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1.
BMC Cancer ; 24(1): 705, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38849731

RESUMO

BACKGROUND: Despite recent improvements in cancer detection and survival rates, managing cancer-related pain remains a significant challenge. Compared to neuropathic and inflammatory pain conditions, cancer pain mechanisms are poorly understood, despite pain being one of the most feared symptoms by cancer patients and significantly impairing their quality of life, daily activities, and social interactions. The objective of this work was to select a panel of biomarkers of central pain processing and modulation and assess their ability to predict chronic pain in patients with cancer using predictive artificial intelligence (AI) algorithms. METHODS: We will perform a prospective longitudinal cohort, multicentric study involving 450 patients with a recent cancer diagnosis. These patients will undergo an in-person assessment at three different time points: pretreatment, 6 months, and 12 months after the first visit. All patients will be assessed through demographic and clinical questionnaires and self-report measures, quantitative sensory testing (QST), and electroencephalography (EEG) evaluations. We will select the variables that best predict the future occurrence of pain using a comprehensive approach that includes clinical, psychosocial, and neurophysiological variables. DISCUSSION: This study aimed to provide evidence regarding the links between poor pain modulation mechanisms at precancer treatment in patients who will later develop chronic pain and to clarify the role of treatment modality (modulated by age, sex and type of cancer) on pain. As a final output, we expect to develop a predictive tool based on AI that can contribute to the anticipation of the future occurrence of pain and help in therapeutic decision making.


Assuntos
Dor do Câncer , Dor Crônica , Humanos , Dor Crônica/diagnóstico , Dor Crônica/etiologia , Estudos Prospectivos , Dor do Câncer/diagnóstico , Feminino , Masculino , Estudos Longitudinais , Neoplasias/complicações , Biomarcadores , Medição da Dor/métodos , Qualidade de Vida , Inteligência Artificial , Eletroencefalografia , Adulto , Pessoa de Meia-Idade
2.
J Clin Periodontol ; 50(11): 1420-1443, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37608638

RESUMO

AIM: To determine the accuracy of biomarker combinations in gingival crevicular fluid (GCF) and saliva through meta-analysis to diagnose periodontitis in systemically healthy subjects. METHODS: Studies on combining two or more biomarkers providing a binary classification table, sensitivity/specificity values or group sizes in subjects diagnosed with periodontitis were included. The search was performed in August 2022 through PUBMED, EMBASE, Cochrane, LILACS, SCOPUS and Web of Science. The methodological quality of the articles selected was evaluated using the QUADAS-2 checklist. Hierarchical summary receiver operating characteristic modelling was employed to perform the meta-analyses (CRD42020175021). RESULTS: Twenty-one combinations in GCF and 47 in saliva were evaluated. Meta-analyses were possible for six salivary combinations (median sensitivity/specificity values): IL-6 with MMP-8 (86.2%/80.5%); IL-1ß with IL-6 (83.0%/83.7%); IL-1ß with MMP-8 (82.7%/80.8%); MIP-1α with MMP-8 (71.0%/75.6%); IL-1ß, IL-6 and MMP-8 (81.8%/84.3%); and IL-1ß, IL-6, MIP-1α and MMP-8 (76.6%/79.7%). CONCLUSIONS: Two-biomarker combinations in oral fluids show high diagnostic accuracy for periodontitis, which is not substantially improved by incorporating more biomarkers. In saliva, the dual combinations of IL-1ß, IL-6 and MMP-8 have an excellent ability to detect periodontitis and a good capacity to detect non-periodontitis. Because of the limited number of biomarker combinations evaluated, further research is required to corroborate these observations.


Assuntos
Interleucina-6 , Periodontite , Humanos , Quimiocina CCL3 , Metaloproteinase 8 da Matriz , Periodontite/diagnóstico , Biomarcadores/análise , Interleucina-1beta , Líquido do Sulco Gengival/química , Saliva/química
3.
BMC Oral Health ; 23(1): 560, 2023 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-37573292

