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1.
Ghana Med J ; 56(2): 95-99, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37449258

RESUMO

Objectives: To evaluate a newly developed, self-expandable anti-reflux Trumpet (ART) stent customized for cardio oesophageal junctional (COJ) cancer on the feasibility of deployment, stent migration, quality of life, and symptom relief. Design: Prospective case series, Proof of concept pilot study. Setting: Tertiary Health Care Center, Hospital Tuanku Jaafar, Seremban, Malaysia. Department of Surgery. Participants: A total of 17 patients diagnosed with advanced COJ tumour and who had never undergone any surgical, endoscopic, or chemoradiotherapy and indicated for stenting were recruited. Interventions: The study period was over nine months, and follow-up was one-month post-stenting. Main outcome measures: Endpoint measures were feasibility of deployment of the new design, symptoms relief, early stent migration, early complication, GERD Q score, and (QOL)assessment. Results: The ART stent was inserted successfully in all cases (17/17, 100%). There were two stent migrations due to the flexibility of the stent at the neck. There were no early or post-stenting one-month complications associated with the procedure. A good flow of contrast was seen in all the stents deployed. GERD Q score was low in all patients pre and post-stenting. Post-stenting there was a relief of dysphagia, weight gain, and a 60% improvement in QOL score. Conclusions: ART stent is feasible and technically successful in COJ tumours. It provides good symptom relief, improves the QOL, and has minimal early complications. Funding: None declared.


Assuntos
Carcinoma , Neoplasias Esofágicas , Refluxo Gastroesofágico , Humanos , Qualidade de Vida , Projetos Piloto , Neoplasias Esofágicas/terapia , Neoplasias Esofágicas/complicações , Cuidados Paliativos/métodos , Refluxo Gastroesofágico/terapia , Refluxo Gastroesofágico/complicações , Stents , Resultado do Tratamento
2.
Ann Med Surg (Lond) ; 65: 102353, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34007446

RESUMO

INTRODUCTION: Signet cell carcinoma (SRCC)of the rectum is a rare subtype of the rectum cancer which accounts for only 0.8% of colorectal cancer in adolescents and young adults (AYAs) which spread aggressively to other organs and peritoneum. CASE PRESENTATION: We present a case of 15-year-old boy from rural area, presented with chronic diarrhea and per rectal bleeding for 3 months. The diagnosis was determined by colonoscope which revealed a fungating mass identified at 10cm from anal verge. Histological examination confirmed diagnosis of signet ring cell adenocarcinoma. CT scan of the abdomen showed thickening involving the recto-sigmoid colon and rectal mass, without evidence of distant metastatic disease. The patient's carcinoembryonic antigen level was within the normal range. He underwent a colostomy and was subjected to neoadjuvant CCRT and surgery. DISCUSSION: This CASE highlights the importance and challenges in achieving early diagnosis and surgical intervention of signet-ring cell carcinoma in adolescents, as most cases are detected at an advanced stage coupled with the scarcity of information on these rarer subtypes which leads to a poor prognosis. CONCLUSION: In managing Signet cell carcinoma of the colorectal, physician have to know that it has a poor prognosis in patients of any age. However, in young teenagers delayed diagnosis and treatment option are narrowed to palliative management. Genetic profiling of family members and similar environment population may be a key to early detection.

3.
Ghana Med J ; 55(3): 226-228, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35950178

RESUMO

Cholelithiasis can present from a milder form of biliary colic to a more severe and complicated one like empyema gallbladder and a lesser-known variant of gangrenous gallbladder called marbleization of the gallbladder. The clinical signs and symptoms are similar to acute cholecystitis. Diabetes mellitus could have a role in the process of marbleization. Diagnosing marbleization of the gall bladder is not easy preoperatively. Computerized tomography is a better diagnostic modality when compared to laboratory investigations. Urgent cholecystectomy is the only option, and there is no role of conservative treatment. We report a case of a 36-year-old man with newly diagnosed Diabetes Mellitus diagnosed initially as acute cholecystitis and managed conservatively. He did not respond to treatment and hence underwent cholecystectomy and intraoperatively was found to have marbleization of the gall bladder.


