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1.
J Neurophysiol ; 127(1): 27-37, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34851768

RESUMO

Although there is evidence that 5-HT acts as an excitatory neuromodulator to enhance maximal force generation, it is largely unknown how 5-HT activity influences the ability to sustain a constant force during steady-state contractions. A total of 22 healthy individuals participated in the study, where elbow flexion force was assessed during brief isometric contractions at 10% maximal voluntary contraction (MVC), 60% MVC, MVC, and during a sustained MVC. The selective serotonin reuptake inhibitor, paroxetine, suppressed physiological tremor and increased force steadiness when performing the isometric contractions. In particular, a main effect of drug was detected for peak power of force within the 8-12 Hz range (P = 0.004) and the coefficient of variation (CV) of force (P < 0.001). A second experiment was performed where intermittent isometric elbow flexions (20% MVC sustained for 2 min) were repeatedly performed so that serotonergic effects on physiological tremor and force steadiness could be assessed during the development of fatigue. Main effects of drug were once again detected for peak power of force in the 8-12 Hz range (P = 0.002) and CV of force (P = 0.003), where paroxetine suppressed physiological tremor and increased force steadiness when the elbow flexors were fatigued. The findings of this study suggest that enhanced availability of 5-HT in humans has a profound influence of maintaining constant force during steady-state contractions. The action of 5-HT appears to suppress fluctuations in force regardless of the fatigue state of the muscle.NEW & NOTEWORTHY Converging lines of research indicate that enhanced serotonin availability increases maximal force generation. However, it is largely unknown how serotonin influences the ability to sustain a constant force. We performed two experiments to assess physiological tremor and force steadiness in unfatigued and fatigued muscle when serotonin availability was enhanced in the central nervous system. Enhanced availability of serotonin reduced physiological tremor amplitude and improved steadiness regardless of muscle fatigue.


Assuntos
Fenômenos Biomecânicos/efeitos dos fármacos , Contração Isométrica/efeitos dos fármacos , Fadiga Muscular/efeitos dos fármacos , Músculo Esquelético/efeitos dos fármacos , Paroxetina/farmacologia , Inibidores Seletivos de Recaptação de Serotonina/farmacologia , Serotonina/metabolismo , Tremor/tratamento farmacológico , Adulto , Cotovelo/fisiologia , Humanos , Masculino , Paroxetina/administração & dosagem , Inibidores Seletivos de Recaptação de Serotonina/administração & dosagem , Adulto Jovem
2.
Clin Radiol ; 75(11): 876.e1-876.e15, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32600652

RESUMO

Thoracic surgery has seen a resurgence in recent years with increasing numbers of cases taken on since the mid-2000s. There has been a paradigm shift in how we manage lung cancer with more emphasis on surgical resection, and this has been aided by minimally invasive video-assisted thoracic surgery (VATS) techniques. As a result, the prevalence of postoperative findings and complications is also increasing, and it is increasingly important for the general radiologist to recognise and diagnose these conditions as thoracic surgical patients may present acutely to non-thoracic surgical institutions. This review will cover both the early and late complications following a variety of lung resection surgeries.


Assuntos
Pneumonectomia/efeitos adversos , Complicações Pós-Operatórias/diagnóstico por imagem , Pneumonia Associada a Assistência à Saúde/diagnóstico por imagem , Pneumonia Associada a Assistência à Saúde/etiologia , Hemotórax/diagnóstico por imagem , Hemotórax/etiologia , Humanos , Pulmão/diagnóstico por imagem , Pulmão/cirurgia , Complicações Pós-Operatórias/etiologia , Atelectasia Pulmonar/diagnóstico por imagem , Atelectasia Pulmonar/etiologia , Enfisema Pulmonar/diagnóstico por imagem , Enfisema Pulmonar/etiologia , Radiografia Torácica , Síndrome do Desconforto Respiratório/diagnóstico por imagem , Síndrome do Desconforto Respiratório/etiologia , Tomografia Computadorizada por Raios X
3.
Gynecol Oncol ; 148(2): 275-280, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29195926

