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1.
Gastroenterol. latinoam ; 31(1): 9-20, mayo 2020. tab, ilus
Artigo em Espanhol | LILACS, PrevCan | ID: biblio-1103076

RESUMO

The outbreak of COVID-19 disease has recently spread from its original place in Wuhan, Hubei province, China, to the entire world, and has been declared to be a pandemic by the World Health Organization in March 2020. All countries in America, in particular Chile, show an important increase in COVID-19 cases and deaths. The clinical manifestations of COVID-19 are a broad spectrum, from asymptomatic mild disease, to severe respiratory failure, shock, multiorgan dysfunction and death. Thus, high clinical suspicion and appropriate structure risk stratification are needed. Health care teams in endoscopy units, are at an increased risk of infection by COVID-19 from inhalation of droplets, mucosae contact, probably contamination due to contact with stools. Endoscopic aerosolized associated infections have also been reported. Different societies' recommendations, have recently placed digestive endoscopy (especially upper) among the high risk aerosol generating procedures (AGPs). In addition, live virus has been found in patient stools. On top of this, the infected health professionals may transmit the infection to their patients. Health care infection prevention and control (HCIPC), has been shown to be effective in assuring the safety of both health care personnel and patients. This is not limited to the correct use of personal protective equipment (PPE), but is based on a clear, detailed and well communicated HCIPC strategy, risk stratification, use of PPE, and careful interventions in patients with moderate and high risk of COVID-19. A conscientious approach regarding limited resources is important, as the simultaneous outbreak in all countries heavily affects the availability of health supplies. The Chilean Gastroenterology Society (SChGE) and Digestive Endoscopy Association of Chile (ACHED) are joining to provide continued updated guidance in order to assure the highest level of protection against COVID-19, for both patients and health care workers. This guideline will be updated online as needed.


El brote de la enfermedad denominada COVID-19, se ha extendido desde su origen en Wuhan, provincia de Hubei, China, a todo el mundo. La Organización Mundial de la Salud lo declaró pandemia en marzo de 2020. Todos los países de América, en especial Chile, presentan incremento de casos y fallecidos. Las manifestaciones clínicas de COVID-19 van desde una enfermedad leve, hasta insuficiencia respiratoria severa, shock, disfunción orgánica y muerte. Se necesita una alta sospecha clínica y una adecuada estratificación del riesgo. El equipo de salud en las unidades de endoscopia, tiene un mayor riesgo de COVID-19 que otras unidades clínicas y de apoyo diagnóstico, dada la mayor exposición a inhalación de gotas, contacto posible con mucosas y contaminación por contacto con deposiciones. Recomendaciones de diferentes sociedades colocan la endoscopia digestiva (especialmente la esofagogastroscopia o endoscopia digestiva alta, EDA) entre los procedimientos generadores de aerosoles (PGA) de alto riesgo. Además, se han encontrado virus viables en las deposiciones de los pacientes. Potencialmente, los profesionales de la salud infectados podrían contagiar a los pacientes. Se ha demostrado que la prevención y control de infecciones asociadas a la atención de salud (IAAS), son efectivos para garantizar la seguridad tanto del personal de salud, como de los pacientes. Esto no es solamente el correcto uso del equipo de protección personal (EPP), sino que se basa en una clara estrategia de IAAS, bien comunicada, con estratificación de riesgo, uso de EPP e intervenciones correctas en pacientes con riesgo moderado y alto. Es relevante un enfoque sobre los limitados recursos, dado la simultaneidad del brote en todos los países, que afecta la disponibilidad de insumos. La Sociedad Chilena de Gastroenterología (SChGE) y la Asociación Chilena de Endoscopia Digestiva (ACHED) publican esta guía actualizada para apoyar las buenas prácticas contra COVID-19, tanto para pacientes como para el equipo de salud. Esta guía podrá tener actualizaciones según avance la información disponible.


Assuntos
Humanos , Pneumonia Viral/prevenção & controle , Endoscopia do Sistema Digestório/normas , Infecções por Coronavirus/prevenção & controle , Betacoronavirus , Pneumonia Viral/epidemiologia , Fatores de Risco , Controle de Infecções/métodos , Guias de Prática Clínica como Assunto , Infecções por Coronavirus/epidemiologia , Pandemias , Unidades Hospitalares/normas
2.
Rev. bras. cancerol ; 66(4): e-041053, 2020.
Artigo em Português | LILACS, PrevCan | ID: biblio-1123243

RESUMO

Introdução: O câncer acometerá cerca de 50% dos indivíduos com infecção pelo vírus da imunodeficiência adquirida (HIV), com importante carga daqueles do tipo não definidores da síndrome da imunodeficiência adquirida (aids). Objetivo: Analisar diferentes fatores de risco para câncer do tipo não definidor na população HIV positiva, por meio da seleção de estudos de coorte realizados em diferentes Regiões do mundo. Método: Trata-se de uma revisão de literatura realizada no período de março a abril de 2019, utilizando os descritores Cancer Risck, HIV e non-AIDS-defining Cancer. Resultados: Os cânceres não definidores, que representam maior incidência entre a população HIV positiva, são o de pulmão, colorretal, cervical, de vagina e útero, gástrico, linfoma de Hodgkin e de fígado. Conclusão: Os estudos demonstram risco aumentado para diversos tipos de câncer não definidores da aids, o que nos leva a um novo paradigma, voltado não somente para o controle do HIV, mas também para a detecção precoce e tratamento oportuno, a fim de minimizar as morbidades e aumentar a expectativa de vida desses indivíduos.


