Reação adversa a medicamento: uma análise comparativa de protocolos utilizados para o tratamento do câncer colorretal / Adverse drug reaction: a comparative analysis of protocols used for treatment of colorectal cancer

Study design: Cohort study Objective: Analyze the adverse reactions that occurred in Brazilian patients with colorectal cancer submitted to chemotherapy with two different protocols, in order to identify the types and severity of those most frequent recorded. Methods: Sixty-three patients, who started treatment from June 2014 to May 2015, were separated into two groups: mFOLFOX6 (protocol containing oxaliplatin, folinic acid and 5-fluorouracil in bolus and continuous infusion, n= 40) and FOLFIRI (protocol containing irinotecan, folinic acid and 5-fluorouracil in bolus and continuous infusions, n= 23). Data related to the demographic and clinical profile of the patients were collected from the medical record, as well as information about the treatment performed and the adverse reactions manifested. The reactions were classified according to their severity (grades 1, 2, 3 and 4) and causality (definite, probable, possible and doubtful). Results: A high frequency of adverse reactions was observed in both groups, reaching 92.5% of patients with mFOLFOX6 protocol and 95.6% with FOLFIRI protocol. Gastrointestinal and neurological toxicities were the most frequent among the groups. When comparing the occurrence of intergroup reactions, there was difference only for gastrointestinal toxicities (p= 0.035). In 17.5% of patients mFOLFOX6 group (n= 7) and in 8.7% of patients FOLFIRI group (n= 2), grades 3 and 4 adverse reactions were observed and classified as probable. Conclusion: The adverse reactions were more diversified and frequent in the mFOLFOX6 group compared to the FOLFIRI group. However, no difference was observed in the severity and causality of reactions in both groups (AU)

Study design: Cohort study Objective: Analyze the adverse reactions that occurred in Brazilian patients with colorectal cancer submitted to chemotherapy with two different protocols, in order to identify the types and severity of those most frequent recorded. Methods: Sixty-three patients, who started treatment from June 2014 to May 2015, were separated into two groups: mFOLFOX6 (protocol containing oxaliplatin, folinic acid and 5-fluorouracil in bolus and continuous infusion, n= 40) and FOLFIRI (protocol containing irinotecan, folinic acid and 5-fluorouracil in bolus and continuous infusions, n= 23). Data related to the demographic and clinical profile of the patients were collected from the medical record, as well as information about the treatment performed and the adverse reactions manifested. The reactions were classified according to their severity (grades 1, 2, 3 and 4) and causality (definite, probable, possible and doubtful). Results: A high frequency of adverse reactions was observed in both groups, reaching 92.5% of patients with mFOLFOX6 protocol and 95.6% with FOLFIRI protocol. Gastrointestinal and neurological toxicities were the most frequent among the groups. When comparing the occurrence of intergroup reactions, there was difference only for gastrointestinal toxicities (p= 0.035). In 17.5% of patients mFOLFOX6 group (n= 7) and in 8.7% of patients FOLFIRI group (n= 2), grades 3 and 4 adverse reactions were observed and classified as probable. Conclusion: The adverse reactions were more diversified and frequent in the mFOLFOX6 group compared to the FOLFIRI group. However, no difference was observed in the severity and causality of reactions in both groups.(AU)

Assessment of quality of life in patients with advanced non-small cell lung carcinoma treated with a combination of carboplatin and paclitaxel / Avaliação da qualidade de vida de pacientes com carcinoma pulmonar de células não pequenas em estágio avançado, tratados com carboplatina associada a paclitaxel

