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2.
Article in Chinese | WPRIM | ID: wpr-888620

ABSTRACT

Colorectal cancer is the second most common malignant tumor in China. The FOLFOXIRI regimen, which combines 5-fluorouracil/leucovorin, oxaliplatin, and irinotecan, is a high-intensity and highly effective chemotherapy regimen. However, the original regimen is poorly tolerated in Chinese patients. In order to promote the standardized and rational application of FOLFOXIRI regimen by clinicians in China, "


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Camptothecin/therapeutic use , China , Colorectal Neoplasms/drug therapy , Consensus , Fluorouracil/therapeutic use , Humans , Irinotecan/therapeutic use , Leucovorin/therapeutic use , Organoplatinum Compounds/therapeutic use , Oxaliplatin , Treatment Outcome
3.
Chinese Medical Journal ; (24): 2475-2482, 2021.
Article in English | WPRIM | ID: wpr-921116

ABSTRACT

BACKGROUND@#There is growing evidence that 5-fluorouracil (5-FU) combined with therapeutic trauma can effectively induce skin repigmentation in vitiligo patients who are unresponsive to conventional treatments. Previous studies have mainly focused on identifying the antimitotic activity of 5-FU for the treatment of skin cancer, but few studies have investigated its extra-genotoxic actions favoring melanocyte recruitment.@*METHODS@#We utilized the full thickness excisional skin wound model in Dct-LacZ transgenic mice to dynamically assess the migration of melanocytes in the margins of wounds treated with or without 5-FU. The in-situ expression of CXCL12 was examined in the wound beds using immunofluorescence staining. Quantitative real-time polymerase chain reaction and Western blotting analyses were performed to detect the expression levels of CXCL12 mRNA and protein in primary mouse dermal fibroblasts treated with or without 5-FU. Transwell assays and fluorescein isothiocyanate (FITC)-phalloidin staining were used to observe cell migration and filamentous actin (F-actin) changes of melan-a murine melanocytes.@*RESULTS@#Whole mount and cryosection X-gal staining showed that the cell numbers of LacZ-positive melanocytes were much higher in the margins of dorsal and tail skin wounds treated with 5-FU compared with the controls. Meanwhile, CXCL12 immunostaining was significantly increased in the dermal compartment of wounds treated with 5-FU (control vs. 5-FU, 22.47 ± 8.85 vs. 44.69 ± 5.97, P < 0.05). Moreover, 5-FU significantly upregulated the expression levels of CXCL12 mRNA (control vs. 5-FU, 1.00 ± 0.08 vs. 1.54 ± 0.06, P < 0.05) and protein (control vs. 5-FU, 1.00 ± 0.06 vs. 2.93 ± 0.10, P < 0.05) in cultured fibroblasts. Inhibition of the CXCL12/CXCR4 axis suppressed melanocyte migration in vitro using a CXCL12 small interfering RNA (siRNA) or a CXCR4 antagonist (AMD3100).@*CONCLUSION@#5-FU possesses a pro-pigmentary activity through activation of the CXCL12/CXCR4 axis to drive the chemotactic migration of melanocytes.


Subject(s)
Animals , Cell Movement , Cell Proliferation , Chemokine CXCL12/genetics , Fibroblasts , Fluorouracil/therapeutic use , Humans , Mice , RNA, Messenger , Receptors, CXCR4
4.
J. oral res. (Impresa) ; 8(5): 363-369, oct. 31, 2019. tab, graf
Article in English | LILACS | ID: biblio-1248086

ABSTRACT

Objective: Chemotherapy treatment against cancer produce systemic toxicities, among which are those related to important structures of the stomatognathic system and its functional activity. 5 Fluorouracil (5-FU) and cyclophosphamide (Cf) are drugs widely used in solid tumors and in bone marrow transplantation, respectively. The objective of this work was to evaluate the toxicity of these drugs regarding functional activity of the submandibular glands, by measuring the percentage of glycogen consumption in two experimental models. Material and Methods: 84 male Wistar rats aged three months were used, housed in individual cages, with controlled temperature and lighting and ad libitum diet. They were divided into four experimental groups: 1) Control (C); 2) Treated with 5-FU+leucovorin (LV) at 20 and 10mg/Kg of body weight respectively for five consecutive days; 3) treated with Cf i.p. at 50mg/Kg of body weight for two consecutive days; and 4) rats with paired feeding (PF): for five and two days respectively, the amount administered resulted from the average of the ingested food of groups 2 and 3. Both submandibular glands were excised. The submandibular glycogen concentration was analyzed at initial time (t0) and after 60 minutes of mechanical stimulation (t60). Results: the average variation changed significantly between time 0 and 60 in the groups C and PF. (p-value=0.0001), the 5-FU + LV treatment group had an average concentration higher at t0 than groups C and PF, without significant consumption at T60. While group Cf showed a lower average concentration at time 0 with respect to groups C and PF, without significant consumption at T60. Conclusion: 5-FU+LV and Cf affect the metabolism of carbohydrates, decreasing the use of glycogen as a metabolic substrate. In the present experimental model, the toxicity of these drugs affected the functional activity of the submandibular gland.


