RESUMEN
BACKGROUND AND AIMS: The overall evidence on the association between gallbladder conditions (GBC: gallstones and cholecystectomy) and pancreatic cancer (PC) is inconsistent. To our knowledge, no previous investigations considered the role of tumour characteristics on this association. Thus, we aimed to assess the association between self-reported GBC and PC risk, by focussing on timing to PC diagnosis and tumour features (stage, location, and resection). METHODS: Data derived from a European case-control study conducted between 2009 and 2014 including 1431 PC cases and 1090 controls. We used unconditional logistic regression models to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs) adjusted for recognized confounders. RESULTS: Overall, 298 (20.8%) cases and 127 (11.6%) controls reported to have had GBC, corresponding to an OR of 1.70 (95% CI 1.33-2.16). The ORs were 4.84 (95% CI 2.96-7.89) for GBC diagnosed <3 years before PC and 1.06 (95% CI 0.79-1.41) for ≥3 years. The risk was slightly higher for stage I/II (OR = 1.71, 95% CI 1.15-2.55) vs. stage III/IV tumours (OR = 1.23, 95% CI 0.87-1.76); for tumours sited in the head of the pancreas (OR = 1.59, 95% CI 1.13-2.24) vs. tumours located at the body/tail (OR = 1.02, 95% CI 0.62-1.68); and for tumours surgically resected (OR = 1.69, 95% CI 1.14-2.51) vs. non-resected tumours (OR = 1.25, 95% CI 0.88-1.78). The corresponding ORs for GBC diagnosed ≥3 years prior PC were close to unity. CONCLUSION: Our study supports the association between GBC and PC. Given the time-risk pattern observed, however, this relationship may be non-causal and, partly or largely, due to diagnostic attention and/or reverse causation.
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Enfermedades de la Vesícula Biliar , Neoplasias de la Vesícula Biliar , Neoplasias Pancreáticas , Estudios de Casos y Controles , Enfermedades de la Vesícula Biliar/cirugía , Neoplasias de la Vesícula Biliar/diagnóstico , Neoplasias de la Vesícula Biliar/epidemiología , Neoplasias de la Vesícula Biliar/etiología , Humanos , Modelos Logísticos , Páncreas/patología , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/epidemiología , Neoplasias Pancreáticas/etiología , Factores de Riesgo , Neoplasias PancreáticasRESUMEN
Background: Family history (FH) of pancreatic cancer (PC) has been associated with an increased risk of PC, but little is known regarding the role of inherited/environmental factors or that of FH of other comorbidities in PC risk. We aimed to address these issues using multiple methodological approaches. Methods: Case-control study including 1431 PC cases and 1090 controls and a reconstructed-cohort study (N = 16 747) made up of their first-degree relatives (FDR). Logistic regression was used to evaluate PC risk associated with FH of cancer, diabetes, allergies, asthma, cystic fibrosis and chronic pancreatitis by relative type and number of affected relatives, by smoking status and other potential effect modifiers, and by tumour stage and location. Familial aggregation of cancer was assessed within the cohort using Cox proportional hazard regression. Results: FH of PC was associated with an increased PC risk [odds ratio (OR) = 2.68; 95% confidence interval (CI): 2.27-4.06] when compared with cancer-free FH, the risk being greater when ≥ 2 FDRs suffered PC (OR = 3.88; 95% CI: 2.96-9.73) and among current smokers (OR = 3.16; 95% CI: 2.56-5.78, interaction FHPC*smoking P-value = 0.04). PC cumulative risk by age 75 was 2.2% among FDRs of cases and 0.7% in those of controls [hazard ratio (HR) = 2.42; 95% CI: 2.16-2.71]. PC risk was significantly associated with FH of cancer (OR = 1.30; 95% CI: 1.13-1.54) and diabetes (OR = 1.24; 95% CI: 1.01-1.52), but not with FH of other diseases. Conclusions: The concordant findings using both approaches strengthen the notion that FH of cancer, PC or diabetes confers a higher PC risk. Smoking notably increases PC risk associated with FH of PC. Further evaluation of these associations should be undertaken to guide PC prevention strategies.