RESUMO

OBJECTIVE: To identify clinicopathologic factors associated with 10-year overall survival in epithelial ovarian cancer (EOC) and primary peritoneal cancer (PPC), and to develop a predictive model identifying long-term survivors. METHODS: Demographic, surgical, and clinicopathologic data were abstracted from GOG 182 records. The association between clinical variables and long-term survival (LTS) (>10years) was assessed using multivariable regression analysis. Bootstrap methods were used to develop predictive models from known prognostic clinical factors and predictive accuracy was quantified using optimism-adjusted area under the receiver operating characteristic curve (AUC). RESULTS: The analysis dataset included 3010 evaluable patients, of whom 195 survived greater than ten years. These patients were more likely to have better performance status, endometrioid histology, stage III (rather than stage IV) disease, absence of ascites, less extensive preoperative disease distribution, microscopic disease residual following cyoreduction (R0), and decreased complexity of surgery (p<0.01). Multivariable regression analysis revealed that lower CA-125 levels, absence of ascites, stage, and R0 were significant independent predictors of LTS. A predictive model created using these variables had an AUC=0.729, which outperformed any of the individual predictors. CONCLUSIONS: The absence of ascites, a low CA-125, stage, and R0 at the time of cytoreduction are factors associated with LTS when controlling for other confounders. An extensively annotated clinicopathologic prediction model for LTS fell short of clinical utility suggesting that prognostic molecular profiles are needed to better predict which patients are likely to be long-term survivors.


Assuntos
Neoplasias Epiteliais e Glandulares/mortalidade , Neoplasias Ovarianas/mortalidade , Neoplasias Peritoneais/mortalidade , Idoso , Ascite/mortalidade , Ascite/patologia , Antígeno Ca-125/metabolismo , Carcinoma Epitelial do Ovário , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasia Residual , Neoplasias Epiteliais e Glandulares/patologia , Neoplasias Ovarianas/patologia , Neoplasias Peritoneais/patologia , Curva ROC , Estados Unidos/epidemiologia
4.
J Appl Microbiol ; 116(2): 368-79, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24176036

RESUMO

AIMS: To examine the use of a natural antimicrobial peptide, human ß-defensin-3 (HBD3), as a means of preventing spoilage from bacterial contamination in brewery fermentations and in bottled beer. METHODS AND RESULTS: A chemically synthesised HBD3 peptide was tested for bactericidal activity against common Gram-positive and Gram-negative beer-spoiling bacteria, including species of Lactobacillus, Pediococcus and Pectinatus. The peptide was effective at the µmol l(-1) range in vitro, reducing bacterial counts by 95%. A gene construct encoding a secretable form of HBD3 was integrated into the genome of the lager yeast Saccharomyces pastorianus strain CMBS-33. The integrated gene was expressed under fermentation conditions and was secreted from the cell into the medium, but a significant amount remains associated with yeast cell surface. We demonstrate that under pilot-scale fermentation conditions, secreted HBD3 possesses bactericidal activity against beer-spoiling bacteria. Furthermore, when added to bottled beer, a synthetic form of HBD3 reduces the growth of beer-spoiling bacteria. CONCLUSIONS: Defensins provide prophylactic protection against beer-spoiling bacteria under brewing conditions and also in bottled beer. SIGNIFICANCE AND IMPACT OF THE STUDY: The results have direct application to the brewing industry where beer spoilage due to bacterial contamination continues to be a major problem in breweries around the world.


Assuntos
Antibacterianos/farmacologia , Cerveja/microbiologia , Lactobacillaceae/efeitos dos fármacos , Pectinatus/efeitos dos fármacos , Saccharomyces/metabolismo , beta-Defensinas/farmacologia , Sequência de Aminoácidos , Antibacterianos/biossíntese , Sequência de Bases , DNA Fúngico/química , Fermentação , Humanos , Lactobacillaceae/crescimento & desenvolvimento , Lactobacillus/efeitos dos fármacos , Lactobacillus/crescimento & desenvolvimento , Dados de Sequência Molecular , Pediococcus/efeitos dos fármacos , Pediococcus/crescimento & desenvolvimento , Projetos Piloto , RNA Fúngico/genética , RNA Fúngico/isolamento & purificação , Saccharomyces/genética , beta-Defensinas/biossíntese , beta-Defensinas/química , beta-Defensinas/genética
5.
Health Educ Res ; 29(4): 566-82, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24488650

RESUMO

This article discusses how process indicators can complement outcomes as part of a comprehensive explanatory evaluation framework, using the example of skills-based behavioural interventions to prevent sexually transmitted infections and promote sexual health among young people in schools. A systematic review was conducted, yielding 12 eligible outcome evaluations, 9 of which included a process evaluation. There were few statistically significant effects in terms of changes in sexual behaviour outcomes, but statistically significant effects were more common for knowledge and self-efficacy. Synthesis of the findings of the process evaluations identified a range of factors that might explain outcomes, and these were organized into two overarching categories: the implementation of interventions, and student engagement and intervention acceptability. Factors which supported implementation and engagement and acceptability included good quality teacher training, involvement and motivation of key school stakeholders and relevance and appeal to young people. Factors which had a negative impact included teachers' failure to comprehend the theoretical basis for behaviour change, school logistical problems and omission of topics that young people considered important. It is recommended that process indicators such as these be assessed in future evaluations of school-based sexual health behavioural interventions, as part of a logic model.