Objetivo: el tratamiento de quimioterapia contra el cáncer produce toxicidades sistémicas, entre las que se encuentran las relacionadas con estructuras importantes del sistema estomatognático y su actividad funcional. El 5-fluorouracilo (5-FU) y la ciclofosfamida (Cf ) son fármacos ampliamente utilizados en tumores sólidos y en trasplantes de médula ósea, respectivamente. El objetivo de este trabajo fue evaluar la toxicidad de estos fármacos con respecto a la actividad funcional de las glándulas submandibulares, midiendo el porcentaje de consumo de glucógeno en dos modelos experimentales. Material y Métodos: se utilizaron 84 ratas Wistar machos de tres meses de edad, alojadas en jaulas individuales, con temperatura e iluminación controladas y dieta ad libitum. Se dividieron en cuatro grupos experimentales: 1) Control (C); 2) Tratados con 5-FU+leucovorina (LV) a 20 y 10mg/Kg de peso corporal, respectivamente, durante cinco días consecutivos; 3) tratados con Cf i.p. a 50mg/Kg de peso corporal durante dos días consecutivos; y 4) ratas con alimentación por parejas (PF): durante cinco y dos días respectivamente, la cantidad administrada resultó del promedio de los alimentos ingeridos de los grupos 2 y 3. Ambas glándulas submandibulares fueron extirpadas. La concentración de glucógeno submandibular se analizó en el momento inicial (t0) y después de 60 minutos de estimulación mecánica (t60). Resultados: la variación promedio cambió significativamente entre el tiempo 0 y 60 en los grupos C y PF. (p=0,0001), el grupo de tratamiento 5-FU+LV tuvo una concentración promedio más alta en t0 que los grupos C y PF, sin un consumo significativo en T60. Mientras que el grupo Cf mostró una concentración promedio más baja en el tiempo 0 con respecto a los grupos C y PF, sin un consumo significativo en T60. Conclusión: 5-FU + LV y Cf afectan el metabolismo de los carbohidratos, disminuyendo el uso de glucógeno como sustrato metabólico. En el presente modelo experimental, la toxicidad de estos medicamentos afectó la actividad funcional de la glándula submandibular.


Subject(s)
Animals , Rats , Submandibular Gland/physiology , Cyclophosphamide/adverse effects , Fluorouracil/adverse effects , Glycogen/metabolism , Rats, Wistar , Cyclophosphamide/therapeutic use , Fluorouracil/therapeutic use , Antineoplastic Agents
5.
Arq. bras. oftalmol ; 82(5): 372-376, Sept.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1019436

ABSTRACT

ABSTRACT Purpose: We evaluated the role of the conjunctival flap rotation technique using 5-fluorouracil and adjuvant therapy with topical cyclosporine A at 0.05% during short pre- and postoperative periods for the prevention of primary pterygium recurrence. Methods: In this prospective study, 76 patients with primary pterygium (76 eyes) were categorized into two groups: the control group with 31 patients who did not receive cyclosporine treatment, and the cyclosporine group with 45 patients who received topical cyclosporine A (0.05%) twice a day, for 10 days before and 10 days after the pterygium excision operations. Patients were examined for disease recurrence, side effects, and complications at 10 and 21 days, and at 2 and 6 months after the operation. Data on demography, systemic diseases, and ophthalmologic histories were obtained from all patients, and these data were analyzed using descriptive statistics involving the absolute and relative percentages of frequency distribution. Goodman test was used for contrasts among multinomial populations to study the association between cyclosporine A and recurrence. Results: Most patients were between 30 and 60 years of age, and 67.1% were women. We confirmed a higher recurrence in patients with occupational sunlight exposure. The cyclosporine A used topically 10 days before and 10 days after the pterygium removal did not significantly reduce the recurrence of the pterygium. Conclusion: Topical 0.05% cyclosporine A when used for 10 days before and 10 days after the pterygium removal does not prevent or reduce the recurrence of primary pterygium.


