RESUMO
OBJECTIVE: To determine the therapeutic effectiveness and safety of transarterial radioembolization (TARE) with Yttrium-90 in patients with colorectal cancer (CRC) liver metastases and to evaluate the prognostic value of different biomarkers. MATERIAL AND METHODS: This prospective longitudinal study enrolled consecutive patients with CRC liver metastases treated with TARE between November 2015 and june 2020. The therapeutic response at three and six months (RECIST1.1 criteria) and the relationship of biomarkers with therapeutic response, by calculating objective tumor response rates (ORR) and disease control (DCR), and overall survival (OS) and progression-free (PFS). RESULTS: Thirty TAREs were performed in 23 patients (mean age, 61.61⯱â¯9.13 years; 56.5% male). At three months, the objective response rate (ORR) was 16.7% and the disease control rate (DCR) 53.3%. At six months, the disease progressed in 80%. The ORR and DCR were significantly associated with age at diagnosis (Pâ¯=â¯0.047), previous bevacizumab treatment (Pâ¯=â¯0.008), pre-TARE haemoglobin (Pâ¯=â¯0.008), NLR (Pâ¯=â¯0.040), pre-TARE albumin (Pâ¯=â¯0.012), pre-TARE ALT (Pâ¯=â¯0.023) and tumour-absorbed doseâ¯>â¯115 Gy (Pâ¯=â¯0.033). Median overall survival (OS) was 12 months (95% CI, 4.75-19.25 months) and median progression-free survival (PFS) 3 months (95% CI, 2.41-3.59). OS was significantly associated with primary tumour resection (Pâ¯=â¯0.019), KRAS mutation (HR: 5.15; Pâ¯=â¯0.024), pre-TARE haemoglobin (HR: 0.50; pâ¯=â¯0.009), pre-TARE NLR (HR: 1.65; Pâ¯=â¯0.005) and PLR (HR: 1.01; Pâ¯=â¯0.042). CONCLUSION: TARE prognosis and therapeutic response were predicted by different biomarkers, ranging from biochemical parameters to tumour dosimetrics.
Assuntos
Neoplasias do Colo , Neoplasias Hepáticas , Idoso , Biomarcadores , Feminino , Humanos , Neoplasias Hepáticas/secundário , Estudos Longitudinais , Masculino , Microesferas , Pessoa de Meia-Idade , Estudos Prospectivos , Compostos Radiofarmacêuticos/uso terapêutico , Estudos Retrospectivos , Radioisótopos de ÍtrioRESUMO
OBJETIVE: To determine the therapeutic effectiveness and safety of transarterial radioembolization (TARE) with Yttrium-90 in patients with colorectal cancer (CRC) liver metastases and to evaluate the prognostic value of different biomarkers. MATERIAL AND METHODS: This prospective longitudinal study enrolled consecutive patients with CRC liver metastases treated with TARE between November 2015 and june 2020. The therapeutic response at three and six months (RECIST1.1 criteria) and the relationship of biomarkers with therapeutic response, by calculating objective tumor response rates (ORR) and disease control (DCR), and overall survival (OS) and progression-free (PFS). RESULTS: Thirty TAREs were performed in 23 patients (mean age, 61,61±9,13 years; 56,5% male). At three months, the objective response rate (ORR) was 16,7% and the disease control rate (DCR) 53,3%. At six months, the disease progressed in 80%. The ORR and DCR were significantly associated with age at diagnosis (P=.047), previous bevacizumab treatment (P=.008), pre-TARE haemoglobin (P=.008), NLR (P=.040), pre-TARE albumin (P=.012), pre-TARE ALT (P=.023) and tumour-absorbed dose>115Gy (P=.033). Median overall survival (OS) was 12 months (95% CI, 4.75-19.25 months) and median progression-free survival (PFS) 3 months (95% CI, 2.41-3.59). OS was significantly associated with primary tumour resection (P=.019), KRAS mutation (HR: 5.15; P=.024), pre-TARE haemoglobin (HR: .50; p=.009), pre-TARE NLR (HR: 1.65; P=.005) and PLR (HR: 1.01; P=.042). CONCLUSION: TARE prognosis and therapeutic response were predicted by different biomarkers, ranging from biochemical parameters to tumour dosimetrics.
