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1.
J Natl Cancer Inst Monogr ; 2023(61): 104-124, 2023 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-37139977

RESUMO

Cancer cells cannot proliferate without sufficient energy to generate biomass for rapid cell division, as well as to fuel their functions at baseline. For this reason, many recent observational and interventional studies have focused on increasing energy expenditure and/or reducing energy intake during and after cancer treatment. The impact of variance in diet composition and in exercise on cancer outcomes has been detailed extensively elsewhere and is not the primary focus of this review. Instead, in this translational, narrative review we examine studies of how energy balance impacts anticancer immune activation and outcomes in triple-negative breast cancer (TNBC). We discuss preclinical, clinical observational, and the few clinical interventional studies on energy balance in TNBC. We advocate for the implementation of clinical studies to examine how optimizing energy balance-through changes in diet and/or exercise-may optimize the response to immunotherapy in people with TNBC. It is our conviction that by taking a holistic approach that includes energy balance as a key factor to be considered during and after treatment, cancer care may be optimized, and the detrimental effects of cancer treatment and recovery on overall health may be minimized.


Assuntos
Neoplasias de Mama Triplo Negativas , Humanos , Neoplasias de Mama Triplo Negativas/terapia , Neoplasias de Mama Triplo Negativas/tratamento farmacológico , Imunoterapia , Metabolismo Energético
2.
Am J Clin Nutr ; 115(3): 925-940, 2022 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-35102364

RESUMO

BACKGROUND: Gastrointestinal enteroendocrine cells express chemosensory bitter taste receptors that may play an important role in regulating energy intake (EI) and gut function. OBJECTIVES: To determine the effect of a bitter hop extract (Humulus lupulus L.) on acute EI, appetite, and hormonal responses. METHODS: Nineteen healthy-weight men completed a randomized 3-treatment, double-blind, crossover study with a 1-wk washout between treatments. Treatments comprised either placebo or 500 mg of hop extract administered in delayed-release capsules (duodenal) at 11:00 h or quick-release capsules (gastric) at 11:30 h. Ad libitum EI was recorded at the lunch (12:00 h) and afternoon snack (14:00 h), with blood samples taken and subjective ratings of appetite, gastrointestinal (GI) discomfort, vitality, meal palatability, and mood assessed throughout the day. RESULTS: Total ad libitum EI was reduced following both the gastric (4473 kJ; 95% CI: 3811, 5134; P = 0.006) and duodenal (4439 kJ; 95% CI: 3777, 5102; P = 0.004) hop treatments compared with the placebo (5383 kJ; 95% CI: 4722, 6045). Gastric and duodenal treatments stimulated prelunch ghrelin secretion and postprandial cholecystokinin, glucagon-like peptide 1, and peptide YY responses compared with placebo. In contrast, postprandial insulin, glucose-dependent insulinotropic peptide, and pancreatic polypeptide responses were reduced in gastric and duodenal treatments without affecting glycemia. In addition, gastric and duodenal treatments produced small but significant increases in subjective measures of GI discomfort (e.g., nausea, bloating, abdominal discomfort) with mild to severe adverse GI symptoms reported in the gastric treatment only. However, no significant treatment effects were observed for any subjective measures of appetite or meal palatability. CONCLUSIONS: Both gastric and duodenal delivery of a hop extract modulates the release of hormones involved in appetite and glycemic regulation, providing a potential "bitter brake" on EI in healthy-weight men.


Assuntos
Humulus , Glicemia , Cápsulas/farmacologia , Estudos Cross-Over , Ingestão de Energia/fisiologia , Fármacos Gastrointestinais/farmacologia , Humanos , Insulina , Masculino , Peptídeo YY , Extratos Vegetais/farmacologia
3.
Nat Commun ; 12(1): 258, 2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431843

RESUMO

The Higgs mechanism, i.e., spontaneous symmetry breaking of the quantum vacuum, is a cross-disciplinary principle, universal for understanding dark energy, antimatter and quantum materials, from superconductivity to magnetism. Unlike one-band superconductors (SCs), a conceptually distinct Higgs amplitude mode can arise in multi-band, unconventional superconductors  via strong interband Coulomb interaction, but is yet to be accessed. Here we discover such hybrid Higgs mode and demonstrate its quantum control by light in iron-based high-temperature SCs. Using terahertz (THz) two-pulse coherent spectroscopy, we observe a tunable amplitude mode coherent oscillation of the complex order parameter from coupled lower and upper bands. The nonlinear dependence of the hybrid Higgs mode on the THz driving fields is distinct from any known SC results: we observe a large reversible modulation of resonance strength, yet with a persisting mode frequency. Together with quantum kinetic modeling of a hybrid Higgs mechanism, distinct from charge-density fluctuations and without invoking phonons or disorder, our result provides compelling evidence for a light-controlled coupling between the electron and hole amplitude modes assisted by strong interband quantum entanglement. Such light-control of Higgs hybridization can be extended to probe many-body entanglement and hidden symmetries in other complex systems.