Introduction: Cancer will affect about 50% of HIV (human immunodeficiency virus) infected individuals with a significant burden of non-AIDS-defining cancers (acquired immunodeficiency syndrome). Objective: To analyse different risk factors for the non-defining type in the HIV positive population through selection of cohort studies conducted in several regions of the world. Method: Literature review conducted from March to April 2019 using the descriptors Cancer Risk, HIV and non-AIDS-defining Cancer. Results: Non-defining cancers representing the greatest incidence among HIV-positive population are lung, colorectal, cervical, vaginal and uterine, gastric, Hodgkin's lymphoma, and liver. Conclusion: Studies demonstrate that there are increased risks for several types of non-AIDS defining cancers, leading to a new paradigm, not only for HIV control but for early detection and timely treatment, in order to minimize the morbidities and increase life expectancy of these individuals.


Introducción: El cáncer afectará aproximadamente al 50% de las personas con infección por virus de inmunodeficiencia adquirida (VIH) con una carga significativa de cánceres que no definen el síndrome de inmunodeficiencia adquirida (sida). Objetivo: Analizar diferentes factores de riesgo para el cáncer no definitorio en la población VIH positivo en estudios de cohortes realizados en diferentes regiones del mundo. Método: Esta es una revisión de la literatura realizada de marzo a abril de 2019 utilizando los descriptores Cancer Risk, HIV non-AIDS-defining Cancer. Resultados: Los cánceres no definitorios que representan el mayor riesgo e incidencia entre la población VIH positivo son de pulmón, colorrectal, cervical, vaginal y uterino, gástrico, linfoma de Hodgkin y de hígado. Conclusión: Los estudios muestran riesgos para varios tipos de cáncer que no definen el sida, lo que nos lleva a un nuevo paradigma, que se centra no solo en el control del VIH sino también en la detección temprana y el tratamiento oportuno.


Assuntos
Humanos , Masculino , Feminino , Infecções por HIV/complicações , Neoplasias , Fatores de Risco , Sobreviventes de Longo Prazo ao HIV
3.
Appl. cancer res ; 39(15): [1-9], 05 nov. 2019. tab
Artigo em Inglês | LILACS, PrevCan | ID: biblio-1100136

RESUMO

Background: Oral submucous fibrosis (OSMF) is a potentially malignant disorder largely seen in the South-Asian countries where areca nut is found to be the main predisposing factor. Pentoxifylline, a methylxanthine derivative, has vasodilating properties and is believed to increase the vascularity of the mucosal layer. This study was designed to determine the effect of pentoxifylline (Trental) on the clinical progression of oral submucous fibrosis. Aim: The present study was aimed to evaluate the effectiveness of drug pentoxifylline in the management of OSMF and to correlate the clinical parameters evaluated before and after treatment. Methods: Study Design: This investigation was conducted as a case-control study incorporating a Control Group in comparison to a Study Group where pentoxifylline 400 mg was administered 3 times daily, as coated, sustainedrelease tablets for prescribed for 3 months. The stipulated period for the study was 8 months and a total of 80 cases of oral submucous fibrosis (40 test subjects and 40 controls) were included in this study and 100% acquiescence was reported at the end of the test period. Results: Mild dizziness and gastric irritation were the only untoward symptoms reported in 2 of the volunteers in the study group during this trial. These were managed by diet protocols. A review of the patients and controls was done at an interval of every 4 weeks for 3 months. The subjective and objective measurements were recorded. The follow-up data at each visit concerning each other and to base-line values were calibrated using nonparametric tests of the Chi-Square test and Mann-Whitney. Significant comparisons with regard to improvement were recorded as objective criteria of mouth opening (u value =1.137, p = 0.260), tongue protrusion (u value = 0.262, p = 0.794 and cheek flexibility (u value =0.990, p = 0.326). Subjective symptoms of burning sensation of mouth (U value = 2.673, p = 0.008), pain on opening the mouth (U value = 4.320, p < 0.0001), difficulty in swallowing and difficulty in the speech were also recorded. Conclusion: This study showed the effectiveness of pentoxifylline as an additional therapy in the routine management of oral submucous fibrosis.


Assuntos
Humanos , Fibrose Oral Submucosa/tratamento farmacológico , Pentoxifilina , Fibrose Oral Submucosa , Terapêutica , Estudos Transversais , Índia
4.
Appl. cancer res ; 39(14): [1-3], 14 nov. 2019. tab
Artigo em Inglês | LILACS, PrevCan | ID: biblio-1100125

RESUMO

Purpose: Cancer survivors often lack the knowledge and skills to return to positive health behaviors following a cancer diagnosis. The use of retreats may be an ideal environment for cancer survivors to learn about health behaviours while receiving social support from other survivors. Methods: Knights Cabin Cancer Retreats was created as a charitable organization in 2014 and is at no cost to participants or their supporters. Elements of the retreat include guided hikes, yoga, classes on nutrition, stress, mindfulness and sleep management techniques, all with a focus on the evidence based theories of behavioral change. Results: Ten retreats have been hosted across Canada to date with 137 cancer survivors and their supporters. Survivors reported that their top learning outcomes from the retreat were physical activity/nutrition and behavioral change/habit development. Conclusion: Knight's Cabin Cancer retreats are unique in their programming with a format of health education that allows for emotional support and engagement with other cancer survivors in a therapeutically natural environment.


