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1.
Rev. ciênc. méd., (Campinas) ; 30: e215075, 10 mar. 2021. tab
Artículo en Portugués | LILACS | ID: biblio-1151684

RESUMEN

A quantidade de pessoas obesas vem crescendo significativamente em todo o mundo.Esse fato representa um risco para o aumento do número de portadores de diabetes mellitus tipo 2. A farmacoterapia do diabetes pode alterar o peso corporal, auxiliando tanto na perda como no ganho ponderal. Diante disso, o objetivo do presente trabalho foi revisar os fármacos utilizados no tratamento da diabetes tipo 2 que podem interferir no peso corporal, a fim de auxiliar os profissionais na orientação de indivíduos portadoresda doença. Para tanto, foi realizada uma revisão integrativa nas bases de dados: SciELO, Scholar Google, PubMed, BVS e Portal de Periódicos Capes, a partir de trabalhos publicados entre 2010 e 2019. Observou-se que as biguanidas, os inibidores da α-glicosidade, os análogos de incretinas, os análogos da amilina e os inibidores do cotransportador de sódio/glicose acarretam perda de peso. Por outro lado, as sulfonilureias, as meglitinidas e as glitazonas conferem ganho de peso ao paciente. Sendo assim, a prescrição desses fármacos deve ser feita de maneira individualizada


Obesity has been growing significantly worldwide, representing a risk for the increase of type 2 diabetes mellitus. The pharmacotherapy of diabetes can alter body weight, aiding in weight loss as well as in weight gain. Therefore, the objective of the present study was to review studies on the drugs used in type 2 diabetes that may interfere with body weight, in order to assist professionals in guiding individuals with diabetes. For this, an integrative review was performed in the SciELO, Scholar Google, PubMed, VHL, and Portal of Capes journals databases, considering works published between 2010 and 2019. We observed that biguanides, α-glucosity inhibitors, analogues of incretins, amylin analogues, and sodium / glucose co-transporter inhibitors lead to weight loss. On the other hand, sulphonylureas, meglitinides, and glitazones confer weight gain. Therefore, the prescription of these drugs should be made in an individualized fashion


Asunto(s)
Servicios Farmacéuticos , Peso Corporal , Personal de Salud , Diabetes Mellitus Tipo 2 , Quimioterapia , Hipoglucemiantes , Aumento de Peso , Obesidad
2.
Rev. venez. oncol ; 33(1): 46-59, mar. 2021. tab
Artículo en Español | LILACS, LIVECS | ID: biblio-1147479

RESUMEN

El cáncer de mama Triple Negativo es un subtipo molecular que se caracteriza por ausencia de expresión de receptores de estrógeno, progesterona y proteína HER2. Representa el 10 % a 15 % de todos los subtipos de cáncer de mama con impacto en el pronóstico y en las líneas de tratamiento; siendo negativo para receptores hormonales y HER2, la terapéutica hormonal y anti-HER2 no cuentan para su manejo. Aún no se dispone de productos dirigidos a blancos específicos para esta categoría.(AU)


The Triple Negative breast cancer is a molecular subtype characterized by no expression of the estrogen, the progesterone and the HER2 protein receptors. They represents 10 % to 15 % of all the breast cancer subtypes with an impact on the prognosis and in the treatment lines; is negative for the hormone receptors and for the HER2, hormonal and the anti-HER2 therapeutics do not count for the management of them. The products targeting specific to this category are not yet available(AU)


Asunto(s)
Humanos , Femenino , Biomarcadores de Tumor , Antraciclinas/uso terapéutico , Taxoides/uso terapéutico , Neoplasias de la Mama Triple Negativas/patología , Neoplasias de la Mama Triple Negativas/epidemiología , Mamografía , Quimioterapia , Oncología Médica
3.
Rev. venez. oncol ; 33(1): 11-32, mar. 2021. ilus, tab, graf
Artículo en Español | LILACS, LIVECS | ID: biblio-1147464