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UNLABELLED: The practice of the Islamic precept of Ramadan (R) imposes to those who practice it important physiological and psychological changes due to the water and dietary restrictions they are subjected to, which has a particular impact on the Muslim students' physical and psychological performances, particularly in multicultural Western societies, where there are no schedule adjustments in daily activities. Among the changes in lifestyle, consequently, the dietary changes are stressed, both qualitative and quantitative. Due to the importance of this issue and facing the limited knowledge the Muslim teenagers who live in non-Islamic societies have about the effects of Ramadan, it is suggested as main objective of this study the analysis of changes in nutrients during R in a group of Muslim students of both sexes, in order to solve and prevent some of the problems shown in this period. MATERIALS AND METHODS: 55 Muslim youngsters were selected (24 men and 31 women) aged between 15 and 18, who practise R; and the diet was analysed by inventory over 3 days, one week before fasting and in the second week during it. RESULTS: In R there are no relevant changes in caloric intake. The consumption of carbohydrates and proteins is increased, and that of fat is decreased. DISCUSSION: the changes in R lead to a diet more regulated to nutritional recommendations; and to this seems to have contributed the fact that the participants took their meals at home, where, in spite of the Western cut of the population, it is felt an important influence of North African traditions and habits, due to its border contact with Morocco.
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Comportamento do Adolescente , Dieta , Jejum , Islamismo , Adolescente , Estudos de Coortes , Registros de Dieta , Carboidratos da Dieta , Gorduras na Dieta , Proteínas Alimentares , Ingestão de Energia , Comportamento Alimentar , Feminino , Humanos , Islamismo/psicologia , MasculinoRESUMO
A 55-year-old man with post-traumatic central cord injury, diagnosed with remitting seronegative symmetrical synovitis with pitting edema (RS3PE syndrome). The clinical picture begins with an acute pain in hands, swelling and stiffness. The physical examination revealed edema with fovea on the back of both hands, with pain and swelling in the metacarpophalangeal joints. Given this, different analytical tests and radiography of hands were requested. We started treatment with 30mg of prednisone, showing significant clinical improvement, disappearing arthritis and edema, and normalization of the analytical values. The peculiarity of presentation of RS3PE syndrome in a patient with a central cord injury is due to the difficulty of identifying it due to the superposition of clinical manifestations together with the lack of knowledge of it, being in the absence of this lesion, an easily diagnosable pathology, do not require excessive complementary tests, and with an excellent prognosis after the appropriate early treatment.
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Síndrome Medular Central/complicações , Edema/complicações , Mãos , Sinovite/sangue , Sinovite/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Sinovite/imunologiaRESUMO
BACKGROUND AND AIMS: The Islamic precept of Ramadan (R), imposes on individuals who practice it important physiological and psychological changes due to water and dietary restrictions to which they are subjected during the day, over a month. This fact makes a singular constrat, particularly in multicultural Western societies, where there is no schedule adjustments in daily activities, which are common in predominantly Muslim countries. Among the changes, includes the activation of mechanisms of adaptation to the hydrosalin restriction, with consequences on the homeostasis of water and ion plasma. On the relevance of the issue and the limited knowledge of the effects of (R) on the ion balance, the aim of the present study is to analyze the behaviour of potassium ion for this month, in order to prevent some problems that may affect health. METHODOLOGY: We have selected 10 young Muslim healthy men, aged between 18 and 25 years who perform Ramadan. Then we have analyzed biochemical parameters including ions, in blood and urine analysis, and also plasma levels of renin and aldosterone, one week before R, first and fourth week of R, and one week after the fasting. RESULTS: During the month of R a decrease in potassium urine excretion by the morning is observed. The consequence of this fact is the increase of the levels in plasma concentration of potassium; throughout the afternoon, an increase in its excretion results more effective during the fourth week of R. DISCUSSION: Changes in the availability of Na+, HCO3- and variability of pH, in the distal tubule, appear to be responsible for the potassium limited excretion observed during the fast of Ramadan. CONCLUSION: These finding put into consideration the need of further studies focussing on potassium homeostasis during Ramadan in order to determine which factors are implicated in the raised levels of K+ observed in plasma.
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Jejum/sangue , Islamismo , Potássio/sangue , Adolescente , Adulto , Aldosterona/sangue , Bicarbonatos/sangue , Homeostase , Humanos , Concentração de Íons de Hidrogênio , Masculino , Renina/sangue , Sódio/sangue , Urodinâmica/fisiologia , Equilíbrio Hidroeletrolítico/fisiologia , Adulto JovemRESUMO
BACKGROUND AND OBJECTIVE: The aim of the present study was to compare the risk stratification obtained with the Framingham function, recommended by the National Cholesterol Education Program (ATP-III), and the risk charts of the Systematic Coronary Risk Evaluation (SCORE) program, in a cohort of subjects between 20 and 75 years (mean 59 years, 70% females) with metabolic syndrome. SUBJECTS AND METHOD: Participants were classified as low, moderate, or high risk by ATP-III and by SCORE of risk at 10 years, respectively. RESULTS: 8.3% of males and 7.4% of women from our study were classified as high risk in 10 years time by Framingham-DORICA. Regarding SCORE program 50% men and 29.6% of women were considered to have high coronary risk. CONCLUSIONS: Risk estimation with SCORE and Framingham function shows significant gender and quantitative differences. There is no concordance between Framingham and SCORE function to estimate cardiovascular risk on subjects included on the high-risk group.