Assuntos
Avaliação de Processos e Resultados em Cuidados de Saúde , Saúde Reprodutiva , Infecções Sexualmente Transmissíveis/prevenção & controle , Adolescente , Comportamento do Adolescente , Educação em Saúde , Humanos , Comportamento Reprodutivo , Serviços de Saúde Escolar , Adulto Jovem
6.
Clin Radiol ; 68(9): 953-61, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23790688

RESUMO

Small cell carcinoma accounts for approximately 20% of lung cancers; however, it rarely occurs at other sites. Extrapulmonary small cell carcinoma (EPSCC) is notoriously aggressive with a strong propensity for both regional and distant spread. The majority of the literature on these uncommon tumours is from a clinicopathological viewpoint with a relative paucity of detail regarding the radiological findings. This review will focus on the imaging features of EPSCC in its predominant sites of origin: the gastrointestinal tract, genitourinary tract, head, neck, and breast. We will also discuss the role of positron-emission tomography (PET)/computed tomography (CT) in the staging of EPSCC.


Assuntos
Carcinoma de Células Pequenas/diagnóstico , Diagnóstico por Imagem/métodos , Adulto , Idoso , Neoplasias da Mama/diagnóstico , Feminino , Neoplasias Gastrointestinais/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Urogenitais/diagnóstico , Adulto Jovem
7.
Gynecol Oncol ; 121(2): 323-7, 2011 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-21277011

RESUMO

OBJECTIVE: Endometrial stromal sarcoma (ESS) is a rare uterine malignancy. The current treatment approaches yield unsatisfactory results, and potential therapeutic targets need exploration. METHODS: We reviewed the electronic medical records of 74 patients with low-grade ESS who had been evaluated at the University of Texas MD Anderson Cancer Center between 1995 and 2006. Using immunohistochemistry, we tested the expression of targets in paraffin-embedded tissue samples taken from 13 of the patients. RESULTS: Forty-seven patients (64%) had a recurrence, and 16 (22%) had died of their disease at last follow-up. The 10-year progression-free survival (PFS) rate was 43% (median PFS duration, 108months), and the overall survival (OS) rate was 85% (median OS, 288months). Patients who received hormonal therapy had an overall response rate of 27%; another 53% had stable disease, with a median time to progression of 24months. No complete response or partial response was observed among patients who received radiotherapy or chemotherapy. In the paraffin-embedded specimens we tested, c-abl was expressed universally. Expression of PDGF-α, PDGF-ß, VEGF, and c-Kit was detected in 33%, 36%, 54%, and 8%, of specimens, respectively. EGFR and HER-2 were not detectable in any specimens. CONCLUSIONS: Our study suggests that ESS is a hormone-dependent malignancy, with hormonal therapy having activity in recurrent disease. Targeted therapy, specifically targeting c-abl may be a potential treatment for this disease.


Assuntos
Neoplasias do Endométrio/tratamento farmacológico , Neoplasias do Endométrio/metabolismo , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/metabolismo , Inibidores de Proteínas Quinases/farmacologia , Sarcoma do Estroma Endometrial/tratamento farmacológico , Sarcoma do Estroma Endometrial/metabolismo , Adulto , Idoso , Intervalo Livre de Doença , Neoplasias do Endométrio/enzimologia , Feminino , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Terapia de Alvo Molecular/métodos , Recidiva Local de Neoplasia/enzimologia , Neoplasias Hormônio-Dependentes/tratamento farmacológico , Neoplasias Hormônio-Dependentes/enzimologia , Neoplasias Hormônio-Dependentes/metabolismo , Inclusão em Parafina , Prognóstico , Receptores Proteína Tirosina Quinases/antagonistas & inibidores , Receptores Proteína Tirosina Quinases/biossíntese , Receptores de Estrogênio/biossíntese , Receptores de Progesterona/biossíntese , Estudos Retrospectivos , Sarcoma do Estroma Endometrial/enzimologia , Adulto Jovem
8.
Water Sci Technol ; 61(12): 3221-7, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20555220

RESUMO

The impact of electrode corrosion behaviour, reactor geometry and current density on electrocoagulation efficiency were investigated for the treatment of molasses process wastewater. Two laboratory-scale vertical plate electrocoagulation reactors were used for this investigation: the first being a low aspect ratio bath reactor with a low specific electrode area, while the other was a high aspect ratio column reactor with a high specific electrode area. Anomalous anodic dissolution and cathodic corrosion of the aluminium electrodes both contributed significantly to overall metal consumption. Increasing specific electrode area and aspect ratio each led to improved treatment efficiency, whereas the impact of current density was more complicated involving the combined influences of several competing effects. The space-time yields of coagulant and bubbles (both functions of specific electrode area, current density and current efficiency) were found to influence mixing within the reactor and thus treatment efficiency.


