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1.
Eur J Nucl Med Mol Imaging ; 51(2): 590-603, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37747578

RESUMO

AIMS: To report long-term outcomes of relapsed prostate cancer (PC) patients treated in a prospective single-arm study with extended-nodal radiotherapy (ENRT) and [11C]-choline positron emission tomography (PET)/computed tomography (CT)-guided simultaneous integrated boost (SIB) to positive lymph nodes (LNs). METHODS: From 12/2009 to 04/2015, 60 PC patients with biochemical relapse and positive LNs only were treated in this study. ENRT at a median total dose (TD) = 51.8 Gy/28 fr and PET/CT-guided SIB to positive LNs at a median TD = 65.5 Gy was prescribed. Median PSA at relapse was 2.3 (interquartile range, IQR:1.3-4.0) ng/ml. Median number of positive LNs: 2 (range: 1-18). Androgen deprivation therapy (ADT) was prescribed for 48 patients for a median of 30.7 (IQR: 18.5-43.1) months. RESULTS: Median follow-up from the end of salvage treatment was 121.8 (IQR: 116.1, 130.9) months; 3-, 5-, and 10-year BRFS were 45.0%, 36.0%, and 24.0%, respectively; DMFS: 67.9%, 57.2%, and 45.2%; CRFS: 62.9%, 53.9%, and 42.0%; and OS: 88.2%, 76.3%, and 47.9%, respectively. Castration resistance (p < 0.0001) and ≥ 6 positive LN (p = 0.0024) significantly influenced OS at multivariate analysis. Castration resistance (p < 0.0001 for both) influenced DMFS and CRFS in multivariate analysis. CONCLUSIONS: In PC relapsed patients treated with ENRT and [11C]-choline-PET/CT-guided SIB for positive LNs, with 10-year follow-up, a median Kaplan-Meier estimate CRFS of 67 months and OS of 110 months were obtained. These highly favorable results should be confirmed in a prospective, randomized trial.


Assuntos
Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias da Próstata , Humanos , Masculino , Antagonistas de Androgênios/uso terapêutico , Radioisótopos de Carbono , Colina , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/radioterapia , Recidiva Local de Neoplasia/tratamento farmacológico , Tomografia por Emissão de Pósitrons , Estudos Prospectivos , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/radioterapia , Neoplasias da Próstata/patologia , Ensaios Clínicos como Assunto
2.
Eur J Nucl Med Mol Imaging ; 45(12): 2071-2078, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29876617

RESUMO

PURPOSE: The value of FDG PET-derived parameters in predicting overall survival (OS), local relapse-free survival (LRFS) and distant relapse-free survival (DRFS) in treated patients with malignant pleural mesothelioma (MPM) was evaluated. METHODS: This retrospective evaluation included 55 MPM patients treated between March 2006 and February 2015 with FDG PET/CT-guided salvage helical tomotherapy (HTT) after previous surgery plus chemotherapy. Univariate Cox regression analysis was performed to assess the impact of the following FDG PET-derived parameters: biological target volume (BTV), mean and maximum standardized uptake values (SUVmean/max), metabolic tumour volume (MTV) and total lesion glycolysis (TLG), measured using different uptake thresholds (40%, 50% and 60%). Logistic regression was then performed to identify the best FDG PET-derived parameters for selecting patients with poorer survival. RESULTS: The median OS was 9.1 months (range 0.0 - 69.6 months) after the end of HTT; 54/55 patients were dead at the last follow-up. BTV and TLG40, TLG50 and TLG60 were the most significant predictors of OS (p < 0.005). The median OS was 4.8 months in patients with MTV60 >5 cm3 and TLG40 >334.4, compared with 13.8 months and 16.1 months in patients with smaller values, respectively. The median LRFS and DRFS were 6.2 months (range 1.2 - 39.4 months) and 6.5 months (0.0 - 66.4 months), respectively. TLG40, TLG50 and TLG60 were significantly correlated with LRFS (p < 0.015). Median DRFS was 6.4 months in patients with MTV40 >39.6 cm3 and 6.2 months in patients with TLG40 >334.4, compared with 17 months and 18.8 months in patients with smaller values. BTV, TLG40 and MTV40 were also found to be good predictors in patients with poor OS/LRFS/DRFS (median survival times less than the median values). CONCLUSION: FDG PET-derived parameters effectively discriminated patients with a poor prognosis and may be helpful in the selection of MPM patients for salvage HTT.


