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Article in Chinese | WPRIM | ID: wpr-879187


Astragali Radix-Curcumae Rhizoma is a classic drug pair mainly used for the treatment of digestive tract-related inflammation and tumors, but the ratio is not fixed in clinical practice. In order to study whether the anti-tumor effect of the drug pair is diffe-rent under different ratios, orthotopic transplantation model of colon cancer was established in mice. Then the principal component analysis(PCA) and cluster analysis(CA) were used to explore the effect of different ratios of the drug pair on the tumor growth and metastasis, and select the optimal ratio of Astragali Radix-Curcumae Rhizoma for anti-colon cancer effect. After administration for 15 days, the body weight of colon cancer mice with the tumor removed, the tumor volume and the number of liver metastases were mea-sured; the pathological changes of tumor tissue and liver tissue were observed by HE staining. At the same time, Western blot method was used to detect the protein expression level of tumor growth-related indicators in tumor tissue(Ki67, HBP1, AFP) and tumor metastasis-related indicators in liver tissue(β-catenin, E-cadherin, vimentin, p53) of the tumor-bearing mice. Subsequently, PCA and CA were used to select the optimal ratio of Astragali Radix-Curcumae Rhizoma for anti-colon cancer effect. The experimental results showed that different ratios of Astragali Radix-Curcumae Rhizoma inhibited tumor growth and metastasis to varying degrees. The ratio at 1∶1 of Astragali Radix-Curcumae Rhizoma had the best inhibitory effect on tumor growth, and the 2∶1 ratio group had the best effect on inhibiting liver metastasis and improving weighed loss. Astragali Radix-Curcumae Rhizoma significantly up-regulated the protein expression of HBP1 in tumor tissue of colon cancer mice, and significantly down-regulated the protein expression of Ki67 and AFP in tumor tissue; meanwhile, Astragali Radix-Curcumae Rhizoma significantly up-regulated the protein expression of E-cadherin in liver tissue of colon cancer mice, and significantly reduced the protein expression of β-catenin, vimentin and p53 in liver tissue. PCA results showed that the first three groups in the Astragali Radix-Curcumae Rhizoma compatibility group that were closer to the sham operation group were in the order of 2∶1, 1∶1 and 3∶2, among which the center distance of the 2∶1 group was the shortest from the sham operation group, indicating that the ratio 2∶1 of Astragali Radix-Curcumae Rhizoma had the best intervention effect on colon cancer in mice, consistent with the commonly used clinical proportion. CA results showed that 11 groups of colon cancer mice were classified into 3 categories: Astragali Radix-Curcumae Rhizoma compatibility group, sham operation group and model group, which was consistent with the theory. The results of this study provide a basis for more effective clinical application of Astragali Radix-Curcumae Rhizoma in the treatment of colon cancer, and provide new ideas for the development of classic drug pairs.

Animals , Astragalus Plant , Colonic Neoplasms/drug therapy , Drugs, Chinese Herbal , Mice , Plant Roots , Rhizome
Article in Chinese | WPRIM | ID: wpr-879022


To screen the sensitive cell lines of active fraction from clove(AFC) on human colon cancer cells, investigate the effects of AFC on the cells proliferation and apoptosis as well as PI3 K/Akt/mTOR(phosphoinositide 3-kinase/Akt/mechanistic target of rapamycin) signaling pathways involved, and reveal the mechanism of AFC for inducing apoptosis of human colorectal carcinoma cells. Cell counting kit-8(CCK-8) assay was used to detect the cytotoxic effect of different concentrations of AFC. AFC-induced apoptosis was detected by Hoechst 33258 fluorescence staining and Annexin V-FITC/PI double staining. HCT116 cells were treated with AFC with or without pretreatment with insulin-like growth factor-Ⅰ(IGF-Ⅰ), and then the protein expression levels of caspase-3, caspase-9, poly ADP-ribose polymerase(PARP), PI3 K, p-PI3 K, Akt, p-Akt, mTOR and p-mTOR in PI3 K/Akt/mTOR signaling pathway were detected by Western blot. RESULTS:: showed that the most obvious inhibitory effect of AFC was on human colon cancer HCT116 cells, and the optimal AFC treatment time was 48 hours. After AFC treatment, typical apoptotic features such as nuclear chromatin concentration, nuclear fragmentation and apoptotic bodies appeared in a dose-dependent manner. Annexin V-FITC/PI double staining showed that as compared with the control group, 50 and 100 μg·mL~(-1) AFC groups increased the apoptosis rate of HCT116 cells significantly(P<0.001); AFC activated caspase-9, cleaved caspase-3 and cleaved PARP in a concentration-dependent manner. The protein expression levels of cleaved caspase-3/procaspase-3, cleaved PARP/PARP and caspase-9/β-actin after treatment of AFC(100 μg·mL~(-1)) were significantly different from those in the control group(P<0.001). The relative protein expression of p-PI3 K, p-Akt and p-mTOR decreased in a concentration dependent manner, while Akt and mTOR showed no significant differences among groups. The ratios of p-PI3 K/PI3 K, p-Akt/Akt and p-mTOR/mTOR in the AFC groups(50 and 100 μg·mL~(-1)) were significantly lower than those in the control group(P<0.01). Its combination with IGF-Ⅰ weakened the effect of AFC in inhibiting PI3 K/Akt/mTOR signaling pathway. The ratios of p-Akt/Akt and p-mTOR/mTOR in the AFC+IGF-Ⅰ group were significantly enhanced as compared with the AFC group(P<0.05). Apoptosis-related protein expression levels(cleaved caspase-3 and cleaved PARP) in HCT116 cells treated with AFC+IGF-Ⅰ were also down regulated. As compared with the AFC group, the ratios of cleaved caspase-3/procaspase-3 and cleaved PARP/PARP in the AFC+IGF-Ⅰ group were significantly decreased(P<0.01). In summary, AFC activated caspase-mediated cascades and induced HCT116 cells apoptosis in a dose-dependent manner, which may be associated with the inhibition of the PI3 K/Akt/mTOR signaling pathway.

