RESUMO
The proteasome inhibitor bortezomib is approved for the treatment of patients with relapsed/refractory multiple myeloma. Botezomib represents a new generation of treatments for multiple myeloma that affects both specific intracellular signaling pathways and the tumor microenvironment. There is a growing body of clinical evidence showing its effectiveness alone and in combination not only in relapsed/refractory cases but also in the front line setting. Regimens incorporating bortezomib and other novel agents such as immunomodulatory derivatives of thalidomide together with commonly used conventional drugs show considerable high response rates including complete response that resulting in improving survival, with or without following stem cell transplantation. Thus these approaches represent a promising future direction in myeloma treatment.
Assuntos
Ácidos Borônicos , Mieloma Múltiplo/tratamento farmacológico , Inibidores de Proteases , Inibidores de Proteassoma , Pirazinas , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ácidos Borônicos/administração & dosagem , Ácidos Borônicos/farmacologia , Bortezomib , Ensaios Clínicos como Assunto , Doxorrubicina/administração & dosagem , Doxorrubicina/uso terapêutico , Humanos , Lipossomos , Melfalan/administração & dosagem , Mieloma Múltiplo/etiologia , NF-kappa B/antagonistas & inibidores , NF-kappa B/fisiologia , Inibidores de Proteases/administração & dosagem , Inibidores de Proteases/farmacologia , Pirazinas/administração & dosagem , Pirazinas/farmacologia , Talidomida/administração & dosagemRESUMO
OBJECTIVES: To investigate the intramuscular changes on sonographic elastography (SE) after low-level static contraction of the masseter muscle, and to clarify the relationship with the total hardness and edematous change. STUDY DESIGN: Ten healthy volunteers performed sustained bilateral biting at 20% of maximal voluntary contraction for 10 min. The SE and magnetic resonance (MR) scans of the masseter muscles were performed before, immediately after, and 10 min after exercise. The masseter muscle elasticity index (MEI) ratio, muscle thickness, and intramuscular soft and hard areas distribution were evaluated on SE images. The signal to noise ratio (SNR), indicating the water content, was measured on MR images. RESULTS: The soft area ratio showed significant correlations with the water content expressed as SNR. The hard area ratio showed significant correlations with the total muscle hardness expressed as the MEI ratio. CONCLUSION: Intramuscular soft and hard areas could be used both clinically and experimentally.