Assuntos
Eletrocoagulação/métodos , Eliminação de Resíduos Líquidos/métodos , Purificação da Água/métodos , Alumínio/análise , Cloretos/análise , Eletrocoagulação/instrumentação , Eletrocoagulação/normas , Eletrodos , Desenho de Equipamento , Alimentos , Concentração de Íons de Hidrogênio , Ferro/análise , Eliminação de Resíduos Líquidos/instrumentação , Purificação da Água/normas
9.
Int J Gynecol Cancer ; 18(6): 1376-80, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18462370

RESUMO

Long-term risk of gynecological malignancies in organ transplantation patients has increased compared with that of the general population owing to the use of immunosuppressive agents. Treatment, especially chemotherapy, in these patients should take into consideration their renal function and the effects of immunosuppressive agents. We here present two case reports of patients with chemotherapy-treated gynecological malignancies who had previously received organ transplantation. The first case, a rare occurrence of simultaneous carcinomas of the uterine corpus and ovary, is the first such report in the English literature describing chemotherapy for concurrent serous papillary ovarian carcinoma and endometrioid endometrial carcinoma in a renal transplant patient. The second case report, describing chemotherapy for cervical cancer following two organ transplantation, also rare, is the first such report in the English literature and the first report of cervical cancer after heart-kidney transplantation.


Assuntos
Antineoplásicos/uso terapêutico , Carcinoma Adenoescamoso/tratamento farmacológico , Transplante de Coração , Transplante de Rim , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Uterinas/tratamento farmacológico , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/cirurgia , Progressão da Doença , Feminino , Sobrevivência de Enxerto/efeitos dos fármacos , Transplante de Coração/imunologia , Humanos , Imunossupressores/farmacologia , Transplante de Rim/imunologia , Pessoa de Meia-Idade , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Neoplasias Uterinas/patologia , Neoplasias Uterinas/cirurgia
10.
Int J Gynecol Cancer ; 18(4): 648-51, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-17892459

RESUMO

Tamoxifen has been found to be safe and effective in gynecological cancer patients with normal renal function. However, to our knowledge, no data exist regarding its effectiveness and toxicity in gynecological cancer patients with chronic kidney disease (CKD). Therefore, we retrospectively evaluated the effects of tamoxifen in patients with recurrent gynecological cancer and CKD. We collected clinical and demographic data for all patients. CKD was defined as a creatinine clearance (CrCl) level of less than 90 mL/min/1.73 m(2), in accordance with the National Kidney Foundation Kidney and Dialysis Outcomes Quality Initiative, and further categorized as mild, moderate, or severe (CrCl levels of 60-89, 30-59, and <30 mL/min/1.73 m(2), respectively). Twenty-nine patients were included in the study--22 with epithelial ovarian cancer, 4 with peritoneal cancer, and 3 with fallopian tube cancer. Thirteen patients had mild CKD, 13 had moderate, and 3 had severe. Most patients had been treated with 20 mg/day of tamoxifen every 4 weeks. The median duration of treatment was 5 months (range, 1-52 months). The overall complete response, partial response, stable disease, and disease progression rates were 0%, 10%, 41%, and 48%, respectively. Twenty-one percent of patients experienced hot flashes, and 7% experienced nausea. No major adverse reactions occurred. These findings were similar to those for gynecological cancer patients with normal renal function. In conclusion, 20 mg/day of tamoxifen is safe and effective in gynecological cancer patients with CKD.


