RESUMO
The only curative treatment option for relapsed patients with acute myeloid leukemia (AML) is allogeneic stem cell transplantation. Depletion of hematopoietic stem cells and leukemic blast cells is achieved through the systemic administration of DNA damaging agents, including total-body irradiation (TBI) prior to transplantation. Since other tissues are radiosensitive, the identification of biomarkers could facilitate the management of additional toxicities. Buccal keratinocytes are readily accessible and could provide a source of cells for RNA analysis. In this study, we obtained miRNAs and mRNAs from daily buccal swabs collected from patients undergoing allogeneic stem cell transplantation. Unexpectedly, there was no prominent p53-induced mRNA or miRNA response in these samples, despite the fact that the p53 pathway is a well-characterized radiation-inducible response. Instead, the expression of mRNAs encoding p53 and cytokeratin 14 (TP53 and KRT14, respectively) decreased precipitously within hours of the first radiation treatment. These patients went on to develop oral mucositis, however, it is unclear whether TP53 and/or KRT14 expression are predictive of this adverse event. Larger scale analysis of buccal epithelial samples from patients undergoing allogeneic stem cell transplantation appears to be warranted.
Assuntos
Regulação Neoplásica da Expressão Gênica/efeitos da radiação , Transplante de Células-Tronco Hematopoéticas , Queratina-14/genética , Mucosa Bucal/efeitos da radiação , Proteína Supressora de Tumor p53/genética , Irradiação Corporal Total/efeitos adversos , Feminino , Humanos , Leucemia Mieloide Aguda/genética , Leucemia Mieloide Aguda/radioterapia , Leucemia Mieloide Aguda/cirurgia , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Fatores de Tempo , Transplante HomólogoAssuntos
Hipocondríase/diagnóstico , Transtornos Paranoides/diagnóstico , Testes Psicológicos , Delusões/psicologia , Diagnóstico Diferencial , Humanos , Hipocondríase/psicologia , Avaliação de Processos e Resultados em Cuidados de Saúde , Transtornos Paranoides/psicologia , Transtornos da Personalidade/psicologia , Pimozida/uso terapêutico , Papel do DoenteRESUMO
Data are presented regarding the decision by medical staff and by patients to discontinue renal dialysis. Some relevant issues regarding the patients are discussed, including their mental competence, underlying motivation and psychiatric state. Also some of the medical factors involved in the decision to stop treatment are considered. Emphasis is placed on the importance of the patients's sense of active participation and involvement in his treatment. Mention is made of the importance of interventions to decrease the psychological morbidity in survivors of patients who stop dialysis.
Assuntos
Eutanásia Passiva/psicologia , Eutanásia/psicologia , Falência Renal Crônica/psicologia , Diálise Renal/psicologia , Suspensão de Tratamento , Ansiedade/psicologia , Atitude do Pessoal de Saúde , Atitude Frente a Morte , Tomada de Decisões , Culpa , Humanos , Ontário , Estudos RetrospectivosRESUMO
PIP: The blood-serum iron concentrations were examined in women using Anagravid (Polfa) as an oral contraceptive (OC). The examined subjects used the preparation for 6 months and their results were compared with those women not using a progestogen contraceptive. The results underwent statistical analysis. It was demonstrated that in the group of patients using Anagravid, the blood-serum iron concentrations were significantly higher when compared with those women who did not receive OCs. The mechanism of this phenomenon remains unclear. (author's modified)^ieng