Assuntos
Neoplasias Pulmonares/diagnóstico por imagem , Mesotelioma/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Feminino , Fluordesoxiglucose F18 , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Masculino , Mesotelioma/patologia , Mesotelioma/terapia , Mesotelioma Maligno , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Valor Preditivo dos Testes , Compostos Radiofarmacêuticos
3.
Eur J Nucl Med Mol Imaging ; 41(7): 1270-9, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24599378

RESUMO

PURPOSE: To evaluate, in prostate cancer (PCa) patients the potential of (11)C-choline PET/CT as a guide to helical tomotherapy (HTT) of lymph-node (LN) relapses with simultaneous integrated boost (SIB). The efficacy and feasibility of HTT in terms of acute toxicity were assessed. METHODS: We enrolled 83 PCa patients (mean age 68 years, range 51 - 82 years) with biochemical recurrence after radical primary treatment (mean serum PSA 7.61 ng/ml, range 0.37 - 187.00 ng/ml; PSA0) who showed pathological findings on (11)C-choline PET/CT only at the LN site. (11)C-Choline PET/CT was performed for restaging and then for radiation treatment planning (PET/CT0). Of the 83 patients, 8 experienced further LN relapse, of whom 5 were retreated once and 3 were retreated twice (total 94 radiotherapy treatments). All pelvic and/or abdominal LNs positive on PET/CT0 were treated with high doses using SIB. Doses were in the range 36 - 74 Gy administered in 28 fractions. After the end of HTT (mean 83 days, range 16 - 365 days), serum PSA was measured in all patients (PSA1) and compared with PSA0 to evaluate early biochemical response. In 47 patients PET/CT was repeated (PET/CT1) to assess metabolic responses at the treated areas. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) were used to assess acute toxicity. RESULTS: PET/CT0 revealed pathological LNs in the pelvis in 49 patients, pathological LNs in the abdomen in 15 patients pathological LNs in both the pelvis and abdomen in 18 patients, and pathological LNs in the pelvis or abdomen and other sites in 12 patients. All these sites were treated with HTT. With respect to PSA0, PSA1 (mean 6.28 ng/ml, range 0.00 - 220.46 ng/ml) showed a complete biochemical response after 66 of the 94 HTT treatments, a partial response after 12 treatments, stable disease after 1 treatment and progression of disease after 15 treatments. Of the 47 patients receiving PET/CT1, 20 showed a complete metabolic response at the treated area, 22 a partial metabolic response, 3 progression of disease and 2 stable disease. HTT with SIB was well tolerated in all patients. Grade 3 acute toxicity in the genitourinary tract was observed in two patients. CONCLUSION: (11)C-Choline PET/CT is a valuable tool for planning and monitoring HTT in LN relapse after primary treatment. High-dose hypofractionated (11)C-choline PET/CT-guided HTT with SIB is well tolerated and is associated with a high early biochemical response rate.


Assuntos
Colina , Tomografia por Emissão de Pósitrons , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/radioterapia , Planejamento da Radioterapia Assistida por Computador/métodos , Radioterapia Guiada por Imagem/métodos , Tomografia Computadorizada por Raios X , Idoso , Idoso de 80 Anos ou mais , Radioisótopos de Carbono , Estudos de Viabilidade , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Neoplasias da Próstata/metabolismo , Neoplasias da Próstata/patologia , Radioterapia Guiada por Imagem/efeitos adversos , Radioterapia de Intensidade Modulada , Recidiva , Resultado do Tratamento
4.
Radiother Oncol ; 166: 92-99, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34748855

RESUMO

INTRODUCTION: Stereotactic ablative radiotherapy (SABR) has been shown to increase survival in oligometastatic disease, but local control of colorectal metastases remains poor. We aimed to identify potential predictive factors of SBRT response through a multicenter large retrospective database and to investigate the progression to the polymetastatic disease (PMD). MATERIAL AND METHODS: The study involved 23 centers, and was approved by the Ethical Committee (Prot. Negrar 2019-ZT). 1033 lung metastases were reported. Clinical and biological parameters were evaluated as predictive for freedom from local progression-free survival (FLP). Secondary end-point was the time to the polymetastatic conversion (tPMC). RESULTS: Two-year FLP was 75.4%. Two-year FLP for lesions treated with a BED < 00 Gy, 100-124 Gy, and ≥125 Gy was 76.1%, 70.6%, and 94% (p = 0.000). Two-year FLP for lesion measuring ≤10 mm, 10-20 mm, and >20 mm was 79.7%, 77.1%, and 66.6% (p = 0.027). At the multivariate analysis a BED ≥125 Gy significantly reduced the risk of local progression (HR 0.24, 95%CI 0.11-0.51; p = 0.000). Median tPMC was 26.8 months. Lesions treated with BED ≥125 Gy reported a significantly longer tPMC as compared to lower BED. The median tPMC for patients treated to 1, 2-3 or 4-5 simultaneous oligometastases was 28.5, 25.4, and 9.8 months (p = 0.035). CONCLUSION: The present is the largest series of lung colorectal metastases treated with SABR. The results support the use of SBRT in lung oligometastatic colorectal cancer patients as it might delay the transition to PMD or offer relatively long disease-free period in selected cases. Predictive factors were identified for treatment personalization.