Apoptosis , Cell Line, Tumor , Cell Proliferation , Colonic Neoplasms/drug therapy , HCT116 Cells , Humans , Phosphatidylinositol 3-Kinases/metabolism , Proto-Oncogene Proteins c-akt/metabolism , Signal Transduction , Syzygium , TOR Serine-Threonine Kinases/metabolism
Article in Chinese | WPRIM | ID: wpr-878893


This study aims to investigate the potential mechanism of curcumin in mediating interleukin-6(IL-6)/signal transducer and activator of transcription 3(STAT3) signaling pathway to repair intestinal mucosal injury induced by 5-fluorouracil(5-FU) chemotherapy for colon cancer. SD rats were intraperitoneally injected with 60 mg·kg~(-1)·d~(-1) 5-FU for 4 days to establish a model of intestinal mucosal injury. Then the rats were randomly divided into model group(equal volume of normal saline), curcumin low, medium and high dose groups(50, 100, 200 mg·kg~(-1)), and normal SD rats were used as control group(equal volume of normal saline). Each group received gavage administration for 4 consecutive days, and the changes of body weight and feces were recorded every day. After administration, blood was collected from the heart, and jejunum tissues were collected. The levels of serum interleukin-1β(IL-1β) and tumor necrosis factor-α(TNF-α) were detected by ELISA, and at the same time, the concentration of Evans blue(EB) in jejunum was measured. Hematoxylin-eosin(HE) staining was used to observe the pathological state of jejunum, and the length of jejunum villi and the depth of crypt were measured. The positive expression levels of claudin, occludin and ZO-1 were detected by immunohistochemistry. Western blot was used to detect the protein expression of IL-6, p-STAT3, E-cadherin, vimentin and N-cadherin in jejunum tissues. The results showed that, curcumin significantly increased body weight and fecal weight(P<0.05 or P<0.01), decreased fecal score, EB concentration, IL-1β and TNF-α levels(P<0.05 or P<0.01) in rats. In addition, curcumin maintained the integrity of mucosal surface and villi structure of jejunum to a large extent, and reduced pathological changes in a dose-dependent manner. Meanwhile, curcumin could increase the positive expression of occludin, claudin and ZO-1(P<0.05 or P<0.01), repair intestinal barrier function, downregulate the protein expression of IL-6, p-STAT3, vimentin and N-cadherin in jejunum tissues(P<0.05 or P<0.01), and upregulate the protein expression of E-cadherin(P<0.05). Therefore, curcumin could repair the intestinal mucosal injury induced by 5-FU chemotherapy for colon cancer, and the mechanism may be related to the inhibition of IL-6/STAT3 signal and the inhibition of epithelial-mesenchymal transition(EMT) process.

Animals , Colonic Neoplasms/drug therapy , Curcumin , Fluorouracil/toxicity , Interleukin-6/genetics , Intestinal Mucosa/metabolism , Rats , Rats, Sprague-Dawley , STAT3 Transcription Factor/metabolism , Signal Transduction
Int. j. morphol ; 36(3): 979-983, Sept. 2018. tab, graf
Article in English | LILACS | ID: biblio-954218


Turbinaria deccurrens Bory contains bioactive compound that is beneficial for health. Turbinaria deccurrens Bory is one of many species of brown seaweed that grows in Indonesian marine life and has been known to have cytotoxic activity. The aim of this study is to determine fucoxantin content and the cytotoxic activity of extract and fraction T. decurrens on colon cancer cell lines. Cytotoxic assay of ethanolic extract, n-hexane, ethyl acetate and ethanolic fractions against HCT-116 by MTS assay using Cell Counting Kit-8 (CCK-8). Fucoxantin content in extract and fraction were analyzed using Reversed-Phase High Performance Liquid Chromatography (RP-HPLC) analysis. Extract and fraction of T. decurrens contain fucoxanthin with the highest content of fucoxanthin was in ethyl acetate fraction. CCK-8 assay showed that extract, n-hexane and ethyl acetate fraction inhibited the growth of HCT-116. Brown seaweed Turbinaria decurrens was potential as an anticolon cancer agent.

Turbinaria deccurrens Bory contiene compuestos bioactivos que son beneficiosos para la salud. Turbinaria deccurrens Bory es una de muchas especies de algas pardas que crecen en aguas marinas de Indonesia y se ha estudiado su actividad citotóxica. El objetivo de este estudio fue determinar el contenido de fucoxantina y la actividad citotóxica del extracto y la fracción de T. decurrens en líneas celulares de cáncer de colon. Se llevó a cabo un ensayo citotóxico de extracto etanólico, nhexano, acetato de etilo y fracciones etanólicas contra HCT-116 mediante ensayo MTS utilizando Cell Counting Kit-8 (CCK-8). El contenido de fucoxantina en el extracto y la fracción se analizaron usando cromatografía líquida de alta resolución de fase reversa (RP-HPLC). El extracto y la fracción de T. decurrens contienen fucoxantina conmayor contenido de fucoxantina en la fracción de acetato de etilo. El ensayo CCK-8 mostró que la fracción de extracto, n-hexano y acetato de etilo inhibía el crecimiento de HCT-116. El alga marrón Turbinaria decurrens es un agente potencial contra el cáncer de colon.

Plant Extracts/administration & dosage , Colonic Neoplasms/drug therapy , Xanthophylls/administration & dosage , HCT116 Cells/drug effects , Phaeophyta , Plant Extracts/chemistry , Xanthophylls/analysis , Cell Line, Tumor/drug effects
Braz. J. Pharm. Sci. (Online) ; 54(4): e17222, 2018. tab, graf, ilus
Article in English | LILACS | ID: biblio-1001590


Colonic carcinoma is one of the most common internal malignancies and is the second leading cause of deaths in United States. Methotrexate (MTX) is a drug of choice in the treatment of colon cancer. The aim of the present research work was to develop and characterize colon targeted pellets of MTX for treatment of colonic carcinoma. The product and process parameters were optimized by screening methods. Pellets were prepared by extrusion spheronization using microcrystalline cellulose (MCC) as spheronizing aid and ethyl cellulose (EC) as release retardant in different ratio. Based on the physical appearance, sphericity and % in vitro drug release, batch P17 containing EC: MCC (3:7) was optimized for core pellets. The site specificity was obtained by screening the coating polymers and by coating the core pellets with EudragitS100. The 32 full factorial design was applied in which airflow rate (X1) and coating time (X2) were the independent parameters and physical appearance (Y1) and time taken for 100% drug release (Y2) were selected as the dependent variables. From the results obtained, 6min of coating time and 60cm3/min airflow rate was optimized. The batch B5 showed appropriate physical appearance and % in vitro drug release upto 17hr indicating sustained release property. The ex-vivo studies performed on rat colon indicated a significant relation with the in vitro drug release. The drug release followed Higuchi's model indicating the diffusion pattern of drug release from the matrix of pellets. Thus, the coated pellets can be a good candidate for site specific delivery of MTX to colon by decreasing the gastric irritation and thus to improve bioavailability.