RESUMEN

Clasificar los carcinomas de pulmón según criterios establecidos por la OMS 2015 en biopsias de la sección de patología respiratoria del Instituto Anatomopatológico "Dr. José Antonio O`Daly" en el período enero 2006-diciembre 2016. Se realizó estudio descriptivo y retrospectivo, en el que se evaluaron todos los casos de carcinomas pulmonares recibidos entre enero 2006 diciembre 2016. La edad de presentación del carcinoma pulmonar fue 61 ± 11,45 años. Fue más frecuente en el sexo masculino 56,57 %. El tipo histológico más frecuente fue el adenocarcinoma 61,6 %. El adenocarcinoma el patrón predominantemente sólido fue el más constante 57,3 %, seguido de patrón predominantemente acinar 18,2 % y patrones mixtos. El carcinoma de células escamosas fue el segundo tipo más frecuente con 30,3 % de los casos representando el carcinoma de células escamosas poco diferenciado no queratinizante un 40 %. El carcinoma neuroendocrino fue el tercer tipo de carcinoma más común y el carcinoma de células pequeñas representó el 80 % de estos casos. Al menos 10,8 % de los casos fueron carcinomas no clasificables por necrosis o muestra escasa. Los casos previamente diagnosticados como adenocarcinoma poco diferenciado se corresponden con patrón sólido. Es importante el uso de inmunohistoquímica para el diagnóstico definitivo especialmente de adenocarcinoma patrón predominantemente sólido. El uso de la actual clasificación permite definir pronóstico y tratamiento personalizado(AU)


To classify the lung carcinomas according to criteria established by WHO 2015 in the biopsies of the section of respiratory pathology of the Anatomo Pathological Institute "Dr. José Antonio O`Daly" in the period January 2006 December 2016. A study will be carried out descriptive and retrospective, in which all cases of the pulmonary carcinomas received between January 2006 and December 2016 were evaluated. The age of presentation of the lung carcinoma was 61 ± 11.45 years old. It was more frequent in the male sex 56.57 %. The most frequent histological type was the adenocarcinoma 61.6 %. The predominantly solid adenocarcinoma pattern was the most constant 57.3 % followed by predominantly acinar pattern 18.2 % and the mixed patterns. The squamous cell carcinoma was the second most frequent type 30.3 %, and the poorly differentiated and non-keratinizing type was a 40 %. The neuroendocrine carcinoma was the third most common type of it the small cell carcinoma accounted an 80 %. At least 10.8 % of the cases were carcinomas unclassifiable due to necrosis or scarce sample. The cases previously diagnosed as poorly differentiated adenocarcinoma correspond to a solid pattern. The immunohistochemically use is important for the definitive diagnosis, especially for the adenocarcinoma predominantly solid pattern. The use of the current classification allowsdefining the prognosis and the personalized treatment(AU)


Asunto(s)
Humanos , Masculino , Femenino , Biopsia , Carcinoma Broncogénico/epidemiología , Neoplasias Pulmonares/epidemiología , Salud Pública , Quimioterapia , Oncología Médica
4.
Nat Commun ; 12(1): 1541, 2021 03 09.
Artículo en Inglés | MEDLINE | ID: mdl-33750829

RESUMEN

Pancreatic ductal adenocarcinoma (PDAC) is characterized by marked desmoplasia and drug resistance due, in part, to poor drug delivery to extravascular tumor tissue. Here, we report that carcinoma-associated fibroblasts (CAFs) induce ß5 integrin expression in tumor cells in a TGF-ß dependent manner, making them an efficient drug delivery target for the tumor-penetrating peptide iRGD. The capacity of iRGD to deliver conjugated and co-injected payloads is markedly suppressed when ß5 integrins are knocked out in the tumor cells. Of note, ß5 integrin knock-out in tumor cells leads to reduced disease burden and prolonged survival of the mice, demonstrating its contribution to PDAC progression. iRGD significantly potentiates co-injected chemotherapy in KPC mice with high ß5 integrin expression and may be a powerful strategy to target an aggressive PDAC subpopulation.


Asunto(s)
Cadenas beta de Integrinas/genética , Cadenas beta de Integrinas/metabolismo , Neoplasias Pancreáticas/metabolismo , Animales , Fibroblastos Asociados al Cáncer , Carcinoma Ductal Pancreático/tratamiento farmacológico , Carcinoma Ductal Pancreático/genética , Carcinoma Ductal Pancreático/metabolismo , Carcinoma Ductal Pancreático/patología , Línea Celular Tumoral , Progresión de la Enfermedad , Sistemas de Liberación de Medicamentos , Quimioterapia , Regulación Neoplásica de la Expresión Génica , Humanos , Ratones , Ratones Endogámicos C57BL , Oligopéptidos , Neoplasias Pancreáticas/tratamiento farmacológico , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/patología , Microambiente Tumoral , Ensayos Antitumor por Modelo de Xenoinjerto
5.
Nat Commun ; 12(1): 1796, 2021 03 19.
Artículo en Inglés | MEDLINE | ID: mdl-33741907