4.
Nutr Clin Pract ; 36(2): 414-418, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32700422

RESUMO

A 22-month-old female with high-risk neuroblastoma completed 5 cycles of chemotherapy then underwent high-dose chemotherapy with autologous stem cell rescue (ASCR). Parenteral nutrition was administered from day +2 following ASCR, as she was unable to tolerate nasogastric feeds because of grade IV mucositis and vomiting. On day +12, she developed worsening metabolic acidosis with above reportable levels of lactic acid. Given the patient's well clinical appearance and paucity of evidence of end-organ dysfunction on physical examination and on laboratory studies, there was high suspicion that the patient's lactic acidosis did not result from tissue hypoxia and was, in fact, a type B lactic acidosis. Thiamin was empirically administered, with rapid improvement in lactic acidosis. Thiamin deficiency was later confirmed by laboratory studies drawn prior to thiamin administration.


Assuntos
Acidose Láctica , Transplante de Células-Tronco Hematopoéticas , Deficiência de Tiamina , Acidose Láctica/etiologia , Acidose Láctica/terapia , Feminino , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Lactente , Tiamina , Deficiência de Tiamina/etiologia , Transplante Autólogo
5.
J Tradit Chin Med ; 40(1): 67-72, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32227767

RESUMO

OBJECTIVE: To investigate the safety of hair essence containing 0.05% purified bee venom (HE-PBV) on the skin and eyes of New Zealand White rabbits. METHODS: HE-PBV which contained 0.05% PBV, purified water, and glycerin, was used as the test substance. The skin-irritation test (SIT) and eye-irritation test (EIT) were conducted according to the Draize method. On the SIT, HE-PBV (0.5 mL) dropped gauze was attached both intact and abraded skin for 24 h. The other side of the skin was used as control. After 24 and 72 h, the treatment site was observed and scored according to evaluation criteria for skin reactions. On the EIT, the rabbits were divided into two groups: eye-washed (three rabbits) and non-eye-washed (six rabbits). HE-PBV (0.1 mL) was squirted into the right eye of rabbits. The left eye was untreated and used as a control. Then, 20-30-s later, the eyes of rabbits in the eye-washed group were washed with ~50 mL of physiologic (0.9%) salt solution. Then, 1, 2, 3, 4 and 7 d after the start of the EIT, the eyes and behavior of the rabbits were observed. The degree of eye irritation elicited by HE-PBV was determined in three steps and then the criteria of the classification of eye-irritation scores. RESULTS: The SIT revealed erythema and edema at the site of HE-PBV application. At 72 h, the body weight of rabbits was reduced slightly, but other symptoms (except erythema and edema) were not observed. The Primary Irritation Index score was 0.6, and HE-PBV was deemed to be a slight irritant. The EIT did not show mortality or body-weight fluctuation, but hyperemic conjunctiva and eyelid closure were noted after HE-PBV administration. Except for these results, the score for the ophthalmic response on days 1, 2, 3, 4 and 7 was 0, and HE-PBV was deemed to be a non-irritant. CONCLUSION: These data suggest that HE-PBV did not elicit eye irritation, but was a slight irritant to the skin of rabbits; the latter slight would have been due to the excipients used in manufacture of the hair essence because PBV has been shown to be safe.


Assuntos
Venenos de Abelha/química , Cosméticos/química , Cosméticos/toxicidade , Olho/efeitos dos fármacos , Cabelo , Segurança , Pele/efeitos dos fármacos , Animais , Masculino , Coelhos
6.
Sci Total Environ ; 728: 138611, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32344222