Methotrexate/administration & dosage , Methotrexate/analysis , Colonic Neoplasms/drug therapy , In Vitro Techniques/instrumentation , Pharmaceutical Preparations/analysis , Colon/abnormalities
Braz. j. med. biol. res ; 51(1): e6472, 2018. graf
Article in English | LILACS | ID: biblio-889011


Cetuximab is widely used in patients with metastatic colon cancer expressing wildtype KRAS. However, acquired drug resistance limits its clinical efficacy. Exosomes are nanosized vesicles secreted by various cell types. Tumor cell-derived exosomes participate in many biological processes, including tumor invasion, metastasis, and drug resistance. In this study, exosomes derived from cetuximab-resistant RKO colon cancer cells induced cetuximab resistance in cetuximab-sensitive Caco-2 cells. Meanwhile, exosomes from RKO and Caco-2 cells showed different levels of phosphatase and tensin homolog (PTEN) and phosphor-Akt. Furthermore, reduced PTEN and increased phosphorylated Akt levels were found in Caco-2 cells after exposure to RKO cell-derived exosomes. Moreover, an Akt inhibitor prevented RKO cell-derived exosome-induced drug resistance in Caco-2 cells. These findings provide novel evidence that exosomes derived from cetuximab-resistant cells could induce cetuximab resistance in cetuximab-sensitive cells, by downregulating PTEN and increasing phosphorylated Akt levels.

Humans , Colonic Neoplasms/drug therapy , PTEN Phosphohydrolase/drug effects , Proto-Oncogene Proteins c-akt/drug effects , Exosomes/drug effects , Cetuximab/pharmacology , Antineoplastic Agents, Immunological/pharmacology , Tetrazolium Salts , Time Factors , Blotting, Western , Analysis of Variance , Caco-2 Cells , Cell Line, Tumor
Rev. Assoc. Med. Bras. (1992) ; 63(12): 1061-1064, Dec. 2017. tab
Article in English | LILACS | ID: biblio-896326


Summary Objective: The present study was designed to evaluate safety and efficacy of recombinant human granulocyte colony stimulating factor (G-CSF) injection and whether this regimen could reduce the incidence of adverse events caused by chemotherapy. Method: A total of 100 patients with colon cancer who were treated with chemotherapy in our hospital from January 2011 to December 2014 were randomly divided into two groups, with 50 patients in each group. The patients in the treatment group received G-CSF 24 hours after chemotherapy for consecutive three days; the patients in the control group received the same dose of normal saline. Routine blood tests were performed 7 days and 14 days after chemotherapy. Results: Compared with the control group, the incidences of febrile neutropenia and leukocytopenia in the treatment group were significantly lower (p<0.05). In addition, the incidence of liver dysfunction in the treatment group was lower than that of the control group, without statistical significance. The incidence of myalgia in the treatment was higher than that of the control group without statistical significance. Conclusion: The present study indicated that G-CSF injection after chemotherapy is safe and effective for preventing adverse events in colon cancer patients with chemotherapy.

Humans , Male , Female , Adult , Aged , Granulocyte Colony-Stimulating Factor/administration & dosage , Granulocyte Colony-Stimulating Factor/adverse effects , Colonic Neoplasms/drug therapy , Chemotherapy-Induced Febrile Neutropenia/prevention & control , Antineoplastic Agents/therapeutic use , Recombinant Proteins/administration & dosage , Recombinant Proteins/adverse effects , Treatment Outcome , Injections , Middle Aged
Braspen J ; 31(4): 335-339, out.-dez. 2016.
Article in Portuguese | LILACS | ID: biblio-847395


Introdução: O câncer colorretal (CC) pode induzir graves complicações clínicas aos portadores dessa neoplasia. A farinha de yacon (FY) (Smallanthus sonchifolius) é rica em fruto-oligossacarídeos (FOS), que são fermentados por bifidobactérias, produzindo efeitos benéficos à saúde intestinal. Seu efeito no CC, entretanto, é ainda desconhecido, sendo o objetivo deste trabalho investigar os efeitos da FY sobre a resposta imunológica de mucosa em animais com CC induzido. Método: Ratos machos Wistar (n=44) foram divididos em grupo S (sem CC e sem FY na dieta), grupo C (com CC e sem FY na dieta), grupo Y (sem CC e com FY na dieta) e grupo CY (com CC e FY na dieta). Durante cinco semanas, os grupos C e CY receberam injeções de 1,2-Dimetilhidrazina para o desenvolvimento do CC, seguidas por duas semanas para formação das lesões neoplá- sicas. Após esse período, os grupos Y e CY consumiram dieta com FY em quantidades suficientes para fornecer 7,5% de FOS por duas semanas e os demais grupos consumiram dieta AIN-93M. Resposta imunológica da mucosa intestinal foi determinada pela dosagem de imunoglobulina A secretória (sIgA) nas fezes pelo método de ELISA. Dados foram avaliados por ANOVA e teste t pareado (p<0,05). Resultados: Após suplementação com FY na dieta, os níveis de sIgA no grupo CY foram superiores aos do grupo S. No grupo CY, os níveis de sIgA aumentaram quando comparados o início e final da intervenção. Conclusão: A FY foi capaz de aumentar os níveis da IgA fecal nos animais com CC.(AU)

Introduction: Colorectal cancer (CC) can induce serious clinical complications in patients with this neoplasm. Yacon flour (YF) (Smallanthus sonchifolius) is rich in fructooligosaccharides (FOS) that are fermented by bifidobacteria producing beneficial effects on intestinal health. Its effect on CC, however, is still unknown, and the objective of this work is to investigate the effects of YF on the immune response of mucosa in animals with induced CC. Methods: Male Wistar rats (n=44) were divided into group S (without CC and without YF in the diet), group C (with CC and without YF in the diet), group Y (without CC and with YF in the diet) And CY group (with CC and YF in the diet). For five weeks, groups C and CY received injections of 1,2-Dimethylhydrazine for the development of CC, followed by two weeks for the formation of neoplastic lesions. After this period, groups Y and CY consumed diet with YF in amounts sufficient to provide 7.5% of FOS for two weeks and the other groups, consumed diet AIN-93M. Immune response of intestinal mucosa was determined by secretory immunoglobulin A (sIgA) dosing in feces by the ELISA method. Data were evaluated by ANOVA and paired t-test (p<0.05). Results: After supplementation with YF in the diet, sIgA levels in the CY group were higher than those in the S group. In the CY group, sIgA levels increased when compared to the beginning and end of the intervention. Conclusion: FY was able to increase faecal IgA levels in animals with CC.(AU)