Assuntos
Colecistite Aguda , Colecistite , Adulto , Colecistite/complicações , Colecistite/diagnóstico , Colecistite/cirurgia , Colecistite Aguda/diagnóstico por imagem , Colecistite Aguda/cirurgia , Humanos , Masculino , Tomografia Computadorizada por Raios X
4.
Med J Malaysia ; 75(5): 467-471, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32918411

RESUMO

INTRODUCTION: Patients undergoing emergency general surgery (EGS) are at risk for death and complications. Information on the burden of EGS is critical for developing strategies to improve the outcomes. METHODS: In this retrospective cohort study, medical records of all general surgical operations in a public hospital were reviewed for the period 1st January 2017 to 31st December 2017. Data on patient demographics, operative workload, case mix, time of surgery and outcomes were analysed. RESULTS: Of the 2960 general surgical operations that were performed in 2017, 1720 (58.1%) of the procedures were performed as emergencies. The mean age for the patients undergoing emergency general surgical procedures was 37.9 years (Standard Deviation, ±21.0), with male preponderance (57.5%). Appendicitis was the most frequent diagnosis for the emergency procedures (43%) followed by infections of the skin and soft tissues (31.6%). Disorders of the colon and rectum ranked as the third most common condition, accounting for 6.7% of the emergency procedures. Majority of emergency surgery (59.3%) took place after office hours and on weekends. Post-operative deaths and admissions to critical care facilities increased during EGS when compared to elective surgery, p<0.01. CONCLUSIONS: EGS constitutes a major part of the workload of general surgeons and it is associated significant risk for death and post-operative complications. The burden of EGS must be recognised and patient care systems must evolve to make surgery safe and efficient.


Assuntos
Serviço Hospitalar de Emergência , Cirurgia Geral , Hospitais Públicos , Adolescente , Adulto , Plantão Médico , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Cirurgia Geral/classificação , Cirurgia Geral/estatística & dados numéricos , Humanos , Lactente , Malásia/epidemiologia , Masculino , Auditoria Médica , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Adulto Jovem
5.
Med J Malaysia ; 75(3): 260-265, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32467542

RESUMO

BACKGROUND: Malaysia continues to have a very low cadaveric organ donation rate of 0.48 per million population. The aim of this paper is to assess the attitude, beliefs and knowledge of patients and relatives at three different hospitals in Negeri Sembilan towards organ donation to increase the acceptability of organ transplant. METHODS: A cross-sectional descriptive study with convenient sampling was carried out Hospital Tuanku Ja'afar, Hospital Port Dickson and Hospital Tuanku Ampuan Najihah in Negeri Sembilan, Malaysia. The participants answered a questionnaire regarding the source of their information about organ donation, their knowledge about brain death and willingness to donate. The association between variables was tested using chi-squared test or Fischer's exact test as appropriate. RESULTS: A total of 385 individuals completed the survey of whom 134 (35%) were willing to donate their organs upon death and 25(19%) were registered donors. Higher educational level (41%), age 30 and below (42%) and people who attended organ donation awareness campaigns (60%) were more willing to donate their organs. Correct understanding of brain death was associated with willingness to be an organ donor. The commonest reason cited for unwillingness to donate was opposition from family members. CONCLUSION: Marital status, religion, source of knowledge and occupation are significant factors in willingness to donate organs among Malaysians. Lower age and higher educational level were positive factors towards organ donation. Direct personal contact through awareness campaigns, family and friends has a potential for greater positive impact on organ donation.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Hospitais , Obtenção de Tecidos e Órgãos , Adolescente , Adulto , Morte Encefálica , Estudos Transversais , Feminino , Humanos , Malásia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
6.
J Taibah Univ Med Sci ; 13(3): 305-308, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31435339

RESUMO

Hyperplastic polyps are the most common polypoidal lesions of the stomach showing a varied presentation. They may be asymptomatic; however, occasionally they can cause anaemia and gastric outlet obstruction. Malignant transformation is a serious complication associated with such polyps. We present the case of an elderly woman who complained of epigastric pain and intermittent vomiting. Oesophagogastroduodenoscopy (OGDS) showed a large pedunculated polyp along the lesser curvature of the stomach, 4 cm from the gastro-oesophageal junction, extending into the first part of the duodenum that caused gastric outlet obstruction. Computed tomography reported a soft-tissue mass arising from the incisura and extending through the pylorus into the duodenum (D1 and proximal D2). An endoscopic polypectomy was performed, and histopathological examination reported evidence of early gastric carcinoma. She underwent regular endoscopic follow-up with biopsies performed over 2 years, and the last follow-up showed mild-to-moderate dysplasia at the previous excision site. She underwent a planned laparoscopic wedge resection, and histopathological examination confirmed the presence of a hyperplastic polyp showing low-grade dysplasia.

