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1.
Int J Cancer ; 139(12): 2859-2864, 2016 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-27578417

RESUMEN

Mechanisms of acquired resistance to trastuzumab-based treatment in gastric cancer are largely unknown. In this study, we analyzed 22 pairs of tumor samples taken at baseline and post-progression in patients receiving chemotherapy and trastuzumab for advanced HER2-positive [immunohistochemistry (IHC) 3+ or 2+ with in-situ hybridization (ISH) amplification] gastric or gastroesophageal cancers. Strict clinical criteria for defining acquired trastuzumab resistance were adopted. Loss of HER2 positivity and loss of HER2 over-expression were defined as post-trastuzumab IHC score <3+ and absence of ISH amplification, and IHC "downscoring" from 2+/3+ to 0/1+, respectively. HER2 IHC was always performed, while ISH was missing in 3 post-progression samples. Patients with initial HER2 IHC score 3+ and 2+ were 14 (64%) and 8 (36%), respectively. Loss of HER2 positivity and HER2 over-expression was observed in 32 and 32% samples, respectively. The chance of HER2 loss was not associated with any of the baseline clinicopathological variables. The only exception was in patients with initial IHC score 2+ versus 3+, for both endpoints of HER2 positivity (80 vs. 14%; p = 0.008) and HER2 over-expression (63 vs. 14%; p = 0.025). As already shown in breast cancer, loss of HER2 may be observed also in gastric cancers patients treated with trastuzumab-based chemotherapy in the clinical practice. This phenomenon may be one of the biological reasons explaining the failure of anti-HER2 second-line strategies in initially HER2-positive disease.


Asunto(s)
Neoplasias Esofágicas/metabolismo , Receptor ErbB-2/metabolismo , Neoplasias Gástricas/metabolismo , Antineoplásicos/uso terapéutico , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/tratamiento farmacológico , Neoplasias Esofágicas/genética , Femenino , Humanos , Inmunohistoquímica , Masculino , Terapia Molecular Dirigida , Metástasis de la Neoplasia , Estadificación de Neoplasias , Receptor ErbB-2/antagonistas & inhibidores , Receptor ErbB-2/genética , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/genética , Trastuzumab/uso terapéutico , Resultado del Tratamiento
2.
Int J Sports Med ; 35(3): 245-52, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23913158

RESUMEN

Most studies regarding the impact of exercise intensity on cardiac autonomic regulation were conducted with athletes and used exercise intensities exceeding those recommended by position stands. We evaluated the influence of exercise intensity in a typical ACSM-aerobic session on 24-h cardiac autonomic modulation in sedentary subjects. Ten healthy sedentary subjects participated in the 3-day study. On 2 days, subjects performed a moderate- or high-intensity aerobic exercise session (MI, HI). The post-exercise protocol consisted of a continuous electrocardiographic recording for 1 h at the laboratory plus 23 h under ambulatory conditions. On the third day 24-h electrocardiographic recording was done without prior exercise (NPE). Heart rate (HR) and frequency-domain parameters (LF, HF) of heart rate variability were evaluated during the entire recovery period. Higher values of HR and lower values of HF and LF were observed throughout the first hour after the HI compared with the MI session. This difference was not observed after in ambulatory awake condition, but reappeared during sleep, when HF values after HI were lower compared with the NPE and MI (p<0.05). Even within the submaximal intensity-range of a typical exercise session, the intensity of exercise influences the post-exercise cardiac autonomic modulation in sedentary subjects.


Asunto(s)
Sistema Nervioso Autónomo/fisiología , Ejercicio Físico/fisiología , Frecuencia Cardíaca/fisiología , Corazón/inervación , Conducta Sedentaria , Adulto , Electrocardiografía , Electrocardiografía Ambulatoria , Prueba de Esfuerzo , Humanos , Esfuerzo Físico , Adulto Joven
3.
Curr Oncol ; 21(3): 125-33, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24940093