Animals , Rats , Immunoglobulin A/immunology , Colonic Neoplasms/drug therapy , Prebiotics/administration & dosage , Prospective Studies , Rats, Wistar
Article in Korean | WPRIM | ID: wpr-149603


PURPOSE: The purpose of this study was to test the mediating effect of psychological distress in the relationship between chemotherapy related cognitive impairment (CRCI) and quality of life (QOL) in people with cancer. METHODS: A purposive sample of 130 patients undergoing chemotherapy was recruited for the cross-sectional survey design. Data were collected from November 2014 to June 2015. The instruments were K-MMSE (Korean Mini-Mental State Examination), Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General (FACT-G). Data were analyzed using descriptive statistics, correlation, and multiple regression using Baron and Kenny steps for mediation. RESULTS: The mean score for objective cognitive function was 27.95 and 69.32 for perceived cognitive decline. Overall quality of life was 91.74. The mean score was 17.52 for psychological distress. The prevalence was 56.2% for anxiety and 63.1% for depression, and 20.0% for CRCI. There were significant correlations among the variables, objective cognitive function and self-reported cognitive decline, psychological distress, and quality of life. Psychological distress was directly affected by CRCI. (R2=29%). QOL was directly affected by CRCI. Psychological distress and CRCI effected QOL (R2=43%). Psychological distress had a partial mediating effect (beta= -.56, p <.001) in the relationship between self-reported cognitive decline and quality of life (Sobel test: Z= -5.08, p <.001). CONCLUSION: Based on the findings of this study, nursing intervention programs focusing on managing cognitive decline, and decreasing psychological distress are highly recommended to improve quality of life in cancer patients.

Adult , Aged , Antineoplastic Agents/therapeutic use , Anxiety/epidemiology , Cognitive Dysfunction/epidemiology , Colonic Neoplasms/drug therapy , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Middle Aged , Quality of Life , Stress, Psychological , Surveys and Questionnaires
Clin. biomed. res ; 36(4): 248-251, 2016. ilus
Article in Portuguese | LILACS | ID: biblio-831615


O tratamento das lesões neoplásicas localmente avançadas de cólon permanece um desafio pelo envolvimento e invasão de órgãos como o pâncreas e o duodeno. Apresentamos um caso de câncer de cólon avançado de um paciente submetido a colectomia direita associada a duodenopancreatectomia. No seguimento de cinco anos, o paciente permanecia livre de doença. Apesar da elevada morbidade, a ressecção multivisceral associada a quimioterapia adjuvante apresenta boa sobrevida e até mesmo cura em longo prazo (AU)

The treatment of locally advanced neoplastic lesions of right colon remains a challenge due to the involvement and invasion of organs such as pancreas and duodenum. We report a case of advanced colon cancer of a patient that underwent right hemicolectomy in association with pancreaticoduodenectomy. The 5-year follow-up showed that the patient remained free of disease. Despite the high morbidity rate, multi-visceral resection associated with adjuvant chemotherapy seems to provide an increase in survival or even long-term cure (AU)

Humans , Middle Aged , Colectomy , Colonic Neoplasms/surgery , Pancreaticoduodenectomy , Colonic Neoplasms/drug therapy , Colorectal Surgery
Clinics ; 70(5): 333-338, 05/2015. graf
Article in English | LILACS | ID: lil-748272


OBJECTIVE: This study investigated the acute hemodynamic responses to multiple sets of passive stretching exercises performed with and without the Valsalva maneuver. METHODS: Fifteen healthy men aged 21 to 29 years with poor flexibility performed stretching protocols comprising 10 sets of maximal passive unilateral hip flexion, sustained for 30 seconds with equal intervals between sets. Protocols without and with the Valsalva maneuver were applied in a random counterbalanced order, separated by 48-hour intervals. Hemodynamic responses were measured by photoplethysmography pre-exercise, during the stretching sets, and post-exercise. RESULTS: The effects of stretching sets on systolic and diastolic blood pressure were cumulative until the fourth set in protocols performed with and without the Valsalva maneuver. The heart rate and rate pressure product increased in both protocols, but no additive effect was observed due to the number of sets. Hemodynamic responses were always higher when stretching was performed with the Valsalva maneuver, causing an additional elevation in the rate pressure product. CONCLUSIONS: Multiple sets of unilateral hip flexion stretching significantly increased blood pressure, heart rate, and rate pressure product values. A cumulative effect of the number of sets occurred only for systolic and diastolic blood pressure, at least in the initial sets of the stretching protocols. The performance of the Valsalva maneuver intensified all hemodynamic responses, which resulted in significant increases in cardiac work during stretching exercises. .

Humans , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Benzodioxoles/pharmacology , Colonic Neoplasms/drug therapy , Isoquinolines/pharmacology , Protein Kinase Inhibitors/pharmacology , Thiophenes/pharmacology , Topoisomerase I Inhibitors/pharmacology , Urea/analogs & derivatives , DNA Replication/drug effects , Drug Synergism , Protein Kinases/metabolism , Protein-Serine-Threonine Kinases/metabolism , Urea/pharmacology
Rev. bras. epidemiol ; 18(1): 248-261, Jan-Mar/2015. tab, graf
Article in Portuguese | LILACS | ID: lil-736433


OBJETIVO: Analisar as desigualdades socioeconômicas na utilização de consultas médicas (CM) no último ano no Brasil. MÉTODOS: Dados da Pesquisa Nacional por Amostra de Domicílios (≥ 20 anos de idade) das Regiões Nordeste (2003, n = 75.652 e 2008, n = 79.779) e Sudeste (2003, n = 76.029 e 2008, n = 79.356) foram analisados segundo CM. Compararam-se as prevalências de CM segundo as variáveis exploratórias demográficas e de saúde no primeiro (D1) e último (D10) decil de renda familiar per capita. As análises consideraram o desenho amostral complexo. RESULTADOS: A proporção de pessoas com CM aumentou no período na Região Nordeste (61,2 para 66,9%) e Sudeste (67,9 para 73,5%). A diferença absoluta de CM, segundo D1 e D10 no período, foi de 6,4 pontos percentuais (pp) no Nordeste e 4,2 pp no Sudeste. Houve importante redução das desigualdades entre os homens; naqueles sem doenças crônicas; naqueles que tinham uma percepção positiva da sua saúde e naqueles sem plano de saúde com direito a CM. A Região Sudeste ainda apresentou redução entre aqueles com apenas uma morbidade autorreferida (8 pp) e com percepção negativa da saúde (6 pp). CONCLUSÃO: Houve aumento de CM no Brasil. Observa-se ainda persistente desigualdade entre os mais pobres e os mais ricos, maior no Nordeste do que no Sudeste. Políticas para a redução da desigualdade em saúde mais eficazes e equânimes devem ser adotadas no Brasil. .