RESUMO

BACKGROUND: The effect of cymenol mouthwashes on levels of dental plaque has not been evaluated thus far. OBJECTIVE: To analyse the short-term, in situ, anti-plaque effect of a 0.1% cymenol mouthwash using the DenTiUS Deep Plaque software. METHODS: Fifty orally healthy participants were distributed randomly into two groups: 24 received a cymenol mouthwash for eight days (test group A) and 26 a placebo mouthwash for four days and a cymenol mouthwash for a further four days thereafter (test group B). They were instructed not to perform other oral hygiene measures. On days 0, 4, and 8 of the experiment, a rinsing protocol for staining the dental plaque with sodium fluorescein was performed. Three intraoral photographs were taken per subject under ultraviolet light. The 504 images were analysed using the DenTiUS Deep Plaque software, and visible and total plaque indices were calculated (ClinicalTrials ID NCT05521230). RESULTS: On day 4, the percentage area of visible plaque was significantly lower in test group A than in test group B (absolute = 35.31 ± 14.93% vs. 46.57 ± 18.92%, p = 0.023; relative = 29.80 ± 13.97% vs. 40.53 ± 18.48%, p = 0.024). In comparison with the placebo, the cymenol mouthwash was found to have reduced the growth rate of the area of visible plaque in the first four days by 26% (absolute) to 28% (relative). On day 8, the percentage areas of both the visible and total plaque were significantly lower in test group A than in test group B (visible absolute = 44.79 ± 15.77% vs. 65.12 ± 16.37%, p < 0.001; visible relative = 39.27 ± 14.33% vs. 59.24 ± 16.90%, p < 0.001; total = 65.17 ± 9.73% vs. 74.52 ± 13.55%, p = 0.007). Accounting for the growth rate with the placebo mouthwash on day 4, the above results imply that the cymenol mouthwash in the last four days of the trial reduced the growth rate of the area of visible plaque (absolute and relative) by 53% (test group A) and 29% (test group B), and of the area of total plaque by 48% (test group A) and 41% (test group B). CONCLUSIONS: The 0.1% cymenol mouthwash has a short-term anti-plaque effect in situ, strongly conditioning the rate of plaque growth, even in clinical situations with high levels of dental plaque accumulation.


Assuntos
Placa Dentária , Gengivite , Humanos , Antissépticos Bucais/uso terapêutico , Placa Dentária/tratamento farmacológico , Placa Dentária/prevenção & controle , Método Duplo-Cego , Higiene Bucal , Índice de Placa Dentária , Gengivite/tratamento farmacológico , Clorexidina/uso terapêutico
4.
J Appl Microbiol ; 130(6): 1913-1924, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33151599

RESUMO

AIMS: To analyse the non-glycosylated protein fraction from Melipona beecheii honey for antimicrobial activity against Escherichia coli O157:H7. METHODS AND RESULTS: The proteins from M. beecheii honey were separated according to their degree of glycosylation using Concanavalin A-affinity chromatography. The total protein extract and its fractions were analysed by 1D and 2D electrophoresis. We also determined the antimicrobial and antihaemolytic activities of the total protein extract and the non-glycosylated fraction. Furthermore, we evaluated the effect of this non-glycosylated fraction for the expression of the Stx1, Stx2, EAE and HlyA pathogen genes. Melipona beecheii honey contained at least 24 proteins with molecular weights ranging between 7·6 and 95 kDa and isoelectric points between 3 and 10, three proteins from the 24 are non-glycosylated. The non-glycosylated fraction had an MIC90 of 1·128 µg ml-1 , and this fraction inhibited the haemolytic activity of the pathogen, as well as reduced the expression of Stx1, Stx2 and HlyA. The MbF1-2 protein from the non-glycosylated fraction was sequenced and identified as a homologue of the royal jelly-like protein of Melipona quadrifasciata. CONCLUSIONS: The non-glycosylated protein fraction from M. beecheii honey greatly contributes to antibacterial activity and it is composed of at least three proteins, of which MbF1-2 provided over 50% of the antimicrobial activity. SIGNIFICANCE AND IMPACT OF THE STUDY: The study showed significant antimicrobial activity from several proteins present in the honey of M. beecheii. Interestingly, the non-glycosylated protein fraction demonstrated antihaemolytic activity and adversely affected the expression of virulence genes in Escherichia coli O157:H7; these proteins have the potential to be used in developing therapeutic agents against this bacterium.