RESUMO Objetivo: Avaliamos os resultados da técnica de rotação de retalho conjuntival com uso de 5-fluorouracil e terapia adjuvante com ciclosporina A tópica a 0,05%, usada no pré e pós-operatório por curto período, quanto à prevenção da recidiva do pterígio primário Métodos: Estudo prospectivo, com 76 pacientes portadores de pterígio primário (76 olhos), divididos em dois grupos: controle com 31 pacientes que não receberam tratamento com ciclosporina e grupo ciclosporina com 45 pacientes que receberam ciclosporina tópica A (0,05%) duas vezes ao dia, por 10 dias antes e 10 dias após a cirurgia de excisão do pterígio. Os pacientes foram avaliados quanto à recorrência, efeitos colaterais e complicações com 10, 21 dias, 2 e 6 meses de pós-operatório. Dados demográficos, doenças sistêmicas e histórico oftalmológico foram coletados de todos os pacientes e esses dados foram analisados por meio de estatística descritiva envolvendo o percentual absoluto e relativo de distribuição de frequência. O teste de Goodman para contrastes entre populações multinomiais foi utilizado para o estudo da associação entre a ciclosporina A e a recorrência Resultados: A maioria dos pacientes tinha entre 30 e 60 anos e 67,1% eram mulheres. Confirmamos uma maior recorrência em pacientes com exposição ocupacional ao sol. A ciclosporina A tópica utilizada 10 dias antes e 10 dias após a remoção do pterígio não reduziu significativamente a sua recorrência Conclusão: A ciclosporina A tópica a 0,05% quando utilizada por 10 dias no pré e 10 dias no pós-operatório, não previne ou reduz a recidiva do pterígio primário significativamente.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Pterygium/prevention & control , Cyclosporine/administration & dosage , Conjunctiva/abnormalities , Immunosuppressive Agents/administration & dosage , Ophthalmic Solutions/administration & dosage , Postoperative Care , Recurrence , Surgical Flaps , Preoperative Care , Pterygium/surgery , Pterygium/drug therapy , Prospective Studies , Combined Modality Therapy , Conjunctiva/surgery , Corneal Diseases/drug therapy , Fluorouracil/therapeutic use
6.
Säo Paulo med. j ; 137(5): 438-445, Sept.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1059106

ABSTRACT

ABSTRACT BACKGROUND: Management of rectal cancer has become more complex with multimodality therapy (neoadjuvant chemoradiotherapy and surgery) and this has led to the need to organize multidisciplinary teams. The aim of this study was to report on the planning, implementation and evaluation of an integrated care pathway for neoadjuvant treatment of middle and lower rectal cancer. DESIGN AND SETTING: This was a cross-sectional post-implementation study that was carried out at a public university cancer center. METHODS: The Framework for Program Evaluation in Public Health of the Centers for Disease Control and Prevention (CDC) was used to identify resources and activities; link results from activities and outcomes with expected goals; and originate indicators and outcome measurements. RESULTS: The logic model identified four activities: stakeholders' engagement, clinical pathway development, information technology improvements and training programs; and three categories of outcomes: access to care, effectiveness and organizational outcomes. The measurements involved 218 patients, among whom 66.3% had their first consultation within 15 days after admission; 75.2% underwent surgery < 14 weeks after the end of neoadjuvant treatment and 72.7% completed the treatment in < 189 days. There was 100% adherence to the protocol for the regimen of 5-fluorouracil and leucovorin. CONCLUSIONS: The logic model was useful for evaluating the implementation of the integrated care pathways and for identifying measurements to be made in future outcome studies.


Subject(s)
Humans , Rectal Neoplasms/therapy , Program Evaluation/methods , Critical Pathways/standards , Neoadjuvant Therapy/standards , Rectal Neoplasms/surgery , Rectal Neoplasms/drug therapy , Brazil , Program Evaluation/standards , Antineoplastic Combined Chemotherapy Protocols , Logistic Models , Leucovorin/therapeutic use , Cross-Sectional Studies , Combined Modality Therapy , Fluorouracil/therapeutic use
7.
Autops. Case Rep ; 9(2): e2019087, Abr.-Jun. 2019. graf, tab
Article in English | LILACS | ID: biblio-1015059