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Neoplasias Pancreáticas/epidemiología , Fumar/efectos adversos , Adulto , Anciano , Estudios de Casos y Controles , Estudios de Cohortes , Diabetes Mellitus/epidemiología , Europa (Continente)/epidemiología , Femenino , Humanos , Modelos Logísticos , Masculino , Anamnesis , Persona de Mediana Edad , Neoplasias/epidemiología , Neoplasias Pancreáticas/genética , Medición de Riesgo , Factores de RiesgoRESUMEN
Atrial fibrillation (AF) represents the most common arrhythmia in patients with chronic kidney disease (CKD). As in the general population, in CKD patients AF is associated with an increased risk of thromboembolism and stroke. However, CKD patients, especially those on renal replacement therapy (RRT), also exhibit an increased risk of bleeding, especially from the gastrointestinal tract. Oral anticoagulation is the most effective form of thromboprophylaxis in patients with AF presenting increased risk of stroke. Limited evidence on efficacy, the increased risk of bleeding as well as some concern regarding the use of warfarin in CKD, has often resulted in the underuse of anticoagulation CKD patients. A large body of evidence suggests that non-vitamin K-dependent oral anticoagulant agents (NOACs) significantly reduce the risk of stroke, intracranial hemorrhage, and mortality, with lower to similar major bleeding rates compared with vitamin K antagonist such as warfarin in normal renal function subjects. Hence, they are currently recommended for patients with atrial fibrillation at risk for stroke. However, NOACs metabolism is largely dependent on the kidneys for elimination and little is known in patients with creatinine clearance <25ml/min who were excluded from all pivotal phase 3 NOACs trials. This review focuses on the current pharmacokinetic, observational, and prospective data on NOACs in patients with moderate to advanced chronic kidney disease (creatinine clearance 15-49ml/min) and those on dialysis.
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Anticoagulantes/uso terapéutico , Fibrilación Atrial/complicaciones , Fibrilación Atrial/tratamiento farmacológico , Insuficiencia Renal Crónica/complicaciones , Accidente Cerebrovascular/prevención & control , Tromboembolia/prevención & control , Administración Oral , Anticoagulantes/administración & dosificación , Anticoagulantes/efectos adversos , Anticoagulantes/farmacocinética , Dabigatrán/administración & dosificación , Dabigatrán/efectos adversos , Dabigatrán/farmacocinética , Dabigatrán/uso terapéutico , Hemorragia/inducido químicamente , Humanos , Estudios Prospectivos , Pirazoles/administración & dosificación , Pirazoles/efectos adversos , Pirazoles/farmacocinética , Pirazoles/uso terapéutico , Piridinas/administración & dosificación , Piridinas/efectos adversos , Piridinas/farmacocinética , Piridinas/uso terapéutico , Piridonas/administración & dosificación , Piridonas/efectos adversos , Piridonas/farmacocinética , Piridonas/uso terapéutico , Rivaroxabán/administración & dosificación , Rivaroxabán/efectos adversos , Rivaroxabán/farmacocinética , Rivaroxabán/uso terapéutico , Accidente Cerebrovascular/etiología , Tiazoles/administración & dosificación , Tiazoles/efectos adversos , Tiazoles/farmacocinética , Tiazoles/uso terapéutico , Tromboembolia/etiología , Warfarina/administración & dosificación , Warfarina/efectos adversos , Warfarina/farmacocinética , Warfarina/uso terapéuticoRESUMEN
According to the recent definition proposed by the Consensus conference on Acute Dialysis Quality Initiative Group, the term cardio-renal syndrome (CRS) has been used to define different clinical conditions in which heart and kidney dysfunction overlap. Type 1 CRS (acute cardio- renal syndrome) is characterized by acute worsening of cardiac function leading to AKI (5, 6) in the setting of active cardiac disease such as ADHF, while type - 2 CRS occurs in a setting of chronic heart disease. Type 3 CRS is closely link to acute kidney injury (AKI), while type 4 represent cardiovascular involvement in chronic kidney disese (CKD) patients. Type 5 CRS represent cardiac and renal involvement in several diseases such as sepsis, hepato - renal syndrome and immune - mediated diseases.