RESUMO

The use of colloidal silver-containing products as dietary supplements, immune boosters and surface disinfectants has increased in recent years which has elevated the potential for human exposure to silver nanoparticles and ions. Product mislabeling and long-term use of these products may put consumers at risk for adverse health outcomes including argyria. This study assessed several physical and chemical characteristics of five commercial products as well as their cytotoxicity using a rat intestinal epithelial cell (IEC-6) model. Concentrations of silver were determined for both the soluble and particulate fractions of the products. Primary particle size distribution and elemental composition were determined by transmission electron microscopy (TEM) and energy-dispersive X-ray spectroscopy (EDS), respectively. Hydrodynamic diameters were measured using nanoparticle tracking analysis (NTA) and dynamic light scattering (DLS). The effect of gastrointestinal (GI) simulation on the colloidal silver products was determined using two systems. First, physical and chemical changes of the silver nanoparticles in these products was assessed after exposure to Synthetic Stomach Fluid (SSF) resulting in particle agglomeration, and the appearance of AgCl on the surfaces and between particles. IEC-6 cells were exposed for 24 h to dilutions of the products and assessed for cell viability. The products were also treated with a three-stage simulated GI system (stomach and intestinal fluids) prior to exposure of the IEC-6 cells to the isolated silver nanoparticles. Cell viability was affected by each of the consumer products. Based on the silver nitrate and commercial silver nanoparticle dose response, the cytotoxicity for each of the colloidal silver products was attributed to the particulate silver, soluble silver or non­silver matrix constituents.


Assuntos
Desinfetantes , Nanopartículas Metálicas , Animais , Humanos , Microscopia Eletrônica de Transmissão , Tamanho da Partícula , Ratos , Prata , Nitrato de Prata
7.
J Dent Res ; 98(11): 1239-1244, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31425664

RESUMO

Dentin hypersensitivity commonly occurs due to opened dentinal tubules for many reasons. In our previous study, copine 7 (CPNE7) could induce dentin formation for an indirect pulp-capping model in vivo. This study aims to investigate the formation of tertiary dentin when CPNE7 is applied to intentionally exposed dentin with nothing over it in vivo, whether it affects microleakage of the teeth, and the penetration ability of CPNE7 molecules through dentinal tubules in vitro. Cervical dentin areas of 6 maxillary incisors of 5 beagles were exposed to a class V-like lesion, and 1 side of 3 maxillary incisors was adapted with recombinant CPNE7 protein for 5 min as the experimental group. The other side was the control group, and there was no treatment of ethylenediaminetetraacetic acid (EDTA) and CPNE7 after preparation. The defects were exposed without any restorations, and all beagles were sacrificed after 4 wk. The fluid penetration of exposed dentin areas was investigated by a microleakage-testing device and confocal laser scanning microscope. Tertiary dentin formation was confirmed with histological scanning electronic microscopic analysis. Tertiary dentin formation reduces dentinal fluid flow due to occluded tubules or discontinuity with primary or secondary dentin. The in vivo hypersensitivity model with the anterior teeth of beagle dogs showed newly formed tertiary dentin at the dentin-pulp boundary in recombinant CPNE7-treated teeth when compared with the untreated control group in histologic analysis. Scanning electronic microscopic analysis revealed occluded sites with mineral deposition of intratubular dentin. In the permeability test, the mean microleakage value of the CPNE7-treated group was significantly lower than that of the control group (P < 0.05). The tubular penetration of rhodamine B-combined CPNE7 was confirmed under confocal laser scanning microscope. CPNE7 induces formation of tertiary dentin through shallowly exposed dentinal tubules, which decreases dentin permeability.


Assuntos
Sensibilidade da Dentina/terapia , Dentina Secundária , Proteínas de Membrana/uso terapêutico , Animais , Capeamento da Polpa Dentária , Cães , Microscopia Eletrônica de Varredura
8.
Biomater Sci ; 7(10): 4099-4111, 2019 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-31355397

RESUMO

Many debilitating infections result from persistent microbial biofilms that do not respond to conventional antibiotic regimens. A potential method to treat such chronic infections is to combine agents which interfere with bacterial biofilm development together with an antibiotic in a single formulation. Here, we explore the use of a new bioresponsive polymer formulation derived from specifically modified alginate nanoparticles (NPs) in order to deliver ciprofloxacin (CIP) in combination with the quorum sensing inhibitor (QSI) 3-amino-7-chloro-2-nonylquinazolin-4(3H)-one (ACNQ) to mature Pseudomonas aeruginosa biofilms. The alginate NPs were engineered to incorporate a pH-responsive linker between the polysaccharide backbone and the QSI, and to encapsulate CIP via charge-charge interactions of the positively-charged drug with the carboxyl residues of the alginate matrix. In this way, a dual-action release of antibiotic and QSI was designed for the low-pH regions of a biofilm, involving cleavage of the QSI-linker to the alginate matrix and reduced charge-charge interactions between CIP and the polysaccharide as the alginate carboxyl side-chains protonated. When tested in a biofilm model the concomitant release of CIP + QSI from the pH-responsive nanoparticles significantly reduced the viability of the biofilm compared with CIP treatment alone. In addition, the alginate NPs were shown to penetrate deeply into P. aeruginosa biofilms, which we attribute in part to the charges of the NPs and the release of the QSI agent. Finally, we tested the formulation in both a 2D keratinocyte and a 3D ex vivo skin infection model. The dual-action bio-responsive QSI and CIP release nanoparticles effectively cleared the infection in the latter, suggesting considerable promise for combination therapeutics which prevent biofilm formation as well as effectively killing mature P. aeruginosa biofilms.