Assuntos
Neoplasias Colorretais , Neoplasias Pulmonares , Radiocirurgia , Neoplasias Retais , Neoplasias Colorretais/patologia , Humanos , Radiocirurgia/métodos , Neoplasias Retais/etiologia , Estudos Retrospectivos
5.
Thorax ; 66(7): 579-84, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21270069

RESUMO

BACKGROUND: Anaerobic bacteria are increasingly regarded as important in cystic fibrosis (CF) pulmonary infection. The aim of this study was to determine the effect of antibiotic treatment on aerobic and anaerobic microbial community diversity and abundance during exacerbations in patients with CF. METHODS: Sputum was collected at the start and completion of antibiotic treatment of exacerbations and when clinically stable. Bacteria were quantified and identified following culture, and community composition was also examined using culture-independent methods. RESULTS: Pseudomonas aeruginosa or Burkholderia cepacia complex were detected by culture in 24/26 samples at the start of treatment, 22/26 samples at completion of treatment and 11/13 stable samples. Anaerobic bacteria were detected in all start of treatment and stable samples and in 23/26 completion of treatment samples. Molecular analysis showed greater bacterial diversity within sputum samples than was detected by culture; there was reasonably good agreement between the methods for the presence or absence of aerobic bacteria such as P aeruginosa (κ=0.74) and B cepacia complex (κ=0.92), but agreement was poorer for anaerobes. Both methods showed that the composition of the bacterial community varied between patients but remained relatively stable in most individuals despite treatment. Bacterial abundance decreased transiently following treatment, with this effect more evident for aerobes (median decrease in total viable count 2.3×10(7) cfu/g, p=0.005) than for anaerobes (median decrease in total viable count 3×10(6) cfu/g, p=0.046). CONCLUSION: Antibiotic treatment targeted against aerobes had a minimal effect on abundance of anaerobes and community composition, with both culture and molecular detection methods required for comprehensive characterisation of the microbial community in the CF lung. Further studies are required to determine the clinical significance of and optimal treatment for these newly identified bacteria.


Assuntos
Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Infecções Bacterianas/tratamento farmacológico , Fibrose Cística/microbiologia , Infecções Oportunistas/tratamento farmacológico , Adolescente , Adulto , Antibacterianos/uso terapêutico , Bactérias/classificação , Bactérias/isolamento & purificação , Bactérias Aeróbias/classificação , Bactérias Aeróbias/efeitos dos fármacos , Bactérias Aeróbias/isolamento & purificação , Bactérias Anaeróbias/classificação , Bactérias Anaeróbias/efeitos dos fármacos , Bactérias Anaeróbias/isolamento & purificação , Infecções Bacterianas/complicações , Contagem de Colônia Microbiana , Fibrose Cística/complicações , Fibrose Cística/fisiopatologia , Feminino , Volume Expiratório Forçado , Humanos , Masculino , Infecções Oportunistas/complicações , Polimorfismo de Fragmento de Restrição , Escarro/microbiologia , Adulto Jovem
6.
Clin Transl Oncol ; 23(8): 1577-1584, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33495981

RESUMO

OBJECTIVES: To report outcomes of stereotactic body radiotherapy (SBRT) in metastatic castration-resistant prostate cancer (mCRPC) patients with oligoprogression (≤ 5 metastases) during first-line treatment with androgen receptor-targeted therapy (ARTT). PATIENTS AND METHODS: Retrospective multi-institutional analysis of mCRPC patients treated with SBRT to oligoprogressive lesions during ARTT. End-points were time to next-line systemic treatment (NEST), radiological progression-free survival (r-PFS) and overall survival (OS). Toxicity was registered according to Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Survival analysis was performed using the Kaplan-Meier method, univariate and multivariate analysis (MVA) were performed. RESULTS: Data from 34 patients were analyzed. Median NEST-free survival, r-PFS, and OS were 16.97, 13.47, and 38.3 months, respectively. At MVA, factors associated with worse NEST-free survival and r-PFS were polymetastatic burden at diagnosis of metastatic hormone-sensitive disease (hazard ratio [HR] 3.66, p = 0.009; HR 3.03, p = 0.034), PSA ≤ 7 ng/ml at mCRPC diagnosis (HR 0.23, p = 0.017; HR 0.19, p = 0.006) and PSADT ≤ 3 months at mCRPC diagnosis (HR 3.39, p = 0.026; HR 2.79, p = 0.037). Polymetastatic state at mHSPC diagnosis was associated with a decreased OS (HR 4.68, p = 0.029). No patient developed acute or late grade ≥ 2 toxicity. CONCLUSION: Our results suggest that SBRT in oligoprogressive mCPRC is safe, effective and seems to prolong the efficacy of the ongoing systemic treatment positively affecting disease progression. Prospective trials are needed.