Assuntos
Carcinoma/complicações , Carcinoma/tratamento farmacológico , Neoplasias dos Genitais Femininos/complicações , Neoplasias dos Genitais Femininos/tratamento farmacológico , Insuficiência Renal Crônica/complicações , Tamoxifeno/efeitos adversos , Tamoxifeno/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos Hormonais/administração & dosagem , Antineoplásicos Hormonais/efeitos adversos , Antineoplásicos Hormonais/uso terapêutico , Relação Dose-Resposta a Droga , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Tamoxifeno/administração & dosagem , Fatores de Tempo , Resultado do Tratamento
11.
Int J Gynecol Cancer ; 18(3): 460-4, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-17854432

RESUMO

The topoisomerase I agents are established as a therapy in recurrent ovarian cancer. Karenitecin, an analog of topotecan with solubility and pharmacologic advantages, was tested in a phase II trial in previously treated patients with recurrent or persistent ovarian cancer. The drug was administered intravenously over 1 h at a dose of 1.0 mg/m(2) daily for 5 days every 21 days. Patients were treated until disease progression, intolerable toxicity, or voluntary withdrawal. Response was evaluated according to modified RECIST criteria. Twenty-seven patients were entered into the study. One patient was inevaluable for not receiving any treatment. Of the 26 evaluable patients, there were two partial responses and one complete response for a total response rate of 12%. This response rate was insufficient to justify accrual to the second stage. The most common grade 3 or 4 toxicities were neutropenia (19%) and gastrointestinal (15%). Karenitecin is a well-tolerated topoisomerase compound but has minimal activity in extensively pretreated ovarian cancer with the dose-schedule employed.


Assuntos
Camptotecina/análogos & derivados , Invasividade Neoplásica/patologia , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias Epiteliais e Glandulares/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Peritoneais/tratamento farmacológico , Adulto , Idoso , Camptotecina/administração & dosagem , Camptotecina/efeitos adversos , Intervalo Livre de Doença , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Seguimentos , Humanos , Infusões Intravenosas , Dose Máxima Tolerável , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Neoplasias Epiteliais e Glandulares/mortalidade , Neoplasias Epiteliais e Glandulares/patologia , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/patologia , Neoplasias Peritoneais/mortalidade , Neoplasias Peritoneais/patologia , Probabilidade , Método Simples-Cego , Análise de Sobrevida , Resultado do Tratamento
12.
Int J Gynecol Cancer ; 18(2): 379-83, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-17624988

RESUMO

Bevacizumab (BVC) is currently used in recurrent ovarian cancer and as part of the initial treatment for ovarian cancer. The most serious toxicities associated with BVC include gastrointestinal perforations, delayed wound healing, and hemorrhage. Arthritis had never been addressed in patients who received BVC treatment. This is the first case report of arthritis emergence linked to BVC administration. A 59-year-old female with recurrent ovarian cancer received multiple hormonal and cytotoxic regimens for 5 years and then developed erosive osteoarthritis of the hands secondary to BVC and paclitaxel. This effect was confirmed by a significant improvement in her symptoms and signs, after treatment was discontinued.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Cistadenocarcinoma Seroso/tratamento farmacológico , Recidiva Local de Neoplasia/tratamento farmacológico , Osteoartrite/induzido quimicamente , Neoplasias Ovarianas/tratamento farmacológico , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais Humanizados , Bevacizumab , Cistadenocarcinoma Seroso/cirurgia , Feminino , Mãos , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Neoplasias Ovarianas/cirurgia , Paclitaxel/administração & dosagem
13.
Int J Gynecol Cancer ; 18(4): 600-14, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-17894799

RESUMO

Estrogen plays a role in ovarian tumorigenesis. Aromatase is the enzyme required for the synthesis of estrogen via conversion of androgen to estrogen, which is the major source of estrogen in postmenopausal women. Aromatase is present in normal ovaries and other tissues (e.g., fat and muscle) as well as in 33-81% tumor tissues of ovarian cancer. Aromatase inhibitors (AIs) block estrogen synthesis by inhibiting aromatase activity. In patients with recurrent ovarian cancer, single-agent AI therapy has been shown to elicit clinical response rates of up to 35.7% and stable disease rates of 20-42%. Given the limited treatment options for recurrent ovarian cancer and the favorable safety profile and convenient use, AI is a rational option for prolonging platinum-free interval in recurrent ovarian cancer. Further studies are required to determine the efficacy of combination treatment with AIs and biological agents, determine the benefit of AIs for treating special types of ovarian cancer (e.g., endometrioid type), and identify biomarkers for targeted patient selection. This review summarizes the current epidemiologic, preclinical, and clinical data regarding estrogen's role in ovarian cancer, the expression and regulation of aromatase in this disease, the development and characteristics of the three generations of AIs, and the preclinical and clinical studies of AIs in the treatment of ovarian cancer.