Assuntos
Humanos , Educação de Pacientes como Assunto , Sobreviventes de Câncer , Qualidade de Vida , Grupos de Autoajuda , Canadá , Exercício Físico/psicologia , Participação da Comunidade
5.
Appl. cancer res ; 39(13): [1-7], 13 nov. 2019. tab, ilus, graf
Artigo em Inglês | LILACS, PrevCan | ID: biblio-1100130

RESUMO

Background: Some prospective studies have observed associations between periodontal disease and breast cancer. Therefore, the aim of the present study was to investigate the composition of the subgingival biofilm of women diagnosed with breast cancer, who also presented with chronic periodontitis. Methods: All subjects underwent clinical and microbiological assessment. Subgingival biofilm samples were taken from at least three sites of 44 women who had breast cancer. The mean levels and proportions of 40 bacterial species were determined by checkerboard DNA-DNA hybridization. Spearman correlation was used to assess possible associations between the mean levels of bacterial species and clinical conditions. Results: The five species found at the highest levels were Prevotella nigrescens, Actinomyces gerencseriae, Neisseria mucosa, Porphyromonas gingivalis and Tannerella forsythia. The species detected in the lowest counts were Propionibacterium acnes, Streptococcus constellatus, Streptococcus intermedius, Eubacterium saburreum and Streptococcus anginosus. No significant association between levels and proportion of bacterial species and clinical parameters were found. Conclusion: In conclusion, the results of the present study found no direct association between the subgingival microbiota and breast cancer and an indirect pathway should be addressed in further studies.


Assuntos
Humanos , Feminino , Adulto , Idoso , Neoplasias da Mama , Periodontite Crônica , Doenças Periodontais , Estudos Transversais , Fatores de Risco , Técnicas Microbiológicas
6.
Appl. cancer res ; 39(11): [1-9], 20190000. ilus, tab
Artigo em Inglês | LILACS, PrevCan | ID: biblio-1050979

RESUMO

Background: Delays that postpone the evaluation and management of malignancy may lead to considerable morbidity. The primary objective of this study was to assess the time required to diagnose and treat lung cancer at an Indian public referral center that predominantly serves lower-income patients. Methods: A review of patients diagnosed with lung cancer between January 2008 and December 2016 was completed. We computed the median time intervals and inter-quartile ranges between symptom onset, definitive diagnostic investigation, confirmed histologic diagnosis, and chemotherapy initiation. Median intervals were correlated with baseline demographics and disease characteristics using Kruskal-Wallis test. Results: One thousand, three hundred and-seventy patients were selected. A majority (94.5%) with non-small cell lung cancer were diagnosed with advanced disease. After developing symptoms, patients required 101 [56­168] days to undergo a definitive diagnostic study, 107 [60­173] days to confirm a diagnosis, and 126 [85­196.8] days to initiate treatment. Patients who were previously treated for tuberculosis required more time to receive chemotherapy compared to those who were not (187 [134­261.5] days vs. 113 [75­180] days, p < 0.0001). A specialty Lung Cancer Clinic was implemented in 2012, and the mean referrals per month increased nearly four-fold (p < 0.0001), but the time required to administer treatment was not shortened. Conclusion: Among lower-income Indian patients, the most prominent delays occur prior to diagnosis. Efforts should be directed toward encouraging physicians to maintain a high index of clinical suspicion and educating patients to report concerning symptoms as early as possible.


Assuntos
Humanos , Adulto , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/terapia , Índia
7.
Appl. cancer res ; 39(12): [1-4], Oct. 22, 2019.
Artigo em Inglês | LILACS, PrevCan | ID: biblio-1096836

RESUMO

Gastric cancer (GC) is the fifth most common type of cancer worldwide with high incidences in Asia, Central, and South American countries. This patchy distribution means that GC studies are neglected by large research centers from developed countries. The need for further understanding of this complex disease, including the local importance of epidemiological factors and the rich ancestral admixture found in Brazil, stimulated the implementation of the GE4GAC project. GE4GAC aims to embrace epidemiological, clinical, molecular and microbiological data from Brazilian controls and patients with malignant and pre-malignant gastric disease. In this letter, we summarize the main goals of the project, including subject and sample accrual and current findings


Assuntos
Humanos , Adulto , Idoso , Neoplasias Gástricas , Brasil , Projetos
8.
Rev. salud pública ; 21(2): 161-167, ene.-abr. 2019. tab, graf
Artigo em Inglês | LILACS, PrevCan | ID: biblio-1101852

RESUMO

ABSTRACT Objective To describe cervical cancer mortality rates and their corresponding trends, and to analyze the spatial correlations of this type of cancer in Natal-RN, Brazil, between 2000 and 2012. Materials and Methods The simple linear regression model, the empirical Bayes method and the Global Moran's index were used for the statistical analysis. Results The mortality coefficient of cervical cancer in Natal, standardized by age range, was 5.5 per 100 000 women. All historical series for the coefficients studied were classified as stable. The Global Moran's index obtained was 0.048, with a p-value for the spatial test correlation between neighborhoods of 0.300. The average family income by neighborhood showed no significant correlation to cervical cancer mortality rates. Conclusion This study found a temporal stabilization and spatial independence trend of cervical cancer mortality rates in women from Natal, as well as the absence of correlation between these rates and the average family income of the of the participating women distributed by neighborhoods. In view of this, changes in the public policies should be made aimed at preventing the disease; adopting these measures could positively impact the screening program, improving the coverage of Pap smears and immunization campaigns against HPV, in order to reverse this trend and achieve a reduction of mortality rates.(AU)


