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1.
Brachytherapy ; 16(3): 466-489, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28342738

RESUMO

PURPOSE: Radiation therapy represents an essential treatment option in the management of soft tissue sarcomas (STS). Brachytherapy represents an important subset of radiation therapy techniques used for STS, with evolving indications and applications. Therefore, the purpose of this guideline was to update clinicians regarding the data surrounding brachytherapy (BT) and provide recommendations for the utilization of BT in patients with STS. METHODS AND MATERIALS: Members of the American Brachytherapy Society with expertise in STS, and STS BT in particular, created an updated guideline for the use of BT in STS based on a literature review and clinical experience. RESULTS: Guidelines are presented with respect to dose and fractionation and technical features to improve outcomes and potentially reduce the risk of toxicity. Brachytherapy as monotherapy can be considered in low-risk cases or in situations where re-irradiation is being considered. Brachytherapy boost can be considered in cases at higher risk of recurrence or where BT alone cannot adequately cover the target volume. To limit wound complications, the start of BT delivery should be delayed until final wound closure, or if after immediate reconstruction, started after postoperative Day 5. CONCLUSIONS: The current guidelines have been created to provide clinicians with a review of the data supporting BT in the management of STS as well as providing indications and technique guidelines to ensure optimal patient selection and clinical outcomes.


Assuntos
Braquiterapia/métodos , Sarcoma/radioterapia , Braquiterapia/efeitos adversos , Consenso , Fracionamento da Dose de Radiação , Humanos , Seleção de Pacientes , Período Pós-Operatório , Radioterapia Adjuvante , Sarcoma/cirurgia , Estados Unidos
2.
Br J Pharmacol ; 171(24): 5696-707, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25131343

RESUMO

BACKGROUND AND PURPOSE: Uveitis is a prevalent intraocular inflammatory disease and one of the most damaging ocular conditions. Pretreatment with melatonin prevented ocular inflammation induced by an intravitreal injection of bacterial LPS in the Syrian hamster. Here, we have assessed the anti-inflammatory effects of melatonin administered after the onset of ocular inflammation. EXPERIMENTAL APPROACH: The eyes of male Syrian hamsters were intravitreally injected with vehicle or LPS. Melatonin was injected i.p. every 24 h, starting 12 or 24 h after the LPS injection. A clinical evaluation (with a score index based on clinical symptoms), the number of infiltrating cells, protein concentration and PGE2 and PGF2α levels in the aqueous humour, as well as retinal NOS activity, lipid peroxidation and TNF-α levels were assessed. Retinal function was assessed by scotopic electroretinography, and light microscopy and immunohistochemistry were used to evaluate the state of the retinal structure. KEY RESULTS: Both treatment regimens with melatonin decreased clinical symptoms, reduced the leakage of cells and proteins, and decreased PG levels in aqueous humour from eyes injected with LPS. In addition, melatonin treatment blocked the decrease in scotopic electroretinogram a- and b-wave amplitude, protected the retinal structure and reduced the increase in NOS activity, lipid peroxidation and TNF-α levels, induced by LPS. CONCLUSIONS AND IMPLICATIONS: These results indicate that treatment with melatonin, starting after the onset of uveitis, attenuated ocular inflammation induced by LPS in the Syrian hamster and support the use of melatonin as a therapeutic resource for uveitis treatment.


Assuntos
Antioxidantes/farmacologia , Humor Aquoso/efeitos dos fármacos , Melatonina/farmacologia , Retina/efeitos dos fármacos , Uveíte/metabolismo , Animais , Humor Aquoso/metabolismo , Cricetinae , Dinoprosta/imunologia , Dinoprosta/metabolismo , Dinoprostona/imunologia , Dinoprostona/metabolismo , Modelos Animais de Doenças , Eletrorretinografia , Imuno-Histoquímica , Injeções Intravítreas , Peroxidação de Lipídeos/efeitos dos fármacos , Lipopolissacarídeos/toxicidade , Masculino , Mesocricetus , Óxido Nítrico Sintase/efeitos dos fármacos , Óxido Nítrico Sintase/metabolismo , Retina/imunologia , Retina/metabolismo , Fator de Necrose Tumoral alfa/efeitos dos fármacos , Fator de Necrose Tumoral alfa/imunologia , Fator de Necrose Tumoral alfa/metabolismo , Uveíte/induzido quimicamente , Uveíte/imunologia
3.
J Biomech Eng ; 123(5): 440-5, 2001 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11601729

RESUMO

An analttically solvable model that considers the elasticity of the cornea is developed for use in the current and novel corneal refractive surgery procedures. The model assumes that the cornea is a thin spheroid shell with an elastic response to intraocular pressure. The value of the Young's modulus of the post-operative cornea and its dependence on the geometric parameters of the ablation zone are estimated employing "best-fit" approach to nomograms currently used in corneal refractive surgery. These elasticity parameters are applied for quantitative modeling of different types of refractive surgery for myopia.


Assuntos
Córnea/cirurgia , Terapia a Laser , Modelos Biológicos , Procedimentos Cirúrgicos Refrativos , Fenômenos Biomecânicos , Engenharia Biomédica , Córnea/fisiopatologia , Elasticidade , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ , Terapia a Laser/métodos , Lasers de Excimer , Miopia/fisiopatologia , Miopia/cirurgia , Ceratectomia Fotorrefrativa , Erros de Refração/fisiopatologia
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