Assuntos
Antibacterianos/farmacologia , Abelhas/química , Escherichia coli O157/efeitos dos fármacos , Mel , Proteínas de Insetos/farmacologia , Animais , Antibacterianos/química , Antibacterianos/isolamento & purificação , Escherichia coli O157/genética , Escherichia coli O157/patogenicidade , Expressão Gênica/efeitos dos fármacos , Hemólise/efeitos dos fármacos , Mel/análise , Proteínas de Insetos/química , Proteínas de Insetos/isolamento & purificação , Testes de Sensibilidade Microbiana , Fatores de Virulência/genética
5.
BMC Oral Health ; 21(1): 118, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33722235

RESUMO

BACKGROUND: The objective of this study was to measure two parameters involved in tri-dimensional implant planning: the position of the buccal and palatal bone wall and the palatal thickness. METHODS: Cone beam computed tomography (CBCT) images (Planmeca ProMax 3D) of 403 teeth (208 upper teeth and 195 lower teeth) were obtained from 49 patients referred to the Dental School of Seville from January to December 2014. The height difference between the palatal and buccal walls was measured on the most coronal point of both walls. The thickness of the palatal wall was measured 2 mm from the most coronal point of the palatal wall. RESULTS: The mean values in the maxilla were 1.7 ± 0.9 mm for central and lateral incisors, 2.2 ± 1.7 mm for canines, 1.6 ± 0.9 mm for premolars and 1.9 ± 1.5 mm for molars. In the lower jaw, the mean values were 1.3 ± 0.8 mm for incisors, 1.7 ± 1.2 mm for canines, 2.3 ± 1.3 mm for premolars, and 2.6 ± 1.7 mm for molars. In the upper jaw, more than 55% of maxillary teeth (excluding second premolars and molars) presented mean height differences greater than 1 mm. In the mandible, more than 60% of incisors showed a buccal bone thickness of 1 mm from the apical to lingual aspect. All teeth except the second premolar presented a buccal wall located more than 1 mm more apically than the lingual bone wall. CONCLUSIONS: The buccal bone wall is located more apically (greater than 1 mm) than the palatal or lingual table in most of the cases assessed. The thickness of the palatal or lingual table is also less than 2 mm in the maxilla and mandible, except in the upper canines and premolars and the lower molars.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Maxila , Dente Pré-Molar/diagnóstico por imagem , Humanos , Mandíbula , Maxila/diagnóstico por imagem , Palato/diagnóstico por imagem
6.
Opt Lett ; 45(13): 3593-3596, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32630907

RESUMO

We study the local density of optical states (LDOS) for lossy dielectric substrates whose electric permittivity has a vanishing real part, approaching zero from the positive side of the real axis. A criterion for evaluating the threshold height above (below) which radiative (non-radiative) processes dominate for a dipole emitter is established. We focus on the case of a vertical dipole above the ϵ-near-zero (ENZ) substrate and show that, in the lossless case, complete LDOS cancellation originates from radiative modes in its near field. We evaluate the performance of commercially available ENZ materials and quantify the limits of such cancellation effects with the intrinsic losses of the substrate.

7.
Br J Nutr ; 123(6): 642-651, 2020 03 28.
Artigo em Inglês | MEDLINE | ID: mdl-31831096

RESUMO

Modern lifestyle increases the prevalence of obesity and its co-morbidities in the young population. High-salt (HS) diets are associated with hypertension and cardiac remodelling. The present study evaluated the potential effects of cardiometabolic programming induced by HS intake during puberty in lean and obese rats. Additionally, we investigated whether HS could exacerbate the impairment of cardiovascular parameters in adult life due to postnatal early overnutrition (PO). At postnatal day 3 (PN3), twenty-four litters of Wistar rats were divided into two groups: normal litter (NL, nine pups/dam) and small litter (SL, three pups/dam) throughout the lactation period; weaning was at PN21. At PN30, the pups were subdivided into two more groups: NL plus HS (NLHS) and SL plus HS (SLHS). HS intake was from PN30 until PN60. Cardiovascular parameters were evaluated at PN120. SL rats became overweight at adulthood due to persistent hyperphagia; however, HS exposure during puberty reduced the weight gain and food intake of NLHS and SLHS. Both HS and obesity raised the blood pressure, impaired baro- and chemoreflex sensitivity and induced cardiac remodelling but no worsening was observed in the association of these factors, except a little reduction in the angiotensin type-2 receptor in the hearts from SLHS animals. Our results suggest that the response of newborn offspring to PO and juveniles to a HS diet leads to significant changes in cardiovascular parameters in adult rats. This damage may be accompanied by impairment of both angiotensin signalling and antioxidant defence in the heart.