RESUMEN Objetivo Describir las tasas de mortalidad por cáncer de cuello uterino y sus tendencias, así como analizar las correlaciones espaciales de este tipo de cáncer en Natal-RN, Brasil, entre 2000 y 2012. Materiales y Métodos Para el análisis estadístico se utilizaron el modelo de regresión lineal simple, la estimación empírica de Bayes y el índice Moran Global. Resultados La tasa de mortalidad por cáncer de cuello uterino en Natal, estandarizado por rango de edad, fue 5.5 por cada 100 000 mujeres. Todas las series históricas para los coeficientes estudiados se clasificaron como estables. El índice Moran Global obtenido fue 0.048, con un valor p de 0.300 para la correlación de prueba espacial entre vecindarios. El ingreso familiar promedio por vecindario no mostró correlación significativa con las tasas de mortalidad por cáncer de cuello uterino. Conclusión En este estudio se observó una tendencia temporal de estabilización e independencia espacial de la tasa de mortalidad por cáncer cervical en mujeres de Natal, así como la ausencia de correlación entre estas tasas y el ingreso familiar promedio de las mujeres participantes, distribuidas por vecindarios de la ciudad. En vista de esto, se sugiere que se adopten cambios en las políticas públicas dirigidas a la prevención de la enfermedad que apunten a medidas que puedan tener un impacto positivo en el programa de monitoreo, mejorando la cobertura de la prueba de Papanicolaou, así como de las campañas de vacunación contra el VPH, con el objetivo de revertir esta tendencia y lograr una reducción en las tasas de mortalidad de la enfermedad.(AU)


Assuntos
Humanos , Feminino , Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/epidemiologia , Programas de Imunização/provisão & distribução , Teste de Papanicolaou/instrumentação , Análise Estatística , Teorema de Bayes , Análise Espaço-Temporal
9.
Appl. cancer res ; 39: 1-6, 2019. tab
Artigo em Inglês | LILACS, PrevCan | ID: biblio-994750

RESUMO

Background: Colorectal cancer (CRC) is one of the most common cancers in Japan. Many factors influence this cancer, one of which is circadian rhythm disruption. Our research investigated the correlation between singlenucleotide polymorphisms (SNPs) in the Period 3 (PER3) (rs2640908), which is one of the circadian genes, and colorectal cancer in the Japanese population. Methods: The study participants consisted of 121 cases and 197 controls. DNA was extracted from participants' peripheral blood cells, and polymerase chain reaction­restriction fragment length polymorphism analysis (PCRRFLP) was performed to detect genotypes of PER3. Results: Participants with T/T genotype were at lower risk of developing colorectal cancer than participants with C/C genotype (adjusted ORs = 0.32 (95% CI: 0.15­0.63)). When stratified by gender and smoking status, T/T genotype were associated with a decreased susceptibility to cancer in males only (adjusted ORs: 0.23 (95% CI: 0.09­0.59)), T/T genotype were also associated with a decreased susceptibility to cancer among both smokers and non-smokers. Conclusions: A significant association was found between the T allele of PER3 polymorphism and a reduced risk of colorectal cancer, especially in males. Smoking status showed no association with the relationship between PER3 genotype and CRC carcinogenesis (AU)


Assuntos
Humanos , Masculino , Feminino , Polimorfismo Genético , Neoplasias Colorretais , Fatores de Risco , Grupo com Ancestrais do Continente Asiático , Genótipo
10.
Appl. cancer res ; 39: 1-6, 2019. ilus, tab
Artigo em Inglês | LILACS, PrevCan | ID: biblio-994774

RESUMO

Background: PTEN loss is observed in 20­30% of prostate cancers and is associated with a poor outcome, but clinical details of the impact of this biomarker are unclear for intermediate grade tumors. Methods: We investigated 43 radical prostatectomy-derived grade 7 prostate tumors from the Clinics Hospital of Ribeirão Preto. Tissue microarray (TMA) blocks were constructed and PTEN copy number status was determined for all patients through fluorescence in situ hybridization (FISH). To determine the presence of PTEN protein loss in our study cohort, we performed immunohistochemistry (IHC) in TMA sections. We then developed an automated algorithm in HALO™ to identify regions of PTEN protein loss in whole prostate scanned sections from ten patients with known PTEN deletion status by FISH. Clinical analyses were conducted to determine the associations between PTEN loss and patient outcome. All statistical analyses were conducted in R v3.4.3 with P-values below 0.05 being considered statistically significant. Results: In this study of 43 grade 7 tumors, we found PTEN deletions by FISH in 18.9% of tumors, and PTEN protein loss by IHC in 16.3% of tumors. Both techniques were highly concordant and complementary. Clinical analysis demonstrated that PTEN deletion by FISH was significantly associated with positive margin invasion (P = 0.04) and Gleason score upgrade (P = 0.001). Digital image analysis of ten representative tumors demonstrated distinct intratumoral heterogeneity for PTEN protein loss in four tumors. Conclusions: This study shows that PTEN loss in Gleason grade 7 tumors can be heterogeneous and that a systematic analysis of this biomarker using a combination of FISH, IHC, and digital imaging may identify patients with a greater risk of poor outcome (AU)