Assuntos
Inibidores da Aromatase/uso terapêutico , Estrogênios/fisiologia , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/etiologia , Aromatase/genética , Aromatase/metabolismo , Inibidores da Aromatase/farmacologia , Terapia de Reposição de Estrogênios/efeitos adversos , Estrogênios/efeitos adversos , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Mitose/efeitos dos fármacos , Mitose/genética , Modelos Biológicos , Neoplasias Ovarianas/genética , Receptores de Estrogênio/genética , Receptores de Estrogênio/metabolismo , Fatores de Risco
14.
Eur J Gynaecol Oncol ; 29(4): 393-6, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18714578

RESUMO

Endometriosis is a common clinical disorder that shares certain characteristics, metastasis and recurrence, with malignant neoplasms. Most malignant ovarian tumors arising from endometriosis are clear cell carcinoma or endometrioid adenocarcinoma. Few reports exist of sarcoma associated with endometriosis, and even fewer exist of multiple types of malignancies occurring simultaneously. Here, we report the case of a 32-year-old woman who presented with infertility and a pelvic mass. She underwent exploratory laparotomy and bilateral salpingo-oophorectomy. She was then referred to our institution for treatment recommendation. The pathologic findings revealed bilateral endometrioid adenofibroma of low malignant potential, which was associated with endometrioid intraepithelial carcinoma in the left ovary and high-grade sarcoma in the right ovary. Both tumors seemed to have arisen from endometriosis. She was treated with 75 mg/m2 of doxorubicin and 10 g/m2 of ifosfamide every three weeks for eight courses. She was later found to have bilateral brain metastases, which were resected and treated by whole-brain irradiation. She was again treated with doxorubicin and ifosfamide. The optimal treatment for endometriosis-associated ovarian cancer depends on the type of malignancy; simultaneously occurring multiple tumor types should be treated individually.


Assuntos
Carcinoma/etiologia , Endometriose/complicações , Doenças Ovarianas/complicações , Neoplasias Ovarianas/etiologia , Sarcoma/etiologia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma/tratamento farmacológico , Neoplasias do Endométrio/complicações , Neoplasias do Endométrio/tratamento farmacológico , Feminino , Humanos , Neoplasias Primárias Múltiplas , Neoplasias Ovarianas/tratamento farmacológico , Sarcoma/tratamento farmacológico
15.
Biochim Biophys Acta ; 1723(1-3): 175-83, 2005 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-15863356

RESUMO

It has been proposed that various urinary proteins interact specifically with different calcium oxalate hydromorphs and these interactions have important implications regarding the understanding of the onset and progress of kidney stone disease. Calcium oxalate monohydrate and dihydrate crystals were grown and characterised thoroughly to establish sample purity. These crystals were then incubated in artificial urine samples containing isolated urinary macromolecules. Crystal growth was prevented by saturating the incubation mix with calcium oxalate, and this was confirmed through electron microscopy and calcium measurements of the incubation mix. The surface interactions between the different calcium oxalate hydrates and urinary proteins were investigated by the use of Western blots and immunoassays. The same proteins, notably albumin, Tamm-Horsfall protein, osteopontin and prothrombin fragment 1, associated with both hydrates. There was a trend for more protein to associate with calcium oxalate dihydrate, and greater quantities of different proteins associated with both hydrates when Tamm-Horsfall protein was removed from the incubation mix. There is no evidence from this study to indicate that particular proteins interact with specific calcium oxalate hydrates, which in turn suggests that these protein-mineral interactions are likely to be mediated through non-specific charge interactions.


Assuntos
Oxalato de Cálcio/metabolismo , Cálculos Renais/metabolismo , Proteínas/metabolismo , Proteinúria/metabolismo , Adulto , Albuminas/metabolismo , Cristalização , Humanos , Masculino
16.
Cochrane Database Syst Rev ; (2): CD003097, 2006 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-16625569