RESUMEN

BACKGROUND: To date, few studies of preoperative chemotherapy or chemoradiotherapy (crt) in gastroesophageal junction (gej) cancer have been statistically powered; indeed, gej tumours have thus far been grouped with esophageal or gastric cancer in phase iii trials, thereby generating conflicting results. METHODS: We studied 41 patients affected by locally advanced Siewert type i and ii gej adenocarcinoma who were treated with a neoadjuvant crt regimen [folfox4 (leucovorin-5-fluorouracil-oxaliplatin) for 4 cycles, and concurrent computed tomography-based three-dimensional conformal radiotherapy delivered using 5 daily fractions of 1.8 Gy per week for a total dose of 45 Gy], followed by surgery. Completeness of tumour resection (performed approximately 6 weeks after completion of crt), clinical and pathologic response rates, and safety and outcome of the treatment were the main endpoints of the study. RESULTS: All 41 patients completed preoperative treatment. Combined therapy was well tolerated, with no treatment-related deaths. Dose reduction was necessary in 8 patients (19.5%). After crt, 78% of the patients showed a partial clinical response, 17% were stable, and 5% experienced disease progression. Pathology examination of surgical specimens demonstrated a 10% complete response rate. The median and mean survival times were 26 and 36 months respectively (95% confidence interval: 14 to 37 months and 30 to 41 months respectively). On multivariate analysis, TNM staging and clinical response were demonstrated to be the only independent variables related to long-term survival. CONCLUSIONS: In our experience, preoperative chemoradiotherapy with folfox4 is feasible in locally advanced gej adenocarcinoma, but shows mild efficacy, as suggested by the low rate of pathologic complete response.

4.
Int Psychogeriatr ; 25(5): 785-95, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23388499

RESUMEN

BACKGROUND: In mild Alzheimer's disease (AD), a deficit in episodic memory, particularly autobiographical memory, is clearly established. Several recent studies have also shown impaired semantic memory from the onset of the disease. Musical memory capacities may be especially preserved and listening to music might encourage autobiographical recall. The aim of this study was to explore recall of popular songs in AD. METHODS: We tested 12 patients with mild AD and 12 control subjects. We created a tool made up of old French popular songs: POP 10. This tool is a questionnaire composed of several subtests: melodic free recall, chorus free recall, melodic recognition, chorus recognition, semantic knowledge, autobiographical recall about the song, and autobiographical recall about the interpreter. RESULTS: We used non-parametric tests, the Mann-Whitney test (M-W), the Friedman test, and the a posteriori Wilcoxon test. Results of AD patients were rather similar to those of control participants for melodic memory. Concerning chorus memory (except recognition), semantic knowledge, and autobiographical recall about the interpreter, results of AD patients were significantly weaker than those of control participants. The most important result concerned autobiographical recall about the song: we found no impairment-related differences between the two groups. CONCLUSION: Our findings demonstrate that popular songs can be excellent stimuli for reminiscence, such as the ability to produce an autobiographical memory related to a song. Thus, we confirm that musical semantic knowledge associated with a song may be relatively preserved in the early stages of AD. This leads to new possibilities for cognitive stimulation.


Asunto(s)
Trastornos de la Memoria/psicología , Memoria Episódica , Recuerdo Mental/fisiología , Música , Semántica , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/complicaciones , Enfermedad de Alzheimer/psicología , Femenino , Francia , Humanos , Masculino , Trastornos de la Memoria/etiología , Escala del Estado Mental , Pruebas Neuropsicológicas , Patrones de Reconocimiento Fisiológico , Reconocimiento en Psicología
5.
Int J Sports Med ; 34(10): 931-5, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23606338

RESUMEN

Previous study showed that muscle sympathetic nerve activity (MSNA) was augmented in anabolic steroids users (AASU). In the present study, we tested the hypothesis that the heart rate (HR) responses after maximal exercise testing would be reduced in AASU. 10 male AASU and 10 AAS nonusers (AASNU) were studied. Cardiopulmonary exercise was performed to assess the functional capacity and heart rate recovery. MSNA was recorded directly from the peroneal nerve by microneurography technique. Peak oxygen consumption (VO2) was lower in AASU compared to AASNU (43.66±2.24 vs. 52.70±1.68 ml/kg/min, P=0.005). HR recovery (HRR) at first and second minute was lower in AASU than AASNU (21±2 vs. 27±2 bpm, P=0.02 and 37±4 vs. 45±2 bpm, P=0.05, respectively). MSNA was higher in AASU than AASNU (29±3 vs. 20±1 bursts/min, P=0.01). Further analysis showed a correlation between HRR and MSNA (r=- 0.64, P=0.02), HRR at first minute and peak VO2 (r=0.70, P=0.01) and HRR at second minute and peak VO2 (r=0.62, P=0.02). The exacerbated sympathetic outflow associated with a lower parasympathetic activation after maximal exercise, which impairs heart rate recovery, strengthens the idea of autonomic imbalance in AASU.


