ABSTRACT
PURPOSE: The standard treatment of rectal adenocarcinoma is total mesorectal excision (TME), in many cases requires a temporary or permanent stoma. TME is associated with high morbidity and genitourinary alterations. Transanal endoscopic microsurgery (TEM) allows access to tumors up to 20 cm from the anal verge, achieves minimal postoperative morbidity and mortality rates, and does not require an ostomy. The treatment of T2, N0, and M0 cancers remains controversial. Preoperative chemoradiotherapy (CRT) in association with TEM reduces local recurrence and increases survival. The TAU-TEM study aims to demonstrate the non-inferiority of the oncological outcomes and the improvement in morbidity and quality of life achieved with TEM compared with TME. METHODS: Prospective, multicenter, randomized controlled non-inferiority trial includes patients with rectal adenocarcinoma less than 10 cm from the anal verge and up to 4 cm in size, staged as T2 or T3-superficial N0-M0. Patients will be randomized to two areas: CRT plus TEM or radical surgery (TME). Postoperative morbidity and mortality will be recorded and patients will complete the quality of life questionnaires before the start of treatment, after CRT in the CRT/TEM arm, and 6 months after surgery in both arms. The estimated sample size for the study is 173 patients. Patients will attend follow-up controls for local and systemic relapse. CONCLUSIONS: This study aims to demonstrate the preservation of the rectum after preoperative CRT and TEM in rectal cancer stages T2-3s, N0, M0 and to determine the ability of this strategy to avoid the need for radical surgery (TME). TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01308190. Número de registro del Comité de Etica e Investigación Clínica (CEIC) del Hospital universitario Parc Taulí: TAU-TEM-2009-01.
Subject(s)
Neoadjuvant Therapy , Rectal Neoplasms/pathology , Rectal Neoplasms/surgery , Follow-Up Studies , Humans , Informed Consent , Intention to Treat Analysis , Neoplasm Staging , Prospective Studies , Sample Size , Treatment OutcomeABSTRACT
The main obstacle in the treatment of cancer patients has been resistance to multiple drugs, leading to the need to develop molecules with a higher specificity target. The liposomal formulation DODAC/2-AEH2P has antitumor potential, inducing apoptosis in several tumor types. Human chronic myeloid leukemia K-562 and K-562 Lucena (MDR+) cells were treated with the DODAC carrier and the liposomal formulation 2-AEH2P. Viability, cell cycle phases, apoptosis, marker expression and mitochondrial potential were analyzed. Significant reduction in viability was observed for all treatments. Changes in the distribution of the cell cycle phases and expression of markers involved in the apoptosis pathways were observed. Reduction of the mitochondrial electrical potential mediated by Bcl-2, being regulated by the reduction of the MTCH2 protein linked to the progression of myeloid leukemia and an increase in the pro-apoptotic proteins Bad and Bax, dependent on p53. This study demonstrated a significant therapeutic potential through apoptotic effects in leukemic cells, regardless of the molecular resistance profile (MDR+).
Subject(s)
Antineoplastic Agents/pharmacology , Cell Proliferation/drug effects , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Organophosphates/pharmacology , Apoptosis/drug effects , Apoptosis Regulatory Proteins/metabolism , Cell Cycle/drug effects , Cell Death/drug effects , Cell Line, Tumor , Cell Survival/drug effects , Drug Resistance, Multiple/drug effects , Drug Synergism , Humans , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology , Liposomes/chemistry , Liposomes/pharmacology , Membrane Potential, Mitochondrial/drug effects , Oleic Acids/chemistry , Oleic Acids/pharmacology , Quaternary Ammonium Compounds/chemistry , Quaternary Ammonium Compounds/pharmacologyABSTRACT
A critical review of the protocol variations in an RTOG prospective randomized multi-institutional clinical trial has been conducted. The objective of the review was to identify variables that might have affected the results of the study. Compliance with general guidelines and specific technical treatment parameters of the Split-Course Radiation Therapy Protocol for Carcinoma of the Base of the Tongue (RTOG #71-02) was analyzed. A +/- 5% variation of the time-dose-fractionation factors, using the NSD and TDF formulae and their respective protocol ratios (ratio between actual case NSD and TDF level and what the protocol recommended), has been defined as fully acceptable. Seventy-two percent of the 141 study cases were within this category. Minor variation has been defined as one resulting in a +/- 6% to +/- 15% deviation from the study values (15.3% of cases). Major and unacceptable variation was a deviation of +/- 16% or more from the research plan (12.7% of cases). After identifying the different variations and correlating them with the clinical results, we conclude that these deviations did not affect the final results to a significant or identifiable degree.