RESUMO

BACKGROUND: Dilatation and effacement of the cervix are not only a result of uterine contractions, but are also dependent upon ripening processes within the cervix. The cervix is a fibrous organ composed principally of hyaluronic acid, collagen and proteoglycan. Hyaluronic acid increases markedly after the onset of labour. An increase in the level of hyaluronic acid is associated with an increase in tissue water content. Cervical ripening during labour is characterised by changes of the cervix and an increased water content. Cervical injection of hyaluronidase was postulated to increase cervical ripening. This is one of a series of reviews of methods of cervical ripening and labour induction using standardised methodology. OBJECTIVES: To determine the effects of hyaluronidase for third trimester cervical ripening or induction of labour in comparison with other methods of induction of labour. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group Trials Register (January 2006) and bibliographies of relevant papers. SELECTION CRITERIA: Clinical trials of hyaluronidase for third trimester cervical ripening or labour induction. DATA COLLECTION AND ANALYSIS: A strategy was developed to deal with the large volume and complexity of trial data relating to labour induction. This involved a two-stage method of data extraction. We assessed trial quality. We contacted study authors for additional information. We collected adverse effects information from the trials. MAIN RESULTS: One trial, with 168 women participating, was included in the review. When compared with placebo for cervical ripening intracervical injections of hyaluronidase resulted in women receiving significantly fewer caesarean sections (18% versus 49%, relative risk (RR) 0.37, 95% confidence interval (CI) 0.22 to 0.61), less need for oxytocin augmentation (10% versus 47%, RR 0.20, 95% CI 0.10 to 0.41), and increased cervical favourability after 24 hours (60% versus 98%, RR 0.62, 95% CI 0.52 to 0.74). No side-effects for mother or baby were reported in this trial. AUTHORS' CONCLUSIONS: Intracervical injections of hyaluronidase for cervical ripening appear beneficial. However, this is not common practice. In addition it is an invasive procedure that women may find unacceptable in the presence of less invasive methods.


Assuntos
Maturidade Cervical , Hialuronoglucosaminidase , Trabalho de Parto Induzido , Ocitócicos , Feminino , Humanos , Gravidez
17.
Cochrane Database Syst Rev ; (2): CD003100, 2006 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-16625570

RESUMO

BACKGROUND: The role of corticosteroids in the process of labour is not well understood. Animal studies have shown the importance of cortisol secretion by the fetal adrenal gland in initiating labour in sheep. Infusion of glucocorticosteroids into the fetus has also shown to induce premature labour in sheep. Given these studies it has been postulated that corticosteroids will promote the induction of labour in women. This is one of a series of reviews of methods of cervical ripening and labour induction using standardised methodology. OBJECTIVES: To determine the effects of corticosteroids for third trimester cervical ripening or induction of labour in comparison with other methods of cervical priming or induction of labour. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group Trials Register (December 2005) and bibliographies of relevant papers. SELECTION CRITERIA: Clinical trials of corticosteroids for third trimester cervical ripening or labour induction. DATA COLLECTION AND ANALYSIS: A strategy was developed to deal with the large volume and complexity of trial data relating to labour induction. This involved a two-stage method of data extraction. We assessed trial quality. We contacted study authors for additional information. We collected adverse effects information from the trials. MAIN RESULTS: Only one small trial (66 women) was included. The primary outcome vaginal birth within 24 hours was not reported. No benefit of intramuscular administration of corticosteroids with intravenous oxytocin was found when compared with oxytocin alone. However, given the small size of this trial this result should be interpreted cautiously. AUTHORS' CONCLUSIONS: The effectiveness of corticosteroids for induction of labour is uncertain. This method of induction of labour is not commonly used and so further research in this area is probably unwarranted.


Assuntos
Anti-Inflamatórios , Maturidade Cervical , Dexametasona , Glucocorticoides , Trabalho de Parto Induzido/métodos , Administração Tópica , Feminino , Humanos , Gravidez , Terceiro Trimestre da Gravidez
18.
J Natl Cancer Inst ; 83(22): 1629-36, 1991 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-1721093

RESUMO

B72.3 is a murine monoclonal antibody that recognizes a high-molecular-weight tumor-associated glycoprotein (TAG-72). Nine patients with TAG-72-positive ovarian carcinoma or papillary serous carcinoma of the peritoneum received an intraperitoneal infusion of 2, 4, or 10 mg B72.3 labeled with 0.5-1.2 (mean, 0.8) mCi 90Y. All patients had laparotomy, with multiple tissue and tumor samples removed 3-7 days later. The concentration of the total 90Y label in peritoneal fluid cleared with an extrapolated half-life of 68.6 +/- 4.5 hours. A low-molecular-weight 90Y-labeled species of metabolite was identified by high-performance liquid chromatography. The concentration of this low-molecular-weight species initially increased in the peritoneal fluid, with a half-life of 0.9 hour, and was rapidly cleared from the peritoneal cavity, with a half-life of 23.1 hours. Both the 90Y-labeled metabolite and the 90Y-labeled B72.3 were absorbed into the plasma, with half-lives of 16 +/- 2.2 hours and 25 +/- 5 hours, respectively. The clearance half-lives for these agents in plasma were 25 +/- 3 hours for the metabolite and 42 +/- 17 hours for B72.3. Approximately 8%-11% of the total injected 90Y label appeared in urine over 72 hours. Most of the label (about 70%) was present as the 90Y-labeled metabolite, but about 30% of the 90Y label in urine appeared identical to the authentic 90Y-labeled B72.3 standard when assayed by chromatography. Tissue distribution studies showed that normal tumor tissue and omentum contained the highest content of 90Y (about 0.017% of the injected dose per gram), followed in descending order by liver, normal lymph nodes, peritoneum, bone, and fascia. The lowest concentrations of 90Y were found in rectus abdominis muscle, bone marrow, and fat. There was substantial heterogeneity in the uptake of the 90Y label into tumor sites among patients and among different sites within the same patient. No correlation could be demonstrated between the TAG-72 content and the amount of 90Y label found in tumor sites. Preliminary radiation dosimetry estimates suggest that the tumor sites received about 82.8 cGy for each millicurie of 90Y administered. Thus, if an adequate total radiation dose can be achieved, 90Y-labeled B72.3 should be therapeutically useful for treating diffuse intraperitoneal disease.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Neoplasias Ovarianas/radioterapia , Radioimunoterapia , Radioisótopos de Ítrio/uso terapêutico , Adulto , Idoso , Anticorpos Monoclonais/administração & dosagem , Feminino , Humanos , Injeções Intraperitoneais , Interferons/farmacologia , Pessoa de Meia-Idade , Distribuição Tecidual , Radioisótopos de Ítrio/administração & dosagem
19.
J Natl Cancer Inst ; 84(4): 241-5, 1992 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-1734085