Assuntos
Ciprofloxacina/uso terapêutico , Nanopartículas/química , Pseudomonas aeruginosa/efeitos dos fármacos , Percepção de Quorum/efeitos dos fármacos , Animais , Biofilmes/efeitos dos fármacos , Linhagem Celular , Ciprofloxacina/química , Humanos , Concentração de Íons de Hidrogênio , Testes de Sensibilidade Microbiana , Infecções por Pseudomonas/tratamento farmacológico , Pseudomonas aeruginosa/patogenicidade , Suínos
9.
Sci Total Environ ; 619-620: 1375-1384, 2018 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-29723948

RESUMO

Given the potential for human exposure to silver nanoparticles from spray disinfectants and dietary supplements, we characterized the silver-containing nanoparticles in 22 commercial products that advertised the use of silver or colloidal silver as the active ingredient. Characterization parameters included: total silver, fractionated silver (particulate and dissolved), primary particle size distribution, hydrodynamic diameter, particle number, and plasmon resonance absorbance. A high degree of variability between claimed and measured values for total silver was observed. Only 7 of the products showed total silver concentrations within 20% of their nominally reported values. In addition, significant variations in the relative percentages of particulate vs. soluble silver were also measured in many of these products reporting to be colloidal. Primary silver particle size distributions by transmission electron microscopy (TEM) showed two populations of particles - smaller particles (<5nm) and larger particles between 20 and 40nm. Hydrodynamic diameter measurements using nanoparticle tracking analysis (NTA) correlated well with TEM analysis for the larger particles. Z-average (Z-Avg) values measured using dynamic light scattering (DLS); however, were typically larger than both NTA or TEM particle diameters. Plasmon resonance absorbance signatures (peak absorbance at around 400nm indicative of metallic silver nanoparticles) were only noted in 4 of the 9 yellow-brown colored suspensions. Although the total silver concentrations were variable among products, ranging from 0.54mg/L to 960mg/L, silver containing nanoparticles were identified in all of the product suspensions by TEM.

10.
BMC Res Notes ; 7: 102, 2014 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-24558976

RESUMO

BACKGROUND: Comprehensive care in homozygous sickle cell disease (HbSS) entails universal neonatal screening and subsequent monitoring of identified patients, a process which has been streamlined in the neighbouring island of Jamaica. In preparation for a similar undertaking in Barbados, we have developed a database of persons with known HbSS, and have piloted processes for documenting clinical manifestations. We now present a brief clinical profile of these findings with comparisons to the Jamaican cohort. METHODS: HbSS participants were recruited from clinics and support groups. A history of select clinical symptoms was taken and blood and urine samples and echocardiograms were analysed. A re-analysis of data from a previous birth cohort was completed. RESULTS: Forty-eight persons participated (32 F/16 M); age range 10-62 yrs. 94% had a history of ever having a painful crisis. In the past year, 44% of participants had at least one crisis. There were >69 crises in 21 individuals; 61% were self-managed at home and the majority of the others were treated and discharged from hospital; few were admitted. The prevalence of chronic leg ulceration was 27%. Forty-two persons had urinalysis, 44% were diagnosed with albuminuria (urinary protein/creatinine ratio ≥30 mg/g). Thirty-two participants had echocardiography, 28% had a TRJV ≥ 2.5 m/s. Re-analysis of the incidence study revealed a sickle gene frequency (95% CI) of 2.01% (0.24 to 7.21). CONCLUSION: Although we share a common ancestry, it is thought that HbSS is less common and less severe in Barbados compared to Jamaica. The Jamaican studies reported a sickle gene frequency of 3.15 (2.81 to 3.52); the prevalence of chronic leg ulcers and albuminuria was 29.5% and 42.5% respectively. These comparisons suggest that our initial thoughts may be speculative and that HbSS may be an underestimated clinical problem in Barbados. A prospective neonatal screening programme combined with centralized, routine monitoring of HbSS morbidity and outcomes will definitively answer this question and will improve the evidence-based care and management of HbSS in Barbados.