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Síndrome Cardiorrenal/fisiopatología , Función Ventricular/fisiología , Progresión de la Enfermedad , HumanosRESUMEN
BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is usually diagnosed in late adulthood; therefore, many patients suffer or have suffered from other diseases. Identifying disease patterns associated with PDAC risk may enable a better characterization of high-risk patients. METHODS: Multimorbidity patterns (MPs) were assessed from 17 self-reported conditions using hierarchical clustering, principal component, and factor analyses in 1705 PDAC cases and 1084 controls from a European population. Their association with PDAC was evaluated using adjusted logistic regression models. Time since diagnosis of morbidities to PDAC diagnosis/recruitment was stratified into recent (<3 years) and long term (≥3 years). The MPs and PDAC genetic networks were explored with DisGeNET bioinformatics-tool which focuses on gene-diseases associations available in curated databases. RESULTS: Three MPs were observed: gastric (heartburn, acid regurgitation, Helicobacter pylori infection, and ulcer), metabolic syndrome (obesity, type-2 diabetes, hypercholesterolemia, and hypertension), and atopic (nasal allergies, skin allergies, and asthma). Strong associations with PDAC were observed for ≥2 recently diagnosed gastric conditions [odds ratio (OR), 6.13; 95% confidence interval CI 3.01-12.5)] and for ≥3 recently diagnosed metabolic syndrome conditions (OR, 1.61; 95% CI 1.11-2.35). Atopic conditions were negatively associated with PDAC (high adherence score OR for tertile III, 0.45; 95% CI, 0.36-0.55). Combining type-2 diabetes with gastric MP resulted in higher PDAC risk for recent (OR, 7.89; 95% CI 3.9-16.1) and long-term diagnosed conditions (OR, 1.86; 95% CI 1.29-2.67). A common genetic basis between MPs and PDAC was observed in the bioinformatics analysis. CONCLUSIONS: Specific multimorbidities aggregate and associate with PDAC in a time-dependent manner. A better characterization of a high-risk population for PDAC may help in the early diagnosis of this cancer. The common genetic basis between MP and PDAC points to a mechanistic link between these conditions.
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Carcinoma Ductal Pancreático/epidemiología , Biología Computacional , Neoplasias Pancreáticas/epidemiología , Análisis de Sistemas , Biología de Sistemas , Biomarcadores de Tumor/genética , Carcinoma Ductal Pancreático/diagnóstico , Carcinoma Ductal Pancreático/genética , Estudios de Casos y Controles , Análisis por Conglomerados , Comorbilidad , Bases de Datos Genéticas , Europa (Continente)/epidemiología , Análisis Factorial , Humanos , Modelos Logísticos , Análisis Multivariante , Oportunidad Relativa , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/genética , Análisis de Componente Principal , Medición de Riesgo , Factores de Riesgo , Factores de TiempoRESUMEN
Chronic kidney disease (CKD) patients demonstrate higher rates of cardiovascular mortality and morbidity; and increased incidence of sudden cardiac death (SCD) with declining kidney failure. Coronary artery disease (CAD) associated risk factors are the major determinants of SCD in the general population. However, current evidence suggests that in CKD patients, traditional cardiovascular risk factors may play a lesser role. Complex relationships between CKD-specific risk factors, structural heart disease, and ventricular arrhythmias (VA) contribute to the high risk of SCD. In dialysis patients, the occurrence of VA and SCD could be exacerbated by electrolyte shifts, divalent ion abnormalities, sympathetic overactivity, inflammation and iron toxicity. As outcomes in CKD patients after cardiac arrest are poor, primary and secondary prevention of SCD and cardiac arrest could reduce cardiovascular mortality in patients with CKD.
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Muerte Súbita Cardíaca/epidemiología , Insuficiencia Renal Crónica/complicaciones , Enfermedad de la Arteria Coronaria/complicaciones , Manejo de la Enfermedad , Humanos , Diálisis Renal/efectos adversos , Factores de Riesgo , Prevención Secundaria , Fibrilación Ventricular/complicacionesRESUMEN
Cardiovascular disease (CV) represents the main risk factor for morbidity and mortality in chronic kidney disease (CKD) patients. Large epidemiological studies have shown direct association between severity of CKD and CV event rates. Although patients with end-stage renal disease (ESRD), including dialysis ones, are at greater CV risk, cardiovascular involvement is already evident at the early stages of CKD. End-stage CKD is characterized conventional atherosclerotic risk factor but they cannot account for CV risk as reï¬ected in high rates of sudden cardiac death, heart failure and myocardial infarction. Non-atherosclerotic processes, including left ventricular hypertrophy and ï¬brosis, mostly account for the excess risk of CV. Employment of cardiac magnetic resonance (CMR) in CKD has brought an improved understanding of the adverse CV changes, known as uremic cardiomyopathy. It is due to ability of cardiac magnetic resonance to provide a comprehensive non - invasive examination of cardiac structure and function, arterial function, myocardial tissue characterization (T1 mapping and inversion recovery imaging), and myocardial metabolic function (spectroscopy).
