ABSTRACT
We examined whether the allelic and/or genotypic profile of locus -1562C/T of the matrix metalloproteinase (MMP-9) gene influences the protein expression levels of MMP-9 in patients with colorectal cancer (CRC) compared with controls. A total of 104 patients with CRC and 84 controls were evaluated. Peripheral blood was collected from both groups and DNA extraction was performed for -1562C/T genotyping; the plasma was used for MMP-9 quantification. The CT genotype was associated with increased MMP-9 expression (P = 0.0211). High levels of protein, independently of polymorphisms, were observed in the patient group (P < 0.0001) compared to controls. Mucinous tumors with signet ring cells were more frequent in females (P = 0.0177). Overall, patients older than 50 years showed a significant risk of developing CRC (P = 0.0001). MMP-9 plasma expression was increased in patients with CRC compared to controls, particularly in those with the heterozygous -1562CT genotype.
Subject(s)
Colorectal Neoplasms/blood , Colorectal Neoplasms/genetics , Matrix Metalloproteinase 9/blood , Matrix Metalloproteinase 9/genetics , Polymorphism, Single Nucleotide/genetics , Adult , Aged , Alleles , Brazil , Colorectal Neoplasms/metabolism , Female , Gene Frequency , Genetic Predisposition to Disease/genetics , Genotype , Humans , Male , Middle AgedABSTRACT
A prospective study was conducted on 79 advanced immunosuppressed AIDS patients from 1997 to 1999, during which nine cases of tuberculosis (TB) were diagnosed. The main clinical and laboratory characteristics and the response to TB treatment were reviewed. The clinical manifestations of TB were: pulmonary (six cases), extrapulmonary (two cases) and disseminated (one case). These patients were being treated with highly active antiretroviral treatment (HAART) and were not responding. In three cases an optional regimen without rifampicin (RMP) was indicated to maintain HAART during TB treatment. A clinical response to TB treatment (disappearance of fever) was observed in 6/9 patients during a mean of 73 days (SD = 96). The three unresponsive patients were those treated without RMP. A switch to TB regimens containing RMP was proposed and successful. In our study, though it was limited by a small sample size, the response to TB regimens without rifampin was poor in immunossupressed patients failing HAART.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , AIDS-Related Opportunistic Infections/drug therapy , Antibiotics, Antitubercular/therapeutic use , Rifampin/therapeutic use , Tuberculosis, Pulmonary/drug therapy , AIDS-Related Opportunistic Infections/complications , Antiretroviral Therapy, Highly Active , Drug Therapy, Combination , Immunocompromised Host , Prospective Studies , Treatment Outcome , Tuberculosis, Pulmonary/complicationsABSTRACT
Drogas utilizadas na medicaçäo pré-anestésica diminuem a CAM dos anestésicos inalatórios. Neste ensaio clínico utiliza-se o método quantitativo de anestesia para comparar e quantificar a reduçäo da CMA95 do enflurano após o uso pré-anestésico de nalbufina, diazepam e morfina. Foram estudados quarenta e cinco pacientes, estado físico I ou II (ASA), sem doenças cardiorrespiratórias, escalados para diferentes tipos de cirurgia eletiva, divididos em 3 grupos de 15 pacientes, de acordo com a medicaçäo pré-anestésica prescrita. A nalbufina e a morfina foram administradas por via muscular na dose de 0,1 a 0,2 mg.kg-1 enquanto o diazepam o foi por via oral na dose de 0,2 a 0,4 mg.kg-1, 1 h antes do início da cirurgia. Durante a visita pré-anestésica, além da medida do volume minuto e freqüência respiratória, que voltariam a ser medidos na sala de operaçöes imediatamente antes da induçäo da anestesia, era também calculada a dose ideal de enflurano. Durante a anestesia, a pressäo arterial foi medida a cada 5 min os batimentos cardíacos e o eletrocardiograma foram monitorizados continuamente. Os dois primeiros foram registrados nas seguintes etapas: visita pré-operatória (controle), imediatamente antes da induçäo da anestesia (inicial), aos 60 min, aos 120 min e ao final da cirurgia. As injeçöes de enflurano líquido foram administradas no ramos expiratório do sistema de inalaçäo com seringas descartáveis de 3 ml. A induçäo da anestesia foi realizada com uma dose precurarizante de pancurônio (1 mg) seguida, 3 min após, de uma dose hipnótica de tiopental (4 a 6 mg.kg-1) e succinilcolina (1 e 2 mg.kg-1) para facilitar a intubaçäo orotraqueal. A manutençäo da anestesia foi realizada com doses intermitentes de enflurano líquido carreadas em quantidades basais de oxigênio...