Assuntos
Barorreflexo/efeitos dos fármacos , Composição Corporal/efeitos dos fármacos , Serviços de Dietética , Obesidade , Cloreto de Sódio na Dieta/administração & dosagem , Remodelação Ventricular/efeitos dos fármacos , Animais , Pressão Sanguínea/efeitos dos fármacos , Ingestão de Líquidos/efeitos dos fármacos , Comportamento Alimentar/efeitos dos fármacos , Feminino , Masculino , Ratos , Ratos Wistar , Maturidade Sexual
8.
J Eur Acad Dermatol Venereol ; 34(10): 2409-2413, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32421881

RESUMO

BACKGROUND: Frontal fibrosing alopecia (FFA) is a lymphocytic scarring alopecia whose worldwide incidence is rising. Environmental triggers combined with genetic predisposition represent one of the current hypotheses in FFA aetiology. Familial clusters are opportunities to investigate the genetic basis of diseases. OBJECTIVES: Assess human leucocyte antigen (HLA) genetic variability in a Brazilian sample of a large familial cluster (six sisters and one daughter) with FFA, unnafected familiar members and sporadic cases of FFA. METHODS: We addressed the HLA-A, HLA-B, HLA-C, HLA-G and HLA-E genetic variability in this family and in seven sporadic FFA cases, comparing allele frequencies with those reported for the São Paulo State from Brazil. RESULTS: Two susceptibility haplotypes, C*17:01:01:02/B*42:01:01:01 and C*07:02:01:03/B*07:02:01:01, were identified among familial cases and also in sporadic cases. The first haplotype is rare among Brazilians, and it was not previously reported as being associated with FFA. Both alleles were found in some different unaffected familiars, what emphasizes the role of environmental triggers in disease development. HLA-A, HLA-G and HLA-E genes were not associated to familiar nor FFA sporadic cases. CONCLUSION: The identification of susceptibility haplotypes in FFA reinforces the genetic predisposition to the disease.


Assuntos
Alopecia , Líquen Plano , Alelos , Alopecia/genética , Brasil , Predisposição Genética para Doença , Haplótipos , Antígenos de Histocompatibilidade Classe II , Humanos
9.
Artigo em Inglês | MEDLINE | ID: mdl-30323038

RESUMO

Although the Sensititre Yeast-One (SYO) and Etest methods are widely utilized, interpretive criteria are not available for triazole susceptibility testing of Candida or Aspergillus species. We collected fluconazole, itraconazole, posaconazole, and voriconazole SYO and Etest MICs from 39 laboratories representing all continents for (method/agent-dependent) 11,171 Candida albicans, 215 C. dubliniensis, 4,418 C. glabrata species complex, 157 C.guilliermondii (Meyerozyma guilliermondii), 676 C. krusei (Pichia kudriavzevii), 298 C.lusitaniae (Clavispora lusitaniae), 911 C.parapsilosissensu stricto, 3,691 C.parapsilosis species complex, 36 C.metapsilosis, 110 C.orthopsilosis, 1,854 C.tropicalis, 244 Saccharomyces cerevisiae, 1,409 Aspergillus fumigatus, 389 A.flavus, 130 A.nidulans, 233 A.niger, and 302 A.terreus complex isolates. SYO/Etest MICs for 282 confirmed non-wild-type (non-WT) isolates were included: ERG11 (C. albicans), ERG11 and MRR1 (C. parapsilosis), cyp51A (A. fumigatus), and CDR2 and CDR1 overexpression (C. albicans and C. glabrata, respectively). Interlaboratory modal agreement was superior by SYO for yeast species and by the Etest for Aspergillus spp. Distributions fulfilling CLSI criteria for epidemiological cutoff value (ECV) definition were pooled, and we proposed SYO ECVs for S. cerevisiae and 9 yeast and 3 Aspergillus species and Etest ECVs for 5 yeast and 4 Aspergillus species. The posaconazole SYO ECV of 0.06 µg/ml for C. albicans and the Etest itraconazole ECV of 2 µg/ml for A. fumigatus were the best predictors of non-WT isolates. These findings support the need for method-dependent ECVs, as, overall, the SYO appears to perform better for susceptibility testing of yeast species and the Etest appears to perform better for susceptibility testing of Aspergillus spp. Further evaluations should be conducted with more Candida mutants.


Assuntos
Antifúngicos/farmacologia , Aspergillus/efeitos dos fármacos , Candida/efeitos dos fármacos , Triazóis/farmacologia , Aspergilose/tratamento farmacológico , Aspergilose/epidemiologia , Aspergilose/microbiologia , Aspergillus/classificação , Aspergillus/isolamento & purificação , Candida/classificação , Candida/isolamento & purificação , Candidíase/tratamento farmacológico , Candidíase/epidemiologia , Candidíase/microbiologia , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Farmacorresistência Fúngica , Fluconazol/farmacologia , Humanos , Hospedeiro Imunocomprometido , Itraconazol/farmacologia , Voriconazol/farmacologia
10.
HIV Med ; 20(3): 192-201, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30620136