OBJECTIVE: To analyze the socioeconomic inequalities in medical visits (MV) in the past year in Brazil. METHODS: Data from adults aged ≥ 20 years old who participated in the Brazilian National Household Surveys and living in the Northeastern (2003; n = 75,652 and 2008, n = 79,779) and Southeastern (2003; n = 76,029 and 2008; n = 79,356) regions were analyzed according to MV. We compared MVs according to demographic and health variables in the first (D1) and last (D10) per capita family income deciles. All analyses considered the complex cluster design. RESULTS: The proportion of people who had MV during this period increased in the Northeastern (from 61.2 to 66.9%) and the Southeastern (from 67.9 to 73.5%) regions. The absolute difference (AD) in the use of MV, according to D1 and D10 in this period, was equal to 6.4 percentage points (pp) in the Northeastern and 4.2 pp in the Southeastern regions. Significant reduction in inequalities was observed among men without chronic diseases, in those who had a positive perception of their health, and among those without health insurance which included MV. The Southeastern region has also showed significant reduction among those with chronic disease (8 pp) and with negative health self-perception (6 pp). CONCLUSION: The increasing number of MVs was found in Brazil. However, persistent inequalities were observed between the poorest and the richest, higher in the Northeastern than in the Southeastern region. More effective and equitable policies to reduce health inequalities should be adopted in Brazil. .

Animals , Female , Humans , Mice , Adenocarcinoma/pathology , Colonic Neoplasms/pathology , Liver Neoplasms/pathology , Liver Neoplasms/secondary , Neoplasm Metastasis/pathology , Adenocarcinoma/drug therapy , Antimetabolites, Antineoplastic/therapeutic use , Antineoplastic Agents, Phytogenic/therapeutic use , Cell Adhesion , Cell Line, Tumor , Camptothecin/analogs & derivatives , Camptothecin/therapeutic use , Collagen Type II/metabolism , Colonic Neoplasms/drug therapy , Fibronectins/metabolism , Floxuridine/therapeutic use , Fluorouracil/therapeutic use , Laminin/metabolism , Liver Neoplasms/drug therapy , Mice, Nude , Models, Biological , Neoplasm Metastasis/prevention & control , Paclitaxel/therapeutic use
s.l; s.n; 2015.
Non-conventional in Spanish | LILACS, BRISA | ID: biblio-833292


A nivel mundial, la incidencia anual de cáncer se estima en 12,7 millones de personas. En la actualidad, el cáncer colorrectal es la tercera neoplasia más frecuente en la población (tras las neoplasias de pulmón y mama), con 1.2 millones de casos nuevos (9.7% del total de los nuevos casos de cáncer). En las Américas, tanto en mujeres como en hombres, el cáncer colorrectal se posiciona también como la tercera causa de incidencia y mortalidad por cáncer, donde cada año se producen más de 245 000 nuevos casos y 112 000 muertes por este tipo de cáncer. De acuerdo a estimaciones, para el año 2030 el número de nuevos casos y muertes por cáncer colorrectal se incrementarán en 70% y 80%, respectivamente, en ambos sexos en las Américas. En el Perú, según el Sistema Nacional de Vigilancia Epidemiológica durante los años 2006-2011 se reporta al cáncer de colon en el noveno lugar con un 3.3% de los casos, a predominio del sexo femenino, teniendo como tasa de mortalidad ajustada total al 2011 6.0 (6 defunciones por 100 000). Todos los estudios reportados muestran un beneficio en términos relativos entre 15 a 20% menor riesgo de morir con el uso de Bevacizumab combinado con quimioterapia en comparación con el uso de quimioterapia sola. Todos los estudios elegidos muestran un beneficio en términos relativos de aproximadamente entre 30 a 40% menor riesgo de padecer progresión de la enfermedad con el uso de quimioterapia sola. Se reporta la mediana de sobrevida en el grupo de intervención y en el grupo control cuya diferencia fue de 1.9 meses. Se reporta una mediana de progresión libre de enfermedad de 8.9 meses para el grupo de Bevacizumab + quimioterapia versus 6.5 meses para el grupo de quimioterapia sola (diferencia de 2.4 meses). Se recomienda cubrir con generación de evidencia y con restricciones.(AU)

Bevacizumab/administration & dosage , Colonic Neoplasms/drug therapy , Colonic Neoplasms/epidemiology , Drug Therapy, Combination , Neoplasm Metastasis , Technology Assessment, Biomedical
s.l; s.n; 2015. tab.
Non-conventional in Spanish | LILACS, BRISA | ID: biblio-833294


A nivel mundial, la incidencia anual de cáncer se estima en 12,7 millones de personas. En la actualidad, el cáncer colorrectal es la tercera neoplasia más frecuente en la población (tras las neoplasias de pulmón y mama), con 1.2 millones de casos nuevos (9.7% del total de los nuevos casos de cáncer). (2) En las Américas, tanto en mujeres como en hombres, el cáncer colorrectal se posiciona también como la tercera causa de incidencia y mortalidad por cáncer, donde cada año se producen más de 245 000 nuevos casos y 112 000 muertes por este tipo de cáncer. De acuerdo a estimaciones, para el año 2030 el número de nuevos casos y muertes por cáncer colorrectal se incrementarán en 70% y 80%, respectivamente, en ambos sexos en las Américas. En el Perú, según el Sistema Nacional de Vigilancia Epidemiológica durante los años 2006-2011 se reporta al cáncer de colon en el noveno lugar con un 3.3% de los casos, a predominio del sexo femenino, teniendo como tasa de mortalidad ajustada total al 2011 6.0 (6 defunciones por 100 000). Para el resultado Supervivencia Global, un resultado primario de importancia, si bien se reportan diferencias que llegan a ser estadísticamente significativas, como una diferencia de medianas para sobrevida global máxima de 4,3 meses entre el grupo cetuximab y el grupo con FOLFOX-4, no llega a ser una diferencia a considerar importante, considerando los efectos adversos. Se reportan una serie de efectos adversos. Se recomienda no cubrir.(AU)