RESUMEN

Most diseases disrupt multiple proteins, and drugs treat such diseases by restoring the functions of the disrupted proteins. How drugs restore these functions, however, is often unknown as a drug's therapeutic effects are not limited to the proteins that the drug directly targets. Here, we develop the multiscale interactome, a powerful approach to explain disease treatment. We integrate disease-perturbed proteins, drug targets, and biological functions into a multiscale interactome network. We then develop a random walk-based method that captures how drug effects propagate through a hierarchy of biological functions and physical protein-protein interactions. On three key pharmacological tasks, the multiscale interactome predicts drug-disease treatment, identifies proteins and biological functions related to treatment, and predicts genes that alter a treatment's efficacy and adverse reactions. Our results indicate that physical interactions between proteins alone cannot explain treatment since many drugs treat diseases by affecting the biological functions disrupted by the disease rather than directly targeting disease proteins or their regulators. We provide a general framework for explaining treatment, even when drugs seem unrelated to the diseases they are recommended for.


Asunto(s)
Complejos Multiproteicos/metabolismo , Preparaciones Farmacéuticas/administración & dosificación , Mapas de Interacción de Proteínas/efectos de los fármacos , Proteínas/metabolismo , Algoritmos , Animales , Biología Computacional/métodos , Quimioterapia/métodos , Humanos , Modelos Teóricos , Unión Proteica/efectos de los fármacos , Mapeo de Interacción de Proteínas/métodos
6.
Medicine (Baltimore) ; 100(3): e23952, 2021 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-33545973

RESUMEN

BACKGROUND: Colorectal cancer has become a major chronic and difficult disease endangering human health. After thousands of years of precipitation, traditional Chinese medicine in China is now also being applied in clinical treatment, with its unique advantages in the treatment of cancer. However, the efficacy of traditional Chinese medicine in the treatment of advanced colorectal cancer still cannot reach consensus in the world. Therefore, the aim of this study was to provide a scheme to evaluate the efficacy and safety of traditional Chinese medicine decoction in the treatment of advanced colorectal cancer, thus providing clinical decision-making. METHODS AND ANALYSIS: The systematic review and meta-analysis will be conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The following 8databases will be searched: China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), Wan Fang Data, the Chinese Science and Technology Periodical Database (VIP), PubMed, Cochrane Library, Embase, and Web of Science. Relevant data will be performed by Revman 5.3 software provided (Cochrane Collaboration) and Stata 14.0 statistical software. RESULTS: The results of this systematic review and meta-analysis will be published in a peer-reviewed journal. INPLASY REGISTRATION NUMBER: INPLASY202080102.


Asunto(s)
Protocolos Clínicos , Neoplasias Colorrectales/tratamiento farmacológico , Quimioterapia/métodos , Medicina China Tradicional/normas , Humanos , Medicina China Tradicional/efectos adversos , Metaanálisis como Asunto , Revisiones Sistemáticas como Asunto
7.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artículo en Inglés | MEDLINE | ID: mdl-33542022

RESUMEN

Pancreatic cancer is the tumour related to higher rates of depression. Several papers have validated the association between pancreatic cancer and depression. It was noticed that in some cases the psychiatric symptoms precede the somatic ones. We present a case of a progressive and incapacitating diffuse abdominal pain, initially attributed to psychosomatic disorder. This hindered a timely correct diagnosis leading to a poor outcome. A pancreatic adenocarcinoma in an unresectable stage was confirmed by histopathology. The patient underwent chemotherapy.


Asunto(s)
Antidepresivos/uso terapéutico , Depresión , Quimioterapia , Mirtazapina/uso terapéutico , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Pancreáticas/tratamiento farmacológico , Dolor Abdominal/etiología , Depresión/diagnóstico , Depresión/tratamiento farmacológico , Depresión/etiología , Fatiga/etiología , Femenino , Humanos , Persona de Mediana Edad , Neoplasias Pancreáticas/patología
8.
Medicine (Baltimore) ; 100(7): e24854, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33607858