Assuntos
Antagonistas de Receptores de Andrógenos/uso terapêutico , Terapia de Alvo Molecular/métodos , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Neoplasias de Próstata Resistentes à Castração/radioterapia , Radiocirurgia/métodos , Idoso , Análise de Variância , Terapia Combinada/métodos , Progressão da Doença , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Intervalo Livre de Progressão , Neoplasias de Próstata Resistentes à Castração/mortalidade , Neoplasias de Próstata Resistentes à Castração/patologia , Dosagem Radioterapêutica , Estudos Retrospectivos , Resultado do Tratamento
7.
J Appl Microbiol ; 107(3): 746-59, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19320949

RESUMO

AIMS: Broad-spectrum antibiotics produced by symbiotic bacteria [entomopathogenic bacterium (EPB)] of entomopathogenic nematodes keep monoxenic conditions in insect cadavers in soil. This study evaluated antibiotics produced by EPB for their potential to control plant pathogenic bacteria and oomycetes. METHODS AND RESULTS: Entomopathogenic bacterium produce antibiotics effective against the fire blight bacterium Erwinia amylovora, including streptomycin resistant strains, and were as effective in phytotron experiments as kasugamycin or streptomycin. Xenorhabdus budapestensis and X. szentirmaii antibiotics inhibited colony formation and mycelial growth of Phytophthora nicotianae. From X. budapestensis, an arginine-rich fraction (bicornutin) was adsorbed by Amberlite((R)) XAD 1180, and eluted with methanol : 1 n HCI (99 : 1). Bicornutin inactivated zoospores, and inhibited germination and colony formation of cystospores at <<25 ppm. An UV-active molecule (bicornutin-A, MW = 826), separated by HPLC and thin-layer chromatography, was identified as a novel hexa-peptide : RLRRRX. CONCLUSIONS: Xenorhabdus budapestensis produces metabolites with strong antibacterial and cytotoxic activity. Individual compounds can be isolated, identified and patented, but their full antimicrobial potential may be multiplied by synergic interactions. SIGNIFICANCE AND IMPACT OF THE STUDY: Active compounds of two new Xenorhabdus species might control plant diseases caused by pathogens of great importance to agriculture such as Erw. amylovora and P. nicotianae.


Assuntos
Antibacterianos/farmacologia , Erwinia amylovora/efeitos dos fármacos , Malus/microbiologia , Photorhabdus/metabolismo , Phytophthora/efeitos dos fármacos , Xenorhabdus/metabolismo , Antibacterianos/isolamento & purificação , Erwinia amylovora/crescimento & desenvolvimento , Testes de Sensibilidade Microbiana , Phytophthora/crescimento & desenvolvimento , Folhas de Planta/microbiologia
8.
J Appl Microbiol ; 104(3): 745-58, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17976177

RESUMO

AIMS: The role of antibiotics produced by bacterial symbionts of entomopathogenic nematodes is to suppress growth of microbes in the soil environment. These antibiotics are active against Gram-positive and Gram-negative bacteria, and were tested against mastitis isolates from dairy cows. METHODS AND RESULTS: Two bioassays were adapted for Xenorhabdus antibiotics; an overlay method on agar plates, and serially diluted, cell-free, Xenorhabdus cultures. The antimicrobial activities of the liquid cultures of 13 strains from five Xenorhabdus species were further evaluated. Antimicrobial activities of the type strains of X. nematophila, X. budapestensis and X. szentirmaii were tested on mastitis isolates of Staphylococcus aureus, Escherichia coli and Klebsiella pneumoniae with both bioassays. A previously reported antibiotic from X. nematophila, nematophin, was synthesized in three steps from tryptamine and 4-methyl-2-oxovaleric acid sodium salt. CONCLUSIONS: The antibiotics of all three Xenorhabdus strains were powerful in either bioassay, but the sensitivity of the isolates differed from each other. While Kl. pneumoniae was the least susceptible, Staph. aureus had the highest sensitivity to each Xenorhabdus strain. Xenorhabdus szentirmaii and X. budapestensis were more potent antibiotic producers than X. nematophila, and raceme nematophin was ineffective against all mastitis isolates. SIGNIFICANCE AND IMPACT OF THE STUDY: These results indicate that Xenorhabdus antibiotics are effective against mastitis isolates and should be further evaluated for their potential in mastitis control or prevention.


Assuntos
Antibacterianos/biossíntese , Mastite Bovina/tratamento farmacológico , Microbiologia do Solo , Xenorhabdus/metabolismo , Animais , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bovinos , Contagem de Colônia Microbiana , Escherichia coli/efeitos dos fármacos , Feminino , Indóis/síntese química , Indóis/farmacologia , Klebsiella pneumoniae/efeitos dos fármacos , Mastite Bovina/microbiologia , Testes de Sensibilidade Microbiana , Especificidade da Espécie , Staphylococcus aureus/efeitos dos fármacos
9.
J Nutr Health Aging ; 21(4): 354-361, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28346561

RESUMO

OBJECTIVE: We aimed to examine the general health and intestinal physiology of young and old non-human primates with comparable life histories and dietary environments. DESIGN: Vervet monkeys (Chlorcebus aethiops sabaeus) in stable and comparable social and nutritional environments were selected for evaluation. Health phenotype, circulating cytokines and biomarkers of microbial translocation (MT) were measured (n=26-44). Subsets of monkeys additionally had their intestinal motility, intestinal permeability, and fecal microbiomes characterized. These outcomes document age-related intestinal changes present in the absence of nutritional stressors, which are all known to affect gastrointestinal motility, microbiome, and MT. RESULTS: We found that old monkeys have greater systemic inflammation and poor intestinal barrier function as compared to young monkeys. Old monkeys have dramatically reduced intestinal motility, and all changes in motility and MT are present without large differences in fecal microbiomes. CONCLUSION: We conclude that deteriorating intestinal function is a feature of normal aging and could represent the source of inflammatory burden yet to be explained by disease or diet in normal aging human primate populations. Intestinal changes were seen independent of dietary influences and aging within a consistent environment appears to avoid major microbiome shifts. Our data suggests interventions to promote intestinal motility and mucosal barrier function have the potential to support better health with aging.