7.
Cancer Chemother Pharmacol ; 79(4): 681-688, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28289865

RESUMO

PURPOSE: A phase I two-period two sequence cross-over study compared the bioavailability of two pimasertib (MSC1936369B/AS703026) formulations (capsule versus tablet) in advanced cancer patients. METHODS: Patients with advanced solid tumors were randomized to one of two treatment sequences utilizing pimasertib tablet (test; 3 × 20 mg, PO QD) and capsule (standard; 2 × 30 mg, PO QD). The trial comprised a screening and baseline period, two time periods or parts A and B, and a trial extension phase. RESULTS: N = 38 patients were randomized to two treatment sequences S1 and S2. PK parameters t 1/2, CL/f, and V z/f were within the same range for the two formulations. Tablet had bioavailability comparable to capsule based on the analysis of AUC0-t, however, tablet administration resulted in an increase of ~25% in C max versus capsule. Common predicted adverse events of pimasertib included ocular events, diarrhea and creatine phosphokinase elevation. Disease control rate was ~29% with 1 partial response and 4 of 10 patients with stable disease >4 months. CONCLUSIONS: Pimasertib tablet was overall well tolerated, had a similar safety and efficacy profile to standard capsule formulation and had bioavailability comparable to capsule.


Assuntos
Antineoplásicos/farmacocinética , Neoplasias/metabolismo , Niacinamida/análogos & derivados , Inibidores de Proteínas Quinases/farmacocinética , Adulto , Idoso , Antineoplásicos/administração & dosagem , Antineoplásicos/uso terapêutico , Área Sob a Curva , Disponibilidade Biológica , Cápsulas , Estudos Cross-Over , Composição de Medicamentos , Feminino , Humanos , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Niacinamida/administração & dosagem , Niacinamida/farmacocinética , Niacinamida/uso terapêutico , Inibidores de Proteínas Quinases/administração & dosagem , Inibidores de Proteínas Quinases/uso terapêutico , Comprimidos , Resultado do Tratamento
8.
Med J Malaysia ; 71(1): 12-6, 2016 02.
Artigo em Inglês | MEDLINE | ID: mdl-27130737

RESUMO

BACKGROUND: Perforated peptic ulcers (PPU) present as serious surgical emergencies that carry high mortality and morbidity. Foreigners with PPU are also managed in our hospital setting. Their inclusion significantly alters the trend and pattern of PPU seen in Malaysia. AIM: To compare per-operative and post-operative features and outcomes of perforated peptic ulcers between Malaysians and foreigners. MATERIAL AND METHODS: This was an analytical crosssectional study. All patients who underwent repair of perforated peptic ulcer disease during a 6-year period were included. 50 consecutive patients' records with perforated peptic ulcer were analysed. Data were collected from operation theatre database and hospital medical records. Chi square and t test were performed using SPSS statistical software. RESULTS: Total of 50 patients, of which 30 were Malaysians and 20 were foreigners. The mean age of Malaysian patients was 58.3 ± 15.2 years whereas the mean age for foreign patients was 30.3 ± 6.7 years, with foreign patients being significantly younger than local patients. Foreigners had significantly smaller ulcers with only 5% of them having ulcers more than 1cm while 36.7% of Malaysian patients had ulcers more than 1cm. Post-operative complications are significantly higher in Malaysian patients (p<0.05) with 40% of Malaysian patients and 10% of foreign patients developing post-operative complications. CONCLUSION: Foreign patients are younger with significantly smaller perforated ulcers and better post-operative outcomes.


