High-dose oral tegafur-uracil maintenance therapy in patients with uterine cervical cancer / 부인종양

OBJECTIVE: The aim of this study was to determine the efficacy and toxicity of oral administration of tegafur-uracil (UFT) at a high dose, 600 mg/day, based on the tegafur dose, against uterine cervical cancer. METHODS: This study consisted of a retrospective analysis. From April 1986 to March 1997, 309 patients with uterine cervical cancer were registered. Oral UFT was administered to 162 patients for maintenance therapy after an initial treatment (the UFT group). The other 147 patients were not treated with UFT (the control group). The survival rate was calculated for both groups and statistically analyzed using the log-rank test. Adverse events were compared between the UFT and control groups. RESULTS: In the UFT group, 103 patients (63.6%) received UFT for > or =90 days. The drug dose was 600 mg/day for 137 patients (84.6%) and 300 to 400 mg/day for the remainder. The overall survival rate was significantly higher in the UFT group than in the control group (p<0.05). The prognosis was particularly favorable in stage III cases, in cases of squamous cell carcinoma, and in cases that were treated by radiotherapy. The most frequent side effects were nausea/vomiting (12.2%), appetite loss (10.1%), and leukopenia/neutropenia (5.8%). CONCLUSION: High-dose oral UFT maintenance treatment prolonged the disease-free survival and overall survival of patients with uterine cervical cancer, particularly of those with advanced disease.

Efeito da revascularização renal sobre a evolução da disfunção renal na nefropatia isquêmica aterosclerótica / Effect of renal revascularization on the development of renal dysfunction in atherosclerotic ischemic nephropathy

A doença renal crônica (DRC) é caracterizada por uma perda progressiva da função renal e suas principais causas são hipertensão arterial (HA) e diabete melito. Entre as causas de HA, podemos destacar a doença renal aterosclerótica (DRA). O desenvolvimento de DRC nos pacientes com DRA parece ser decorrente não apenas do acometimento das artérias renais principais, mas também da microcirculação renal, o que pode justificar o fato de o sucesso do procedimento não garantir uma melhora da evolução da DRC. Até o presente momento, não existe evidência de benefício da angioplastia em relação ao tratamento clínico exclusivo nos pacientes com DRA. O presente trabalho analisa os estudos mais significantes sobre os desfechos renais em pacientes portadores de DRA submetidos à revascularização ou ao tratamento clínico exclusivo.

Chronic kidney disease (CKD) is characterized by a progressive loss of renal function and its main causes are hypertension and diabetes mellitus. Among the causes of hypertension is atherosclerotic renal disease (ARD). The development of CKD in patients with ARD appears to be due not only to the involvement of the main renal arteries, but also of the renal microcirculation, which may explain the fact that the success of the procedure does not guarantee an improvement in the progression of CKD. To date there is no evidence of benefit of angioplasty compared to medical treatment alone in patients with ARD. The present paper analyzes the most significant studies on renal outcomes in patients with ARD undergoing revascularization or medical treatment alone.

Consejería en la detección de VPH como prueba de tamizaje de cáncer cervical: un estudio cualitativo sobre necesidades de mujeres de Michoacán, México / Counseling for HPV detection when used to screen for cervical cancer: a qualitative study on the needs of women from Michoacan, Mexico

Objetivo. Explorar las necesidades de información y consejería de un grupo de mujeres mexicanas al utilizar la prueba de virus de papiloma humano (VPH). Material y métodos. En 2011, se realizaron 24 entrevistas semiestructuradas a mujeres que recibieron el resultado de una prueba de VPH, en dos municipios del estado de Michoacán. El análisis cualitativo de las entrevistas se realizó con las técnicas de la comparación constante. Resultados. Durante el tamizaje, las mujeres recibieron escasa consejería; experimentaron angustia y confusión. Las usuarias de la prueba se mostraron interesadas en recibir información sobre el VPH y el cáncer cervical, el significado de sus resultados, los pasos que habrían de realizar en la atención, apoyo emocional e información vinculada con la transmisión sexual de VPH. Conclusiones. Se requiere diseñar e implementar políticas para impartir educación para la salud y consejería, a la par de la realización de pruebas de VPH.

Objective. To explore the information and counseling needs of a group of Mexican women during use of the HPV test. Materials and methods. In 2011, 24 semistructured interviews were done with women upon receiving HPV test results in two municipalities in the state of Michoacan. Qualitative analysis of the interviews was done using constant comparison techniques. Results. During their use of screening services women received limited counseling; they felt anguish and confusion. Women were interested in receiving information and advice on HPV and cervical cancer, the meaning of test result, next steps to be taken in their healthcare use as well as information and emotional support related to the sexual transmission of HPV. Conclusions. The design and implementation of policies are needed which instigate health education and counseling in conjunction with HPV testing.