Assuntos
Anemia Falciforme/diagnóstico , Programas de Rastreamento/métodos , Vigilância da População/métodos , Sistema de Registros/estatística & dados numéricos , Adolescente , Adulto , Albuminúria/diagnóstico , Albuminúria/epidemiologia , Anemia Falciforme/epidemiologia , Anemia Falciforme/genética , Barbados/epidemiologia , Criança , Estudos de Coortes , Comorbidade , Feminino , Homozigoto , Humanos , Recém-Nascido , Jamaica/epidemiologia , Úlcera da Perna/diagnóstico , Úlcera da Perna/epidemiologia , Masculino , Pessoa de Meia-Idade , Triagem Neonatal/métodos , Projetos Piloto , Adulto Jovem
11.
J Surg Oncol ; 109(7): 740-5, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24375188

RESUMO

BACKGROUND: The role of systemic chemotherapy (SC) in conjunction with cytoreductive surgery (CS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in appendiceal mucinous carcinoma peritonei (MCP) is unknown. METHODS: A retrospective review (1999-2011) of MCP patients who had undergone CS/HIPEC with or without perioperative SC. RESULTS: Twenty-two low-grade MCP patients treated with CS/HIPEC and SC were matched to patients who received CS/HIPEC alone. Median overall survival (OS) was 107 months for patients treated with perioperative SC compared to 72 without (P = 0.46). CS/HIPEC was performed on 109 patients with high-grade MCP: 70 were treated with perioperative SC, while 39 were not. Median OS (22.1 vs. 19.6 months, P = 0.74) and progression-free survival (PFS) (10.9 vs. 7.0 months, P = 0.47) were similar in patients treated with SC compared to CS/HIPEC alone. Progression while on pre-operative SC was seen in eight patients (17%), while four (8%) had a partial response. Treatment with post-operative SC was associated with longer PFS (13.6 months) compared to pre-operative SC (6.8 months, P < 0.01) and CS/HIPEC alone (7.0 months, P = 0.03). CONCLUSIONS: Post-operative SC appears to improve PFS in patients with high-grade appendiceal MCP treated with CS/HIPEC. In contrast, there is no evidence to support the routine use of perioperative SC in low-grade disease.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Neoplasias do Apêndice/terapia , Hipertermia Induzida , Neoplasias Peritoneais/terapia , Pseudomixoma Peritoneal/terapia , Neoplasias do Apêndice/mortalidade , Terapia Combinada , Feminino , Humanos , Infusões Parenterais , Masculino , Pessoa de Meia-Idade , Neoplasias Peritoneais/mortalidade , Pseudomixoma Peritoneal/mortalidade , Estudos Retrospectivos
12.
Community Ment Health J ; 50(6): 737-42, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24337476

RESUMO

This study explored the feasibility and effects of humour-related interventions for mentally ill adults. Twelve, randomly assigned, participated in each of 3 arms--stand up comedy training (the experimental arm), discussing comedy videos (the active control arm), and no humour-related intervention (the passive control arm). Quantitative and qualitative data were collected at baseline, end of interventions (3 months) and follow up (after another 3 months). Scale comparisons were largely negative, although self-esteem marginally increased in the experimental arm. Interview responses indicated benefits for the interventions, including improved self-esteem in the experimental arm. These results, though mixed, justify further study.


Assuntos
Terapia do Riso/métodos , Transtornos Mentais/terapia , Adulto , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Satisfação do Paciente , Projetos Piloto , Autoimagem , Resultado do Tratamento
13.
Int J Obes (Lond) ; 38(8): 1068-74, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24276017