Assuntos
Humanos , Masculino , Neoplasias da Próstata/patologia , PTEN Fosfo-Hidrolase/metabolismo , Prognóstico , Prostatectomia , Neoplasias da Próstata/genética , Imuno-Histoquímica , Biomarcadores Tumorais , Estudos de Coortes , Hibridização in Situ Fluorescente , Heterogeneidade Genética , Gradação de Tumores
11.
Appl. cancer res ; 39: 1-8, 2019. ilus, tab
Artigo em Inglês | LILACS, PrevCan | ID: biblio-994785

RESUMO

Background: Epidermal growth factor receptor (EGFR) is potential prognostic biomarker expressed in many human cancers. Prognostic significance of EGFR immunohistochemical expression has not been established in prostatic acinar adenocarcinoma, therefore we aimed to evaluate the frequency of expression of EGFR in prostatic adenocarcinoma and its association with other prognostic parameters. Methods: The study included 123 cases of biopsy proven prostatic acinar adenocarcinoma treated at Liaquat National hospital, Karachi from January 2013 till December 2017. Paraffin blocks of all cases were retrieved; sections were cut and stained with haematoxylin and eosin. Pathologic characteristics including tumor quantification, WHO grade group, gleason score, perineural and lymphovascular invasion were evaluated. EGFR immunohistochemistry (IHC) was performed on all tissue blocks. Results: Mean age of the patients included in the study was 69.05±8.68years. High gleason scores i.e. 8 & 9 were noted in 22% (27 cases) and 22.8% (28 cases) respectively. Similarly, 22.8% (28 cases) showed WHO grade group 5. 52.8% (65 cases) had > 50% tissue involvement by carcinoma and perineural invasion was seen in 37.4% (46 cases). Positive EGFR expression was noted in 18.7% (23 cases), while 81.3% (100 cases) showed negative EGFR expression. Significant association of EGFR expression was noted with gleason score (p-value = < 0.001), WHO grade (p = < 0.001), tumor quantification (p =0.007) and perineural invasion (p = < 0.001). Moreover, significant association of EGFR expression was also seen with disease recurrence and Her2neu over expression. Patients with low gleason scores (score 6 and 7) and lower grade group (1, 2 & 3) were less likely to have positive EGFR expression as compared to patients with high gleason score (score 9) and higher grade group (5). Similarly, patients with perineural invasion were more likely to have positive EGFR expression. Conclusion: We found a relatively low EGFR expression in our patients with prostatic adenocarcinoma; however, its association with poor prognostic parameters like high gleason score, higher grade group, perineural invasion, higher tissue involvement by cancer and disease recurrence signifies its importance as a prognostic parameter in prostatic acinar adenocarcinoma (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Próstata/patologia , Carcinoma de Células Acinares/patologia , Receptores ErbB/análise , Prognóstico , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/genética , Biomarcadores Tumorais , Carcinoma de Células Acinares/diagnóstico , Carcinoma de Células Acinares/genética , Intervalo Livre de Doença , Gradação de Tumores
12.
Appl. cancer res ; 39: 1-5, 2019. ilus, tab
Artigo em Inglês | LILACS, PrevCan | ID: biblio-997737

RESUMO

Purpose: We investigated the clinical outcome of sodium alginate treatment in radiation-induced pharyngeal mucositis (RIPM) after neck irradiation. Materials and methods: The study population included 32 patients (11 lung cancer, 10 breast cancer, 7 head and neck cancer, and 4 other primary lesions) who underwent neck external beam radiotherapy at the authors' institution between June 2006 and 2016. The patients received 5% sodium alginate solution orally for RIPM. Those who were followed up for less than 2 months or did not receive 5% sodium alginate were excluded from this retrospective study. RIPM was graded weekly as an acute toxicity according to the Common Terminology Criteria for Adverse Events (CTCAE), version 4. The administration of 10-15 ml of sodium alginate before each meal was continued until the radiotherapy was completed and after resolution of odynophagia. The efficacy of sodium alginate was assessed by two radiation oncologists as follows: Grade I, ineffective; grade II, moderately effective; grade III, very effective. When sodium alginate was ineffective, other analgesics, such as nonsteroidal antiinflammatory drugs (NSAIDS) or opioids, were added. Relationships between the presence/absence of additional analgesics and the radiation dose were investigated. Results: The median duration from the start of irradiation to sodium alginate administration was 15 days (range, 5­36 days). RIPM improved in 29/32 patients (grade: II, n = 22; III, n = 7). Three patients showed no improvement. No sodium alginate-related toxicities occurred. Additional analgesics were required in 5/32 patients. The radiation dose in these 5 patients was significantly higher than that in the sodium alginate-alone group (63.6 ± 7.8 Gy vs 48.3 ± 14.8Gy, P = 0.02). Patients who received > 50 Gy tended to require additional analgesics more frequently than those who received ≤50Gy (P = 0.10). Conclusions: The concurrent administration of sodium alginate and neck irradiation was feasible and tolerable without obvious toxicities. Under certain conditions sodium alginate could be a promising alternative to NSAIDs and opioids in RIPM. The results justify further prospective evaluations with detailed treatment protocols to clarify whether sodium alginate can improve RIPM (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Faringe/efeitos da radiação , Alginatos/uso terapêutico , Mucosite/tratamento farmacológico , Radioterapia/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento , Mucosite/etiologia , Analgésicos/uso terapêutico , Pescoço/efeitos da radiação
13.
Appl. cancer res ; 39: 1-8, 2019. ilus, tab
Artigo em Inglês | LILACS, PrevCan | ID: biblio-997743