Assuntos
Envelhecimento/fisiologia , Chlorocebus aethiops/fisiologia , Microbioma Gastrointestinal , Motilidade Gastrointestinal/fisiologia , Inflamação/fisiopatologia , Mucosa Intestinal/fisiologia , Junções Íntimas/fisiologia , Animais , Biomarcadores/sangue , Citocinas/sangue , Dieta , Feminino , Humanos , Masculino
10.
Endocr Regul ; 50(1): 16-23, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27560632

RESUMO

OBJECTIVE: A disturbance of sensorimotor gating measured by prepulse inhibition of acoustic startle (PPI) is one of the best tests of the schizophrenia-like behavior. Vasopressin was implicated in the development of schizophrenia; therefore, the naturally occurring vasopressin-deficient Brattleboro rat has been suggested to be a reliable non-pharmacological animal model. However, previous studies focusing on PPI deficit did not use proper control and despite clear gender differences in the development of the disorder, the effect of gender has been mostly neglected. METHODS: First, we compared the "noise" and "tone" type prepulse at 73-77-81 dB intensity during the light or dark phase using small (~150 g) or big (~500 g) Wistar rats. The test parameters were validated by a pharmacological schizophrenia model (30 mg/kg ketamine i.p.). Than male, female, and lactating vasopressin-deficient animals were compared with +/+ ones. RESULTS: We established that the prepulse "noise" type is not optimal for PPI testing. The cycle of the day as well as the body weight had no effect on PPI. Even if we compared vasopressin-deficient animals with their closely related +/+ controls, the PPI deficiency was visible with more pronounced effect at 77 dB prepulse intensity similarly to pharmacological schizophrenia model. Despite our expectation, the gender as well as lactation had no effect on the vasopressin-deficiency induced PPI deficit. CONCLUSIONS: The present data confirmed and extended our previous studies that vasopressin-deficient rat is a good model of schizophrenia. It seems that female as well as lactating Brattleboro rats are useful tools for testing putative novel antipsychotics in line with special attention required for schizophrenic women.


Assuntos
Peso Corporal , Ritmo Circadiano , Inibição Pré-Pulso/fisiologia , Vasopressinas/deficiência , Animais , Feminino , Masculino , Ratos , Ratos Brattleboro , Reflexo de Sobressalto , Fatores Sexuais
11.
Clin Oncol (R Coll Radiol) ; 28(8): 490-500, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-26961088

RESUMO

AIMS: To report 5 year outcome and late toxicity in prostate cancer patients treated with image-guided tomotherapy with a moderate hypofractionated simultaneous integrated boost approach. MATERIALS AND METHODS: In total, 211 prostate cancer patients, 78 low risk, 53 intermediate risk and 80 high risk were treated between 2005 and 2011. Intermediate- and high-risk patients received 51.8 Gy to pelvic lymph nodes and concomitant simultaneous integrated boost to prostate up to 74.2 Gy/28 fractions, whereas low-risk patients were treated to the prostate only with 71.4 Gy/28 fractions. Daily megavoltage computed tomography (MVCT) image guidance was applied. Androgen deprivation was prescribed for a median duration of 6 months for low-risk patients (for downsizing), 12 months for intermediate-risk and 36 months for high-risk patients. The 5 year biochemical relapse-free survival (bRFS), cancer-specific survival (CSS), overall survival and late gastrointestinal and genitourinary CTCAE.v3 toxicity were assessed. The effect of several clinical variables on both outcome and gastrointestinal/genitourinary toxicity was tested by uni- and multivariate Cox regression analyses. RESULTS: After a median follow-up of 5 years, the late toxicity actuarial incidence was: genitourinary ≥ grade 2: 20.2%; genitourinary ≥ grade 3: 5.9%; gastrointestinal ≥ grade 2: 17%; gastrointestinal ≥ grade 3: 6.3% with lower prevalence at the last follow-up visit (≥ grade 3: genitourinary: 1.9%; gastrointestinal: 1.9%). Major predictors of ≥ grade 3 genitourinary and gastrointestinal late toxicity were genitourinary acute toxicity ≥ grade 2 (hazard ratio: 4.9) and previous surgery (hazard ratio: 3.4). The overall 5 year bRFS was 93.7% (low risk: 94.6%; intermediate risk: 96.2%; high risk: 91.1%), overall survival and CSS were 88.6% (low risk: 90.5%; intermediate risk: 87.4%; high risk: 87%) and 97.5% (low risk: 98.7%; intermediate risk: 95%; high risk: 94.3%), respectively. Risk classes and androgen deprivation were not significantly correlated with either bRFS, overall survival or CSS. Twelve patients experienced a biochemical relapse but none experienced clinically proven local and/or pelvic recurrence. CONCLUSION: A satisfactory 5 year outcome with an acceptable toxicity profile was observed. The combination of image-guided radiotherapy-intensity-modulated radiotherapy, high equivalent 2 Gy dose (EQD2) with a moderate hypofractionated approach and extensive prophylactic lymph node irradiation also leads to very good outcome in high-risk patients.