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Técnicas de Imagen Cardíaca/métodos , Cardiomiopatías/diagnóstico por imagen , Cardiomiopatías/etiología , Espectroscopía de Resonancia Magnética , Insuficiencia Renal Crónica/complicaciones , Uremia/complicaciones , Enfermedades Cardiovasculares/diagnóstico por imagen , Enfermedades Cardiovasculares/etiología , Humanos , Insuficiencia Renal Crónica/fisiopatología , Rigidez Vascular , Función Ventricular IzquierdaRESUMEN
Pulmonary hypertension is defined as an increased systolic pulmonary pressure of >30 mm Hg, and it shows a 40% prevalence in hemodialysis patients due to vascular access (both central venous catheter and arteriovenous fistula). Secondary pulmonary hypertension in chronic kidney disease patients is strictly related to pulmonary circulation impairment together with chronic volume overload and increased levels of cytokines and growth factors, such as FGF, PDGF, and TGF-ß, leading to fibrosis. Endothelial dysfunction, together with lower activation of NOS, increased levels of serum endothelin and fibrin storages, involves an extensive growth of endothelial cells leading to complete obliteration of pulmonary vessels. Pulmonary hypertension has no pathognomonic and distinctive symptoms and signs; standard transthoracic echocardiography allows easy assessment of compliance of the right heart chambers. The therapeutic approach is based on traditional drugs such as digitalis-derived drugs, vasodilatory agents (calcium channel blockers), and oral anticoagulants. New pharmacological agents are under investigation, such as prostaglandin analogues, endothelin receptor blockers, and phosphodiesterase-5 inhibitors.
RESUMEN
BACKGROUND: The incidence of colorectal cancer (CRC) in Peru has been increasing, and no data have been published on the molecular features. We explored the most relevant genetic events involved in colorectal carcinogenesis, with clinical implications. METHODS: Using immunohistochemistry for mismatch-repair (MMR) proteins (MLH1, MSH2, MSH6, and PMS2) and microsatellite instability analysis, we evaluated the status of 90 non-selected CRC Peruvian patients followed in a nationwide reference hospital for cancer (INEN, Lima). Tumours with loss of hMLH1 were evaluated further for hMLH1 promoter hypermethylation and all cases were evaluated for the presence of KRAS and BRAF-V600E mutations. RESULTS: MMR deficiency was found in 35 (38.8%) patients. We identified an unexpected association between MMR deficiency and older age. Among the 14 cases with loss of MLH1, 10 samples exhibited hypermethylation. Of the 90 cases evaluated, 15 (16.7%) carried KRAS mutations; we found one previously unreported mutation (G13R). CONCLUSIONS: Peruvian CRC tumours exhibited the highest prevalence of MMR deficiency reported to date. The expected hereditary component was also high. The age of onset of these MMR deficient tumours was greater than that observed for non-MMR deficient cases, suggesting the ineffectiveness of the Bethesda criteria for Lynch syndrome screening in Peru. Prospective studies are warranted to define the molecular characteristics of CRC in this population.
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Neoplasias Colorrectales/genética , Reparación de la Incompatibilidad de ADN/genética , Trastornos por Deficiencias en la Reparación del ADN/genética , Mutación , Proteínas Proto-Oncogénicas/genética , Proteínas ras/genética , Adulto , Edad de Inicio , Anciano , Anciano de 80 o más Años , Disparidad de Par Base , Neoplasias Colorrectales/epidemiología , Neoplasias Colorrectales/metabolismo , Trastornos por Deficiencias en la Reparación del ADN/metabolismo , Trastornos por Deficiencias en la Reparación del ADN/patología , Proteínas de Unión al ADN/metabolismo , Femenino , Silenciador del Gen , Humanos , Inmunohistoquímica , Masculino , Metilación , Inestabilidad de Microsatélites , Persona de Mediana Edad , Estadificación de Neoplasias , Regiones Promotoras Genéticas/genética , Proteínas Proto-Oncogénicas/metabolismo , Proteínas Proto-Oncogénicas p21(ras) , Adulto Joven , Proteínas ras/metabolismoRESUMEN
AIMS: A new real-time PCR assay that simultaneously amplifies a 102-bp fragment of the cagE gene from Helicobacter pylori and a new internal positive control containing a specific sequence of the gyrB gene from Aeromonas hydrophila, was developed and validated for the detection of H. pylori in environmental samples. METHODS AND RESULTS: The specificity, limits of detection and quantification, repeatability, reproducibility, and accuracy of the method were calculated. The resulting values confirmed the applicability of the method for the quantitative detection of H. pylori. The feasibility of the method was also evaluated by testing 13 pyloric antrum-positive biopsies and 69 water samples, including potable (10), surface (19) and wastewater (40) matrices. The results showed that all the biopsies and 3 of the 40 wastewater samples analysed were positive. CONCLUSIONS: This real-time PCR method provides a sensitive, specific, and accurate method for the rapid quantification of H. pylori in environmental samples. SIGNIFICANCE AND IMPACT OF THE STUDY: The PCR diagnostic system proposed in this work, provides a suitable tool for the quantitative detection of H. pylori in environmental samples and can be useful for verifying the role of water as a potential route of its transmission.