Aprendizaje cooperativo para forjar vivienda saludable en Bogotá: estudio de caso / Cooperative learning for improving healthy housing conditions in Bogota: a case study

Objetivo Construir desde la comunidad una propuesta educativa orientada al auto empoderamiento para mejorar las condiciones sanitarias y de habitabilidad de la vivienda. Método Con un enfoque constructivista y con base en el programa "Gestores comunitarios del hábitat", se trabajó con quince familias residentes en el barrio Mochuelo Bajo de la Localidad de Ciudad Bolívar en Bogotá, Colombia, con el fin de que identificaran los aspectos sanitarios más relevantes para el mejoramiento de sus viviendas y propusieran la metodología y organización de la propuesta educativa. Resultados Se identificaron veinti ún indicadores epidemiológicos ligados a una vivienda insalubre, los cuales sirvieron como base para definir las problemáticas específicas y establecer la metodología para diseñar la propuesta educativa. Discusión El curso diseñado pretende fomentar la educación y las capacidades en salud de la comunidad con el fin de mejorar las condiciones de habitabilidad de las viviendas y lograr un entorno saludable del hábitat que les permita desarrollarse con bienestar y dignidad.

Objective This was a community-based effort at constructing an educational proposal orientated towards self-empowerment aimed at improving the target population's sanitary, housing and living conditions through cooperative learning. Methods A constructivist approach was adopted based on a programme called "Habitat community manger". The project involved working with fifteen families living in the Mochuelo Bajo barrio in Ciudad Bolívar in Bogotá, Colombia, for identifying the most relevant sanitary aspects for improving their homes and proposing a methodology and organisation for an educational proposal. Results Twenty-one poor housing-related epidemiological indicators were identified which formed the basis for defining specific problems and establishing a methodology for designing an educational proposal. Discussion The course which emerged from the cooperative learning experience was designed to promote the community's skills and education regarding health aimed at improving households' living conditions and ensuring a healthy environment which would allow them to develop an immediate habitat ensuring their own welfare and dignity.

Estudo de fase II avaliando eficácia e toxicidade de UFT (uracil e tegafur) e leucovorin, administrados duas vezes ao dia, no tratamento de pacientes com câncer metastático de cólon e reto / Phase II trial evaluating the efficacy and toxicity of UFT and toxicity of UFT and leucovorin twice-daily as a treatment for metastatic colorectal cancer

O desenvolvimento clínico de novos fármacos é uma tarefa bastante complexa, que requer a participação de um grande número de investigadores e instituições. A disponibilidade de fármacos ativos contra o câncer de cólon e reto avançado sempre foi limitada, e por muitos anos este foi considerado um tumor resistente ao tratamento sistêmico, sendo essencialmente incurável a partir do momento em que se detectavam metástases à distância. Entretanto, a última década testemunhou um notável progresso no tratamento desta doença, graças ao desenvolvimento de diversos novos fármacos. Material e métodos: Revisamos nossa contribuição ao tratamento do câncer de cólon e reto avançado, representada por 94 manuscritos indexados (Pubmed, 06/08/2007), e 82 trabalhos apresentados em congressos internacionais...

Introduction: The clinical development of new drugs is a complex task that requires the participation of a large number of investigators and institutions. The availability of active drugs against advanced colorectal cancer has always been limited, and for many years this was considered a resistant tumor, which was essentially incurable once it had metastasized. However, the last decade has witnessed a remarkable progress in the treatment of this disease, thanks to the development of several new drugs. Material e methods: We reviewed our contribution to the treatment of advanced colorectal cancer through 94 indexed manuscripts (Pubmed, august 06, 2007), and 82 abstracts presented at International Congresses. Of those, we selected 51 publications that best represent our line of research, and our contribution to the treatment of this cancer. Results: We have a total of 10 drugs with proven activity against colorectal cancer. We have contributed in a substantial way for the clinical approval of two of those drugs, the oral capecitabine and the UFT, which can replace the old 5-fluorouracil with some advantages. We have also participated in the clinical development of irinotecan, oxaliplatin, bevacizumab and cetuximabe. Conclusion: We have participated in the development of the majority of new drugs available for the treatment of colorectal cancer. The availability of these new drugs has changed the natural history of this tumor, and patients may now expect not only an increase in median survival, but the presence of distant metastasis is not necessarily an impediment for a treatment with curative intent.

Efficacy of UFT plus oral leucovorin in advanced colorectal cancer: a multicenter study.

PURPOSE: To evaluate the efficacy and toxicity of UFT plus oral leucovorin in advanced colorectal cancer. MATERIAL AND METHOD: Twenty cases of advanced colorectal cancer were entered into the study. All patients must have histologic proof and have measurable disease. Prior to the treatment all patients should have normal baseline hematology and normal liver and renal function, ECOG Performance status < or = 2 and age 18-75 years. Chemotherapeutic drugs consisted of UFT 350 mg/m2/day divided into 3 doses (8 hours apart) plus oral leucovorin 15 mg every 8 hours. Duration of treatment was 21 days per each cycle. Treatment was recycled every 28 days. RESULTS: Four cases (22.2%) had partial responses and six cases (33.3%) had stable disease. Duration of response was 4(+)-7+ months. Toxicity was darkened skin, mild diarrhea and mild alopecia. CONCLUSION: UFT plus oral leucovorin was one of the active regimens in the treatment of advanced colorectal cancer.