RESUMO

Background: Squamous cell carcinoma (SCC) of head and neck is highly prevalent in South-asian countries, owing to high consumption of areca nut/gutka and chewing tobacco. p27kip1 is a tumor suppressor gene, thought to be downregulated in oral squamous cell carcinoma. Therefore, in the present study we used immunohistochemical analysis to investigate an association between low p27kip1 expression in SCC of the head and neck and adverse outcomes/risk factors. Methods: Total 105 cases of SCC of head and neck excision specimens were selected from records of pathology department archives that underwent surgeries at Liaquat National hospital, Karachi from January 2008 till December 2013. Clinical and pathologic characteristics of patients were evaluated and p27kip1 immunohistochemistry was applied on tumor blocks. Results: In our study, low expression of p27kip1 in SCC of head and neck was seen in 39(37.1%) cases while 66(62. 9%) of the cases showed high expression for p27kip1. Significant association of p27kip1 expression with pan/gutka usage (p = 0.004), and recurrence (p = 0.001) was noted; however, no significant association of p27kip1 expression with other clinicopathologic features was seen. Multivariate binary logistic regression showed cases with history of pan/gutka usage were more likely to show low p27kip1 expression. Similarly, we also found that recurrence was more likely to develop in patients with low expression of p27kip1 in comparison to cases showing high p27kip1 expression. Conclusion: Loss of p27kip1 expression is a significant event involved in the pathogenesis of SCC head and neck especially that of oral cavity. Significant association of gutka/areca nut with low p27kip1 expression in our study suggests that loss p27kip1 expression is a major event involved in areca nut induced SCC of head and neck in this part of the world; however, more large scale molecular based studies are required to validate this observation. Moreover, significant association of low p27kip1 expression with tumor recurrence suggests its importance as a prognostic biomarker in SCC of head and neck (AU)


Assuntos
Humanos , Masculino , Feminino , Tabaco/efeitos adversos , Neoplasias Bucais/complicações , Imuno-Histoquímica/métodos , Carcinoma de Células Escamosas , Biomarcadores , Inibidor de Quinase Dependente de Ciclina p27 , Neoplasias de Cabeça e Pescoço/genética
14.
Appl. cancer res ; 39: 1-8, 2019. tab
Artigo em Inglês | LILACS, PrevCan | ID: biblio-999247

RESUMO

Background: The population-based mammography screening program (MSP) is aimed to reduce breast cancer mortality, to detect breast cancer at an early stage, and to allow for less invasive treatment. However, it also has some potential harms, such as overdiagnosis and overtreatment. Therefore, it is necessary that women receive sufficient and balanced information to enable informed decision-making. We examined knowledge about benefits and harms of the MSP in Germany among first-time invitees of different socio-demographic backgrounds. Methods: This observational study assessed knowledge about benefits and harms of the MSP among women who were invited to the MSP for the first time by six multiple choice items, using a postal survey. We investigated (i) single items of knowledge, (ii) the distribution of sufficient knowledge stratified by education, migration status and invitation, and (iii) possible determinants of sufficient knowledge by analyzing Odds Ratios (ORs) using bivariate and multivariate logistic regression. Results: In total, 5397 women included in the analyses. 46.1% of the study population had sufficient knowledge about benefits and harms of the MSP. However, women with low educational level and migration background had higher proportions of insufficient knowledge and used most frequently the option "don't know". Women had the most difficulties answering the numeric question and the question about the target group correctly. Results from the logistic regression showed that the odds of having sufficient knowledge were higher among well-educated women (OR 3.84, 95%CI 3.24­4.55), among women who already received the MSP invitation (OR 1.38, 95%CI 1.20­1.59) and lowest among Turkish women (OR 0.14, 95%CI 0.07­0.25). Conclusions: Women with low education and migration background need adapted information regarding benefits and harms of the MSP and are important target groups for further developing the information material about mammography screening to reduce disparities in knowledge and enable informed decision-making (AU)


Assuntos
Humanos , Feminino , Migrantes , Mamografia , Programas de Rastreamento , Conhecimento , Dano ao Paciente , Estudo Observacional
15.
Appl. cancer res ; 39: 1-6, 2019. ilus, tab
Artigo em Inglês | LILACS, PrevCan | ID: biblio-1006568