ABSTRACT

The combination of cisplatin and gemcitabine is the standard first-line treatment of metastatic biliary tract cancer (BTC) patients. The benefit of second-line chemotherapy in these patients is controversial. This study aims to evaluate the activity of FOLFIRI (fluorouracil and irinotecan) after failure to the first-line platinum and gemcitabine-based chemotherapy in metastatic BTC patients. We present a single-institution, retrospective cohort study. Patients with locally advanced or metastatic BTC who progressed after at least one line of chemotherapy, consecutively treated at our Institution between 2007 and 2017 were included. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were overall survival (OS), clinical benefit rate (CBR) and safety profile of FOLFIRI. Twelve patients were included in the analysis, with a median follow up of 5 months (95% CI 2.77-7.20). The median number of cycles received was 3 (range 1 to 9). Four grade 3 toxicities were recorded; no grade 4 toxicities and no treatment-related deaths occurred. The median PFS was 1.7 months (95% CI; 0.66-2.67), and median OS was 5 months (95% CI; 2.77-7.20). Two patients presented stable disease, providing a CBR of 17%. We concluded that FOLFIRI presented a favorable toxicity profile and a modest activity in metastatic BTC patients who had progressed to platinum and gemcitabine and may be considered in patients who are able to tolerate additional lines of chemotherapy. Immunotherapy and targeted therapies selected according to the tumoral genomic profile are promising alternatives to improve the outcomes of second-line treatment in BTC.


Subject(s)
Humans , Biliary Tract Neoplasms/drug therapy , Fluorouracil/therapeutic use , /therapeutic use , Neoplasm Metastasis/drug therapy
8.
Autops. Case Rep ; 8(4): e2018049, Oct.-Dec. 2018. ilus, graf
Article in English | LILACS | ID: biblio-986574

ABSTRACT

5-Fluorouracil (5-FU), in combination with other cytotoxic drugs, is commonly used to treat a variety of cancers. Dihydropyrimidine dehydrogenase (DPD) catalyzes the first catabolic step of the 5-FU degradation pathway, converting 80% of 5-FU to its inactive metabolite. Approximately 0.3% of the population demonstrate complete DPD deficiency, translating to extreme toxicity of 5-FU. Here we present a case of a patient who had a fatal outcome after treatment with 5-FU who was found to have an unknown DPD deficiency discovered at autopsy.


Subject(s)
Humans , Male , Middle Aged , Dihydropyrimidine Dehydrogenase Deficiency/pathology , Fluorouracil/toxicity , Head and Neck Neoplasms , Autopsy , Fatal Outcome , Drug-Related Side Effects and Adverse Reactions/pathology , Dihydropyrimidine Dehydrogenase Deficiency/drug therapy , Fluorouracil/therapeutic use , Lymph Nodes
9.
Autops. Case Rep ; 8(1): e2018005, Jan.-Mar. 2018. ilus
Article in English | LILACS | ID: biblio-905466

ABSTRACT

Chemotherapy is considered "state of the art" for the treatment of poorly differentiated neuroendocrine neoplasms. Unfortunately, there is no standard effective post-first-line treatment for relapsing high-grade gastroenteropancreatic neuroendocrine neoplasms. We report the case of a patient with a gastric neuroendocrine carcinoma stage IV, with massive gastrointestinal bleeding at diagnosis. After the first line of platin-based chemotherapy a major tumoral response was documented, but the patient relapsed after 4 months. A second line of chemotherapy treatment was given, with the FOLFOX regimen, and the patient has been free of progression for almost 2 years. There is no second-line standard treatment accepted for this type of carcinoma, but 5-fluorouracil combined with oxaliplatin showed interesting antitumor activity.


Subject(s)
Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma/drug therapy , Fluorouracil/therapeutic use , Neuroendocrine Tumors/drug therapy , Organoplatinum Compounds/therapeutic use , Stomach Neoplasms/drug therapy , Antineoplastic Agents/therapeutic use , Neoplasm Metastasis , Reference Standards , Treatment Outcome
10.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 27(4): 294-301, out.-dez. 2017. tab, ilus
Article in Portuguese | LILACS | ID: biblio-879474

ABSTRACT

A concomitância de doença arterial coronariana e câncer é uma apresentação frequente na prática da cardiologia. Além de compartilharem os mesmos fatores de risco para seu desenvolvimento e, portanto, os mesmos grupos demográficos, a toxicidade vascular da quimioterapia e da radioterapia torna mais alta a incidência da doença no grande grupo de sobreviventes do câncer. No ciclo do tratamento oncológico, a ocorrência de eventos cardíacos maiores, secundários ou não à cardiotoxicidade, é determinante de alteração ou interrupção de tratamento, com efeito importante na sobrevida. O objetivo da assistência especializada é retornar o paciente ao tratamento o mais precocemente possível e, na fase tardia, evitar a morte por doença cardiovascular. As peculiaridades da apresentação da doença coronariana e do diagnóstico e tratamento percutâneo são aqui discutidas


Concomitant coronary artery disease and cancer is a common presentation in current cardiovascular practice. Besides sharing the same risk factors for their development, and accordingly, the same demographic groups, vascular toxicity from chemotherapy and radiotherapy make the incidence of the disease higher in the large group of cancer survivors. During the cancer treatment cycle, the occurrence of major cardiac events, whether due to cardiotoxicity or not, is responsible for changes or interruption of treatment, with important effects on survival. The goal of specialized care is to return the patient to treatment as early as possible and in the later phase, to avoid death from cardiovascular disease. The specific characteristics of coronary disease and percutaneous diagnosis and treatment are discussed here