Assuntos
Emigrantes e Imigrantes , Úlcera Péptica Perfurada/cirurgia , Adulto , Idoso , Emergências , Feminino , Humanos , Malásia , Masculino , Pessoa de Meia-Idade , Úlcera Péptica Perfurada/complicações , Complicações Pós-Operatórias , Estudos Retrospectivos
9.
Bone Joint J ; 98-B(4): 498-503, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27037432

RESUMO

AIMS: The objective of this double-blind randomised controlled trial was to assess whether ultrasound guidance improved the efficacy of corticosteroid injections for Morton's neuroma (MN). PATIENTS AND METHODS: In all, 50 feet (40 patients) were recruited for this study but five feet were excluded due to the patients declining further participation. The mean age of the remaining 36 patients (45 feet) was 57.8 years (standard deviation (sd) 12.9) with a female preponderance (33F:12M). All patients were followed-up for 12 months. Treatment was randomised to an ultrasound guided (Group A) or non-ultrasound guided (Group B) injection of 40 mg triamcinolone acetonide and 2 ml 1% lignocaine, following ultrasound confirmation of the diagnosis. RESULTS: The mean visual analogue score for pain improved significantly in both groups (Group A - from 64 mm, sd 25 mm to 29 mm, sd 27; Group B - from 69 mm, sd 23 mm to 37 mm, sd 25) with no statistical difference between them at all time-points. The failure rate within 12 months of treatment was 11/23 (48%) and 12/22 (55%) in Groups A and B, respectively (p = 0.458). The improvement in Manchester Oxford Foot Questionnaire Index and patient satisfaction favoured Group A in the short-term (three months) that almost reached statistical significance (p = 0.059 and 0.066 respectively). However, this difference was not observed beyond three months. CONCLUSION: This study has shown that ultrasound guidance did not demonstrably improve the efficacy of corticosteroid injections in patients with MN. TAKE HOME MESSAGE: In the presence of a clear diagnosis of MN, a trained clinician who understands the forefoot anatomy may perform an injection without ultrasound guidance with good and safe results.


Assuntos
Antepé Humano/inervação , Glucocorticoides/administração & dosagem , Neuroma/tratamento farmacológico , Neoplasias do Sistema Nervoso Periférico/tratamento farmacológico , Intervalo Livre de Doença , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Neuroma/diagnóstico por imagem , Satisfação do Paciente , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Estudos Retrospectivos , Resultado do Tratamento , Ultrassonografia
10.
Foot Ankle Surg ; 21(2): 103-7, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25937409

RESUMO

BACKGROUND: The purpose of this study was to investigate the influence of joint configuration and preparation on first metatarsophalangeal (MTPJ) union rates. METHODS: We performed a retrospective analysis of first MTPJ arthrodeses undertaken in our institution. Clinical notes, radiographs and postal questionnaires were used to determine outcome. RESULTS: Two hundred first MTPJ arthrodeses (172 patients) were included in the analysis (34 male: 138 female; mean age 62 yr). The overall union rate was 93.5%. Union was achieved in 109/118 MTPJs (92.4%) prepared in the flat-on-flat configuration and in 78/82 (95%) prepared in the ball-and-socket configuration (p=0.438). Higher union rates favoured low-velocity joint preparation [using rongeur only 21/21 (100%), rongeur and burr 26/27 (96.3%) and conical reamer 31/34 (91.2%)] but this did not reach statistical significance (p=0.317). There was a 95% satisfaction rate with surgery but male patients were less satisfied (p=0.031). CONCLUSION: Union rates were not influenced by joint configuration or preparation techniques.


Assuntos
Artrite/cirurgia , Artrodese/métodos , Hallux Rigidus/cirurgia , Hallux Valgus/cirurgia , Idoso , Feminino , Hallux/cirurgia , Humanos , Masculino , Articulação Metatarsofalângica/cirurgia , Pessoa de Meia-Idade , Estudos Retrospectivos
11.
Ann Gastroenterol ; 27(1): 34-41, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24714557