RESUMO

Background: Detection of somatic mutations is a mandatory practice for therapeutic definition in precision oncology. However, somatic mutation detection protocols use DNA from formalin-fixed and paraffin-embedded (FFPE) tumor tissues, which can result in detection of nonreproducible sequence artifacts, especially C:G > T:A transitions, in DNA. In recent studies, DNA pretreatment with uracil DNA glycosylase (UDG), an enzyme involved in base excision repair, significantly reduced the number of DNA artifacts after mutation detection by next-generation sequencing (NGS) and other methods, without affecting the capacity to detect real mutations. This study aimed to evaluate the effects of UDG enzymatic pretreatment in reducing the number of DNA sequencing artifacts from FFPE tumor samples, to improve the accuracy of genetic testing in the molecular diagnostic routine. Methods: We selected 12 FFPE tumor samples (10 melanoma, 1 lung, and 1 colorectal tumor sample) with different storage times. We compared sequencing results of a 16-hotspot gene panel of NGS libraries prepared with UDG-treated and untreated samples. Results: All UDG-treated samples showed large reductions in the total number of transitions (medium reduction of 80%) and the transition/transversion ratio (medium reduction of 75%). In addition, most sequence artifacts presented a low variant allele frequency (VAF < 10%) which are eliminated with UDG treatment. Conclusion: Including UDG enzymatic treatment before multiplex amplification in the NGS workflow significantly decreased the number of artifactual variants detected in FFPE samples. Thus, including this additional step in the current methodology should improve the rate of true mutation detection in the molecular diagnostic routine.


Assuntos
Humanos , Medição da Dor , Inclusão em Parafina , Testes Diagnósticos de Rotina , Uracila-DNA Glicosidase , Sequenciamento Completo do Genoma
16.
Appl. cancer res ; 39: 1-5, 2019. ilus, tab
Artigo em Inglês | LILACS, PrevCan | ID: biblio-1015230

RESUMO

Background: Human biological material has become an important resource for biomedical research. Tumor Biobanks are facilities that collect, store and distribute samples of tumor and normal tissue for further use in basic and translational cancer research. mRNA-translation has been demonstrated to modulate protein levels and is considered a fundamental post-transcriptional mechanism of gene expression regulation. Thus, determining translation efficiencies of individual mRNAs in human tumors may add another layer of information that contributes to the understanding of tumorigenic pathways. To analyze the RNAs actively engaged in translation, RNAs associated with ribosomes (polysomes) are isolated, identified and compared to total RNA. However, the application of this technique in human tumors depends on the stability of the polysomal structure under Biobank storage conditions that usually consists of ultra-low temperature. Since the effect of freezing on the stability of the polysomal structure in stored tumor samples is not known, it is essential to evaluate this factor in the frozen samples, validating the use of biobank samples in studies of translational efficiency. Methods: Xenograft tumors were divided in two parts, half was subject to immediate processing, and half was frozen for posterior analysis. Both parts were subject to polysomal separation, RNA extraction and identification through RNAseq. Results: It was possible to successfully extract and identify total and polysomal RNA from both fresh and frozen tumoral tissue. The quantification of the polysome profile indicated no difference in the translational efficiency estimated in fresh versus frozen tissue. Gene expression data from the fresh versus frozen tissues were compared and the correlation between the polysome associated fresh x frozen (R = 0,89) and total fresh x frozen (0,90) mRNAs was calculated. No difference was identified between the two conditions. Conclusions: We demonstrated that tissue freezing does not affect the polysomal structure, consequently validating the viability of the use of biobank stored tissue for polysome associated RNA analysis (AU)


Assuntos
Humanos , Polirribossomos , RNA , Expressão Gênica , Regulação da Expressão Gênica , Neoplasias
17.
Appl. cancer res ; 39: 1-8, 2019. Ilustr., Tab.
Artigo em Inglês | LILACS, PrevCan | ID: biblio-1015366

RESUMO

Background: The capacity for prognostic prediction of cutaneous melanoma, one of the most aggressive cancers, is still difficult due to the tumor heterogeneity and lack of reliable tumor markers. The objective of this study is to correlate, through immunohistochemistry, a Ki-67 and Kindlin-1 staining in malignant melanomas with the prognosis of the disease. Methods: A historical cohort study. Immunohistochemistry, using mouse anti-human Kindlin-1 and Ki-67 monoclonal antibodies, was performed using tissue blocks from primary cutaneous melanoma patients treated between 2006 and 2014 at our institution. Information regarding pathological data and outcomes were retrieved from medical records. Statistical analyses were conducted in SPSS version 18.0. Results: Thirty patients were included. The median age was from 50.93 ± 15.31 years old. The expression of Ki-67 was detected in all patients with primary cutaneous melanoma, while Kindlin-1 was negative in two. Kindlin expression was not significantly correlated with Ki-67 expression by Spearman's rank correlation analysis (P = 0.46), as well as the expression of both markers and the clinical stage (P = 0.34 and 0.18, respectively). Breslow, Clark and mitotic rate were significantly correlated with AJCC stage (P = 0.001). Conclusion: Other studies investigating clinical evolution are needed to further test the potential of these markers as possible prognostic markers (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Antígeno Ki-67/metabolismo , Melanoma/patologia , Proteínas de Membrana/metabolismo , Prognóstico , Coloração e Rotulagem , Imuno-Histoquímica , Biomarcadores Tumorais , Estudos de Coortes , Melanoma/diagnóstico , Estadiamento de Neoplasias
18.
Appl. cancer res ; 39: 1-7, 2019. ilustr.
Artigo em Inglês | LILACS, PrevCan | ID: biblio-1023627

