ABSTRACT
BACKGROUND: The eyelids play an important role in our appearance and are usually the first to show signs of age. The Fotona SP Spectro Systems consist of a range of noninvasive laser treatments that work together synergistically to tighten the collagen in four dimensions and provide long-lasting firmness to the face. The Fotona SP Spectro combines two wavelengths: Er:YAG (2940 nm) and Nd:YAG (1064 nm) with four distinct treatments: SmoothLiftingTM, FRAC3®, PIANO®, and SupErficialTM, allowing safe, painless, noninvasive, and no downtime rejuvenation. AIMS: To present a new protocol of treatment with Fotona SP Spectro for eyebrow elevation, which we call fox eyes lift (FEL), and compare it to the standard SmoothEye® (SE) protocol. METHODS: This is a prospective, interventional, split-face study. The sample consisted of 21 subjects (19 women) with a mean age of 50.1 ± 7.9 years who underwent two different protocols, that is, SE on one side and FEL on the other. The protocol used on each side was selected by drawing lots. Three sessions were held at 1-month intervals. Standardized photographic documentation was obtained before and 30 days after the end of treatment. Eyebrow position before and after complete treatment was quantified using ImageJ software. RESULTS: Statistical analysis by ANOVA showed a significant improvement in eyebrow position after treatment with both protocols, with a significantly greater effect of FEL (p = 0.0003 d = 0.95). CONCLUSION: Fox eyes lift is an efficient and safe technique providing significant improvement in the position of the eyebrow.
Subject(s)
Laser Therapy , Lasers, Solid-State , Skin Aging , Humans , Female , Adult , Middle Aged , Eyebrows , Prospective Studies , Laser Therapy/methods , Collagen , Lasers, Solid-State/therapeutic use , Rejuvenation , Treatment OutcomeABSTRACT
Checkpoint inhibitors, cancer immunotherapies, are the new forms of treatment for gray zone lymphoma, a rare subtype that combines the characteristics of both Hodgkin and non-Hodgkin disease forms. Programmed cell death protein 1/programmed cell death ligand 1 (PD-L1/PD-1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) modulate the immune system function. Immunological checkpoints can be stimulatory or inhibitory, and tumors can use these checkpoints to protect against immune system attacks. This is a case report of a difficult diagnosis and describes the most current treatment using checkpoint inhibitors, through the review of the clinical record of a patient diagnosed with gray area lymphoma in August 2019, using a descriptive and cross-sectional analysis of the clinical history and disease evolution. The case showed that pembrolizumab therapy is an effective treatment option for patients with rare gray zone lymphoma refractory to different lines of treatment. Both the diagnosis and treatment of gray area lymphoma remain a challenge for the medical and multiprofessional teams, and collaboration between them ensured effective treatment for the patient.
Subject(s)
Lymphoma, Non-Hodgkin , Lymphoma , Neoplasms , Humans , Cross-Sectional Studies , Lymphoma/pathology , Treatment Outcome , B7-H1 Antigen/metabolismABSTRACT
Limited data are available regarding contemporary multiple myeloma (MM) treatment practices in Latin America. In this retrospective cohort study, medical records were reviewed for a multinational cohort of 1103 Latin American MM patients (median age, 61 years) diagnosed in 2008-2015 who initiated first-line therapy (LOT1). Of these patients, 33·9% underwent autologous stem cell transplantation (ASCT). During follow-up, 501 (45·4%) and 129 (11·7%) patients initiated second- (LOT2) and third-line therapy (LOT3), respectively. In the LOT1 setting, from 2008 to 2015, there was a decrease in the use of thalidomide-based therapy, from 66·7% to 42·6%, and chemotherapy from, 20·2% to 5·9%, whereas use of bortezomib-based therapy or bortezomib + thalidomide increased from 10·7% to 45·5%. Bortezomib-based therapy and bortezomib + thalidomide were more commonly used in ASCT patients and in private clinics. In non-ASCT and ASCT patients, median progression-free survival (PFS) was 15·0 and 31·1 months following LOT1 and 10·9 and 9·5 months following LOT2, respectively. PFS was generally longer in patients treated with bortezomib-based or thalidomide-based therapy versus chemotherapy. These data shed light on recent trends in the management of MM in Latin America. Slower uptake of newer therapies in public clinics and poor PFS among patients with relapsed MM point to areas of unmet therapeutic need in Latin America.