RESUMO

BACKGROUND: Gastric cancer is notably one of the leading causes of cancer-related death in the world. In Malaysia, these patients present in the advanced stage, thus narrowing the treatment options and making the surgery nearly impossible for successful curative resection. Failure to identify high-risk patients and delay in diagnostic endoscope procedure contributed to the delay in diagnosis. The aim of the study was to develop and validate a scoring system (MARK's Quadrant) which can identify symptomatic patients who are at risk for gastric cancer. METHODS: A 3-phase approach was undertaken: Phase 1: development of the weighted scoring system; Phase 2: estimating positive predicting value of MARK's Quadrant; and Phase 3: a) testing the validity of MARK's Quadrant in an open-access endoscope system; and b) comparing its usefulness compared to conventional referral system. RESULTS: In phases 1 and 2, MARK's Quadrant with weighted symptoms was developed. The sensitivity of MARK's Quadrant is 88% and the specificity is 45.5% to detect cancerous and precancerous lesions of gastric. This was confirmed by the prospective data from phase 3 of this study where the diagnostic yield of MARK's Quadrant to detect any pathological lesion was 95.2%. This score has a high accuracy efficiency of 75%, hence comparing to routine referral system it has an odds ratio (95%CI) of 10.98 (4.63-26.00), 6.71 (4.46-10.09) and 0.95 (0.06-0.15) (P<0.001 respectively) for cancer, precancerous lesion and benign lesion diagnosis respectively. CONCLUSION: MARK's Quadrant is a useful tool to detect early gastric cancer among symptomatic patients in a low incidence region.

12.
ANZ J Surg ; 84(1-2): 47-51, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-23057502

RESUMO

BACKGROUND: Although laparoscopic surgeries are associated with reduced surgical stress response and shortened post-operative recovery, intense pain and high analgesia requirements in the immediate post-operative period are often the chief complaints. AIM: The aim of this study was to evaluate the effect of pre-emptive intraperitoneal local anaesthetic drugs on post-operative pain management and metabolic stress response in laparoscopic appendicectomy. METHOD: The method used was a randomized double-blinded placebo-controlled study. Patients with clinical diagnosis of acute appendicitis who fulfil the criteria, were taken into this study. Primary outcomes investigated were consumption of patient-controlled analgesia during the immediate post-operative period (first 6 h) and subsequent 18 h as well as serum cortisol sampling. RESULTS: Total of 120 patients were recruited into three different treatment groups (placebo, ropivacaine, levobupivacaine). In order to maintain visual analogue score of 0-1 during the immediate post-operative period, patients in the placebo group required significantly (P < 0.001) higher dose of analgesia (morphine/mg) - 11 mg (8.3-15.5) as compared with ropivacaine - 4 mg (3.0-6.0) and levobupivacaine - 3.5 mg (2.0-5.0). The immediate post-operative serum cortisol showed a significant increase in serum cortisol in the placebo group (P = 0.001) as compared with ropivacaine and levobupivacaine groups. CONCLUSION: Pre-emptive intraperitoneal local anaesthesia in laparoscopy surgery is a safe, non-invasive procedure that can benefit patients by reducing the immediate post-operative pain intensity and metabolic stress response of the body.


Assuntos
Anestesia Local/métodos , Anestésicos Locais/administração & dosagem , Apendicectomia/métodos , Apendicite/cirurgia , Laparoscopia , Dor Pós-Operatória/prevenção & controle , Estresse Fisiológico , Adulto , Amidas/administração & dosagem , Analgesia Controlada pelo Paciente/estatística & dados numéricos , Biomarcadores/sangue , Bupivacaína/administração & dosagem , Bupivacaína/análogos & derivados , Método Duplo-Cego , Feminino , Humanos , Hidrocortisona/sangue , Infusões Parenterais , Levobupivacaína , Masculino , Medição da Dor , Dor Pós-Operatória/sangue , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/tratamento farmacológico , Ropivacaina , Resultado do Tratamento
13.
Eur J Cancer ; 48(18): 3319-27, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22921184