RESUMO

OBJECTIVES: The reported prevalence of chronic obstructive pulmonary disease (COPD) in people living with HIV (PLWHIV) varies widely. Our objective was to estimate the prevalence of airflow obstruction and COPD in unselected PLWHIV and identify characteristics that increase the risk of nonreversible airflow obstruction in order to guide case finding strategies for COPD. METHODS: All adults attending the Chronic Viral Illness Service were invited to participate in the study, regardless of smoking status or history of known COPD/asthma. Individuals underwent spirometric testing both before and after use of a salbutamol bronchodilator. Airflow obstruction was defined as forced expiratory volume in 1 s (FEV1 )/forced vital capacity (FVC) < 0.7 post-bronchodilation, whereas COPD was defined as FEV1 /FVC < 0.7 post-bronchodilation and Medical Research Council (MRC) score > 2. Multivariate logistic regression was used to evaluate risk factors associated with airflow obstruction, reported as adjusted odds ratios (aORs). RESULTS: Five hundred and three participants successfully completed spirometry testing. The median (Q1; Q3) age was 52 (44; 58) years. The median (Q1; Q3) CD4 count was 598 (438; 784) cells/µL and the median (Q1; Q3) nadir CD4 count was 224 (121; 351) cells/µL. There were 119 (24%) current smokers and 145 (29%) former smokers. Among those screened, 54 (11%) had airflow obstruction whereas three (1%) of the participants had COPD. Factors that were associated with airflow obstruction included a history of smoking [aOR 2.2; 95% confidence interval (CI) 1.1; 4.7], older age (aOR 1.6; 95% CI 1.2; 2.2), and lower CD4 count (aOR 0.8; 95% CI 0.7; 1.0). CONCLUSIONS: Airflow obstruction was relatively uncommon. Our findings suggest that PLWHIV who are ≥50 years old, smokers and those with nadir CD4 counts ≤ 200 cells/µL could be targeted to undergo spirometry to diagnose chronic airflow obstruction.


Assuntos
Albuterol/administração & dosagem , Infecções por HIV/complicações , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Adulto , Albuterol/farmacologia , Contagem de Linfócito CD4 , Canadá/epidemiologia , Estudos Transversais , Feminino , Volume Expiratório Forçado/efeitos dos fármacos , Infecções por HIV/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Doença Pulmonar Obstrutiva Crônica/etiologia , Medição de Risco , Espirometria , Centros de Atenção Terciária , Capacidade Vital/efeitos dos fármacos
11.
NMR Biomed ; 32(12): e4178, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31608515

RESUMO

Phosphorus (31 P) MRSI provides opportunities to monitor potential biomarkers. However, current applications of 31 P MRS are generally restricted to relatively small volumes as small coils are used. Conventional surface coils require high energy adiabatic RF pulses to achieve flip angle homogeneity, leading to high specific absorption rates (SARs), and occupy space within the MRI bore. A birdcage coil behind the bore cover can potentially reduce the SAR constraints massively by use of conventional amplitude modulated pulses without sacrificing patient space. Here, we demonstrate that the integrated 31 P birdcage coil setup with a high power RF amplifier at 7 T allows for low flip angle excitations with short repetition time (TR ) for fast 3D chemical shift imaging (CSI) and 3D T1 -weighted CSI as well as high flip angle multi-refocusing pulses, enabling multi-echo CSI that can measure metabolite T2 , over a large field of view in the body. B1+ calibration showed a variation of only 30% in maximum B1 in four volunteers. High signal-to-noise ratio (SNR) MRSI was obtained in the gluteal muscle using two fast in vivo 3D spectroscopic imaging protocols, with low and high flip angles, and with multi-echo MRSI without exceeding SAR levels. In addition, full liver MRSI was achieved within SAR constraints. The integrated 31 P body coil allowed for fast spectroscopic imaging and successful implementation of the multi-echo method in the body at 7 T. Moreover, no additional enclosing hardware was needed for 31 P excitation, paving the way to include larger subjects and more space for receiver arrays. The increase in possible number of RF excitations per scan time, due to the improved B1+ homogeneity and low SAR, allows SNR to be exchanged for spatial resolution in CSI and/or T1 weighting by simply manipulating TR and/or flip angle to detect and quantify ratios from different molecular species.