RESUMEN

ABSTRACT: Malignant gastric lymphoma (MGL) accounts for a small proportion (upto 5%) of gastric malignancies. However, unlike for advanced gastric cancer (AGC) that requires surgical treatment, the standard treatments for MGL are chemotherapy and radiotherapy. Hence, the initial impression of the endoscopist is critical for the differential diagnosis and for planning future treatment. The purpose of this study was to assess the endoscopic diagnostic accuracy and the possibility of distinguishing between AGC and MGL depending on the endoscopist's experience.A total of 48 patients who had MGL, and 48 age and sex-matched patients who had AGC were assessed by endoscopic review at a tertiary referral hospital between June 2008 and February 2017. Two endoscopic specialists reviewed the endoscopic findings and divided these diagnoses into 5 groups: Borrmann type (1, 2, 3, and 4) and early gastric cancer-like type. After this, 7 experts and 8 trainees were asked to complete a quiz that was comprised of 6 images for each of the 96 cases and to provide an endoscopic diagnosis for each case. The test results were analyzed to assess the diagnostic accuracy according to the pathologic results, endoscopic subgroups, and endoscopists' experience. For inter-observer agreement was calculated with Fleiss kappa values.The overall diagnostic accuracy of endoscopic findings by the experts was 0.604 and that by the trainees was 0.493 (P = .050). There was no significant difference in the diagnosis according to the final pathology (lymphoma cases, 0.518 vs 0.440, P = .378; AGC cases, 0.690 vs 0.547, P = .089, respectively). In the subgroup analysis, the experts showed significantly higher diagnostic accuracy for the endoscopic Borrmann type 4 subgroup, including lymphoma or AGC cases, than the trainees (P = .001). Inter-observer agreement of final diagnosis (Fleiss kappa, 0.174) and endoscopic classification groups (Fleiss kappa, 0.123-0.271) was slightly and fair agreement.The experts tended to have a higher endoscopic diagnostic accuracy. Distinguishing MGL from AGC based on endoscopic findings is difficult, especially for the beginners. Even if the endoscopic impression is AGC, it is important to consider MGL in the differential diagnosis.


Asunto(s)
Endoscopía/métodos , Linfoma no Hodgkin/patología , Neoplasias Gástricas/patología , Competencia Clínica/estadística & datos numéricos , Diagnóstico Diferencial , Quimioterapia/métodos , Endoscopía/clasificación , Endoscopía/estadística & datos numéricos , Femenino , Humanos , Linfoma no Hodgkin/diagnóstico por imagen , Linfoma no Hodgkin/tratamiento farmacológico , Linfoma no Hodgkin/radioterapia , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Radioterapia/métodos , Reproducibilidad de los Resultados , Especialización/estadística & datos numéricos , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/radioterapia , Neoplasias Gástricas/cirugía , Apoyo a la Formación Profesional/métodos , Apoyo a la Formación Profesional/estadística & datos numéricos
10.
Anticancer Res ; 41(2): 1077-1082, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33517318

RESUMEN

BACKGROUND/AIM: This study examined the prognostic impact of the past history of breast cancer screening within the last 2 years (PH-BCS), for patients with triple negative breast cancer (TNBC), a subtype that carries extremely poor prognosis. PATIENTS AND METHODS: Eighty-six consecutive cases with TNBC, who underwent surgery at our faculty from 2009 to 2015, were divided into two groups according to PH-BCS. Prognostic analyses for disease-free survival and overall survival between the two groups were performed. RESULTS: The positive PH-BCS group (n=44) had a significantly better prognoses than the negative PH-BCS group (n=42) (p<0.001). No recurrent cases were observed in the positive PH-BCS group. In the negative PH-BCS group, tumor and node status and chemotherapy were indicated as significant prognostic factors, and further step-wise multivariate analysis revealed only node status as a significant prognostic factor. CONCLUSION: Breast cancer screening at least every 2 years may improve the prognosis of TNBC.


Asunto(s)
Detección Precoz del Cáncer/métodos , Neoplasias de la Mama Triple Negativas/diagnóstico , Neoplasias de la Mama Triple Negativas/mortalidad , Adulto , Anciano , Quimioterapia , Femenino , Humanos , Metástasis Linfática , Persona de Mediana Edad , Pronóstico , Análisis de Supervivencia , Neoplasias de la Mama Triple Negativas/tratamiento farmacológico , Neoplasias de la Mama Triple Negativas/patología
11.
BMC Bioinformatics ; 22(1): 28, 2021 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-33482713