Assuntos
Neoplasias da Próstata/radioterapia , Radioterapia Guiada por Imagem/métodos , Radioterapia de Intensidade Modulada/efeitos adversos , Radioterapia de Intensidade Modulada/métodos , Idoso , Idoso de 80 Anos ou mais , Tomografia Computadorizada de Feixe Cônico/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/mortalidade , Hipofracionamento da Dose de Radiação , Radioterapia Guiada por Imagem/efeitos adversos , Resultado do Tratamento
12.
Biochim Biophys Acta ; 915(1): 19-27, 1987 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-3113485

RESUMO

Phosphorylase ab was prepared in vitro by partial phosphorylation of rabbit skeletal muscle phosphorylase b and was isolated by DEAE-Sephacel chromatography. Its phosphorylated and non-phosphorylated subunits could not be distinguished by different affinity to substrates, activators or inhibitors, indicating their coordinated function. In the absence of nucleotide activators, the Km values for Pi and glucose-1-P were 28 mM and 18 mM, respectively. Activity in the presence of 16 mM glucose-1-P was doubled by 10(-4) M AMP or 10(-3) M IMP, mainly by lowering the Km for glucose-1-P. Half-maximum activation was exerted by 2 microM AMP or 0.1 mM IMP. Activation by these nucleotides showed no cooperativity. Glucose exerted competitive inhibition with respect to glucose-1-P, while for the inhibition by glucose-6-P an allosteric mechanism is suggested; the appropriate Ki values were 4.5 mM and 1.5 mM, respectively. The Hill coefficient for glucose-1-P binding was about 1.0, even in the presence of glucose (up to 10 mM), but 10 mM glucose-6-P lowered it to 0.47, indicating a negative heterotropic cooperativity. Effective regulation of the activity of phosphorylase ab by physiological concentrations of Pi, AMP, IMP and glucose-6-P suggests its metabolic control under in vivo condition.


Assuntos
Músculos/enzimologia , Fosforilases/metabolismo , Monofosfato de Adenosina/farmacologia , Regulação Alostérica , Animais , Ligação Competitiva , Cafeína/farmacologia , Ativação Enzimática/efeitos dos fármacos , Glucose/farmacologia , Glucose-6-Fosfato , Glucofosfatos/metabolismo , Glucofosfatos/farmacologia , Inosina Monofosfato/farmacologia , Cinética , Fosforilase a/antagonistas & inibidores , Fosforilase a/metabolismo , Fosforilase b/antagonistas & inibidores , Fosforilase b/metabolismo , Fosforilação , Coelhos
13.
J Gen Physiol ; 109(1): 3-14, 1997 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-8997661

RESUMO

Local anesthetics are a diverse group of ion channel blockers that can be used to probe conformational changes in the pore. We examined the effects of the local anesthetic tetracaine on rod and olfactory cyclic nucleotide-gated channels expressed from subunit 1 in Xenopus oocytes. We found that 40 microM tetracaine effectively blocked the bovine rod channel but not the rat olfactory channel at saturating concentrations of cGMP. By testing chimeric channels containing regions of sequence from both rod and olfactory channels, we found that determinants of apparent affinity for tetracaine at saturating cGMP did not map to any one region of the channel sequence. Rather, the differences in apparent affinity could be explained by differences between the chimeras in the free energy of the opening allosteric transition. If a channel construct (such as the rod channel) spent appreciable time in the closed state at saturating cGMP, then it had a high apparent affinity for tetracaine. If, on the other hand, a channel construct (such as the olfactory channel) spent little time in the closed state at saturating cGMP, then it had a low apparent affinity for tetracaine. Furthermore, tetracaine became more effective at low concentrations of cGMP and at saturating concentrations of cAMP, conditions which permit the channels to spend more time in the closed configuration. These results were well fit by a model in which tetracaine binds more tightly to the closed channel than to the open channel. Dose-response curves for tetracaine in the presence of saturating cGMP are well fit with a Michaelis-Menten binding scheme indicating that a single tetracaine molecule is sufficient to produce block. In addition, tetracaine block is voltage dependent with an effective z delta of +0.56. These data are consistent with a pore-block hypothesis. The finding that tetracaine is a state-dependent pore blocker suggests that the inner mouth of the pore of cyclic nucleotide-gated channels undergoes a conformational change during channel opening.