Cetuximab/administration & dosage , Colonic Neoplasms/drug therapy , Colonic Neoplasms/epidemiology , Neoplasm Metastasis , Technology Assessment, Biomedical
Rev. bras. parasitol. vet ; 23(4): 501-508, Oct-Dec/2014. tab, graf
Article in English | LILACS | ID: lil-731259


Toxoplasmosis stands out as a global disease that has felines as definitive hosts. In the municipality of Natal, Rio Grande do Norte State, Brazil, two parks are notable for their ecological and social importance. This study aimed to investigate the presence of Toxoplasma gondii in short hair cats, bats and small non-volant mammals in these two ecological reserves. Altogether, biological samples were obtained from 154 mammals, 92 wild animals from both areas and 62 domestic cats of the Parque da Cidade. In total, 22 (53.7%) non-volant wild mammals, 11 (21.5%) bats and 28 (52.8%) cats were positive for IgG anti-T. gondii antibodies using the Modified Agglutination Test (≥ 25). It was possible to detect the presence of T. gondii DNA, by means of a molecular amplification of a B1 gene fragment (155bp), in 92 tissue samples from wild animals, including Didelphis albiventris, Monodelphis domestica, Artibeus lituratus, Carollia perspicillata and Glossophaga soricina. Of the 62 cats examined by the same molecular method, T. gondii DNA could be detected in 4 cats. In this study, it was observed the circulation of T. gondii in wild species and domestic cats, demonstrating the involvement of wild and domestic animals in the cycle of T. gondii.

Toxoplasmose destaca-se como uma doença global que tem felinos como hospedeiros definitivos. No município de Natal, Rio Grande do Norte, Brasil, dois parques são notáveis por sua importância ecológica e social. Este estudo teve como objetivo investigar a presença de Toxoplasma gondii em gatos de rua, morcegos e pequenos mamíferos não-voadores nestas duas reservas ecológicas. No total, as amostras biológicas foram obtidas de 154 mamíferos, 92 animais selvagens de ambas as áreas e 62 gatos domésticos do Parque da Cidade. No total, 22 (53,7%) mamíferos silvestres não-voadores, 11 (21,5%) morcegos e 28 (52,8%) gatos foram positivos para IgG anti-T. gondii utilizando o Teste de Aglutinação Modificado (≥ 25). Foi possível detectar a presença de DNA de T. gondii, por meio de uma amplificação molecular de um fragmento do gene B1 (155bp), em 92 amostras de tecido de animais selvagens, incluindo Didelphis albiventris, Monodelphis domestica, Artibeus lituratus, Carollia perspicillata e Glossophaga soricina. Dos 62 gatos examinadas pelo mesmo método molecular, DNA de T. gondii pode ser detectado em quatro gatos. Neste estudo, observou-se a circulação de T. gondii em espécies selvagens e gatos domésticos, demonstrando o envolvimento de animais domésticos e selvagens no ciclo de T. gondii.

Aged , Humans , Male , Antimetabolites, Antineoplastic/administration & dosage , Colonic Neoplasms/drug therapy , Floxuridine/administration & dosage , Lymphatic Metastasis , Liver Neoplasms/secondary , Administration, Oral , Colonic Neoplasms/pathology , Colonic Neoplasms/surgery , Drug Administration Schedule , Hepatectomy
Braz. dent. j ; 25(6): 538-542, Nov-Dec/2014. tab
Article in English | LILACS | ID: lil-732251


The aim of this study was to evaluate the degree of conversion (DC) and the cytotoxicity of photo-cured experimental resin composites containing 4-(N,N-dimethylamino)phenethyl alcohol (DMPOH) combined to the camphorquinone (CQ) compared with ethylamine benzoate (EDAB). The resin composites were mechanically blended using 35 wt% of an organic matrix and 65 wt% of filler loading. To this matrix was added 0.2 wt% of CQ and 0.2 wt% of one of the reducing agents tested. 5x1 mm samples (n=5) were previously submitted to DC measurement and then pre-immersed in complete culture medium without 10% (v/v) bovine serum for 1 h or 24 h at 37 °C in a humidifier incubator with 5% CO2 and 95% humidity to evaluate the cytotoxic effects of experimental resin composites using the MTT assay on immortalized human keratinocytes cells. As a result of absence of normal distribution, the statistical analysis was performed using the nonparametric Kruskal-Wallis to evaluate the cytotoxicity and one-way analysis of variance to evaluate the DC. For multiple comparisons, cytotoxicity statistical analyses were submitted to Student-Newman-Keuls and DC analysis to Tukey's HSD post-hoc test (=0.05). No significant differences were found between the DC of DMPOH (49.9%) and EDAB (50.7%). 1 h outcomes showed no significant difference of the cell viability between EDAB (99.26%), DMPOH (94.85%) and the control group (100%). After 24 h no significant difference were found between EDAB (48.44%) and DMPOH (38.06%), but significant difference was found compared with the control group (p>0.05). DMPOH presented similar DC and cytotoxicity compared with EDAB when associated with CQ.