Asunto(s)
Anabolizantes/efectos adversos , Andrógenos/efectos adversos , Ejercicio Físico/fisiología , Frecuencia Cardíaca/efectos de los fármacos , Adulto , Prueba de Esfuerzo , Tolerancia al Ejercicio/efectos de los fármacos , Tolerancia al Ejercicio/fisiología , Frecuencia Cardíaca/fisiología , Humanos , Masculino , Consumo de Oxígeno/efectos de los fármacos , Entrenamiento de Fuerza , Autoadministración , Sistema Nervioso Simpático/efectos de los fármacos
6.
Curr Oncol ; 20(4): e283-8, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23904766

RESUMEN

Increased insulin-like growth factor (igf) signalling has been observed in breast cancer, including endocrine-responsive cancers, and has been linked to disease progression and recurrence. In particular, igf-1 has the ability to induce and promote lymphangiogenesis through the induction of vascular endothelial growth factor C (vegfc). In the present study, we analyzed serum and tumour samples from 60 patients with endocrine-positive breast cancer to determine the expression and the possible relationship of circulating igf-1, igf binding protein 3 (igfbp3), and vegfc with the presence of lymphatic metastasis and other immunohistochemical parameters. The analysis revealed a clear and significant correlation between high basal levels of igf-1, igfbp3, and vegfc and lymph node metastasis in endocrine-responsive breast cancer. In addition, expression of those molecules was significantly higher in breast cancer patients than in healthy control subjects. Those findings may enable more accurate prediction of prognosis in patients with breast cancer.

7.
J Hand Surg Eur Vol ; 47(4): 364-368, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-35000473

RESUMEN

We used high-resolution ultrasound to examine 35 median nerves (35 patients) with failed carpal tunnel decompression to identify the cause of failure. The carpal tunnel was examined before revision surgery, and the results were correlated with surgical findings. The cross-sectional area was measured, and nerve morphology was analysed at the sites of compression. We found persistent median nerve compression in 30 out of 35 patients. In 20 patients, the compression was caused by a residual transverse carpal ligament, in four by perineural fibrosis, in five by both of these causes and in one by tenosynovitis. In four patients, evidence of median nerve injury with an epineural/fascicular lesion was detected; and in one, no abnormalities were found. Surgical findings were consistent with the ultrasound findings except in one patient where tenosynovitis was associated with a giant cell tumour, which was missed by ultrasound. High-resolution ultrasound can provide helpful information in preoperative diagnosis of failed carpal tunnel decompression with good correlation between the ultrasound and surgical findings.Level of evidence: IV.


Asunto(s)
Síndrome del Túnel Carpiano , Tenosinovitis , Síndrome del Túnel Carpiano/diagnóstico por imagen , Síndrome del Túnel Carpiano/patología , Síndrome del Túnel Carpiano/cirugía , Descompresión Quirúrgica/métodos , Humanos , Nervio Mediano/diagnóstico por imagen , Nervio Mediano/patología , Nervio Mediano/cirugía , Tenosinovitis/diagnóstico por imagen , Tenosinovitis/cirugía , Ultrasonografía
8.
Eur Rev Med Pharmacol Sci ; 26(22): 8481-8501, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-36459030

RESUMEN

In recent years, the advanced knowledge of clinical, biological and molecular features of prostate cancer have led to the introduction of new drugs and have allowed the relocation of old drugs in different settings. In this way, the new concepts of systemic disease arise: high risk or high volume vs. low risk and low volume disease castration sensitive prostate cancer (CSPC), diversifying the use of previously approved drugs (CRPC) and opening new scenarios for sequence therapy. The aim of this review is to integrate new developments into the medical management of systemic prostate cancer.