RESUMO

BACKGROUND: In rodents, hypothalamic brain-derived neurotrophic factor (BDNF) expression appears to be regulated by melanocortin-4 receptor (MC4R) activity. The impact of MC4R genetic variation on circulating BDNF in humans is unknown. OBJECTIVE: The objective of this study is to compare BDNF concentrations of subjects with loss-of-function (LOF) and gain-of-function (GOF) MC4R variants with those of controls with common sequence MC4R. METHODS: Circulating BDNF was measured in two cohorts with known MC4R sequence: 148 subjects of Pima Indian heritage ((mean±s.d.): age, 15.7±6.5 years; body mass index z-scores (BMI-Z), 1.63±1.03) and 69 subjects of Hispanic heritage (10.8±3.6 years; BMI-Z, 1.57±1.07). MC4R variants were characterized in vitro by cell surface expression, receptor binding and cyclic AMP response after agonist administration. BDNF single-nucleotide polymorphisms (SNPs) rs12291186, rs6265 and rs7124442 were also genotyped. RESULTS: In the Pima cohort, no significant differences in serum BDNF was observed for 43 LOF subjects versus 65 LOF-matched controls (age, sex and BMI matched; P=0.29) or 20 GOF subjects versus 20 GOF-matched controls (P=0.40). Serum BDNF was significantly associated with genotype for BDNF rs12291186 (P=0.006) and rs6265 (P=0.009), but not rs7124442 (P=0.99); BDNF SNPs did not interact with MC4R status to predict serum BDNF. In the Hispanic cohort, plasma BDNF was not significantly different among 21 LOF subjects, 20 GOF subjects and 28 controls (P=0.79); plasma BDNF was not predicted by BDNF genotype or BDNF-x-MC4R genotype interaction. CONCLUSIONS: Circulating BDNF concentrations were not significantly associated with MC4R functional status, suggesting that peripheral BDNF does not directly reflect hypothalamic BDNF secretion and/or that MC4R signaling is not a significant regulator of the bulk of BDNF expression in humans.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/metabolismo , Hispânico ou Latino , Hipotálamo/metabolismo , Indígenas Norte-Americanos , Obesidade/metabolismo , Polimorfismo de Nucleotídeo Único , Receptor Tipo 4 de Melanocortina/metabolismo , Adolescente , Adulto , Arizona , Fator Neurotrófico Derivado do Encéfalo/sangue , Fator Neurotrófico Derivado do Encéfalo/genética , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Predisposição Genética para Doença , Genótipo , Hispânico ou Latino/genética , Hispânico ou Latino/estatística & dados numéricos , Humanos , Indígenas Norte-Americanos/genética , Indígenas Norte-Americanos/estatística & dados numéricos , Estudos Longitudinais , Masculino , Mutação , Obesidade/etnologia , Obesidade/genética , Regiões Promotoras Genéticas , Receptor Tipo 4 de Melanocortina/sangue , Receptor Tipo 4 de Melanocortina/genética
14.
Clin Transplant ; 27(2): 169-77, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23216662

RESUMO

Hepatocellular carcinoma (HCC) continues to rise and is still a major cause of mortality. Orthotopic liver transplantation (OLT) continues to give patients the best chance for cure, but recurrence of the disease remains a problem. Even with the implementation of the Milan criteria, recurrence rates have been shown to be 8-15% in most studies and even higher in patients who are beyond the Milan criteria. Therefore, several investigators have looked into the value of adjuvant therapy using systemic cytotoxic chemotherapy in HCC after OLT. Unfortunately, most of the trials are very small, and the results have been disappointing. But trials using Licartin seem to be promising, and other drugs such as FOLFOX and sorafenib warrant further investigation based on their efficacy in the advanced disease. In this review, we will review the current data on efficacy and rationale of adjuvant treatment for HCC after OLT including novel biomarkers.


Assuntos
Antineoplásicos/uso terapêutico , Carcinoma Hepatocelular/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , Transplante de Fígado , Recidiva Local de Neoplasia/prevenção & controle , Anticorpos Monoclonais/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores/sangue , Carcinoma Hepatocelular/cirurgia , Quimioterapia Adjuvante , Fluoruracila/uso terapêutico , Humanos , Leucovorina/uso terapêutico , Neoplasias Hepáticas/cirurgia , Recidiva Local de Neoplasia/sangue , Recidiva Local de Neoplasia/diagnóstico , Niacinamida/análogos & derivados , Niacinamida/uso terapêutico , Compostos Organoplatínicos/uso terapêutico , Compostos de Fenilureia/uso terapêutico , Sorafenibe , Serina-Treonina Quinases TOR/antagonistas & inibidores
15.
Complement Ther Clin Pract ; 18(2): 106-13, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22500848

RESUMO

This study focused on the effect of a brief CBT-based relaxation/guided visualization intervention on perceived stress, dyadic satisfaction and psychological symptoms. This study also tested the hypothesis that indicators of global orientation including Sense of Coherence and Differentiation of Self would mediate between perceived stress and symptoms of physical, psychological and relational distress. A three session intervention used guided visualization scripts which incorporated relaxation and controlled breathing techniques as well as a CBT approach that focused on stress management and internal locus of control. Results indicated that after the intervention, participants showed lower levels of perceived stress and lower levels of dyadic distress, as well as lower psychological and physical complaints as reported with the Symptom Checklist-90-R. Both Sense of Coherence and Differentiation of Self were mediators for the effect of perceived stress on the number of endorsed symptoms.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Imagens, Psicoterapia/métodos , Terapia de Relaxamento/métodos , Estresse Psicológico/terapia , Adolescente , Adulto , Exercícios Respiratórios , Feminino , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Senso de Coerência , Resultado do Tratamento , Adulto Jovem
16.
Heart Lung ; 40(4): 310-9, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21724041