Assuntos
Anestésicos Locais/farmacologia , AMP Cíclico/farmacologia , GMP Cíclico/farmacologia , Canais Iônicos/antagonistas & inibidores , Canais Iônicos/metabolismo , Tetracaína/farmacologia , Animais , Bovinos , Quimera , Relação Dose-Resposta a Droga , Feminino , Técnicas In Vitro , Modelos Biológicos , Mucosa Olfatória/metabolismo , Ratos , Células Fotorreceptoras Retinianas Bastonetes/metabolismo , Tetracaína/metabolismo , Xenopus
14.
J Gen Physiol ; 110(5): 591-600, 1997 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-9348330

RESUMO

Local anesthetics are a diverse group of clinically useful compounds that act as pore blockers of both voltage- and cyclic nucleotide-gated (CNG) ion channels. We used the local anesthetic tetracaine to probe the nature of the conformational change that occurs in the pore of CNG channels during the opening allosteric transition. When applied to the intracellular side of wild-type rod CNG channels expressed in Xenopus oocytes from the alpha subunit, the local anesthetic tetracaine exhibits state-dependent block, binding with much higher affinity to closed states than to open states. Here we show that neutralization of a glutamic acid in the conserved P region (E363G) eliminated this state dependence of tetracaine block. Tetracaine blocked E363G channels with the same effectiveness at high concentrations of cGMP, when the channel spent more time open, and at low concentrations of cGMP, when the channel spent more time closed. In addition, Ni2+, which promotes the opening allosteric transition, decreased the effectiveness of tetracaine block of wild-type but not E363G channels. Similar results were obtained in a chimeric CNG channel that exhibits a more favorable opening allosteric transition. These results suggest that E363 is accessible to internal tetracaine in the closed but not the open configuration of the pore and that the conformational change that accompanies channel opening includes a change in the conformation or accessibility of E363.


Assuntos
Anestésicos Locais/farmacologia , GMP Cíclico/fisiologia , Ativação do Canal Iônico/fisiologia , Canais Iônicos/antagonistas & inibidores , Canais Iônicos/química , Tetracaína/farmacologia , Animais , Bovinos , Canais Iônicos/genética , Modelos Biológicos , Conformação Molecular , Mutação , Níquel/farmacologia , Oócitos/metabolismo , Xenopus
15.
Acta Vet Hung ; 53(1): 65-71, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15782660

RESUMO

The blowfly Lucilia sericata (Meigen, 1826) (Diptera: Calliphoridae) is the primary agent of cutaneous myiasis of sheep in northern Europe, southern Africa, Australia and New Zealand. As the application of chemicals has several disadvantages, alternative control measures of traumatic myiasis of livestock must be developed. In this study, the use of entomopathogenic nematodes (EPNs) as potential biocontrol agents against second instar larvae of Lucilia sericata was considered. The following nematode species were tested: Heterorhabditis bacteriophora (IS 5, HHU 1, Hmol, HNC 1, HAZ 36, Hbrecon, HHU 2, HAZ 29, HHP 88, HHU 3, HHU 4 and HGua), Steinernema intermedia, NC513 strain of S. glaserii, S. anomali, S. riobrave, Steinernema sp. and 5 strains of S. feltiae (22, Vija Norway, HU 1, scp, and IS 6). None of the examined EPN species or strains showed larvicidal efficacy at 37 degrees C (no killing effect was observed in the case of the two heat-tolerant strains--H. bacteriophora and S.feltiae) against L. sericata larvae. At lower temperatures (20 degrees C and 25 degrees C) only strains of S. feltiae were found to be active. The overall odds ratios calculated for L. sericata maggots to contract S. feltiae nematode infection show significant (p < 0.05) effect only in the case of strains HU 1, 22 and IS 6. In the case of strains HU 1 and 22 parasitic forms of S. feltiae could be detected in the dead larvae of L. sericata. Strain IS 6 (and also Vija Norway at 20 degrees C) penetrated and killed fly larvae, but only adult forms of the nematode occurred in the cadavers.


Assuntos
Dípteros/crescimento & desenvolvimento , Miíase/veterinária , Nematoides/fisiologia , Controle Biológico de Vetores , Doenças dos Ovinos/prevenção & controle , Animais , Larva/crescimento & desenvolvimento , Miíase/prevenção & controle , Ovinos , Doenças dos Ovinos/parasitologia
16.
Talanta ; 48(4): 827-37, 1999 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18967525

RESUMO

A new type of radiofrequency capacitively coupled plasma torch is presented. The torch electrode geometry is coaxial with a tubular central electrode and one or two outer ring electrodes. The argon plasma is generated at 275 W radiofrequency power and 27.12 MHz and it has a very good stability and a low gas consumption of 0.4 l min(-1). The nebulized sample is introduced through the tubular electrode into the core of the annular shaped plasma thus achieving a better atomisation and a lower background. The limits of detection for 20 elements are in the range of ng ml(-1) and the dynamic range between 2.5 and 3.5. The best results are obtained with the torch with two outer ring electrodes.