Subject(s)
Multiple Myeloma/therapy , Practice Patterns, Physicians'/statistics & numerical data , Adult , Age Factors , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bortezomib/administration & dosage , Comorbidity , Drug Utilization/statistics & numerical data , Female , Follow-Up Studies , Hematopoietic Stem Cell Transplantation/statistics & numerical data , Humans , Kaplan-Meier Estimate , Latin America/epidemiology , Male , Middle Aged , Multiple Myeloma/epidemiology , Private Facilities/statistics & numerical data , Public Facilities/statistics & numerical data , Retrospective Studies , Thalidomide/administration & dosage , Treatment OutcomeSubject(s)
Gene Expression Regulation , Myelodysplastic Syndromes , Primary Myelofibrosis , Tumor Suppressor Protein p53/biosynthesis , Aged , Disease-Free Survival , Female , Humans , Male , Middle Aged , Myelodysplastic Syndromes/diagnosis , Myelodysplastic Syndromes/metabolism , Myelodysplastic Syndromes/mortality , Primary Myelofibrosis/diagnosis , Primary Myelofibrosis/metabolism , Primary Myelofibrosis/mortality , Survival RateABSTRACT
Tem sido dada grande importância aos avanços na biologia molecular e genética no estabelecimento de novos protocolos, bem como à descoberta de novos marcadores tumorais, úteis ao diagnóstico e tratamento precoces de várias doenças neoplásicas, inclusive a leucemia linfocítica crônica de células B (LLC-B). Para avaliação da atual significância do sistema de estadiamento clínico de Rai no prognóstico de 50 pacientes com LLC-B em um hemocentro estadual, bem como para comparação entre os resultados do estadiamento com valores séricos de LDH e CD38 ao diagnóstico, foram coletados dos prontuários dos pacientes dados referentes à contagem total de linfócitos e plaquetas, concentração de hemoglobina, e também informações quanto à presença ou ausência de linfadenopatia e/ou organomegalia no período de admissão. Quando comparados os resultados do estadiamento com aqueles de outros estudos, observou-se uma situação preocupante quanto ao percentual superior de pacientes já classificados como de alto risco ao diagnóstico. Este quadro de aparente atraso na detecção da LLC-B foi em parte atribuído à dificuldade de acesso a centros especializados e/ou atraso na avaliação hematológica. Além disso, observaram-se incoerências entre os valores de LDH e CD38, e entre estes e o sistema de classificação clínica de Rai. Os resultados sugerem que este sistema de classificação pode ainda ser útil como panorama geral comparativo da LLC-B entre diferentes populações, mas também enfatizam a necessidade de modelos prognósticos específicos que considerem, além dos dados clínicos e marcadores CD38 e LDH, outros indicadores mais precisos do status mutacional IgVH para prognósticos e terapias mais exatos.
It has been given great importance to the advances in molecular biology and genetics in the establishment of new protocols, as well as to the discovery of new tumoral markers, useful to early diagnosis and treatment of various cancer diseases, inclusive B-cell Chronic Lymphocytic Leukemia (B-CLL). For evaluation of the actual significance of Rai clinical staging system in the prognosis of 50 B-CLL patients at a state hemocenter, as well as for comparison between the staging results with the serum values of LDH and CD38 at diagnosis, it was collected from patient promptuaries the data regarding the total lymphocyte and platelet counting, hemoglobin concentration, and also information about the presence or absence of linfadenopathy and/or organomegaly. When compared the staging results with those of other studies, it was noted a worrying situation considering the superior percentage of patients already classified as of high risk at diagnosis. This picture of apparent delay in the detection of CLL-B was to some extent attributed to the difficulty of access to specialized centers and/or delay in hematological evaluation. Additionally, it was observed some incoherence between LDH and CD38, and between these and the clinical classification system of Rai. The results suggest that this classification system may still be useful as a general comparative prospect of B-CLL between different populations, but also emphasize the requirement of specific prognostic models that consider, beyond the clinical data e the markers CD38 and LDH, other more precise indicatives of IgVH mutational status for more accurate prognosis and therapeutics.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged, 80 and over , Blood Specimen Collection/methods , Hematologic Tests , Leukemia, Lymphocytic, Chronic, B-Cell , PrognosisABSTRACT
BACKGROUND: Primary Antiphospholipid Antibody Syndrome (PAAS) is characterized by detection of antiphospholipid antibodies associated with venous or arterial thrombosis and/or miscarriages by patients with no other associated disease such as systemic lupus erythematosus (SLE). Primary Antiphospholipid Antibody Syndrome has many clinical manifestations of which dermatological ones are probably the most common. The purpose of this study was to determine the frequency of each cutaneous lesion, describing clinical features essential for diagnosis, in patients with Antiphospholipid Antibody Syndrome (AAS) attending Walter Cantídio University Hospital. METHODS: Sixty patients with clinical findings suggestive of AAS were screened, and submitted for clinical and laboratory evaluations including lupus anticoagulant (KCT), anticardiolipin antibodies (IgG and IgM: ELISA), routine laboratory tests and screening tests for possible associated conditions. RESULTS: Twenty-five cases of primary and 14 cases of secondary AAS were diagnosed by clinical and laboratory evidences. Persistent elevated antiphospholipid antibodies without history of thromboembolic events or miscarriages were demonstrated in 21 patients. Forty percent of the patients with AAS had a cutaneous feature as the major complaint. These were dermographism (15), acrocyanosis (13), urticaria (9), diffuse alopecia (9), livedo reticularis (seven), Raynaud's phenomenon (three), purpura (two), ulcers and necrosis (four), nodules (four), pterygium ungueum (one) and subungual hemorrhage (one). CONCLUSIONS: Dermatological complaints are very frequent in patients with AAS and may be the first clue to the syndrome. Therefore a careful history and detailed physical examination are essential to diagnose AAS. All dermatologists should investigate the possibility of AAS when facing cutaneous findings related to venous or arterial thrombosis or microthrombosis.
Subject(s)
Antiphospholipid Syndrome/blood , Antiphospholipid Syndrome/epidemiology , Skin Ulcer/blood , Skin Ulcer/epidemiology , Adolescent , Adult , Antibodies, Anticardiolipin/blood , Antiphospholipid Syndrome/etiology , Brazil/epidemiology , Enzyme-Linked Immunosorbent Assay , Female , Humans , Lupus Coagulation Inhibitor/blood , Male , Middle Aged , Skin Ulcer/etiologyABSTRACT
Nódulos linfóides estäo presentes em medulas ósseas normais, e significativamente aumenteados de acordo com a idade, sexo, e em certas doenças. Relatamos três casos de portadores de síndrome mielodisplásica com nódulos linfóides detectados através da biópsia óssea, no Serviço de Hematologia da Universidade Federal do Ceará. Os agregados linfóides foram caracterizados atavés da morfologia, citoquímica e imuno-histoquímica. A evoluçäo de cada paciente é apresentada. Säo discutidas a associaçäo síndrome mielodisplásica-doença linfoproliferativa e a importância da detecçäo e seguimento de nódulos linfóides nestes pacientes