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Proteínas Bacterianas/genética , Helicobacter pylori/aislamiento & purificación , Reacción en Cadena de la Polimerasa/métodos , Microbiología del Agua , Abastecimiento de Agua , Cartilla de ADN , ADN Bacteriano/análisis , Helicobacter pylori/genética , Límite de Detección , Sensibilidad y Especificidad , Eliminación de Residuos LíquidosRESUMEN
We report a new seminested PCR method for detection of Legionella pneumophila based on the simultaneous amplification of a 387 bp fragment of the dotA gene and a 827 bp recombinant fragment that serves as an internal positive control. This new detection system was validated and its specificity and detection limit were determined. Parallel analysis of 90 environmental samples to compare this method, a real-time PCR method and the standard culture isolation method, demonstrated that this seminested method is useful for the study of L. pneumophila.
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Técnicas Bacteriológicas , Legionella pneumophila/aislamiento & purificación , Reacción en Cadena de la Polimerasa/métodos , Microbiología del Agua , Proteínas Bacterianas/genética , Proteínas Portadoras/genética , Legionella pneumophila/genética , Proteínas de la Membrana/genética , Reacción en Cadena de la Polimerasa/normas , Estándares de Referencia , Sensibilidad y EspecificidadRESUMEN
Exocrine pancreatic cancer is one of the neoplasias with a worse prognosis, with conventional treatments having little impact on disease outcome. Research and genomic high-throughput technology is continuously expanding our knowledge of pancreas cancer biology. Characterization of genetic and epigenetic alterations in pancreatic tumors has allowed a better understanding of the progression model of the disease at the molecular level. The development of new therapeutic approaches with target- oriented agents is been tested in the preclinical and clinical settings. This review updates the current available data on pancreatic cancer molecular biology.
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Genes Supresores de Tumor , Oncogenes , Neoplasias Pancreáticas/genética , Carcinoma Ductal Pancreático/genética , Aberraciones Cromosómicas , Progresión de la Enfermedad , Perfilación de la Expresión Génica , Regulación Neoplásica de la Expresión Génica , Genes p16 , Genes p53 , Genes ras , Humanos , Proteínas de Neoplasias/genética , Síndromes Neoplásicos Hereditarios/genética , PronósticoRESUMEN
A new real-time PCR assay was developed and validated in combination with an immunomagnetic separation system for the quantitative determination of Legionella pneumophila in water samples. Primers that amplify simultaneously an 80-bp fragment of the dotA gene from L. pneumophila and a recombinant fragment including a specific sequence of the gyrB gene from Aeromonas hydrophila, added as an internal positive control, were used. The specificity, limit of detection, limit of quantification, repetitivity, reproducibility, and accuracy of the method were calculated, and the values obtained confirmed the applicability of the method for the quantitative detection of L. pneumophila. Moreover, the efficiency of immunomagnetic separation in the recovery of L. pneumophila from different kinds of water was evaluated. The recovery rates decreased as the water contamination increased (ranging from 59.9% for distilled water to 36% for cooling tower water), and the reproducibility also decreased in parallel to water complexity. The feasibility of the method was evaluated by cell culture and real-time PCR analysis of 60 samples in parallel. All the samples found to be positive by cell culture were also positive by real-time PCR, while only eight samples were found to be positive only by PCR. Finally, the correlation of both methods showed that the number of cells calculated by PCR was 20-fold higher than the culture values. In conclusion, the real-time PCR method combined with immunomagnetic separation provides a sensitive, specific, and accurate method for the rapid quantification of L. pneumophila in water samples. However, the recovery efficiency of immunomagnetic separation should be considered in complex samples.