RESUMEN

BACKGROUND: Drug repositioning is an emerging approach in pharmaceutical research for identifying novel therapeutic potentials for approved drugs and discover therapies for untreated diseases. Due to its time and cost efficiency, drug repositioning plays an instrumental role in optimizing the drug development process compared to the traditional de novo drug discovery process. Advances in the genomics, together with the enormous growth of large-scale publicly available data and the availability of high-performance computing capabilities, have further motivated the development of computational drug repositioning approaches. More recently, the rise of machine learning techniques, together with the availability of powerful computers, has made the area of computational drug repositioning an area of intense activities. RESULTS: In this study, a novel framework SNF-NN based on deep learning is presented, where novel drug-disease interactions are predicted using drug-related similarity information, disease-related similarity information, and known drug-disease interactions. Heterogeneous similarity information related to drugs and disease is fed to the proposed framework in order to predict novel drug-disease interactions. SNF-NN uses similarity selection, similarity network fusion, and a highly tuned novel neural network model to predict new drug-disease interactions. The robustness of SNF-NN is evaluated by comparing its performance with nine baseline machine learning methods. The proposed framework outperforms all baseline methods ([Formula: see text] = 0.867, and [Formula: see text]=0.876) using stratified 10-fold cross-validation. To further demonstrate the reliability and robustness of SNF-NN, two datasets are used to fairly validate the proposed framework's performance against seven recent state-of-the-art methods for drug-disease interaction prediction. SNF-NN achieves remarkable performance in stratified 10-fold cross-validation with [Formula: see text] ranging from 0.879 to 0.931 and [Formula: see text] from 0.856 to 0.903. Moreover, the efficiency of SNF-NN is verified by validating predicted unknown drug-disease interactions against clinical trials and published studies. CONCLUSION: In conclusion, computational drug repositioning research can significantly benefit from integrating similarity measures in heterogeneous networks and deep learning models for predicting novel drug-disease interactions. The data and implementation of SNF-NN are available at http://pages.cpsc.ucalgary.ca/ tnjarada/snf-nn.php .


Asunto(s)
Biología Computacional , Reposicionamiento de Medicamentos , Preparaciones Farmacéuticas , Algoritmos , Quimioterapia , Redes Neurales de la Computación , Reproducibilidad de los Resultados
12.
Parasit Vectors ; 14(1): 36, 2021 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-33422141

RESUMEN

BACKGROUND: Zoonotic visceral leishmaniasis by Leishmania infantum is a first-order pathology in canine veterinary clinics in endemic areas. Moreover, canine infections are considered the main reservoir for human disease; despite their importance in the control of the disease within a One Health approach, no scientometric study has been published. Aims of the study included analyzing the impact of canine leishmaniasis (CanL) on the scientific literature, drugs or combinations used, trends in the period from 2000 to 2020 and efficacy criteria employed. METHODS: A Web of Science (WOS)-based analysis of publications on CanL and chemotherapy of the disease in the period 2000-2020 was carried out using a stepwise methodology. Data were analyzed by year, geographical origin, chemical groups, drugs and combinations, and efficacy criteria. RESULTS: Reports on CanL (n = 3324) represented < 16% of all publications on leishmaniasis (n = 20,968), and of these around 18% (n = 596) were related to chemotherapy. Publication records on CanL followed the distribution of the infection by L. infantum in endemic areas although Mediterranean countries were overrepresented in the reports on chemotherapy of CanL. Publications on the main antileishmanial drugs used in clinical practice showed a sustained tendency in the period analyzed. Pentavalent antimonials (SbV), alone or in combination with allopurinol, represented > 50% of all publications on chemotherapy of CanL despite the availability of more recently marketed drugs. CONCLUSIONS: Chemotherapy of CanL still relies on SbV and combinations and to a lesser extent on miltefosine (MIL). Reports on chemotherapy are scarce and mostly publicly funded, and the variability of experimental conditions hampers the direct comparison of the efficacy of drugs, combinations and schedules. The vast majority of reports on efficacy do not include any information on supportive therapy; this reduces the actual value of the studies if intended for the practical management of the disease. Complete reports on the chemotherapy (etiological + symptomatic) would add value to the trials performed.


Asunto(s)
Antiprotozoarios/uso terapéutico , Enfermedades de los Perros/tratamiento farmacológico , Quimioterapia/métodos , Leishmaniasis/tratamiento farmacológico , Alopurinol/uso terapéutico , Anfotericina B/uso terapéutico , Animales , Enfermedades de los Perros/epidemiología , Perros , Combinación de Medicamentos , Humanos , Leishmania infantum , Leishmaniasis/epidemiología , Leishmaniasis Visceral/epidemiología , Leishmaniasis Visceral/terapia , Fosforilcolina/análogos & derivados , Publicaciones
14.
Dtsch Med Wochenschr ; 146(1): 23-29, 2021 01.
Artículo en Alemán | MEDLINE | ID: mdl-33395723