Asunto(s)
Neoplasias de la Próstata , Masculino , Humanos , Neoplasias de la Próstata/tratamiento farmacológico , Neoplasias de la Próstata/cirugía , Inmunoterapia , Algoritmos , Conocimiento , Castración
9.
Minerva Ginecol ; 61(1): 77-80, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19204664

RESUMEN

UNLABELLED: The uterine metastases of melanoma are very rare. At the present time, only one case occurred in our department. CASE REPORT: a 54-year-old plurigravid woman showed a metrorrhagia of unknown origin. The patient underwent a diagnostic hysteroscopy and an endometrial biopsy, in order to investigate the symptomatic postmenopausal bleeding and exclude a neoplasia, such as the endometrial carcinoma. The patient was discharged with a diagnosis of uterine fibromatosis and called back to go through a complete laparoscopic hysterectomy and bilateral adnexectomy. During the operation, some metastases were found in the genital tract. An accurate physical examination allowed us to discover a cutaneous nevus, the excision and histology of which revealed its malignancy. The immunohistochemistry of the surgical sample was able to confirm the hypothesized relationship between the nevus and the metastases, thus leading to the diagnosis of malignant melanoma metastases, genital tract. It is important to make an accurate diagnostic passage to exclude tumoral pathology in patients with atypical uterine bleeding. Every uterine bleeding of the postmenopausal period (abnormal uterine bleeding, AUB) is considered atypical and it has to be early investigated, in order to exclude any endometrial cancer. The nature of the uterine bleedings can be ascribed to atrophy, dysfunctional matters (dysfunctional uterine bleeding, DBU), benign organic alterations, only in 7-10% of cases to endometrial cancer and more rarely to metastatic tumours, as well as this case of melanoma. Physicians should be aware of such unusual possibilities in order to look carefully for metastatic implants in adenomyomas.


Asunto(s)
Neoplasias Endometriales/complicaciones , Neoplasias Endometriales/secundario , Melanoma/complicaciones , Melanoma/secundario , Metrorragia/etiología , Posmenopausia , Neoplasias Cutáneas/patología , Biopsia , Diagnóstico Diferencial , Neoplasias Endometriales/diagnóstico , Neoplasias Endometriales/cirugía , Femenino , Humanos , Histerectomía/métodos , Histeroscopía/métodos , Inmunohistoquímica , Melanoma/diagnóstico , Melanoma/cirugía , Persona de Mediana Edad , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/cirugía , Resultado del Tratamiento
10.
Gastroenterol Res Pract ; 2018: 2373868, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29983708

RESUMEN

BACKGROUND: High neutrophil to lymphocyte ratio (NLR) has shown to be a predictor of poor outcomes in various malignancies, including pancreatic cancer. METHODS: We assessed 70 consecutive pts with histologically confirmed mPC who received chemotherapy with nab-paclitaxel/gemcitabine at two different European oncologic centers between January 2012 and November 2015. Variables assessed for prognostic correlations included age ≥ 66, sex, Karnofsky PS score, primary tumor site, baseline CA19.9 level ≥ 59xULN, 12-week decrease of the CA19.9 level ≥ 50% from baseline, basal bilirubin level, baseline NLR, biliary stent implantation, and liver metastasis. Survival analyses were generated according to the Kaplan-Meier method. Univariate and multivariate analyses were performed by a Cox proportional hazard model. RESULTS: According to NLR values, the patients were divided into two groups: high and low. Low group patients showed a better median PFS (7 months versus 5 months) and median OS (13 months versus 7 months) in respect to high group patients. At multivariate analysis, Karnofsky PS < 80% (HR = 0.4; CI 0.2-1.2), liver metastases (HR = 0.4; CI 0.18-0.82), and NLR ≥ 5 (HR = 2.7; 95% CI 1.4-5.2) were predictors of poorer OS. Based on the presence of one or more independent prognostic factors, three risk categories were identified: good-risk, intermediate-risk and poor-risk. The median OS was 22, 10, and 7 months, respectively. CONCLUSIONS: Baseline NLR is an independent predictor of survival of patients with mPC receiving palliative chemotherapy and could be useful to develop a simple clinical score to identify a subgroup of patients with a low chance to benefit from chemotherapy.

