ABSTRACT
BACKGROUND: Graft-versus-host disease (GVHD) is an immune system reaction that occurs in patients with a history of hematopoietic stem cell transplantation (HSCT), in which the grafted donor's cells attack those of the host. The objective of this systematic review was to present a study on oral squamous cell carcinoma (OSSC) that developed from GVHD areas in patients undergoing HSCT. MATERIAL AND METHODS: An electronic search was conducted in the databases PUBMED, WEB OF SCIENCE, SCOPUS, MEDLINE and SCIENCE DIRECT, according to PRISMA guidelines. RESULTS: Of the 1582 results, 23 articles were included, resulting in 81 cases. The most common underlying disease for performing the transplant was Myeloid Leukemia (55.6%). The mean age was 39 years, with a predilection for males (64.2%). The tongue was the site of GVHD that most frequently underwent transformation to SCC (59.3%). The average time between transplantation and the development of GVHD was of approximately of 8 months, while the average period of development between transplantation and the development of OSCC was of approximately of 111 months. The most common treatment to GVHD was cyclosporine associated with corticosteroids. CONCLUSIONS: OSCCs arising from areas of GVHD present a different evolution from conventional oral carcinomas, since they affect younger patients, smoking and alcohol are not important etiological factors and finally because they present good prognosis, but further studies with larger number cases followed are needed to confirm our findings.
Subject(s)
Carcinoma, Squamous Cell , Graft vs Host Disease , Head and Neck Neoplasms , Mouth Neoplasms , Male , Humans , Adult , Carcinoma, Squamous Cell/complications , Squamous Cell Carcinoma of Head and Neck/complications , Mouth Neoplasms/etiology , Graft vs Host Disease/complications , Head and Neck Neoplasms/complicationsABSTRACT
Serotonergic mechanisms have an important function in the central control of circulation. Here, the acute effects of three selective serotonin (5-HT) reuptake inhibitors (SSRIs) on autonomic and cardiorespiratory variables were measured in rats. Although SSRIs require 2-3 weeks to achieve their full antidepressant effects, it has been shown that they cause an immediate inhibition of 5-HT reuptake. Seventy male Wistar rats were anesthetized with urethane and instrumented to record blood pressure, heart rate, renal sympathetic nerve activity (RSNA), and respiratory frequency. At lower doses, the acute cardiovascular effects of fluoxetine, paroxetine and sertraline administered intravenously were insignificant and variable. At middle and higher doses, a general pattern was observed, with significant reductions in sympathetic nerve activity. At 10 min, fluoxetine (3 and 10 mg/kg) reduced RSNA by -33±4.7 and -31±5.4%, respectively, without changes in blood pressure; 3 and 10 mg/kg paroxetine reduced RSNA by -35±5.4 and -31±5.5%, respectively, with an increase in blood pressure +26.3±2.5; 3 mg/kg sertraline reduced RSNA by -59.4±8.6%, without changes in blood pressure. Sympathoinhibition began 5 min after injection and lasted approximately 30 min. For fluoxetine and sertraline, but not paroxetine, there was a reduction in heart rate that was nearly parallel to the sympathoinhibition. The effect of these drugs on the other variables was insignificant. In conclusion, acute peripheral administration of SSRIs caused early autonomic cardiovascular effects, particularly sympathoinhibition, as measured by RSNA. Although a peripheral action cannot be ruled out, such effects are presumably mostly central.
Subject(s)
Animals , Male , Fluoxetine/administration & dosage , Kidney/drug effects , Paroxetine/administration & dosage , Selective Serotonin Reuptake Inhibitors/administration & dosage , Sertraline/administration & dosage , Sympathetic Nervous System/drug effects , Antidepressive Agents/administration & dosage , Antidepressive Agents/pharmacology , Arterial Pressure/drug effects , Baroreflex/drug effects , Cardiovascular Physiological Phenomena/drug effects , Fluoxetine/pharmacology , Heart Rate/drug effects , Kidney/innervation , Kidney/surgery , Paroxetine/pharmacology , Rats, Wistar , Respiratory Rate/drug effects , Selective Serotonin Reuptake Inhibitors/pharmacology , Sertraline/pharmacology , Vital Signs/drug effectsABSTRACT
In a multicenter randomized double-blind, trial, 90 patients received either fleroxacin 400mg pa once/day or ciprofloxacin 500mg po twice/day for treatment of complicated urinary tract infections (UTI). Treatment was administered orally and presumptively. Bacteriological efficacy was assessed 7 days post-treatment. In total, 78 patients were available for efficacy testing: 40 in the fleroxacin group and 38 in the ciprofloxacin group. The bacteriological cure rate was 92.5% and 94.7% in the fleroxacin and ciprofloxacin groups, respectively. The most commonly isolated pathogen (E.coli) was erradicated in 94.1% and 95.8% of the cases in fleroxacin and ciprofloxacin groups, respectively. Eight patients in the fleroxacin group had some adverse events, two of them severe (insomnia and photodermatitis). In the ciprofloxacin group, 11 patients had adverse events of mild to moderate intensity, mainly affecting the digestive system. ln conclusion, fleroxacin 400mg po once/day and ciprofloxacin 500mg po twice/day were both effective in the treatment of complicated urinary tract infections.