RESUMEN

Pharmacogenomics (PGx) is a key component of personalized medicine to improve clinical outcome of drug therapy and/or to avoid adverse drug reactions. Major efforts are currently spent internationally to implement PGx diagnostics into clinical practice. Evidence-based recommendations for dose-adjusted treatment which are established by international expert groups covering clinical and pharmacological expertise are publicly available. Clinical relevant examples for PGx diagnostics such as genetic testing for dihydropyrimidin-dehydrogenase and thiopurin-S-methyltransferase, as well as for various cytochrome P450 enzymes are summarized to promote the clinical implementation process of PGx in Germany.


Asunto(s)
Quimioterapia/métodos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/prevención & control , Pruebas de Farmacogenómica , Variantes Farmacogenómicas/genética , Genoma Humano/genética , Humanos
15.
Medicine (Baltimore) ; 100(2): e24156, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33466189

RESUMEN

ABSTRACT: Patients with colorectal cancer (CRC) treated with curative intent surgery undergo continuous fluorouracil (5-FU) infusion-based chemotherapy using totally implantable central venous port system (TICVPS) in cases with high risk of recurrence. Approximately 30% of patients relapse after therapy completion, especially within 2 years. Hence, many patients with high risk CRC keep the TICVPS for 6 to 24 months after treatment with regular intervals of TICVPS flushing. However, little is known about the proper interval duration of the port. The aim of this study is to investigate whether a 3 months extended interval is safe and if port maintenance is feasible.A retrospective cohort was compiled of patients with CRC who underwent curative intent surgery and perioperative chemotherapy using TICVPS between 2010 and 2017. The primary end point was TICVPS maintenance rate, including maintenance of TICVPS for at least 6 months, planned TICVPS removal after 6 months, and regaining the use of TICVPS at the time of recurrence.A total of 214 patients with CRC underwent curative intent treatments during the study period. Among them, 60 patients were excluded, including 6 patients for early recurrence within 3 months and 54 patients with violation of flushing interval. Finally, 154 patients were analyzed. Mean flushing interval was 98.4 days (95% confidence interval [CI], 96.2-100.6; range, 60-120). In December 2018, 35 patients kept the TICVPS, 92 patients had planned removal, 25 patients reused the TICVPS, and 2 patients had to unexpectedly remove the TICVPS due to site infection and pain. Thus, the functional TICVPS maintenance rate was 98.8% (152/154). Thirty-eight patients relapsed, and 30 patients were treated with intravenous chemotherapy. Among them, 25 patients (83.3%) reused the maintained TICVPS without a reinsertion procedures.Our study demonstrated that 3-month interval access and flushing is safe and feasible for maintaining TICVPS during surveillance of patients with CRC. An extended interval up to 3 months can be considered because it is compatible with CRC surveillance visit schedules.


Asunto(s)
Cateterismo Venoso Central/normas , Catéteres Venosos Centrales/tendencias , Quimioterapia/instrumentación , Adulto , Anciano , Antineoplásicos/uso terapéutico , Infecciones Relacionadas con Catéteres/prevención & control , Cateterismo Venoso Central/instrumentación , Cateterismo Venoso Central/enfermería , Neoplasias Colorrectales/tratamiento farmacológico , Neoplasias Colorrectales/cirugía , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Tiempo
16.
Lancet ; 397(10272): 375-386, 2021 01 30.
Artículo en Inglés | MEDLINE | ID: mdl-33485464