Subject(s)
Tongue Neoplasms/radiotherapy , Clinical Trials as Topic/methods , Humans , Mathematics , Myelitis/etiology , Neoplasm Staging , Radiation Protection , Radiation Tolerance , Radiotherapy/adverse effects , Radiotherapy Dosage , Skin Diseases/etiology , Spinal Cord/radiation effects , Technology, Radiologic , Time Factors , Tongue Neoplasms/pathologyABSTRACT
Este estudo avaliou a capacidade de um sal mineral rico em molibdênio (Mo) em prevenir a intoxicação cúprica acumulativa (ICA), mediante a análise das variáveis clínicas e dos teores de cobre (Cu) e Mo hepático. Foram utilizados 25 ovinos cruzados da raça Ile-de-France, aleatoriamente distribuídos igualmente em cinco grupos, em que o grupo 1 recebia dieta contendo 80% de volumoso e 20% de concentrado, os grupos 2 e 3 recebiam 50% de volumoso e 50% de concentrado, e os grupos 4 e 5 recebiam a mesma dieta dos grupos 2 e 3, com a adição diária de 150mg de sulfato de Cu. Os grupos 1, 3 e 5 recebiam sal mineral contendo 300ppm de Mo. Foram realizadas três biópsias hepáticas para determinação de Cu, Mo e Zn. Três ovinos do grupo 4 e um do grupo 5 manifestaram ICA. Não houve diferença na frequência de mortalidade entre os grupos (P=0,56). Os teores de Cu hepático nos ovinos com ICA (2450ppm) foram superiores aos que não intoxicaram (1518ppm). Quanto maior a ingestão de Mo na dieta, menor foi o acúmulo de Cu hepático ao término do experimento (r = -0,72).(AU)
The aim of this project is to evaluate the capacity of a molybdenum-rich mineral salt in the prevention of cumulative cooper poisoning (CCP) in sheep, through clinical and hepatic copper and molybdenum concentrations. Twenty five crossbreed Ile-de-France sheep were randomly distributed equally into five groups. Group 1 received a 80% forage and 20% concentrate diet, groups 2 and 3 received a 50% forage and 50% concentrate diet, and groups 4 and 5 received the same diet as groups 2 and 3 with a daily supplementation of 150 mg of copper sulfate. Groups 1, 3 and 5 received a mineral salt with 300 ppm of molybdenum. Three times during the experiment a liver biopsy was carried out to evaluate the degree of copper accumulation. Three sheep from group 4 and one sheep from group 5 showed a clinical picture of CCP. There was no difference in the frequency of mortality between groups 4 and 5 (P=0.56). The liver copper concentration was higher in sheep with CCP (2450 ppm) compared to sheep that did not present CCP (1518 ppm). The higher the ingestion of molybdenum in the diet the lower the liver copper concentration at the end of the experiment (r=-0.72).(AU)
Subject(s)
Animals , Copper , Molybdenum/administration & dosage , Poisoning/veterinary , Sheep , Liver Diseases/diagnosis , Liver Diseases/veterinary , ZincSubject(s)
Genital Diseases, Female/complications , Hemorrhage/etiology , Menopause , Menstruation Disturbances/etiology , Age Factors , Aged , Estrogens/adverse effects , Female , Follow-Up Studies , Genital Diseases, Female/diagnosis , Hemorrhage/diagnosis , Humans , Menstruation Disturbances/diagnosis , Middle Aged , Ovarian Neoplasms/complications , Polyps/complications , Time Factors , Uterine Neoplasms/complicationsSubject(s)
Abortion, Spontaneous/microbiology , Bacteria/isolation & purification , Extraembryonic Membranes/microbiology , Fungi/isolation & purification , Adolescent , Adult , Aerobiosis , Anaerobiosis , Aspergillus/isolation & purification , Bacteroides/isolation & purification , Candida/isolation & purification , Corynebacterium/isolation & purification , Curettage , Escherichia coli/isolation & purification , Female , Fusobacterium/isolation & purification , Humans , Lactobacillus/isolation & purification , Neisseria gonorrhoeae/isolation & purification , Peptococcus/isolation & purification , Peptostreptococcus/isolation & purification , Pharynx/microbiology , Placenta/microbiology , Pregnancy , Propionibacterium/isolation & purification , Staphylococcus/isolation & purification , Streptococcus/isolation & purification , Streptococcus pyogenes/isolation & purificationSubject(s)