RESUMO

OBJECTIVE: Previous research indicates the beneficial effects of humor among healthy adults. Little is known about the physical and psychological effects of sense of humor and laughter among patients with chronic obstructive pulmonary disease (COPD). METHODS: Patients with COPD (n = 46; mean age ± SD, 66.9 ± 9.9 years) completed assessments of sense of humor, depression, anxiety, quality of life, and recent illness. A subset of patients (n = 22) completed a laughter induction study and were randomly assigned to view either a humorous or a neutral video. Pulmonary function, mood state, and dyspnea were assessed before and after the video. RESULTS: Sense of humor was associated with fewer symptoms of depression and anxiety and an enhanced quality of life. However, the induction of laughter led to lung hyperinflation. CONCLUSION: Sense of humor among patients with COPD is associated with positive psychological functioning and enhanced quality of life, but laughing aloud may cause acute deterioration in pulmonary function secondary to worsened hyperinflation.


Assuntos
Adaptação Psicológica , Depressão/psicologia , Terapia do Riso/métodos , Doença Pulmonar Obstrutiva Crônica/psicologia , Qualidade de Vida/psicologia , Senso de Humor e Humor como Assunto/psicologia , Afeto , Idoso , Análise de Variância , Depressão/terapia , Feminino , Nível de Saúde , Humanos , Masculino , Psicometria , Análise de Regressão , Testes de Função Respiratória , Autorrelato , Estatística como Assunto , Estresse Psicológico , Inquéritos e Questionários , Fatores de Tempo
17.
J Clin Oncol ; 28(31): 4714-21, 2010 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-20876421

RESUMO

PURPOSE: To determine whether [(18)F]fluorodeoxyglucose positron emission tomography (FDG-PET) can delineate patients with esophageal cancer who may not benefit from esophagectomy after chemoradiotherapy. PATIENTS AND METHODS: We reviewed records of 163 patients with histologically confirmed stage I to IVA esophageal cancer receiving chemoradiotherapy with or without resection with curative intent. All patients received surgical evaluation. Initial and postchemoradiotherapy FDG-PET scans and prognostic/treatment variables were analyzed. FDG-PET complete response (PET-CR) after chemoradiotherapy was defined as standardized uptake value ≤ 3. RESULTS: Eighty-eight patients received trimodality therapy and 75 received chemoradiotherapy. Surgery was deferred primarily due to medical inoperability or unresectable/metastatic disease after chemoradiotherapy. A total of 105 patients were evaluable for postchemoradiotherapy FDG-PET response. Thirty-one percent achieved a PET-CR. PET-CR predicted for improved outcomes for chemoradiotherapy (2-year overall survival, 71% v 11%, P < .01; 2-year freedom from local failure [LFF], 75% v 28%, P < .01), but not trimodality therapy. On multivariate analysis of patients treated with chemoradiotherapy, PET-CR is the strongest independent prognostic variable (survival hazard ratio [HR], 9.82, P < .01; LFF HR, 14.13, P < .01). PET-CR predicted for improved outcomes regardless of histology, although patients with adenocarcinoma achieved a PET-CR less often. CONCLUSION: Patients treated with trimodality therapy found no benefit with PET-CR, likely because FDG-PET residual disease was resected. Definitive chemoradiotherapy patients achieving PET-CR had excellent outcomes equivalent to trimodality therapy despite poorer baseline characteristics. Patients who achieve a PET-CR may not benefit from added resection given their excellent outcomes without resection. These results should be validated in a prospective trial of FDG-PET-directed therapy for esophageal cancer.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/patologia , Esofagectomia , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Capecitabina , Quimioterapia Adjuvante , Meios de Contraste , Desoxicitidina/administração & dosagem , Desoxicitidina/análogos & derivados , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/radioterapia , Neoplasias Esofágicas/cirurgia , Feminino , Fluoruracila/administração & dosagem , Fluoruracila/análogos & derivados , Humanos , Estimativa de Kaplan-Meier , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Paclitaxel/administração & dosagem , Compostos de Platina/administração & dosagem , Tomografia por Emissão de Pósitrons/métodos , Valor Preditivo dos Testes , Compostos Radiofarmacêuticos , Dosagem Radioterapêutica , Radioterapia Adjuvante , Indução de Remissão , Estudos Retrospectivos , Resultado do Tratamento
18.
Solid State Nucl Magn Reson ; 36(3): 129-36, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19765956