RESUMO

BACKGROUND: SF1126 is a peptidic pro-drug inhibitor of pan-PI3K/mTORC. A first-in-human study evaluated safety, dose limiting toxicities (DLT), maximum tolerated dose (MTD), pharmacokinetics (PK), pharmacodynamics (PD) and efficacy of SF1126, in patients with advanced solid and B-cell malignancies. PATIENTS AND METHODS: SF1126 was administered IV days 1 and 4, weekly in 28day-cycles. Dose escalation utilised modified Fibonacci 3+3. Samples to monitor PK and PD were obtained. RESULTS: Forty four patients were treated at 9 dose levels (90-1110 mg/m(2)/day). Most toxicity was grade 1 and 2 with a single DLT at180 mg/m(2) (diarrhoea). Exposure measured by peak concentration (C(max)) and area under the time-concentration curve (AUC(0-)(t)) was dose proportional. Stable disease (SD) was the best response in 19 of 33 (58%) evaluable patients. MTD was not reached but the maximum administered dose (MAD) was 1110 mg/m(2). The protocol was amended to enrol patients with CD20+ B-cell malignancies at 1110 mg/m(2). A CLL patient who progressed on rituximab [R] achieved SD after 2 months on SF1126 alone but in combination with R achieved a 55% decrease in absolute lymphocyte count and a lymph node response. PD studies of CLL cells demonstrated SF1126 reduced p-AKT and increased apoptosis indicating inhibition of activated PI3K signalling. CONCLUSION: SF1126 is well tolerated with SD as the best response in patients with advanced malignancies.


Assuntos
Antineoplásicos/uso terapêutico , Cromonas/uso terapêutico , Proteínas de Neoplasias/antagonistas & inibidores , Neoplasias/tratamento farmacológico , Oligopeptídeos/uso terapêutico , Inibidores de Fosfoinositídeo-3 Quinase , Pró-Fármacos/uso terapêutico , Inibidores de Proteínas Quinases/uso terapêutico , Proteínas/antagonistas & inibidores , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Antineoplásicos/farmacocinética , Antineoplásicos/farmacologia , Cromonas/administração & dosagem , Cromonas/efeitos adversos , Cromonas/farmacocinética , Cromonas/farmacologia , Relação Dose-Resposta a Droga , Feminino , Gastroenteropatias/induzido quimicamente , Doenças Hematológicas/induzido quimicamente , Humanos , Hipopotassemia/induzido quimicamente , Infusões Intravenosas , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Leucemia Linfocítica Crônica de Células B/enzimologia , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/enzimologia , Masculino , Dose Máxima Tolerável , Alvo Mecanístico do Complexo 1 de Rapamicina , Pessoa de Meia-Idade , Terapia de Alvo Molecular , Complexos Multiproteicos , Neoplasias/enzimologia , Oligopeptídeos/administração & dosagem , Oligopeptídeos/efeitos adversos , Oligopeptídeos/farmacocinética , Oligopeptídeos/farmacologia , Pró-Fármacos/administração & dosagem , Pró-Fármacos/efeitos adversos , Pró-Fármacos/farmacocinética , Pró-Fármacos/farmacologia , Inibidores de Proteínas Quinases/administração & dosagem , Inibidores de Proteínas Quinases/efeitos adversos , Inibidores de Proteínas Quinases/farmacocinética , Inibidores de Proteínas Quinases/farmacologia , Terapia de Salvação , Serina-Treonina Quinases TOR , Adulto Jovem
14.
Artigo em Inglês | MEDLINE | ID: mdl-22074882

RESUMO

In the present study, the FT-IR and FT-Raman spectra of 3-methyl-2-nitrophenol (C(7)H(7)O(3)N) (3M2NP) have been recorded in the range of 4000-100 cm(-1). The fundamental modes of vibrational frequencies of 3M2NP are assigned. All the geometrical parameters have been calculated by HF and DFT (LSDA and B3LYP) methods with 6-31G(d,p) and 6-311G(d,p) basis sets. Optimized geometries of the molecule have been interpreted and compared with the reported experimental values for phenol and some substituted phenol. The harmonic and anharmonic vibrational wave numbers, IR intensities and Raman activities are calculated at the same theory levels used in geometry optimization. The calculated frequencies are scaled and compared with experimental values. The scaled vibrational frequencies at LSDA/B3LYP/6-311G(d,p) seem to coincide with the experimentally observed values with acceptable deviations. The impact of substitutions on the benzene structure is investigated. The molecular interactions between the substitutions (OH, CH(3) and NO(2)) are also analyzed. A detailed interpretation of the infrared spectra of was also reported more precisely. Charge transfer occurring in the molecule between HOMO and LUMO energies, frontier energy gap are calculated and presented. On the basis of the thermodynamic properties of the title compound at different temperatures have been calculated, revealing the correlations between standard heat capacities (C) standard entropies (S), and standard enthalpy changes (H) and temperatures.