O objetivo deste estudo foi avaliar o grau de conversão (GC) e a citotoxicidade de resinas compostas experimentais utilizando o álcool 4-(N,N-dimetilamino) fenil etílico (DMPOH) associado à canforoquinona (CQ) como sistema fotoiniciador (SF) comparado à versão comercial utilizando o benzoato de etilamina (EDAB). Para tanto, as resinas compostas experimentais foram mecanicamente misturadas utilizando (em peso): 35% de matriz orgânica e 65% em peso de partículas de carga. Posteriormente, foram adicionados 0,2% de CQ e 0,2% de um dos agentes redutores testados. Amostras de 5 x 1 mm (n=5) foram previamentes submetidas à análise de GC e posteriormente, esterilizadas e colocadas no meio de cultura completo sem soro fetal bovino estéril por 1 h ou 24 h a 37 °C em encubadora com 5% de CO2 and 95% de umidade para avaliar os efeitos citotóxicos das resinas compostas experimentais utilizando o método MTT emcélulas células humanas imortalizadas de queratinócitos. Os dados de citotoxicidade foram submetidos à análise estatística de Kruskal-Wallis e de GC à análise de variância com um fator. Em virtude da ausência de normalidade, a análise estatística da citotoxicidade foi realizada utilizando-se o teste não-paramétrico de Kruskal-Wallis. Para o GC, os dados foram submetidos à análise de variaância de 1 fator. Posteriormente para múltiplas comparações, os dados de citotoxicidade foram submetidos ao teste Student-Newman-Keuls e o GC ao teste de Tukey's HSD post-hoc (=0.05). Não foi observada diferença estatística entre o GC de DMPOH (49,9%) e EDAB (50,7%). Para os resultados de 1 h não houve diferença na viabilidade celular entre EDAB (99,26%), DMPOH (94,85%) e o grupo controle (100%). Após 24 h, nenhuma diferença estatística foi encontrada entre EDAB (48,44%) e DMPOH (38,06%), entretanto, diferença significativa foi encontrada em relação ao grupo controle (p>0,05). O DMPOH apresentou GC e citotoxicidade semelhante à EDAB quando associado à CQ.

Adult , Aged , Female , Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Colonic Neoplasms/drug therapy , Stomach Neoplasms/drug therapy , Administration, Oral , Cisplatin/administration & dosage , Drug Administration Schedule , Doxorubicin/administration & dosage , Etoposide/administration & dosage , Floxuridine/administration & dosage , Gallbladder Neoplasms/drug therapy , Infusions, Intravenous , Mitomycin , Mitomycins/administration & dosage , Splenic Neoplasms/drug therapy
Braz. dent. j ; 25(6): 565-570, Nov-Dec/2014. graf
Article in English | LILACS | ID: lil-732255


The passive fit of implant-supported dentures is fundamental to the rehabilitation success due the absence of the periodontal ligament in osseointegrated implants. Many techniques to obtain passive fit have been reported in the literature, some inaccessible for the clinicians and dental laboratories. This case report presents a technique to fabricate fixed complete dentures aiming at obtain passive fit with reduced time and cost, but without demerit for the aesthetics, function and longevity. A 40-year-old woman was referred for treatment presenting some teeth in the maxilla and an edentulous mandible, reporting eating problems related to instability and little retention of the mandibular complete denture. Treatment based on the reverse planning was performed to guide the rehabilitation with a complete mandibular fixed complete denture and maxillary occlusal plane adjustment. The framework of the fixed complete denture was manufactured luting a cast metal bar above the prepared titanium cylinder abutments using resin cement. The aim of this technique was to obtain a fixed complete denture with passive fit presenting positive esthetic and functional outcomes after 2 years of follow-up.

A adaptação passiva de próteses implantossuportadas é fundamental para o sucesso da reabilitação devido à inexistência de ligamento periodontal em implantes osseointegrados. Inúmeras técnicas de confecção da infraestrutura destas próteses tem sido relatadas na literatura, algumas inacessíveis para os clínicos e laboratórios de prótese. Este relato de caso apresenta uma técnica para confecção de próteses totais fixas visando obtenção de adaptação passiva com tempo e custo reduzido, porém sem demérito à estética, função e longevidade. Uma paciente de 40 anos se apresentou para tratamento apresentando alguns dentes na maxila e mandíbula edêntula, relatando dificuldades na mastigação relacionados a instabilidade e falta de retenção da prótese total inferior. Foi realizado um planejamento reverso para orientar a reabilitação com prótese total mandibular fixa e adequação do plano oclusal da maxila. A infraestrutura da prótese total fixa foi confeccionada pela cimentação de uma barra metálica em cilindros de titânio preparados com cimento resinoso. O objetivo desta técnica foi obter uma prótese total fixa com adaptação passiva apresentando resultados positivos em termos de estética e função após 2 anos de acompanhamento.

Animals , Female , Male , Mice , Adenocarcinoma/drug therapy , Antineoplastic Agents/therapeutic use , Colonic Neoplasms/drug therapy , Floxuridine/therapeutic use , Fluorouracil/therapeutic use , Adenocarcinoma/pathology , Adenocarcinoma/radiotherapy , Bone Marrow/pathology , Combined Modality Therapy , Colonic Neoplasms/pathology , Colonic Neoplasms/radiotherapy , Floxuridine/administration & dosage , Floxuridine/toxicity , Fluorouracil/administration & dosage , Fluorouracil/toxicity , Mice, Inbred BALB C , Mice, Inbred DBA , Spleen/pathology , Thymus Gland/pathology , Weight Gain
Rev. latinoam. enferm ; 22(6): 1056-1062, 16/12/2014. tab
Article in English | LILACS | ID: lil-732942


OBJECTIVES: to analyze the effect of self-esteem, assertiveness, self-efficacy and resiliency on alcohol and tobacco consumption in adolescents. METHOD: a descriptive and correlational study was undertaken with 575 adolescents in 2010. The Self-Esteem Scale, the Situational Confidence Scale, the Assertiveness Questionnaire and the Resiliency Scale were used. RESULTS: the adjustment of the logistic regression model, considering age, sex, self-esteem, assertiveness, self-efficacy and resiliency, demonstrates significance in the consumption of alcohol and tobacco. Age, resiliency and assertiveness predict alcohol consumption in the lifetime and assertiveness predicts alcohol consumption in the last year. Similarly, age and sex predict tobacco consumption in the lifetime and age in the last year. CONCLUSION: this study can offer important information to plan nursing interventions involving adolescent alcohol and tobacco users. .

OBJETIVOS: analisar o efeito da autoestima, assertividade, autoeficácia e resiliência sobre o consumo de álcool e tabaco em adolescentes. MÉTODO: estudo descritivo correlacional com 575 adolescentes, realizado no ano 2010. Foram utilizadas a Escala de Autoestima, o Questionário de Confiança Situacional, o Questionário de Assertividade e a Escala de Resiliência. RESULTADOS: o ajuste do modelo de regressão logística, considerando a idade, sexo, autoestima, assertividade, autoeficácia e resiliência foi significante em relação ao consumo de álcool e tabaco. A idade, resiliência e assertividade foram preditores do consumo de álcool em algum momento na vida e a idade e a assertividade foram preditores no último ano. Para o consumo de tabaco, a idade e o sexo foram preditores em algum momento na vida e a idade no último ano. CONCLUSÃO: este estudo pode proporcionar informações importantes para o planejamento de intervenções de enfermagem em adolescentes usuários de álcool e tabaco .