Assuntos
Imageamento por Ressonância Magnética , Fósforo/química , Imagem Corporal Total , Feminino , Humanos , Fígado/metabolismo , Masculino , Músculos/metabolismo , Imagens de Fantasmas , Fosfocreatina/metabolismo
12.
NMR Biomed ; 32(1): e4015, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30376201

RESUMO

The differentiation grade of cervical cancer is histologically assessed by examining biopsies or surgical specimens. MRS is a highly sensitive technique that images tissue metabolism and can be used to increase the specificity of tissue characterization in a non-invasive manner. We aim to explore the feasibility of using in vivo 1 H-MRS at 7 T in women with cervical cancer to study tissue fatty acid composition. 10 women with histologically proven Stage IB1-IIB cervical cancer were scanned with a whole-body 7 T MR system with a multi-transmit system and an internal receive only monopole antenna. A STEAM sequence was used to obtain 1 H-MRS data. Fatty acid resonances were fitted with Lorentzian curves and the 2.1 ppm/1.3 ppm ratios were calculated. 1 H-MRS data showed fatty acid signals resonating at 2.1 ppm, 1.9 ppm, 1.5 ppm, 1.3 ppm and 0.9 ppm. Mean 2.1/1.3 ppm ratios were 0.019 ± 0.01, 0.021 ± 0.006, 0.12 ± 0.089 and 0.39 ± 0.27 for normal, Grade I, Grade II and Grade III groups respectively. Poorly differentiated tumor tissue (Grade III) showed elevated fatty acid ratios when compared with the well differentiated tumor (Grade I) or normal tissue. 1 H-MRS in cervical cancer at 7 T is feasible and individual fatty acid signals were detected. In addition, poorly differentiated tumors show more fatty acid unsaturation. The 2.1 ppm/1.3 ppm ratio has potential for tumor characterization in a non-invasive manner for uterine cervical cancer.


Assuntos
Espectroscopia de Prótons por Ressonância Magnética , Neoplasias do Colo do Útero/diagnóstico por imagem , Adulto , Idoso , Ácidos Graxos/metabolismo , Feminino , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Neoplasias do Colo do Útero/patologia
13.
Gynecol Oncol ; 153(2): 223-229, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30765148

RESUMO

BACKGROUND: Intraperitoneal (IP) chemotherapy can improve outcomes for women with optimally cytoreduced epithelial ovarian cancer but toxicities are a concern. We conducted 2 phase 2 trials of an IV/IP regimen using carboplatin and paclitaxel without (Trial A) and with bevacizumab (Trial B). METHODS: Both trials consisted of carboplatin AUC 6 day 1, and paclitaxel 60 mg/m2 on days 1,8, 15 of a 21-day cycle; in Trial B, patients received IV bevacizumab 15 mg/kg every cycle starting cycle 2. Chemotherapy was administered IV for cycle 1 and then IP for all subsequent cycles. Primary objectives included safety and tolerability, pathologic CR rate (Trial A), and the rate of completion of IP cycles of therapy (Trial B). Progression-free (PFS), overall survival (OS), and pharmacokinetic analysis were secondary endpoints. RESULTS: 81 patients were treated on both trials (n = 40 and 41 in trials A and B, respectively). Median age for trials A and B was 59 (range, 36-76) and 55 (range, 19-69) years, respectively. 68% and 85% of patients, respectively for A and B, completed at least 4 cycles of treatment in both trials. Treatment with bevacizumab resulted in higher rates of grade 3 fatigue (37 versus 33%) and grade 3-4 diarrhea (22 versus 8%). Median PFS was 23.5 (95%CI 16.2-35.3) and 25 (95%CI 16.4-42.7) months, respectively; median OS was 68 (95%CI 49.5-NR) and 79.7 (95%CI 59.0-79.7) months, respectively for Trial A and B. CONCLUSIONS: Weekly administered IP carboplatin and IP paclitaxel is tolerable and safe with similar activity with and without concommittant bevacizumab in these 2 trials.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Carcinoma Epitelial do Ovário/terapia , Neoplasias Ovarianas/terapia , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Bevacizumab/administração & dosagem , Bevacizumab/efeitos adversos , Carboplatina/administração & dosagem , Carboplatina/efeitos adversos , Carcinoma Epitelial do Ovário/mortalidade , Carcinoma Epitelial do Ovário/patologia , Quimioterapia Adjuvante/métodos , Procedimentos Cirúrgicos de Citorredução/métodos , Esquema de Medicação , Feminino , Humanos , Infusões Intravenosas , Infusões Parenterais , Pessoa de Meia-Idade , Ductos Paramesonéfricos/patologia , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/patologia , Ovariectomia/métodos , Paclitaxel/administração & dosagem , Paclitaxel/efeitos adversos , Intervalo Livre de Progressão , Adulto Jovem
14.
J Hum Nutr Diet ; 32(4): 468-479, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30663156