RESUMO

BACKGROUND: Chemotherapeutic study of cervical squamous cell carcinoma has shown some positive results. Complete plus partial (overall) response rates of 15%-35% (complete response rate, less than 5%) were achieved with the use of a small number of cytotoxic single agents in patients with advanced disease. In addition, overall response rates of 60%-70% (complete response rates, 10%-20%) were achieved with cisplatin-based, multiagent regimens in patients with primary, locally advanced disease. However, the lack of clear evidence that existing chemotherapy can achieve a survival benefit, coupled with the worldwide annual deaths of hundreds of thousands of women from cervical cancer, indicates the urgent need for effective systemic therapy for this disease. PURPOSE: In view of the preclinical and clinical evidence that supports testing of the novel combination of 13-cis-retinoic acid (13-cRA) plus interferon-alpha (IFN-alpha) in cervical squamous cell carcinoma, we conducted a phase II study of this regimen in locally advanced disease. METHODS: Twenty-six patients with untreated, locally advanced squamous cell carcinoma of the cervix were treated daily for at least 2 months with oral 13-cRA (1 mg/kg) and subcutaneous recombinant human IFN alpha-2a (6 million units). In 21 patients (81%), the disease was stage II or higher. RESULTS: Thirteen patients (50%) experienced major responses (tumor regression greater than or equal to 50%) in association with resolution of symptoms; one achieved complete response, and 12 experienced partial response. Seven with partial response are improving further, four are being maintained in partial response, and one responder has relapsed during therapy. The response rate is 58% (11 of 19) in patients with stage IIB or higher disease and 66% (10 of 15) in patients with bulky disease (at least one dimension greater than or equal to 10 cm). Of the 13 non-responders, nine have stable disease and four have had disease progression during therapy. Toxicity was minimal. CONCLUSION: These preliminary results indicate that systemic 13-cRA plus IFN alpha-2a is a highly active, well-tolerated therapy for locally advanced cervical cancer.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Neoplasias do Colo do Útero/tratamento farmacológico , Adulto , Idoso , Avaliação de Medicamentos , Feminino , Humanos , Interferon alfa-2 , Interferon-alfa/administração & dosagem , Isotretinoína/administração & dosagem , Pessoa de Meia-Idade , Proteínas Recombinantes , Indução de Remissão
20.
Cancer Res ; 49(5): 1220-2, 1989 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-2917352

RESUMO

Recent reports have shown allele loss at the c-Ha-ras1 locus on the short arm of chromosome 11 in some types of tumors. To determine whether loss of heterozygosity occurs at the c-Ha-ras1 locus in uncultured human ovarian carcinomas we used Southern blot analysis to study DNA from 17 pairs of ovarian tumors and matched white blood cell samples from the same patients. In one of these 17 tumors, the c-Ha-ras1 locus was rearranged, and in five tumor DNAs from ten informative patients, a c-Ha-ras1 allele was lost. This loss, of relatively high incidence, appears to be an important characteristic of human ovarian cancer and may provide a useful tool for understanding its biological behavior.


Assuntos
Alelos , Mapeamento Cromossômico , Neoplasias Ovarianas/genética , Proto-Oncogenes , Cromossomos Humanos Par 11 , Feminino , Rearranjo Gênico , Heterozigoto , Humanos
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