Assuntos
Modelos Químicos , Nitrofenóis/química , Análise Espectral Raman , Absorção , Elétrons , Entropia , Conformação Molecular , Teoria Quântica , Solventes/química , Espectrofotometria Ultravioleta , Espectroscopia de Infravermelho com Transformada de Fourier , Vibração
16.
Spectrochim Acta A Mol Biomol Spectrosc ; 84(1): 86-98, 2011 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-21993260

RESUMO

In this work, the comparative analysis is made on the structure and vibrational spectra of 1,2-Dinitro benzene (1,2-DNB) and 1-Fluoro-3-nitro benzene (1-F-3-NB) molecules. The FT-IR and FT-Raman experimental spectra of the molecules have been recorded using Bruker IFS 66 V spectrometer in the range of 4000-100 cm(-1). Making use of the recorded data, the complete vibrational assignments are made and analyses of the observed fundamental bands of molecules are carried out. The experimental determinations of vibrational frequencies are compared with those obtained theoretically from ab-initio Hartree-fock (HF) and DFT (B3LYP and B3PW91) methods with 6-31++G (d, p) and 6-311++G (d, p) basis sets. The differences between the observed and scaled wave number values of most of the fundamentals of the molecules are very small in B3LYP than HF. The geometries and normal modes of vibrations obtained from ab-initio HF and B3LYP/B3PW91 calculations are compared with the experimentally observed data. Comparison of the simulated spectra of the molecules provides important information regarding the difference and similarity of the vibrational characteristics between the molecules. The impact of substitutions on the structures between the molecules is also investigated.


Assuntos
Benzeno/química , Dinitrobenzenos/química , Modelos Químicos , Teoria Quântica , Análise Espectral Raman , Vibração , Conformação Molecular , Espectroscopia de Infravermelho com Transformada de Fourier
17.
Artigo em Inglês | MEDLINE | ID: mdl-21840753

RESUMO

The FT-IR and FT-Raman spectra of 1-bromo-3-fluorobenzene (C(6)H(4)FBr) molecule have been recorded using Bruker IFS 66V spectrometer in the range of 4000-100 cm(-1). The molecular geometry and vibrational frequencies in the ground state are calculated using the DFT (B3LYP, B3PW91 and MPW91PW91) methods with 6-31++G(d,p) and 6-311++G(d,p) basis sets. The computed values of frequencies are scaled using a suitable scale factor to yield good coherence with the observed values. The isotropic DFT (B3LYP, B3PW91 and MPW1PW91) analysis showed good agreement with the experimental observations. Comparison of the fundamental vibrational frequencies with calculated results by B3LYP methods. The complete data of this molecule provide the information for future development of substituted benzene. The influence of bromine and fluorine atom on the geometry of benzene and its normal modes of vibrations has also been discussed. A study on the electronic properties, such as absorption wavelengths, excitation energy, dipole moment and frontier molecular orbital energies, was performed by time dependent DFT (TD-DFT) approach. The electronic structure and the assignment of the absorption bands in the electronic spectra of steady compounds were discussed. The calculated HOMO and LUMO energies show that charge transfer occurs within the molecule. On the basis of the thermodynamic properties of the title compound at different temperatures have been calculated in gas phase, revealing the correlations between standard heat capacities (C) standard entropies (S), standard enthalpy changes (H) and temperatures.


Assuntos
Bromo/química , Fluorbenzenos/química , Espectrofotometria Ultravioleta/métodos , Espectroscopia de Infravermelho com Transformada de Fourier/métodos , Análise Espectral Raman/métodos , Algoritmos , Benzeno/química , Eletrônica , Entropia , Flúor/química , Modelos Moleculares , Conformação Molecular , Software , Espectrofotometria Infravermelho/métodos , Vibração
18.
Artigo em Inglês | MEDLINE | ID: mdl-21561799