Urinary Fistula , Vaginal Fistula , Abdomen/surgery , Cautery , Female , Genital Neoplasms, Female/complications , Humans , Iatrogenic Disease , Inflammation/etiology , Postoperative Complications , Preoperative Care , Ureteral Diseases/etiology , Ureteral Diseases/surgery , Urinary Diversion , Urinary Fistula/etiology , Urinary Fistula/surgery , Urinary Incontinence/etiology , Urography , Vaginal Fistula/etiology , Vaginal Fistula/surgery , Vesicovaginal Fistula/etiology , Vesicovaginal Fistula/surgeryABSTRACT
The authors studied 32 families with 36 RB patients. Among them 24 were sporadic cases; four had recurrence of RB; two had RB plus bone tumour in relatives and two were RB propositi. Two evaluations with an interval from four to 13 years were made. In the first the recurrence risk was informed as high or low. The patients' decisions were evaluated at the second consultation. The authors considered that counselling was negative in more than 50% of cases. For normal parents, prognosis of RB was severe, whereas for RB patients it was mild.
Subject(s)
Eye Neoplasms/genetics , Genetic Counseling , Retinoblastoma/genetics , Adolescent , Adult , Brazil , Female , Humans , Male , Neoplasm Recurrence, Local/genetics , Pedigree , Risk FactorsABSTRACT
Tumor-maximum ratios and back-scatter factors were measured for 8 MV x-rays. The measured TMR's are found to conform to the empirical expression TMR(t) = K(t) At m(t). Hence, log-log plots of TMR vs. area at various depths in water, yield straight lines from which values of TMRo (for 0 x 0 cm2 field) are obtained by extrapolation. From these values, scatter-phantom ratios are also derived.
Subject(s)
Radiotherapy Dosage , Dose-Response Relationship, Radiation , Humans , Methods , Neoplasms/radiotherapyABSTRACT
O trabalho apresenta a sobrevida atuarial de 161 pacientes com retinoblastoma tratados no Hospital A. C. Camargo da Fundaçäo Antonio Prudente - Säo Paulo, quanto ao estádio da doença, sexo, lateraliidade, tratamento prévio a admissäo e período em que foram tratados. Os melhores resultados foram obtidos nos grupos de portadores de tumores intra-oculares, nos casos virgens de tratamento e nos que seguiram protocolos completos
Subject(s)
Humans , Male , Female , Prognosis , Retinoblastoma , Registries , Sex FactorsABSTRACT
Foi realizado o estudo nutricional e da amplitude de acomodacao em escolares de faixa etaria media de 8 anos. Foram classificados do ponto de vista nutricional em eutroficos, desnutridos vigentes e pregressos. Posteriormente realizou-se a confrontacao das amplitudes de acomodacao dos mesmos
Subject(s)
Child , Humans , Male , Female , Accommodation, Ocular , Nutrition Disorders , AnthropometryABSTRACT
Descrevemos um paciente portador de retinoblastoma bilateral associado a retardo mental. Seu estudo citogenético em linfócitos do sangue periférico detectou uma deficiência parcial do cromossomo 13. Seu estudo quantitativo da enzima D-esterase em hemolisado revelou valores inferiores aos de seus pais
Subject(s)
Cytogenetics , Retinoblastoma/etiologyABSTRACT
Os autores descrevem um caso com diagnóstico de linfoma näo-Hodgkin (Burkitt) cujas manifestaçöes oculares foram as típicas de uma leucemia linfocítica aguda e discutem clinicamente os critérios de classificaçäo destas patologias