RESUMO

BACKGROUND: The influence of nutrition on breast cancer prognosis is still inconclusive and therefore dietary interventions incorporating dietary biomarkers are needed to confirm compliance with dietary goals and clarify biological mechanisms. The present study assessed whether a lifestyle intervention in breast cancer survivors could affect dietary biomarkers of fruit and vegetables and fatty acids. METHODS: In this phase II single-arm trial, 37 overweight/obese early stage breast cancer patients completed a 12-week diet and exercise intervention. The intervention involved 1-h weekly diet sessions delivered by a dietician and 75-min bi-weekly physical activity sessions of moderate-to-high intensity led by trained monitors. Before and after the intervention, three 24-h dietary recalls were carried out to calculate nutrient intakes and, in addition, blood samples were taken to measure plasma carotenoids, vitamin E and retinol concentrations and erythrocyte membrane fatty acid (EFA) composition. Wilcoxon signed rank tests were used to assess changes in dietary and biomarkers measurements over the intervention period. RESULTS: After the intervention, there was a significant increase in the intake of dietary carotenoids (+15.1% compared to baseline) but not plasma carotenoids levels (+6.3%). Regarding the EFA levels, we observed a significant decrease in percentage of saturated fatty acids (-1.4%) and n-6 polyunsaturated fatty acids (-2.9%) and an increase in monounsaturated fatty acids (1.7%) and total and long-chain n-3 polyunsaturated fatty acids (by 13.1% and 13.7%, respectively). A favourable decrease in the ratio of long-chain n-6 to n-3 polyunsaturated fatty acids (-9.1%) was also observed. CONCLUSIONS: After a short-term diet and exercise intervention in overweight/obese breast cancer survivors, we observed significant changes in dietary nutrients and fatty acid biomarkers, suggesting positive dietary changes that could be relevant for breast cancer prognosis.


Assuntos
Neoplasias da Mama/sangue , Carotenoides/sangue , Dieta/métodos , Membrana Eritrocítica/metabolismo , Ácidos Graxos/análise , Estilo de Vida , Adulto , Biomarcadores/sangue , Neoplasias da Mama/complicações , Sobreviventes de Câncer/psicologia , Dieta/psicologia , Ingestão de Energia , Exercício Físico , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/complicações , Obesidade/terapia , Sobrepeso/sangue , Sobrepeso/complicações , Sobrepeso/terapia , Cooperação do Paciente , Resultado do Tratamento , Adulto Jovem
15.
Trop Anim Health Prod ; 51(8): 2473-2479, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31197723

RESUMO

The present study compared the feeding behaviour of goats in the early morning (EM = 7:00-8:30 a.m.) and late morning (LM = 9:30-11:00 a.m.) in response to their natural gastrointestinal nematode (GIN) infection status. Twelve female adult goats (37 ± 7.7 kg live weight (LW); 5 ± 1 years) with browsing experience in the tropical deciduous forest were divided into two groups (n = 6): INF group, with natural GIN infection, and non-infected (NI) group, dewormed with moxidectin (0.4 mg/kg LW subcutaneous). Feeding behaviour (dry matter intake (DMI)) of two resource types (grasses vs. shrubs + herbs) was estimated by direct observation for 4 weeks on two grazing moments (EM vs. LM). Environmental temperature and relative humidity at pasture level were measured twice weekly. The GIN egg counts and goats' LW were measured on days 0, 14 and 28. Temperature (mean ± standard deviation) at EM (26.2 ± 1.5 °C) was lower than at LM (38.7 ± 1 °C; P < 0.01). Humidity was higher on the EM (85.1 ± 2.6%) compared to LM (60.4 ± 5.6%; P < 0.01). Irrespective of the infection status, goats consumed similar amounts of grass and shrubs + herbs during EM (P > 0.05). On the other hand, the experimental groups consumed more grass than shrubs + herbs during LM (P < 0.05). The latter suggested prophylactic behaviours strategies to (a) avoid GIN infective larvae, (b) balance the protein:energy ratio of the diet and (c) avoid saturation of detoxification pathways for the secondary compounds consumed from shrubs + herbs. The constant consumption of shrubs + herbs during the study may have reduced the GIN egg count of the INF group.