Subject(s)
Humans , Male , Female , Coronary Artery Disease/physiopathology , Drug Therapy/methods , Acute Coronary Syndrome/physiopathology , Neoplasms/physiopathology , Neoplasms/therapy , Risk Factors , Paclitaxel/therapeutic use , Angioplasty/methods , Drug-Eluting Stents , Capecitabine/therapeutic use , Fluorouracil/therapeutic use , Myocardial Infarction
11.
Arq. bras. oftalmol ; 80(2): 131-136, Mar.-Apr. 2017. tab, graf
Article in English | LILACS | ID: biblio-838789

ABSTRACT

ABSTRACT In this systematic review, we evaluated studies involving adjuvant and primary topical treatment for ocular surface squamous neoplasia (OSSN). The findings were: (i) adjuvant 5-fluorouracil (5-FU) reduces the risk of relapse after surgical excision with mild side effects [level Ib, grade of recommendation (GR) A]. (ii) Primary topical mitomycin (MMC) produces a high rate of complete response, low recurrence rate, and mild side effects (level Ib, GR A). (iii) Primary chemotherapy versus adjuvant chemotherapy produce similar rates of recurrence, with no significant difference (level IIb, GR B). (iv) Adjuvant 5-FU versus MMC showed no significant differences, with mild side effects in both groups and a better toxicity profile for MMC (level III, GR C). (v) Primary topical 5-FU versus MMC versus interferon (IFN) showed similar rates of tumor recurrence, mild side effects for all drugs, and more severe side effects in the 5-FU arm, followed successively by MMC and IFN (level III, GR C).


RESUMO Revisão sistemática envolvendo estudos sobre o tratamento adjuvante e tratamento tópico primário para a neoplasia escamosa da superfície ocular. Os resultados foram: (i) 5-fluorouracil adjuvante reduziu o risco de recidiva após a excisão cirúrgica com efeitos colaterais leves (nível Ib, Grau de recomendação (GR) A). (ii) Mitomicina tópica primária produziu uma alta taxa de resposta completa, baixa taxa de recorrência e efeitos colaterais leves (nível Ib, GR A). (iii) Quimioterapia primária versus adjuvante produz taxas semelhantes de recorrência (nível IIb, GR B). (iv) 5- 5-FU versus mitomicina adjuvante não mostrou diferenças significativas nas taxas de recorrencia, com efeitos coalterais leves em ambos os grupos e melhor perfil de toxicidade para mitomicina (nível III, GR C). (v) 5- 5-FU tópico primário versus mitomicina ou interferon (INF) apresentam taxa similar de recorrência, com efeito colateral leve, mas com maior incidencia no braço 5- 5-FU, seguido pela Mitomicina e IFN (nível III, GR C).


Subject(s)
Humans , Carcinoma, Squamous Cell/drug therapy , Mitomycin/therapeutic use , Corneal Diseases/drug therapy , Eye Neoplasms/drug therapy , Fluorouracil/therapeutic use , Recurrence , Recombinant Proteins/therapeutic use , Administration, Topical , Chemotherapy, Adjuvant/methods , Conjunctival Neoplasms/drug therapy , Conjunctival Neoplasms/therapy , Corneal Diseases/therapy , Eye Neoplasms/therapy , Interferon alpha-2 , Antineoplastic Agents/therapeutic use
12.
Rev. Hosp. Ital. B. Aires (2004) ; 36(4): 143-149, dic. 2016. graf, ilus, tab
Article in Spanish | LILACS | ID: biblio-1145235

ABSTRACT

El virus del papiloma humano (VPH) es una de las enfermedades de transmisión sexual más comunes. Puede afectar tanto el aparato genital masculino y femenino, como también el área perianal, ano, y diversas áreas de cabeza y cuello y otorrinolaringológicas, ya sea como lesiones benignas o como promotor de lesiones malignas. Las lesiones benignas por VPH en genitales masculinos se caracterizan fundamentalmente por la aparición de lesiones verrugosas, aunque también puede manifestarse mediante lesiones planas atípicas. En algunos casos hay ausencia de lesiones macroscópicamente visibles que pueden hacerse evidentes con la prueba de ácido acético. La biopsia de la lesión, su evaluación anatomopatológica y, sobre todo, la determinación de la existencia y el tipo de virus involucrado mediante PCR (reacción en cadena de la polimerasa) permiten confirmar el diagnóstico. En algunas ocasiones es necesario realizar una cistoscopia para diagnosticar lesiones intrauretrales y vesicales. Los tratamientos propuestos son muy variados y de eficacia dispar, desde las topicaciones y la electrocirugía o la criocirugía, hasta el empleo de la tecnología láser. La prevención con el uso de protección durante el acto sexual así como la educación sexual son fundamentales. En los últimos 10 años se ha implementado el uso de la vacuna para el VPH en niñas con el fin de disminuir la incidencia de lesiones de alto grado y de cáncer de cuello uterino, pero su indicación en varones es menos clara y aún no ha sido consensuada. (AU)