17.
J Nematol ; 26(3): 278-85, 1994 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19279893

RESUMO

The phospholipid composition of Steinernema carpocapsae was studied in relation to diet and culture temperature. When reared at 18 and 27.5 C on Galleria mellonella or on an artificial diet supplemented with lard, linseed oil, or fish oil as lipid sources, nematode phospholipids contained an abundance of 20-carbon polyunsaturated fatty acids, with eicosapentaenoic acid (20:5(n - 3)) predominant, regardless of the fatty acid composition of the diet. Because the level of linolenic acid (18:3(n - 3)) in nematode phospholipids was very low and because eicosapentaenoic acid was present even when its precursor (linolenic acid) was undetectable in the diet, S. carpocapsae likely produces n - 3 polyunsaturated fatty acids by de novo biosynthesis, a pathway seldom reported in eukaryotic animals. Reduction of growth temperature from 25 to 18 C increased the proportion of 20:5(n - 3) but not other polyunsaturated fatty acids. A fluorescence polarization technique revealed that vesicles produced from phospholipids of nematodes reared at 18 C were less ordered than those from nematodes reared at 27.5 C, especially in the outermost region of the bilayer. Dietary fish oil increased fluidity in the outermost region but increased rigidity in deeper regions. Therefore, S. carpocapsae appears to modify its membrane physical state in response to temperature, and eicosapentaenoic acid may be involved in this response. The results also indicate that nematode membrane physical state can be modified dietarily, possibly to the benefit of host-finding or survival of S. carpocapsae at low temperatures.

18.
Acta Biol Hung ; 40(3): 255-69, 1989.
Artigo em Inglês | MEDLINE | ID: mdl-2633588

RESUMO

Fourteen precocene-1 (P1) derivatives differing at C-7 were synthetized and tested for their antiallatal activities on Locusta migratoria (in vitro and in vivo) and nematocidal effects on Caenorhaditis elegans. An outstanding antiallatal effect was produced by 7-propargyloxy-P1 in vitro. It caused an elevated rate of mortality when applied in vivo to locusts or nematodes. The antiallatal effect of 7-cyclopentyloxy-P1 was not accompanied by toxicity. Aralkyloxy substitution at C-7 eliminated the precocene activity.


Assuntos
Benzopiranos/farmacologia , Caenorhabditis/efeitos dos fármacos , Gafanhotos/efeitos dos fármacos , Animais , Benzopiranos/síntese química , Gafanhotos/crescimento & desenvolvimento , Hormônios Juvenis/antagonistas & inibidores , Relação Estrutura-Atividade
19.
Fogorv Sz ; 87(11): 329-34, 1994 Nov.
Artigo em Húngaro | MEDLINE | ID: mdl-7821446

RESUMO

Authors report on the sedative anxiolytic and anterograde amnesia causing effect of "Dormicum", in connection with 170 dental and/or oral surgery interventions. Initial dose of Dormicum was 0.1 mg/body weight kgs,--necessary repetitions occurred with 0.02-0,03 mg/body weight kgs. In 75% of the patients an acceptable level of sedation developed by using 0.1 mg/body weight kgs. In more than 90% of the cases anterograde amnesia could be observed, which seemed to be the most important element of this kind of treatment.


Assuntos
Anestesia Dentária/métodos , Midazolam , Cirurgia Bucal , Anestesia Local , Ansiolíticos/administração & dosagem , Relação Dose-Resposta a Droga , Feminino , Humanos , Hipnóticos e Sedativos/administração & dosagem , Injeções , Masculino , Midazolam/administração & dosagem
20.
Q J Nucl Med Mol Imaging ; 56(5): 421-9, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23069921

RESUMO

High risk prostate cancer patients have a significant risk to develop regional lymph node metastases, and this represent a major cause of biochemical failure. Although pelvic lymphadenectomy is the gold standard to assess the status of pelvic lymph nodes, a diagnostic imaging tool to non-invasively explore patients and to detect metastases, both in staging and in re-staging phase, would be of particular help in clinical management. In staging phase, while choline PET/CT specificity has been reported to be fairly high in lymph nodal detection, its sensitivity is not adequate due to its spatial resolution. Its role in the evaluation of patients with biochemical relapse or with suspected relapse has been successfully documented. In particular, choline PET/CT has great potential as a single step whole body diagnostic procedure to evaluate lymph nodal and bone metastatic involvement. Salvage lymph nodal dissection was recently listed as a possible experimental option for patients with nodal recurrent prostate cancer, even in the absence of solid prospective data. Radiation treatment for lymph-node recurrence is a therapeutic option evaluated in several studies, in particular by using stereotactic treatment or whole pelvic lymph-nodal irradiation plus a boost on choline PET/CT positive lymph nodes. In the present review an analysis of the specific role of choline PET/CT in guiding a specific treatment on lymph nodal site in prostate cancer patients is reported.


Assuntos
Linfonodos/diagnóstico por imagem , Imagem Multimodal , Tomografia por Emissão de Pósitrons , Neoplasias da Próstata/patologia , Tomografia Computadorizada por Raios X , Humanos , Metástase Linfática , Masculino , Pelve , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/diagnóstico
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