RESUMO

The FT-IR and FT-Raman vibrational spectra of 1,3-dichlorobenzene (1,3-DCB) have been recorded using Bruker IFS 66 V Spectrometer in the range 4000-100 cm(-1). A detailed vibrational spectral analysis has been carried out and assignments of the observed fundamental bands have been proposed on the basis of peak positions and relative intensities. The optimized molecular geometry, vibrational frequencies, atomic charges, dipole moment, rotational constants and several thermodynamic parameters in the ground state were calculated using ab initio Hartree-Fock (HF) and DFT (B3LYP) methods with 6-31++G (d, p) and 6-311++G (d, p) basis sets. With the help of different scaling factors, the observed vibrational wave numbers in FT-IR and FT-Raman spectra were analyzed and assigned to different normal modes of the molecule. Most of the modes have wave numbers in the expected range. The inductive effect of Chlorine atoms in the benzene molecule has also been investigated.


Assuntos
Clorobenzenos/química , Modelos Químicos , Espectroscopia de Infravermelho com Transformada de Fourier , Análise Espectral Raman , Conformação Molecular , Estrutura Molecular , Teoria Quântica , Vibração
19.
Ann Oncol ; 22(9): 2137-2143, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21325451

RESUMO

BACKGROUND: AT7519 is an inhibitor of multiple cyclin-dependent kinases (CDKs). Based on potent antitumor activity in preclinical models, a first-in-human clinical trial in refractory solid tumors investigated its safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD). PATIENTS AND METHODS: AT7519 was administered in a '3 + 3' dose- escalation scheme on 5 consecutive days every 3 weeks to patients with advanced, refractory solid tumors. Samples to monitor AT7519 PK and PD were obtained. RESULTS: Twenty-eight patients were treated at seven dose levels (1.8-40 mg/m(2)/day). At 40 mg/m(2)/day, one patient developed hypotension and ST segment elevation. At 34 mg/m(2)/day, dose-limiting toxic effects (DLTs) were QTc prolongation with one death (grade 5), fatigue (grade 4) and mucositis (grade 3). Electrocardiogram review suggested a dose-dependent increase in QTc and recruitment was discontinued without establishing a maximum tolerated dose. Four patients exhibited stable disease for >6 months and one had a prolonged partial response. PK profile revealed modest interpatient variation with linear exposure at increasing doses. Inhibition of markers of CDK activity was observed across the dose range and manifested in antiproliferative activity at a dose of 28 mg/m(2). CONCLUSION: AT7519 elicited clinical and PD activity resulting from CDK inhibition at doses below the appearance of DLT of QTc prolongation.


Assuntos
Neoplasias/tratamento farmacológico , Neoplasias/metabolismo , Piperidinas/administração & dosagem , Piperidinas/farmacocinética , Pirazóis/administração & dosagem , Pirazóis/farmacocinética , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Antineoplásicos/farmacocinética , Quinases Ciclina-Dependentes/antagonistas & inibidores , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Neoplasias/enzimologia , Piperidinas/efeitos adversos , Inibidores de Proteínas Quinases/administração & dosagem , Inibidores de Proteínas Quinases/efeitos adversos , Inibidores de Proteínas Quinases/farmacocinética , Pirazóis/efeitos adversos
20.
Artigo em Inglês | MEDLINE | ID: mdl-21185772

RESUMO

The FT-IR and FT-Raman spectra of 3-Bromo phenol (3-BP) molecule have been recorded using Bruker IFS 66V spectrometer in the range of 4000-100 cm(-1). The molecular geometry and vibrational frequencies in the ground state are calculated by using the ab initio Hartree-fock (HF) and DFT (B3LYP) methods with 6-31G (d, p) and 6-311G (d, p) basis sets. The computed values of frequencies are scaled using a suitable scale factor to yield good coherence with the observed values. Making use of the recorded data, the complete vibrational assignments are made and analysis of the observed fundamental bands of molecule is carried out. The geometries and normal modes of vibrations obtained from ab initio HF and B3LYP calculations are in good agreement with the experimentally observed data. The differences between the observed and scaled wave number values of most of the fundamentals are very small in DFT than HF. The inductive effect of halogen atom in the molecule has also been investigated.


Assuntos
Modelos Químicos , Fenóis/química , Teoria Quântica , Análise Espectral Raman , Vibração , Conformação Molecular , Espectroscopia de Infravermelho com Transformada de Fourier
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