Human papiloma virus (HPV) is one of the most common sexual transmitted diseases. It can affect the male genitalia, as well as the perianal and anal regions and multiple areas of the head and neck and otorhinolaryngological structures, as benign lesiones or as a promoter of malignant lesions. Benign male genitalia lesions are characterized mainly by verrucous lesions, although flat atypical lesions can be found, as well as the abscence of macroscopic visible lesions that in some cases can become evident using the acetic acid test. Lesion biopsy, its histological evaluation, and the determination of the existence and type of virus using PCR (Polymerase Chain Reaction) can confirm the diagnosis. In some cases is necessary to do a cistoscopy to diagnose intraurethral and vesical lesions. Proposed treatments are varied and with a wide range of efficacy, from topications to electro or cryosurgery, and the use of laser technology. Sexual education and the use of sexual protection are essential in prevention. In the last 10 years the use of VPH vaccine in girls was widely spread, in order to decrease the incidence of high grade lesions and cervix cancer. Its indication in male patients is less clear and not yet consented among specialists. (AU)


Subject(s)
Humans , Male , Papillomavirus Infections/therapy , Reproductive Tract Infections/therapy , Podophyllin/therapeutic use , Podophyllotoxin/therapeutic use , Sex Education , Trichloroacetic Acid/therapeutic use , Condylomata Acuminata/etiology , Polymerase Chain Reaction , Condoms , Papillomavirus Infections/diagnosis , Papillomavirus Infections/pathology , Papillomavirus Infections/prevention & control , Papillomavirus Infections/drug therapy , Alphapapillomavirus/pathogenicity , Papillomavirus Vaccines/therapeutic use , Laser Therapy , Reproductive Tract Infections/diagnosis , Reproductive Tract Infections/etiology , Reproductive Tract Infections/pathology , Reproductive Tract Infections/drug therapy , Fluorouracil/administration & dosage , Fluorouracil/therapeutic use , Lidocaine/administration & dosage , Lidocaine/therapeutic use
13.
Article in English | WPRIM | ID: wpr-172539

ABSTRACT

Pseudomyxoma peritonei is a very rare condition, and even rarer in patients with history of cancer. A 70-year old woman with a history of breast cancer was admitted with abdominal pain and distention. Abdominal computed tomography revealed ascites collection, diffuse engorgement and infiltration of the mesenteric vessel, suggesting peritonitis or peritoneal carcinomatosis. Diagnostic paracentesis was attempted several times, but a sufficient specimen could not be collected due to the thick and gelatinous nature of the ascites. Therefore, the patient underwent diagnostic laparoscopy for tissue biopsy of the peritoneum, which indicated pseudomyxoma peritonei. However, the origin of the pseudomyxoma peritonei could not be identified intraoperatively due to adhesions and large amount of mucoceles. Systemic chemotherapy was performed using Fluorouracil, producing some symptomatic relief. After discharge, abdominal pain and distention gradually worsened, so at 18 months after initial diagnosis the patient received palliative surgery based on massive mucinous ascites and palpable mass at the omentum. The patient expired after surgery due to massive bleeding.


Subject(s)
Abdomen/diagnostic imaging , Aged , Antimetabolites, Antineoplastic/therapeutic use , Ascites , Breast Neoplasms/pathology , Colonoscopy , Female , Fluorouracil/therapeutic use , Humans , Laparoscopy , Peritoneal Neoplasms/diagnosis , Peritoneum/pathology , Pseudomyxoma Peritonei/diagnosis , Tomography, X-Ray Computed
14.
Article in Korean | WPRIM | ID: wpr-73834

ABSTRACT

Radiation dermatitis can develop after fluoroscopy-guided interventional procedures. Cases of fluoroscopy-induced radiation dermatitis have been reported since 1996, mostly documented in the fields of radiology, cardiology and dermatology. Since diagnosis and treatment of fluoroscopy-induced radiation dermatitis can be difficult, high grade of suspicion is required. The extent of this reaction is determined by radiation dose, duration of exposure, type of procedure, and host factors and can be aggravated by concomitant use of photosensitizers. Follow-up is important after long and complicated procedures and efforts to minimize radiation exposure time will be necessary to prevent radiation dermatitis. Herein, we report a case of a 58-year-old man with hepatocellular carcinoma presenting with subacute radiation dermatitis after prolonged fluoroscopic exposure during transarterial chemoembolization and chemoport insertion. Physicians should be aware that fluoroscopy is a potential cause of radiation dermatitis.


