer de mama basado en el estudio mamográfico de las mujeres entre 50 y 65 años de edad constituye el mejor medio para realizar el diagnóstico precoz de la enfermedad. A menos de un mes de reiniciado este proceso en el Policlínico Cerro, se le diagnosticó a una paciente asintomática, de 59 años de edad, un tumor en línea media de los cuadrantes superiores de la mama izquierda. Se le realizó una cirugía conservadora, y se resecó un tumor de 0,7 cm de diámetro, que resultó ser un carcinoma ductal infiltrante en estadio precoz. La paciente fue clasificada de bajo riesgo, actualmente recibe tratamiento adyuvante con poliquimioterapia y su evolución es satisfactoria. Una vez más queda demostrada la importancia del pesquizaje como alternativa para lograr el tratamiento curativo del cáncer de mama, que hoy constituye la primera causa de muerte por cáncer no sólo en la mujer cubana(AU)


Screening of breast cancer based on mammography study of women aged between 50 and 65 is the better tool to perform the early diagnosis of this disease. At less than a month of onset of this process in Cerro polyclinic, a asymptomatic patient aged 59 was diagnosed with a tumor in middle line of high of the left breast quadrants. She underwent a conservative surgery and a ductal carcinoma of 0,7 cm was resected in early stage. Patient was classified as of low risk, nowadays she receives adjuvant treatment with polychemotherapy and its course is satisfactory. Again it was demonstrated the significance of screening as a alternative to achieve the curative treatment of breast cancer, which now is the first cause of death by cancer not only in Cuban woman(AU)


Subject(s)
Humans , Female , Middle Aged , Breast Neoplasms/diagnostic imaging , Mammography/methods , Carcinoma, Ductal, Breast/surgery , Chemotherapy, Adjuvant/adverse effects , Early Diagnosis
19.
Clinics ; 64(11): 1059-1064, Nov. 2009. graf, tab
Article in English | LILACS | ID: lil-532532

ABSTRACT

INTRODUCTION AND OBJECTIVE: Neoadjuvant and adjuvant therapies for soft tissue sarcomas of the extremities are still controversial. The aim of this study was to analyze the results of a protocol of neoadjuvant chemoradiation therapy for extremity sarcomas. METHODS: A retrospective analysis was carried out in a consecutive series of 49 adult patients with advanced extremity soft tissue sarcomas that could not be resected with adequate margins during the primary resection. All patients were treated with a protocol of preoperative radiation therapy at a total dose of 30 Gy, concomitant with doxorubicin (60 mg/m²) chemotherapy. The main endpoints assessed were local recurrence-free survival, metastasis-free survival and overall survival. The median follow-up time was 32.1 months. RESULTS: The five-year local recurrence-free survival, metastasis-free survival and overall survival rates were 81.5 percent, 46.7 percent and 58.3 percent, respectively. For high-grade tumors, the five-year metastasis-free and overall survival rates were only 36.3 percent and 41.2 percent, respectively. Severe wound complications were observed in 41.8 percent of the patients who underwent surgery. These complications precluded adjuvant chemotherapy in 73.7 percent (14/19) of the patients eligible to receive it. CONCLUSIONS: In this study, neoadjuvant chemoradiation therapy was associated with a good local control rate, but the distant relapse-free rate and overall survival rate were still poor. The high rate of wound complications modified the planning of adjuvant treatment in most patients.


Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Neoadjuvant Therapy/adverse effects , Sarcoma/mortality , Soft Tissue Neoplasms/mortality , Chemotherapy, Adjuvant/adverse effects , Doxorubicin/adverse effects , Epidemiologic Methods , Extremities , Neoplasm Recurrence, Local , Radiotherapy, Adjuvant/adverse effects , Sarcoma/therapy , Soft Tissue Neoplasms/therapy , Treatment Outcome , Young Adult
20.
Rev. méd. Chile ; 137(5): 649-656, mayo 2009. ilus, tab
Article in Spanish | LILACS | ID: lil-521867

ABSTRACT

Background: Survival rates after curative surgery for gastric cancer are disappointing. Therefore adjuvant therapeutic strategies are required. Aim: To analyze survival and side effects of treatment among gastric cancer patients treated with adjuvant chemo radiotherapy after curative resection of gastric adenocarcinoma. Material and methods: Retrospective review of medical records of 74 patients aged 20 to 74 years, treated with complete resection of gastric adenocarcinoma followed by adjuvant chemo radiation. Survival analysis was based on the records and information from the National Mortality Registry. Results: Five years survival fluctuated from 50 percent among patients in stage IB to 25 percent among those is stage IV. Significant acute toxicity was observed in 23 patients (31 percent). No patients died due to acute toxicity. Eleven patients (16.4 percent) developed significant late toxicity, with two possible deaths related to treatment. Conclusions: Postoperative chemo radiotherapy is feasible in our experience. Continues infusion of 5-fluoruracil is recommended to reduce toxicity.


Subject(s)
Adult , Aged , Humans , Middle Aged , Young Adult , Adenocarcinoma/therapy , Stomach Neoplasms/therapy , Adenocarcinoma/mortality , Chemotherapy, Adjuvant/adverse effects , Disease-Free Survival , Neoplasm Staging , Retrospective Studies , Radiotherapy, Adjuvant/adverse effects , Survival Analysis , Stomach Neoplasms/mortality , Treatment Outcome , Young Adult
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