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Proteínas Bacterianas/genética , Proteínas Portadoras/genética , Agua Dulce/microbiología , Separación Inmunomagnética/métodos , Legionella pneumophila/aislamiento & purificación , Proteínas de la Membrana/genética , Reacción en Cadena de la Polimerasa/métodos , Abastecimiento de Agua , Cartilla de ADN , ADN Bacteriano/análisis , Legionella pneumophila/genética , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Contaminación del AguaRESUMEN
Fungal infections are an increasing cause of morbidity and mortality in patients with haematological malignancies. The organism most often responsible are Candida spp., particurarly Candida Albicans. This report describes our experience in a 63-year-old man who developed symptoms of hepatosplenic candidiasis caused by Candida tropicalis after treatment for acute myeloid leukaemia (AML). The fungal infection was successfully controlled using fluconazole, and the patient has been disease-free for more than 11 months after antileukemic chemotherapy without any recurrence of Candida infections. Our experience suggests that AML and chemotherapy associated fungal infections can be controlled with an appropriate therapeutic regimen.
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Antifúngicos/administración & dosificación , Candidiasis/tratamiento farmacológico , Daunorrubicina/administración & dosificación , Fluconazol/administración & dosificación , Leucemia Mielomonocítica Aguda/complicaciones , Antibióticos Antineoplásicos/administración & dosificación , Antineoplásicos/efectos adversos , Antineoplásicos/uso terapéutico , Candidiasis/inducido químicamente , Candidiasis/etiología , Supervivencia sin Enfermedad , Humanos , Enfermedades Renales/tratamiento farmacológico , Enfermedades Renales/virología , Liposomas , Hepatopatías/tratamiento farmacológico , Hepatopatías/virología , Masculino , Persona de Mediana Edad , Resultado del TratamientoAsunto(s)
Ciclofosfamida/uso terapéutico , Trasplante de Células Madre Hematopoyéticas , Inmunosupresores/uso terapéutico , Púrpura Trombocitopénica Trombótica/tratamiento farmacológico , Púrpura Trombocitopénica Trombótica/cirugía , Adulto , Humanos , Masculino , Intercambio Plasmático , Púrpura Trombocitopénica Trombótica/terapia , Trasplante Autólogo , Insuficiencia del TratamientoRESUMEN
INTRODUCTION: AILD-type T-cell lymphoma is characterized by very poor prognosis in most patients and the response rate to conventional chemotherapy is unsatisfactory. MATERIALS AND METHODS: Two patients (a 65 year old female and a 67 year old male) with AILD-type lymphoma who did not respond to conventional treatment with steroids or aggressive chemotherapy were treated with Methotrexate and Prednisone. Both patients received a weekly dose of MTX (10 mg/m(2)) that was administered orally in combination with PDN at an initial dose (15 mg/day), given on a daily basis. RESULTS: Both patients responded rapidly showing marked improvement with no major side effects. Complete clinical remission was recorded in the two patients who were treated with this combination after conventional chemotherapy had failed to produce any improvement. CONCLUSION: Our observations in two patients with refractory/relapsed AILD-type lymphoma who were given low-dose oral MTX as salvage treatment, suggest that this agent has immunosuppressive effects that can be beneficial for treating patients with AILD-type T-cell lymphoma. Pilot clinical trials are needed to verify its efficacy in this setting.
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Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Linfadenopatía Inmunoblástica/tratamiento farmacológico , Linfoma de Células T Periférico/tratamiento farmacológico , Metotrexato/administración & dosificación , Prednisona/administración & dosificación , Administración Oral , Anciano , Femenino , Humanos , Masculino , Inducción de Remisión , Terapia Recuperativa , Resultado del TratamientoRESUMEN
Small cell lung cancer (SCLC) expresses neuroectodermal markers including HuD, the best characterized member of the Hu gene family. The aim of this study is to optimize a simple and sensitive reverse transcriptase-polymerase chain reaction assay to detect circulating HuD-expressing cells for the early detection of SCLC recurrences. HuD-specific primers that selectively amplify the three HuD isoforms allowed the detection of one tumor cell/10(6) non-tumor cells. However, HuD transcripts were also detected in the mononuclear fraction of all samples from normal individuals (n=6) and patients with SCLC (n=5). By contrast, HuD protein was not detected in these fractions using Western blotting. More quantitative assays are necessary to examine the value of HuD transcript detection for the identification of tumor recurrences.