RESUMO

Background: Mutations in the RAS/RAF pathway predict resistance to anti-epidermal growth factor receptor antibodies in colorectal cancer (CRC), and may be targets for future therapies. This study investigates concordance of BRAF, HRAS, KRAS, NRAS and PIK3CA mutation status in primary CRC with matched liver (n = 274), lung (n = 114) or combined liver and lung metastases (n = 14). Methods: Next generation sequencing was performed on DNA from formalin-fixed paraffin embedded CRC and matched liver and/or lung metastases, for recurrent mutations in BRAF, HRAS, KRAS, NRAS and PIK3CA and using the single-molecule molecular inversion probe method. Results: Paired sequencing results on all five genes were reached in 249 of the 402 cases (62%). The obtained number of unique reads was not always sufficient to confidently call the absence or presence of mutations for all regions of interest. The mutational status of matched pairs was highly concordant; 91.1% concordance for all five genes, 95.5% for KRAS, 99.1% for NRAS. Lung metastases more often harboured RAS mutations compared to liver metastases (71% vs. 48%, p < 0.001). Conclusions: In this large series of CRC we show that both primary tumors and corresponding metastases can be used to determine the mutational status for targeted therapy, given the high concordance rates. Next generation sequencing including a single molecule tags is feasible, however in combination with archival formalin-fixed paraffin embedded material is limited by coverage depth.


Assuntos
Humanos , Neoplasias Colorretais/genética , Proteínas ras/genética , Proteínas Proto-Oncogênicas B-raf/genética , Neoplasias Hepáticas/genética , Neoplasias Pulmonares/genética , Sequência de Bases , Neoplasias Colorretais/patologia , Sequenciamento de Nucleotídeos em Larga Escala , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/secundário , Mutação/genética
19.
Appl. cancer res ; 38: 1-7, jan. 30, 2018. tab., ilus
Artigo em Inglês | LILACS, PrevCan | ID: biblio-910436

RESUMO

Background: Diffusion-weighted magnetic resonance imaging (DW-MRI) provides information on the cellularity and movement of water molecules in tissues and 18F­fluorodeoxyglucose (18F­FDG) positron emission tomography/computed tomography (18F­FDG PET/CT) assesses cellular glucose metabolism, however both variables are related to tumour aggressiveness. The aim of this study is to investigate the potential correlation of the apparent diffusion coefficient (ADC) assessed by diffusion-weighted MRI (DWI) and glucose metabolism determined by the standardized uptake value (SUV) calculated from 18F­FDG PET/CT data in non-small cell lung cancer (NSCLC) with the occurrence of metastasis to the lymph nodes. Methods: 18F­FDG PET/CT and DWI (TR/TE, 1800/93 ms; b-values, 0 and 600 s/mm2) were performed in 37 consecutive patients with histologically verified NSCLC. SUVmax was calculated based on the PET-CT data. The minimum ADC (ADCmin) was determined by placing a region-of-interest (ROI) covering the entire tumou. Results of 18F­FDG PET/CT and DWI were compared on a per-patient basis. Pearson's correlation coefficient was used for statistical analysis. Results: Correlation analysis of the ADCmin and SUVmax revealed that the inverse correlation was good for all the masses (p< 0.001) and the lymph nodes (p < 0.001) for each histological subtype, for both adenocarcinomas (p < 0.001) lymph nodes (p = 0.005) and squamous cell carcinomas (p < 0.001). No significant correlation was found in the comparison of the ADCmin and SUVmax of the lymph nodes for squamous cell carcinomas (p = 0.066). Conclusions: This study verified the relationship between the SUVmax and the ADCmin in NSCLC. The significant inverse correlation of these two quantitative imaging approaches highlights the association between metabolic activity and tumour cellularity. Therefore, DWI with ADC measurement might represent a new biomarker in NSCLC.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Imagem por Ressonância Magnética , Tomografia por Emissão de Pósitrons , Neoplasias Pulmonares
20.
Appl. cancer res ; 38: 1-7, jan. 30, 2018. tab, ilus
Artigo em Inglês | LILACS, PrevCan | ID: biblio-910438

RESUMO

Background: Circulating tumor cells (CTCs) play an important role in progression and metastasis, particularly in form of cluster, which is called circulating tumor microemboli (CTM), and can be found in the peripheral blood of cancer patients. The aim of this study was to evaluate the presence of CTCs and CTM, and its influence on tumor progression in lung cancer patients. Methods: CTCs were isolated by Isolation by Size of Epithelial Tumor cells (ISET®) Technology. The samples of metastatic lung cancer patients were collected before the beginning of systemic chemotherapy. CTCs and CTM were identified according to their morphological features. Results: Fifteen patients were analyzed. Patients who had CTM in blood previously the beginning of systemic therapy had poor progression-free survival (PFS) compared to those with absence of CTM, although without statistical significance (median PFS 3.1 months × 6.7 months, p = 0.29). Moreover, patients without any prior treatment had less than 3 CTCs/mL compared to patients previously exposed to chemotherapy, who had 3 CTCs/mL or more (p = 0.31). Additionally, these patients, with prior treatment, showed poor PFS, compared to chemo-naive patients, although without statistical significance (mean PFS: 4.6 months × 7.3 months, p = 0.47). Conclusions: We identified, even in a limited number of samples, that an elevated baseline levels of CTCs and the presence of CTM were associated with poor prognosis in patients with metastatic lung cancer. In addition, we showed that an increase of CTCs counts could indicate a pre-existing resistance. However, further studies with a large cohort are needed to support this information


Assuntos
Humanos , Projetos Piloto , Neoplasias Pulmonares , Células Neoplásicas Circulantes , Metástase Neoplásica
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