11.
Braz J Med Biol Res ; 39(1): 53-62, 2006 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-16400464

RESUMEN

Since neurovascular control is altered in obese subjects, we hypothesized that weight loss by diet (D) or diet plus exercise training (D + ET) would improve neurovascular control during mental stress in obese women. In a study with a dietary reduction of 600 kcal/day with or without exercise training for 4 months, 53 obese women were subdivided in D (N = 22, 33 +/- 1 years, BMI 34 +/- 1 kg/m2), D + ET (N = 22, 33 +/- 1 years, BMI 33 +/- 1 kg/m2), and nonadherent (NA, N = 9, 35 +/- 2 years, BMI 33 +/- 1 kg/m2) groups. Muscle sympathetic nerve activity (MSNA) was measured by microneurography and forearm blood flow by venous occlusion plethysmography. Mental stress was elicited by a 3-min Stroop color word test. Weight loss was similar between D and D + ET groups (87 +/- 2 vs 79 +/- 2 and 85 +/- 2 vs 76 +/- 2 kg, respectively, P < 0.05) with a significant reduction in MSNA during mental stress (58 +/- 2 vs 50 +/- 2, P = 0.0001, and 59 +/- 3 vs 50 +/- 2 bursts/100 beats, P = 0.0001, respectively), although the magnitude of the response was unchanged. Forearm vascular conductance during mental stress was significantly increased only in D + ET (2.74 +/- 0.22 vs 3.52 +/- 0.19 units, P = 0.02). Weight loss reduces MSNA during mental stress in obese women. The increase in forearm vascular conductance after weight loss provides convincing evidence for D + ET interventions as a nonpharmacologic therapy of human obesity.


Asunto(s)
Dieta Reductora , Ejercicio Físico , Obesidad/terapia , Estrés Psicológico/fisiopatología , Sistema Nervioso Simpático/fisiopatología , Adulto , Índice de Masa Corporal , Femenino , Antebrazo/irrigación sanguínea , Humanos , Músculo Esquelético/irrigación sanguínea , Músculo Esquelético/inervación , Obesidad/fisiopatología , Obesidad/psicología , Pletismografía , Factores de Tiempo
13.
Rev. bras. pesqui. méd. biol ; Braz. j. med. biol. res;39(1): 53-62, Jan. 2006. tab, graf
Artículo en Inglés | LILACS | ID: lil-419151

RESUMEN

Since neurovascular control is altered in obese subjects, we hypothesized that weight loss by diet (D) or diet plus exercise training (D + ET) would improve neurovascular control during mental stress in obese women. In a study with a dietary reduction of 600 kcal/day with or without exercise training for 4 months, 53 obese women were subdivided in D (N = 22, 33 ± 1 years, BMI 34 ± 1 kg/m²), D + ET (N = 22, 33 ± 1 years, BMI 33 ± 1 kg/m²), and nonadherent (NA, N = 9, 35 ± 2 years, BMI 33 ± 1 kg/m²) groups. Muscle sympathetic nerve activity (MSNA) was measured by microneurography and forearm blood flow by venous occlusion plethysmography. Mental stress was elicited by a 3-min Stroop color word test. Weight loss was similar between D and D + ET groups (87 ± 2 vs 79 ± 2 and 85 ± 2 vs 76 ± 2 kg, respectively, P < 0.05) with a significant reduction in MSNA during mental stress (58 ± 2 vs 50 ± 2, P = 0.0001, and 59 ± 3 vs 50 ± 2 bursts/100 beats, P = 0.0001, respectively), although the magnitude of the response was unchanged. Forearm vascular conductance during mental stress was significantly increased only in D + ET (2.74 ± 0.22 vs 3.52 ± 0.19 units, P = 0.02). Weight loss reduces MSNA during mental stress in obese women. The increase in forearm vascular conductance after weight loss provides convincing evidence for D + ET interventions as a nonpharmacologic therapy of human obesity.


Asunto(s)
Humanos , Femenino , Adulto , Dieta Reductora , Terapia por Ejercicio , Obesidad/terapia , Estrés Psicológico/fisiopatología , Sistema Nervioso Simpático/fisiopatología , Índice de Masa Corporal , Antebrazo/irrigación sanguínea , Músculo Esquelético/irrigación sanguínea , Músculo Esquelético/inervación , Obesidad/fisiopatología , Obesidad/psicología , Pletismografía , Factores de Tiempo
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