OBJETIVOS: analizar el efecto de la autoestima, asertividad, autoeficacia y resiliencia sobre el consumo de alcohol y tabaco en adolescentes. MÉTODO: descritivo correlacional con 575 adolescentes, en 2010. Se utilizaron la Escala de Autoestima, el Cuestionario de Confianza Situacional, el Cuestionario de Asertividad y la Escala de Resiliencia. RESULTADOS: el ajuste del modelo de regresión logística, considerando la edad, sexo, autoestima, asertividad, autoeficacia y resiliencia, muestra significancia en el consumo de alcohol y tabaco. La edad, resiliencia y asertividad predicen el consumo de alcohol alguna vez en la vida y la edad y asertividad en el último año. De la misma forma la edad y sexo predicen el consumo de tabaco alguna vez en la vida y la edad en el último año. CONCLUSIÓN: este estudio puede proporcionar información importante para la planificación de intervenciones en enfermería de los adolecentes usuarios de alcohol y tabaco. .

Animals , Mice , Antineoplastic Agents/therapeutic use , Antiviral Agents/therapeutic use , Bromodeoxyuridine/analogs & derivatives , Floxuridine/therapeutic use , Adenocarcinoma/drug therapy , Adenocarcinoma/enzymology , Bromodeoxyuridine/therapeutic use , Colonic Neoplasms/blood , Colonic Neoplasms/drug therapy , Colonic Neoplasms/enzymology , Drug Therapy, Combination , Fluorouracil/blood , Liver Neoplasms/mortality , Liver Neoplasms/secondary , Lung Neoplasms/blood , Lung Neoplasms/drug therapy , Lung Neoplasms/enzymology , Mice, Inbred BALB C , Pyrimidine Phosphorylases , Pentosyltransferases/metabolism , Prodrugs/therapeutic use
Arq. gastroenterol ; 51(3): 186-191, Jul-Sep/2014. tab, graf
Article in English | LILACS | ID: lil-723859


Context Capecitabine, an oral drug, is as effective as traditional chemotherapy drugs. Objectives To investigate the adhesion to treatment with oral capecitabine in breast and colorectal cancer, and to determine any correlation with changes in patient’s quality of life. Methods Patients with colorectal cancer or breast cancer using capecitabine were included. The patients were asked to bring any medication left at the time of scheduled visits. The QLQ-C30 questionnaire was applied at the first visit and 8-12 weeks after treatment. Results Thirty patients were evaluated. Adherence was 88.3% for metastatic colon cancer, 90.4% for non-metastatic colon cancer, 94.3% for rectal cancer and 96.2% for metastatic breast cancer. No strong correlation between adherence and European Organisation for Research and Treatment of Cancer QLQ-C30 functional or symptom scale rates had been found. There was no statistically significant correlation between compliance and the functional and symptom scales of the questionnaire before and after chemotherapy, with the exception of dyspnea. Conclusions Although no absolute adherence to oral capecitabine treatment had been observed, the level of adherence was good. Health professionals therefore need a greater focus in the monitoring the involvement of patients with oral treatment regimens. Patients with lesser degrees of dyspnea had greater compliance. .

Contexto A capecitabina, uma droga oral, é tão eficaz quanto as drogas quimioterápicas tradicionais. Objetivos Investigar a adesão ao tratamento oral com capecitabina para câncer de mama e colorretal e determinar qualquer correlação com as mudanças na qualidade de vida do paciente. Métodos Pacientes com câncer colorretal ou de mama em uso de capecitabina foram incluídos. A cada consulta os pacientes trouxeram a medicação restante. O questionário de qualidade de vida QLQ- C30 foi aplicado na primeira visita e 8-12 semanas após o tratamento. Resultados Trinta pacientes foram avaliados. A adesão foi de 88,3% para o câncer de cólon metastático, 90,4% para o de cólon não-metastático, 94,3% para o de reto e 96,2% para o de mama metastático. Com exceção da dispnéia, não houve forte correlação entre adesão e as taxas European Organisation for Research and Treatment of Cancer QLQ-C30 em relação a escala funcional ou de sintomas no início ou após quimioterapia. Conclusões O nível de adesão foi bom, embora não houvesse adesão absoluta ao tratamento com capecitabina oral. Os profissionais de saúde, portanto, precisam dar maior atenção a pacientes em regimes de tratamento oral. Os pacientes com menor grau de dispneia tiveram maior adesão. Neoplasias colorretais, terapia .

Female , Humans , Male , Middle Aged , Antimetabolites, Antineoplastic/administration & dosage , Breast Neoplasms/drug therapy , Colonic Neoplasms/drug therapy , Deoxycytidine/analogs & derivatives , Fluorouracil/analogs & derivatives , Medication Adherence/statistics & numerical data , Rectal Neoplasms/drug therapy , Administration, Oral , Cohort Studies , Deoxycytidine/administration & dosage , Fluorouracil/administration & dosage , Prospective Studies , Surveys and Questionnaires
Article in Korean | WPRIM | ID: wpr-74442


Wernicke's encephalopathy (WE) caused by thiamine deficiency is an acute neurological disorder. Clinically, the classic triad of WE consists of ophthalmoplegia, ataxia, and mental status changes. Thiamine deficiency is known to occur commonly in chronic alcoholic patients. Sometimes, it can occur in patients after gastrointestinal surgery and in those with malabsorption. In addition, patients undergoing renal dialysis, suffering from hyperemesis gravidarum, receiving total parenteral nutrition (TPN), and being treated with chemotherapeutic agents are also prone to develop thiamine deficiency. Herein, we report two cases of WE that developed following simultaneous 5-fluorouracil (5-FU) chemotherapy and TPN in colon cancer patients which was successfully treated with thiamine administration.

Adult , Antimetabolites, Antineoplastic/therapeutic use , Brain/diagnostic imaging , Colonic Neoplasms/drug therapy , Fluorouracil/therapeutic use , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Parenteral Nutrition, Total , Thiamine/therapeutic use , Vitamin B Complex/therapeutic use , Wernicke Encephalopathy/diagnosis