Assuntos
Comportamento Alimentar , Doenças das Cabras/prevenção & controle , Infecções por Nematoides/veterinária , Ração Animal/análise , Animais , Anti-Helmínticos/farmacologia , Dieta/veterinária , Fezes/parasitologia , Feminino , Gastroenteropatias/parasitologia , Gastroenteropatias/veterinária , Doenças das Cabras/parasitologia , Cabras , Macrolídeos/farmacologia , Nematoides , Infecções por Nematoides/tratamento farmacológico , Infecções por Nematoides/prevenção & controle , Contagem de Ovos de Parasitas/veterinária , Poaceae
16.
Trop Anim Health Prod ; 51(6): 1591-1599, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30827004

RESUMO

This study validated a protocol to identify the nutraceutical value of Gymnopodium floribundum (GF) foliage based on its effects on sheep nutrition, production and health and its impact on adult Haemonchus contortus. Thirty animals (17.8 ± 3.44 kg BW) were distributed into five experimental groups (n = 6). Groups T1-T3 received feed including 20%, 30% and 40% GF content, respectively, and group T4 received feed with 0% GF. Groups T1-T4 were all infected with 6000 H. contortus infective larvae (L3). Group T5 included six worm-free lambs fed a diet without GF. Feed intake, dry matter digestibility (DMD) and organic matter digestibility (OMD) were measured, in addition to the faecal excretion of eggs per gram (EPG) and total faecal egg count (TFEC) of H. contortus. On day 39 post-infection, lambs were humanely slaughtered to recover and count adult parasites and assess the length and fecundity of female worms. Higher levels of GF in the diet reduced DMD and OMD (P < 0.05), with the lowest values in T3 (40% GF) (P < 0.05). Body weight gain was similar for all groups (0.18 to 0.2 kg/day; P > 0.05). EPG and TFEC were lower in T1 and T3 than in T4 (P < 0.05), and the number of adult female worms was lowest in T3 (P < 0.05). In conclusion, GF leaf meal can be considered a nutraceutical when included at 40% (T3) in the diet of lambs, based on its ability to decrease the EPG and TFEC of H. contortus by reducing the female worm burden. A 40% inclusion level had no negative impact on lamb diet intake, production and health, although a reduction of digestibility was observed.


Assuntos
Ração Animal/análise , Dieta/veterinária , Suplementos Nutricionais , Hemoncose/veterinária , Haemonchus , Doenças dos Ovinos/parasitologia , Animais , Fezes/parasitologia , Feminino , Hemoncose/prevenção & controle , Masculino , Contagem de Ovos de Parasitas/veterinária , Distribuição Aleatória , Ovinos , Doenças dos Ovinos/prevenção & controle
17.
Trop Anim Health Prod ; 51(8): 2243-2251, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31140120

RESUMO

This study assessed the effect of total dry matter intake (DMI), plant life form and strata harvested on the gastrointestinal nematode (GIN) worm burdens of tracer kids and lambs browsing heterogeneous vegetation during the rainy season (August-November). The rainy season was divided into 6 2-week periods (P1-P6), and environmental conditions (rainy days, rainfall, temperature and humidity) were recorded daily. Five pairs each of tracer kids and tracer lambs raised free of GIN infections were used. Every 15 days, different pairs of kids and lambs were introduced to a 2.2-ha plot and co-grazed with a flock of 30 sheep and 70 goats for a period of 3 weeks. Feeding behaviour of each pair of tracers was measured in weeks 2 and 3. The continuous bite monitoring method was used to estimate total DMI, DMI of plant life forms and DMI from plants of different strata. After each 3-week period, the tracer pair was maintained indoors for 28 days and necropsied on day 29 to recover the worm burden. The feeding behaviour of the tracers was compared between periods (P2-P6) and between kids and lambs. The differences in the worm burdens of the tracers between periods were not associated with total DMI or DMI from plant life forms. Worm burdens were highest during P5 and P6 in tracer kids and lambs (P < 0.05), suggesting a build-up of infective larvae in the tropical deciduous forest (TDF). The lower worm burdens of tracer kids compared with lambs (P < 0.05) seemed to be associated with less low- and more medium-stratum ingestion.


Assuntos
Doenças das Cabras/parasitologia , Infecções por Nematoides/veterinária , Contagem de Ovos de Parasitas/veterinária , Doenças dos Ovinos/parasitologia , Ração Animal , Animais , Fezes , Comportamento Alimentar , Gastroenteropatias/veterinária , Cabras , Enteropatias Parasitárias/parasitologia , Enteropatias Parasitárias/veterinária , Nematoides , Chuva , Estações do Ano , Ovinos
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