Subject(s)
Carcinoma, Hepatocellular/radiotherapy , Embolization, Therapeutic , Fluoroscopy , Fluorouracil/therapeutic use , Gamma Rays , Humans , Liver Neoplasms/radiotherapy , Male , Middle Aged , Radiodermatitis/diagnosis
15.
Yonsei Medical Journal ; : 1276-1281, 2016.
Article in English | WPRIM | ID: wpr-79763

ABSTRACT

Locally advanced hepatocellular carcinoma (HCC) with portal vein thrombosis carries a 1-year survival rate <10%. Localized concurrent chemoradiotherapy (CCRT), followed by hepatic arterial infusion chemotherapy (HAIC), was recently introduced in this setting. Here, we report our early experience with living donor liver transplantation (LDLT) in such patients after successful down-staging of HCC through CCRT and HAIC. Between December 2011 and September 2012, eight patients with locally advanced HCC at initial diagnosis were given CCRT, followed by HAIC, and underwent LDLT at the Severance Hospital, Seoul, Korea. CCRT [45 Gy over 5 weeks with 5-fluorouracil (5-FU) as HAIC] was followed by HAIC (5-FU/cisplatin combination every 4 weeks for 3-12 months), adjusted for tumor response. Down-staging succeeded in all eight patients, leaving no viable tumor thrombi in major vessels, although three patients first underwent hepatic resections. Due to deteriorating liver function, transplantation was the sole therapeutic option and offered a chance for cure. The 1-year disease-free survival rate was 87.5%. There were three instances of post-transplantation tumor recurrence during follow-up monitoring (median, 17 months; range, 10-22 months), but no deaths occurred. Median survival time from initial diagnosis was 33 months. Four postoperative complications recorded in three patients (anastomotic strictures: portal vein, 2; bile duct, 2) were resolved through radiologic interventions. Using an intensive tumor down-staging protocol of CCRT followed by HAIC, LDLT may be a therapeutic option for selected patients with locally advanced HCC and portal vein tumor thrombosis.


Subject(s)
Adult , Carcinoma, Hepatocellular/complications , Chemoradiotherapy , Cisplatin/therapeutic use , Disease-Free Survival , Female , Fluorouracil/therapeutic use , Humans , Liver Neoplasms/complications , Liver Transplantation , Living Donors , Male , Middle Aged , Neoplasm Recurrence, Local , Portal Vein , Venous Thrombosis/complications
16.
Rev. bras. epidemiol ; 18(1): 248-261, Jan-Mar/2015. tab, graf
Article in Portuguese | LILACS | ID: lil-736433

ABSTRACT

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. .


Subject(s)
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
17.
Ciênc. saúde coletiva ; 20(3): 851-864, 03/2015. graf
Article in Portuguese | LILACS | ID: lil-742232

ABSTRACT

Para fundamentar as ações de cuidado integralizado em saúde da mulher é necessário compreender de que modo o apoio social pode contribuir para minimizar as repercussões do diagnóstico e do tratamento da neoplasia mamária. O objetivo deste estudo é analisar a contribuição da produção científica nacional e internacional acerca do apoio social percebido por mulheres diagnosticadas com câncer de mama. A amostra foi constituída de 12 publicações, obtidas a partir de critérios de inclusão preestabelecidos, nas bases de dados MedLine, Lilacs e PsycINFO, na última década (2000-2010). Os resultados foram sistematizados em categorias temáticas: percepção do apoio familiar, apoio social percebido, percepção do apoio educacional, necessidade de aprimoramento da pesquisa e assistência às mastectomizadas e suas famílias. Os estudos dedicados à dimensão subjetiva do apoio social ainda são incipientes. As evidências disponíveis sugerem que a literatura é circunscrita a temas de interesse das profissões tradicionais da área da saúde, como Enfermagem e Medicina, privilegiando construtos que podem ser diretamente quantificados. A preocupação com o apoio social deve estar presente desde a fase de diagnóstico até a reabilitação psicossocial, como parte do processo de enfrentamento.