RESUMEN

BACKGROUND: Approved systemic treatments for malignant pleural mesothelioma (MPM) have been limited to chemotherapy regimens that have moderate survival benefit with poor outcomes. Nivolumab plus ipilimumab has shown clinical benefit in other tumour types, including first-line non-small-cell lung cancer. We hypothesised that this regimen would improve overall survival in MPM. METHODS: This open-label, randomised, phase 3 study (CheckMate 743) was run at 103 hospitals across 21 countries. Eligible individuals were aged 18 years and older, with previously untreated, histologically confirmed unresectable MPM, and an Eastern Cooperative Oncology Group performance status of 0 or 1. Eligible participants were randomly assigned (1:1) to nivolumab (3 mg/kg intravenously once every 2 weeks) plus ipilimumab (1 mg/kg intravenously once every 6 weeks) for up to 2 years, or platinum plus pemetrexed chemotherapy (pemetrexed [500 mg/m2 intravenously] plus cisplatin [75 mg/m2 intravenously] or carboplatin [area under the concentration-time curve 5 mg/mL per min intravenously]) once every 3 weeks for up to six cycles. The primary endpoint was overall survival among all participants randomly assigned to treatment, and safety was assessed in all participants who received at least one dose of study treatment. This study is registered with ClinicalTrials.gov, NCT02899299, and is closed to accrual. FINDINGS: Between Nov 29, 2016, and April 28, 2018, 713 patients were enrolled, of whom 605 were randomly assigned to either nivolumab plus ipilimumab (n=303) or chemotherapy (n=302). 467 (77%) of 605 participants were male and median age was 69 years (IQR 64-75). At the prespecified interim analysis (database lock April 3, 2020; median follow-up of 29·7 months [IQR 26·7-32·9]), nivolumab plus ipilimumab significantly extended overall survival versus chemotherapy (median overall survival 18·1 months [95% CI 16·8-21·4] vs 14·1 months [12·4-16·2]; hazard ratio 0·74 [96·6% CI 0·60-0·91]; p=0·0020). 2-year overall survival rates were 41% (95% CI 35·1-46·5) in the nivolumab plus ipilimumab group and 27% (21·9-32·4) in the chemotherapy group. Grade 3-4 treatment-related adverse events were reported in 91 (30%) of 300 patients treated with nivolumab plus ipilimumab and 91 (32%) of 284 treated with chemotherapy. Three (1%) treatment-related deaths occurred in the nivolumab plus ipilimumab group (pneumonitis, encephalitis, and heart failure) and one (<1%) in the chemotherapy group (myelosuppression). INTERPRETATION: Nivolumab plus ipilimumab provided significant and clinically meaningful improvements in overall survival versus standard-of-care chemotherapy, supporting the use of this first-in-class regimen that has been approved in the USA as of October, 2020, for previously untreated unresectable MPM. FUNDING: Bristol Myers Squibb.


Asunto(s)
Antineoplásicos Inmunológicos/administración & dosificación , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Ipilimumab/administración & dosificación , Nivolumab/administración & dosificación , Anciano , Quimioterapia , Femenino , Humanos , Masculino
17.
Rev Rene (Online) ; 22: e59963, 2021. graf
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1149524

RESUMEN

RESUMO Objetivo identificar as atividades farmacológicas da manteiga de bacuri (Platonia insignis Mart.). Métodos revisão integrativa, realizada nas bases de dados Literatura Latino-americana e do Caribe em Ciências da Saúde, Cumulative Index to Nursing and Allied Health Literature, EMBASE, MEDLINE/PubMed, Web of Science, Cochrane Library e SCOPUS, sem delimitação temporal e de idioma. A seleção se constituiu de 13 ensaios pré-clínicos. A avaliação das informações ocorreu de forma descritiva, confrontando com os achados pertinentes. Resultados observou-se que 50,0% das publicações foram indexadas na MEDLINE/PubMed, maioria das publicações ocorreram na Inglaterra (61,5%), seguidas do Brasil e dos Estados Unidos, ambos com 13,3%. Destaca-se que 100,0% dos artigos foram ensaios pré-clínicos; atividades farmacológicas para antioxidante (38,4%) e antileishmanicidas (30,7%). Registrou-se que 38,4% dos ensaios apresentaram testes de toxicidade. Conclusão a manteiga de bacuri (Platonia insignis Mart.) apresentou atividades farmacológicas em ensaios pré-clínicos, como antioxidantes, antileshimaniose, anticonvulsivante e cicatrização de feridas.


ABSTRACT Objective to identify the pharmacological activities of bacuri butter (Platonia insignis Mart.). Methods an integrative review, carried out in the databases of Latin American and Caribbean Literature in Health Sciences, Cumulative Index to Nursing and Allied Health Literature, EMBASE, MEDLINE/PubMed, Web of Science, Cochrane Library and SCOPUS, without the time and language restriction. The selection consisted of 13 pre-clinical trials. The information assessment descriptively took place, comparing with the pertinent findings. Results it was observed that 50.0% of the publications were indexed in MEDLINE/PubMed, most publications were from England (61.5%), followed by Brazil and the United States, both with 13.3%. It is noteworthy that 100.0% of the articles were pre-clinical trials; pharmacological activities for antioxidants (38.4%) and antileishmanicides (30.7%). It was found that 38.4% of the trials presented toxicity tests. Conclusion bacuri butter (Platonia insignis Mart.) Showed pharmacological activities in pre-clinical trials, such as antioxidants, antileshimaniasis, anticonvulsant and wound healing.


