ABSTRACT
BACKGROUND: Retrospective data suggest an association between bevacizumab efficacy and the incidence of arterial hypertension (AHT). Additionally, epigenetic mechanisms have been related to AHT. METHODS: This prospective observational study conducted by GEICAM Spanish Breast Cancer Research Group included metastatic breast (MBC) or colorectal (mCRC) cancer patients treated with bevacizumab-containing chemotherapy as first-line treatment. Blood pressure (BP) levels were measured (conventional and 24-h Holter monitoring) at baseline and up to cycle 3. Primary endpoint assessed BP levels increase as predictive factor for progression-free survival (PFS). Germline DNA methylation profile was explored in pre-treatment blood samples; principal component analysis was used to define an epigenetic predictive score for increased BP levels. RESULTS: From Oct-2012 to Jul-2016, 143 (78 MBC and 65 mCRC) patients were included. The incidence of AHT according to guidelines was neither predictive of PFS nor of best overall tumor response (BOR). No statistically significant association was observed with systolic BP nor diastolic BP increment for PFS or BOR. Grade 3 and 4 adverse events were observed in 37 and 5% of patients, respectively. We identified 27 sites which baseline methylation status was significantly associated to BP levels increase secondary to bevacizumab-containing chemotherapy. CONCLUSIONS: Neither the frequency of AHT nor the increase of BP levels were predictive of efficacy in MBC and mCRC patients treated with bevacizumab-containing chemotherapy. CLINICAL TRIAL REGISTRY: ClinicalTrials.gov Identifier: NCT01733628.
Subject(s)
Bevacizumab , Breast Neoplasms , Colorectal Neoplasms , Hypertension , Humans , Bevacizumab/therapeutic use , Bevacizumab/administration & dosage , Female , Colorectal Neoplasms/drug therapy , Colorectal Neoplasms/pathology , Breast Neoplasms/drug therapy , Breast Neoplasms/pathology , Middle Aged , Hypertension/chemically induced , Prospective Studies , Aged , Male , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Aged, 80 and over , Progression-Free Survival , DNA MethylationABSTRACT
Objective. to evaluate the clinical effect of a probiotic mouthwash in reducing generalized marginal chronic gingivitis using positive and negative control groups. methodology. four-week study conducted in San Luis Potosí, Mexico, from january to march 2017. participants were healthy, non-smokers with generalized marginal chronic gingivitis; age range 18-45 years. subjects were randomized and divided into three groups: group A: mouthwash based on 0.05 percent cetylpyridinium chloride (CPC) (positive control); group B: mouthwash based on probiotics (experimental); group C: placebo mouthwash (negative control). no oral hygiene practices or routines were modified; subjects were followed for 4 weeks. the primary outcome variable of interest was the Löe and Silness gingival index, and the secondary one, the Quigley Heinn plaque index modified by Turesky. results. of the 45 patients included, 19 (42.2 percent) were men and 26 (57.7 percent) women, mean age was 22.8±2.07. each group consisted of 15 subjects; all subjects completed the study. there was no statistically significant reduction in gingival inflammation when comparing the 3 treatment groups (p=0.540) with respect to the gingival index. A comparison was made before and after the treatment and in the 3 groups there was no reduction of the gingival inflammation. plaque reduction was not statistically significant when comparing the 3 groups (p=0.278). however, when doing intra-group comparison, it was found that the patients in group A had a reduction in plaque index (p<0.005), which was not observed in groups B (p=0.1103) and C (p=0.1508). conclusions. the use of a probiotic mouth mouthwash did not reduce gingival inflammation or the accumulation of dentobacterial plaque in a period of 4 weeks. there were no statistically significant differences between the study groups.
Subject(s)
Humans , Adolescent , Adult , Middle Aged , Chlorhexidine/therapeutic use , Probiotics/therapeutic use , Dental Plaque/prevention & control , Gingivitis/prevention & control , Anti-Infective Agents, Local/therapeutic use , Mouthwashes/therapeutic use , Periodontal Index , Pilot Projects , Mexico , Mouthwashes/chemistrySubject(s)
Humans , Male , Female , Respiratory Insufficiency/diagnosis , Respiratory Insufficiency/therapy , Status Asthmaticus/diagnosis , Status Asthmaticus/therapy , Pneumonia/diagnosis , Pneumonia/therapy , Pleural Effusion/diagnosis , Pleural Effusion/therapy , Pulmonary Embolism/diagnosis , Pulmonary Embolism/therapy , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/therapy , Hemoptysis/diagnosis , Hemoptysis/therapy , Pneumothorax/diagnosis , Pneumothorax/therapy , Glomerulonephritis/diagnosis , Glomerulonephritis/therapy , Pyelonephritis/diagnosis , Pyelonephritis/therapy , Sepsis/diagnosis , Sepsis/therapy , Epilepsy/diagnosis , Epilepsy/therapy , Meningitis, Pneumococcal/diagnosis , Meningitis, Viral/diagnosis , Meningitis, Viral/therapy , Heart Failure/diagnosis , Heart Failure , Heart Failure/therapy , Myocardial Infarction/diagnosis , Myocardial Infarction/therapy , Pericardial Effusion/diagnosis , Pericardial Effusion/therapy , Shock/diagnosis , Shock/therapy , Endocarditis/diagnosis , Endocarditis/therapy , Atrial Fibrillation/diagnosis , Atrial Fibrillation/therapy , Hyperthyroidism/diagnosis , Hyperthyroidism/therapy , Diabetic Ketoacidosis/diagnosis , Diabetic Ketoacidosis/therapy , Inert Gas Narcosis , Poisoning/diagnosis , Poisoning/therapyABSTRACT
Se estudiaron en forma prospectiva 75 pacientes del sexo femenino con incontinencia urinaria identificada desde el punto de vista clínico. Se les realizó perfil de presión uretral estático sin micción y se encontró incontinencia de urgencia en 26, de esfuerzo en 25 y de tipo mixto en 24. No hubo diferencias en la previsión vesicalbasal. La longitud funcional de la uretra sí se afecta en el tipo de urgencia, y da como resultado diferencias con respecto a la de esfuerzo y mixta. Tanto la presión máxima de cierre como la uretral máxima disminuyen conforme progresa la edad de la mujer, sin guardar relación con el tipo de incontinencia. La presión máxima de cierre y uretral máxima en la incontinencia de urgencia produce diferencias a una p en relación con las de esfuerzo y mixta. La utilidad clínica del perfil de presión uretral es un aspecto controvertido. Los datos que se informan en este artículo indican que se tiene que revalorar su posición, pues podrían ser de gran ayuda para la valoración integral de la incontinencia urinaria de urgencia.