RESUMO

Supermicroporous paramagnetic materials SiO(2)-Al(2)O(3)-MnO and SiO(2)-MnO with different manganese concentrations have been probed by solid-state (29)Si NMR and magnetic susceptibility measurements. The (29)Si T(1) and T(2) experiments, performed in static and spinning samples, have resulted in determination of electron relaxation times, providing, in turn, quantitative interpretations of (29)Si T(1) times in terms of distances Mn-Si. The NMR relaxation data have revealed (29)Si T(1) time distributions, which are close to Gaussian and observed as different T(1) values obtained in MAS NMR experiments for isotropic (29)Si resonances and their sidebands. Such (29)Si T(1) distributions, being a common phenomenon in paramagnetic silica-based materials, can be however masked by the bulk magnetic susceptibility (BMS) effects increasing with concentrations of paramagnetic centers. The presence of T(1) distributions, in itself, is not a criterion for incorporation of paramagnetic ions into the silica matrix or its surface. However, a quantitative analysis of the experimentally-observed short (29)Si T(1) components, based on the well-determined electron relaxation times, can provide such a criterion.


Assuntos
Espectroscopia de Ressonância Magnética/métodos , Compostos de Manganês/química , Óxidos/química , Dióxido de Silício/química , Óxido de Alumínio/química , Isótopos , Porosidade , Silício
19.
Eye (Lond) ; 22(4): 592-6, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17464304

RESUMO

PURPOSE: To investigate the anatomic basis of atypical angiographic leaks in central serous chorioretinopathy (CSC) with optical coherence tomography (OCT). METHODS: Fluorescein angiography (FA) and OCT were performed in three eyes of three patients (two men, one woman) with CSC. The angiographic leaks were treated with transpupillary thermotherapy (TTT) in two patients with long-standing CSC. The investigations were repeated in the treated patients during follow-up visits. RESULTS: Clinically, all patients demonstrated typical CSC; the female patient had subretinal fibrin under the detachment. FA showed unusual leakage patterns and OCT revealed bridging tissue connecting the pigment epithelial detachment (PED) to the overlying detached retina in all patients. CSC resolved completely in the two patients who underwent TTT along with normalization of the OCT findings. In one patient re-evaluated before complete resolution of CSC, OCT showed a flattened PED with disappearance of the bridging tissue and persistent serous detachment. FA demonstrated conversion of the previously atypical leak into a classic 'smokestack' configuration. Over the next month, leakage resolved completely. CSC and the anatomical findings persisted in the untreated patient. CONCLUSION: OCT identified a potential anatomic basis for unusual angiographic leakage pattern in all three cases of CSC evaluated.


Assuntos
Doenças da Coroide/diagnóstico , Doenças Retinianas/diagnóstico , Adulto , Doenças da Coroide/patologia , Doenças da Coroide/cirurgia , Extravasamento de Materiais Terapêuticos e Diagnósticos/patologia , Feminino , Angiofluoresceinografia , Humanos , Masculino , Doenças Retinianas/patologia , Doenças Retinianas/cirurgia , Tomografia de Coerência Óptica
20.
Eye (Lond) ; 22(1): 100-6, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16732205

RESUMO

AIM: To evaluate transpupillary thermotherapy (TTT) for the treatment of subfoveal focal leaks in central serous chorioretinopathy (CSC). METHODS: The patients presenting with long-standing CSC, but without the features of chronicity, were offered the options of TTT, photodynamic therapy (for subfoveal leaks), photocoagulation (for extrafoveal leaks), or observation. The patients who opted for TTT or observation were enrolled in this study. TTT was performed using a spot diameter of 0.5 mm for 1 min. Best-corrected visual acuity (BCVA), status of macular detachment, and fluorescein angiographic status were evaluated at 1, 3, and 6 months. RESULTS: This study included 39 patients (40 eyes) with CSC between 4 and 12 months, of whom 25 patients (25 eyes) opted for TTT for subfoveal leaks. Fourteen patients (15 eyes) were followed up without treatment. The groups were comparable in age, sex, and baseline BCVA. Minimum follow-up was 6 months. Within 3 months, TTT resulted in the resolution of the serous detachment in 24 (96%) eyes with a single session; one eye required a repeat treatment. Eight control eyes demonstrated persisting CSC at the last follow-up. Visual acuity improved in 23 (92%) treated and five (33%) control eyes; the difference in outcome was statistically significant (P<0.001). One case developed choroidal neovascularization, which resolved with visual recovery to 20/20 after repeat-TTT. CONCLUSION: TTT resulted in the resolution of CSC with subfoveal angiographic leaks with significant improvement in visual outcome, in comparison to the natural history of persistent CSC.


Assuntos
Doenças da Coroide/terapia , Hipertermia Induzida/métodos , Doenças Retinianas/terapia , Adulto , Estudos de Casos e Controles , Corioide , Feminino , Seguimentos , Fóvea Central , Humanos , Masculino , Pessoa de Meia-Idade , Estatística como Assunto , Tomografia , Acuidade Visual
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