Asunto(s)
Benzofenonas , Clusiaceae , Composición de Medicamentos , Sinergismo Farmacológico , Quimioterapia
18.
Ann Pharmacother ; 55(1): 80-88, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32567362

RESUMEN

OBJECTIVES: To discuss the evidence and caveats associated with estimated and measured creatinine clearance (eClCr and mClCr) and glomerular filtration rate (eGFR and mGFR) assessments of kidney function in patients with more extreme forms of obesity. DATA SOURCES: PubMed (1976 to mid-May 2020) was used, with bibliographies of retrieved articles searched for additional articles. STUDY SELECTION AND DATA EXTRACTION: Articles using gold standard mGFR to evaluate eClCr, mClCr, and eGFR assessments of kidney function in patients with more extreme forms of obesity were included. DATA SYNTHESIS: The overestimation of GFR by mClCr is well established, but mClCr is an alternative to mGFR assessments for determining medication dosing in patients with extremes of body size or muscle mass, or in patients receiving narrow therapeutic index medications when eGFR is likely to be inaccurate. The vast majority of studies comparing eGFR assessments with gold standard indicators of kidney function were attempts to validate eGFR equations for diagnosing and staging chronic kidney disease (CKD). RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE: For dosing medications in patients with stable kidney function and extreme obesity, a deindexed 4-variable Modification of Diet in Renal Disease or CKD Epidemiology Collaboration equation is an alternative to Cockcroft-Gault. Consistent use of the same equation by provider and between providers within any given setting is of paramount importance. CONCLUSIONS: In patients with extreme obesity and stable kidney function, eClCr or eGFR using deindexed values provides estimates of function for dosing adjustments of medications with elimination by the kidneys, but more research is needed with respect to the best size descriptor to use with estimating equations.


Asunto(s)
Creatinina/orina , Tasa de Filtración Glomerular , Riñón/fisiopatología , Obesidad Mórbida/fisiopatología , Insuficiencia Renal Crónica/fisiopatología , Adulto , Anciano , Quimioterapia/métodos , Femenino , Tasa de Filtración Glomerular/fisiología , Humanos , Persona de Mediana Edad , Obesidad Mórbida/orina , Preparaciones Farmacéuticas/administración & dosificación , Insuficiencia Renal Crónica/orina
19.
Estud. Psicol. (Campinas, Online) ; 38: e190121, 2021. tab, graf
Artículo en Inglés | LILACS, Index Psicología - Revistas técnico-científicas | ID: biblio-1133863

RESUMEN

The diagnosis of childhood cancer, the treatment itself and its sequelae can be considered as stressful events in the child's life, requiring the use of coping strategies. The aim of this study was to describe the coping behaviors used by children and adolescents with cancer undergoing chemotherapy treatment, separated by sex, age and type of cancer. A total of 15 children and adolescents, from 6 to 12 years old, of both sexes, answered the Hospitalization Coping Strategies instrument regarding coping behaviors. Participants referred to behaviors with greater chances of an adaptive outcome: watching TV, talking, and taking their medicines. There were differences in the coping behaviors regarding sex, age, and types of cancer. These differences highlight the need for personalized interventions that include specific characteristics to facilitate the child's adaptation to the treatment.


O diagnóstico de câncer infantil, o próprio tratamento e suas sequelas podem ser considerados eventos estressores na vida de uma criança, demandando o uso de estratégias de enfretamento ou coping. O objetivo do estudo foi descrever os comportamentos de coping utilizados por crianças e adolescentes com câncer frente ao tratamento quimioterápico, diferenciadas quanto ao sexo, a idade e ao tipo de câncer que enfrentam. Quinze crianças e adolescentes, de seis a doze anos de idade, de ambos os sexos, responderam o instrumento de Avaliação das Estratégias de Enfrentamento da Hospitalização sobre os comportamentos de enfrentamento. Os participantes referiram recorrer a comportamentos com maiores chances de um desfecho adaptativo: assistir televisão, conversar e tomar remédio. Com relação aos comportamentos de enfrentamento relatados, foram encontradas diferenças quanto ao sexo, idade e tipos de câncer enfrentado, que sinalizam a necessidade de intervenções personalizadas que contemplem características específicas para facilitar a adaptação da criança ao tratamento.


Asunto(s)
Adaptación Psicológica , Psicología Infantil , Quimioterapia , Neoplasias
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