OBJECTIVE: Non-small cell lung carcinoma (NSCLC) is the most common type of lung cancer. Most patients are diagnosed at an advanced stage, palliative chemotherapy therefore being the only treatment option. This study was aimed at evaluating the health-related quality of life (HRQoL) of advanced-stage NSCLC patients receiving palliative chemotherapy with carboplatin and paclitaxel. METHODS: This was a multiple case study of advanced-stage NSCLC outpatients receiving chemotherapy at a public hospital in Rio de Janeiro, Brazil. The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire was used in conjunction with its supplemental lung cancer-specific module in order to assess HRQoL. RESULTS: Physical and cognitive functioning scale scores differed significantly among chemotherapy cycles, indicating improved and worsened HRQoL, respectively. The differences regarding the scores for pain, loss of appetite, chest pain, and arm/shoulder pain indicated improved HRQoL. CONCLUSIONS: Chemotherapy was found to improve certain aspects of HRQoL in patients with advanced-stage NSCLC. .

OBJETIVO: O carcinoma pulmonar de células não pequenas (CPCNP) é tipo mais comum de câncer de pulmão. Como a maioria dos pacientes é diagnosticada em estágio avançado, a quimioterapia paliativa é a única opção de tratamento. Este estudo avaliou a qualidade de vida relacionada à saúde (QVRS) de pacientes com CPCNP avançado no decorrer da quimioterapia paliativa com carboplatina e paclitaxel. MÉTODOS: Trata-se de um estudo de casos múltiplos de pacientes ambulatoriais com CPCNP em estágio avançado recebendo quimioterapia em um hospital público no Rio de Janeiro (RJ). Para a avaliação da QVRS, foram usados o European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire e seu módulo específico para câncer de pulmão. RESULTADOS: Houve diferenças significativas na pontuação nas escalas de capacidade física e cognitiva durante a quimioterapia, indicando melhora e piora da QVRS, respectivamente. As diferenças na pontuação nos itens dor, perda de apetite, dor no tórax e dor no braço ou ombro indicaram melhora da QVRS. CONCLUSÕES: Observou-se que a quimioterapia melhora alguns aspectos da QVRS de pacientes com CPCNP avançado. .

Impacto da formação e da função dos corpúsculos lipídicos na resposta imune na infecção experimental por Mycobacterium bovis BCG / Impact of the formation and the function of the lipid bodies in the immune reply in the experimental infection for Mycobacterium bovis BCG

Corpúsculos lipídicos são organelas citoplasmáticas que aumentam em tamanho e número em leucócitos envolvdos em grande variedade de processos inflamatórios, infecciosos e neoplásicos in vivo e in vitro, incluindo infecções micobacterianas. Sua morfologia, constituição proteica e lipídica e capacidade de interagir com outras organelas pode variar de acordo com o tipo de célula e com as vias específicas de biogênese estimuladas. Estas estruturas contém uma série de proteínas, incluindo pequenas GTPases, proteínas da família Rab e quinases indicando possível participação destas organelas na sinalização intracelular, na comunicação intercelular e no metabolismo lipídico. Os corpúsculos lipídicos também compartimentalizam enzimas e moléculas envolvidas na produção de eicosanóides, além de funcionarem como regiões de armazenamento de citocinas em leucócitos inflamatórios, sugerindo sua participação como plataformas intracelulares induzíveis e altamente reguladas para a produção e/ou secreção de mediadores lipídicos e citocinas em resposta a condições inflamatórias, incluindo infecções por patógenos intracelulares. dados recentes do nosso grupo indicam a participação importante destas organelas na síntese de prostaglandina E2 (PGE2), um conhecido desativador de resposta citotóxica contra patógenos intracelulares, viabilizando a sobrevivência micobacteriana pela modulação negativa da atividade de macrófagos. A infecção por micobactérias patogênicas induz a formação de corpúsculos lipídicos em macrófagos de forma dependente de dose e tempo, além de induzirem processo de apoptose em neutrófilos no sítio da infecção. Células apoptóticas, por sua vez, têm mostrado papel na modulação da resposta imune contra patógenos intracelulares. Neste estudo, investigamos a participação e função de corpúsculos lipídicos de macrófagos em modelo murino de tuberculose e sua relação com a sobrevivência e/ou multiplicação micobacterianas. Para esse propósito, macrófagos...