It is necessary to understand how social support can contribute to minimize the impact of the diagnosis and treatment of mammary tumors in order to underpin the actions of comprehensive women's health care. This study seeks to analyze the contribution of the national and international literature regarding the perceived social support by women diagnosed with breast cancer. Twelve studies were selected from the MedLine, Lilacs and PsycINFO databases over a 10-year period (2000-2010) with pre-defined criteria for inclusion. The results were organized into thematic categories: the perception of family support; perceived social support; the perception of educational support; the need to improve the research and the assistance given to women after mastectomy and their families. The studies dedicated to the subjective dimension of social support are still incipient. The available evidence suggests that the literature is limited to topics of interest to the traditional health professions, such as Nursing and Medicine, focusing on constructs that can be directly quantified. The concern with social support must be present from the time of diagnosis to psychosocial rehabilitation, as part of the process of tackling the situation.


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Antimetabolites, Antineoplastic/blood , Antimetabolites, Antineoplastic/pharmacokinetics , Colorectal Neoplasms/drug therapy , Deoxycytidine/analogs & derivatives , Fluorouracil/analogs & derivatives , Age Factors , Area Under Curve , Antimetabolites, Antineoplastic/therapeutic use , Capecitabine , Colorectal Neoplasms/metabolism , Deoxycytidine/blood , Deoxycytidine/pharmacokinetics , Deoxycytidine/therapeutic use , Floxuridine/blood , Fluorouracil/blood , Fluorouracil/pharmacokinetics , Fluorouracil/therapeutic use , Glomerular Filtration Rate , Metabolic Clearance Rate , Sex Factors
18.
Article in English | WPRIM | ID: wpr-157197

ABSTRACT

Hepatoblastoma usually occurs in children under the age of 2 years, with very few cases reported in adults. We experienced a case of adult hepatoblastoma in a 36-year-old female with chronic hepatitis B . She had experienced sudden onset abdominal pain. Her serum alpha-fetoprotein level was markedly elevated, and abdominal CT showed a 9-cm mass with internal hemorrhage in the right hepatic lobe with hemoperitoneum, so an emergency hepatic central bisectionectomy was performed. The initial histologic examination revealed that the mass mimicked combined hepatocellular carcinoma and cholangiocarcinoma with spindle-cell metaplasia of the cholangiocarcinoma element. Follow-up abdominal CT performed 3 months later showed a 5.5-cm metastatic mass in the left subphrenic area. Laparoscopic splenectomy with mass excision was performed, and hepatoblastoma was confirmed histologically. A histologic re-examination of previously obtained surgical specimens also confirmed the presence of hepatoblastoma. Metastatic hepatoblastoma was found at multiple sites of the abdomen during follow-up, and so chemotherapy with cisplatin, 5-fluorouracil (5-FU), and vincristine was applied, followed by carboplatin and doxorubicin . Despite surgery and postoperative chemotherapy, she died 12 months after symptom onset.


Subject(s)
Adult , Carcinoma, Hepatocellular/pathology , Cholangiocarcinoma/pathology , Cisplatin/therapeutic use , Diagnostic Errors , Doxorubicin/therapeutic use , Drug Therapy, Combination , Female , Fluorouracil/therapeutic use , Hepatitis B, Chronic/complications , Hepatoblastoma/drug therapy , Humans , Liver Neoplasms/drug therapy , Tomography, X-Ray Computed , Vincristine/therapeutic use
20.
Article in English | WPRIM | ID: wpr-191018

ABSTRACT

Primary colorectal choriocarcinoma is a rare neoplasm. Only 19 cases have been reported worldwide, most of which involved adenocarcinomas. The prognosis is usually poor, and the standard therapy for this tumor has not been established. A 61-year-old woman presented with constipation and lower abdominal discomfort. She was diagnosed with primary adenocarcinoma with focal choriocarcinomatous differentiation in the sigmoid colon and liver metastasis. Because the serum beta-human chorionic gonadotropin level was not significantly elevated, and because only focal choriocarcinomatous differentiation was diagnosed, we selected the chemotherapy regimen that is used for the treatment of metastatic colorectal adenocarcinoma. The patient survived for 13 months after the initial diagnosis. This is the first case in Korea to assess the suppressive effects of the standard chemotherapy for colorectal adenocarcinoma against coexisting colorectal choriocarcinoma and adenocarcinoma.


Subject(s)
Adenocarcinoma/diagnosis , Antineoplastic Agents/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , CA-19-9 Antigen/analysis , Chorionic Gonadotropin, beta Subunit, Human/blood , Colon, Sigmoid/pathology , Colonic Neoplasms/diagnosis , Colonoscopy , Constipation/etiology , Female , Fluorouracil/therapeutic use , Humans , Leucovorin/therapeutic use , Liver Neoplasms/secondary , Middle Aged , Organoplatinum Compounds/therapeutic use , Prognosis , Tomography, X-Ray Computed
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