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1.
Ann Palliat Med ; 10(8): 9149-9156, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34488400

RESUMEN

BACKGROUND: Hepatocellular carcinoma (HCC) is a highly vascularized tumor in which abnormal blood vessels contribute to poor treatment efficacy and prognosis. In this study, we assessed the efficacy, safety, and potential ability of bevacizumab to normalize tumor vascularity in patients with advanced HCC. METHODS: Patients with histologically or clinically confirmed advanced HCC that were refractory to conventional transarterial chemoembolization (c-TACE) received a transarterial infusion of bevacizumab (5 mg/kg), followed by c-TACE (named as BEVA-TACE). The primary endpoint was overall survival (OS), which was defined as the time from a patient identified as TACE refractory to the occurrence of death. The secondary endpoints included progression-free survival (PFS) and the disease control rate (DCR). RESULTS: From January 2014 to December 2017, 20 patients with Barcelona Clinic Liver Cancer (BCLC) staging scores C (80.0%) or D (20.0%) received BEVA-TACE. The median OS time was 9.2 months [95% confidence interval (CI): 2.1-22.6 months]. The median PFS time was 6.3 months (95% CI: 1.0-10.5 months). Despite the late stage, 1 patient (5.0%) had a complete response (CR), 6 patients (30.0%) had a partial response (PR), and 10 patients (50.0%) had stable disease (SD) [overall response rate (ORR) 30.0%; DCR 85.0%]. The most common adverse events (AEs) were postembolic syndrome (25%), hyperbilirubinemia (10.0%), and melena (10.0%). Severe III-IV oral mucositis and hypertension were observed in only 1 patient (5.0%) during the follow-up period. CONCLUSIONS: BEVA-TACE showed clinical efficacy, and patients with TACE-refractory HCC had acceptable AE rates. A low dose of targeted localized vessel bevacizumab infusion may normalize the condition of tumor blood vessels in patients with advanced HCC.


Asunto(s)
Carcinoma Hepatocelular , Quimioembolización Terapéutica , Neoplasias Hepáticas , Bevacizumab/uso terapéutico , Carcinoma Hepatocelular/tratamiento farmacológico , Terapia Combinada , Humanos , Neoplasias Hepáticas/tratamiento farmacológico
2.
Georgian Med News ; (316-317): 52-55, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34511444

RESUMEN

The aim of the work was to evaluate the effectiveness of the radiosurgery method in the treatment of malignant tumors of the larynx. The treatment of 48 patients was carried out using the "Rocus-AM" device. The larynx was irradiated 5 times a week, with a single focal dose of 2.5 Gy and a total dose of 35 Gy. Besides the radiotherapy, the patients received intravenous 5-fluorouracil in a dose of 250 mg/m2 every other day during the whole course of the radiotherapy. After 14 days, the tumour response to irradiation was assessed. The clinical monitoring of the course of the disease has resulted in 1) recovery of laryngeal dividing function within two days in 100% of patients; 2) temporary swallowing dysfunction in 8% of patients, and 3) recovery of respiratory function at 2-6 months after therapy in 98% of patients. The three-year recurrence-free survival rate was 95.8%. The prospects for further research and improvement of the technique are related to the necessity of a comparative analysis of the recurrence-free survival of patients with laryngeal cancer treated with this technique and control groups of patients who received presurgical or postsurgical distant radiotherapy.


Asunto(s)
Neoplasias Laríngeas , Laringe , Radiocirugia , Terapia Combinada , Fluorouracilo , Humanos , Neoplasias Laríngeas/radioterapia , Neoplasias Laríngeas/cirugía , Resultado del Tratamiento
3.
Clin Plast Surg ; 48(4): 651-658, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34503725

RESUMEN

Adjuvant therapy plays an integral role in the treatment algorithm for stage III and stage IV cutaneous melanoma. Current ongoing clinical trials are exploring the effects of neoadjuvant therapeutics, specifically for the presurgical treatment of high-risk, borderline resectable disease. In both the adjuvant and neoadjuvant settings, the early chemotherapeutic and biochemical antitumor agents are making way to newer immune therapies, mutation-specific targeted therapies, and oncolytic vaccines that are transforming the treatment of malignant melanoma. The use of these systemic therapies in addition to surgical resection has been shown to increase both overall and progression-free survival.


Asunto(s)
Melanoma , Neoplasias Cutáneas , Quimioterapia Adyuvante , Terapia Combinada , Humanos , Melanoma/tratamiento farmacológico , Terapia Neoadyuvante , Neoplasias Cutáneas/terapia
4.
Rozhl Chir ; 100(7): 325-329, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34465108

RESUMEN

Skin abscess is one of the most common infections of skin and soft tissues. Incision and drainage under local anesthesia is the mainstay of treatment. Although previous small-scale studies failed to show a benefit of antibiotics in patients with simple abscesses, the use of antibiotic therapy is still encountered in the treatment of uncomplicated skin abscesses in our practice. The purpose of our study was to evaluate existing data assessing the effect of adjuvant antibiotic therapy on abscess management. Although as indicated by two recent multicenter studies, antibiotics may provide a positive effect in the management, it is important to consider the risk of resistance associated with antibiotic overuse and to approach each case individually.


Asunto(s)
Absceso , Infecciones de los Tejidos Blandos , Absceso/tratamiento farmacológico , Absceso/cirugía , Antibacterianos/uso terapéutico , Terapia Combinada , Drenaje , Humanos
5.
Pan Afr Med J ; 39: 84, 2021.
Artículo en Francés | MEDLINE | ID: mdl-34466186

RESUMEN

The treatment of acute osteomyelitis is becoming more challenging since the emergence of community-acquired methicillin-resistant Staphylococcus aureus. We collected data on all patients with acute osteomyelitis caused by this germ over a period of 21 years (January 1995-December 2016) and we analyzed the peculiarities of this disorder. Our case series includes 15 children, with an average age of 9 years. All patients had affected lower limb. Local trauma was reported in 8 cases and skin carriage in 4 cases. Acute onset was reported in 12 cases associated with pseudo-paralysis of the affected limb. One patient had Staphylococcus aureus pulmonary infection with signs of septicopyemia. Blood culture was positive in 8 cases. In one case PCR assay for detection of Panton-Valentine leukocidin was performed with positive result. All these patients underwent surgical debridement and received secondarily adapted empirical antibiotic therapy. Outcome was good in 8 cases and poor in the other cases, with transition to a chronic state in 6 cases and one case of death. Pathological fracture was reported in 3 cases. Osteomyelitis cause by community-acquired methicillin-resistant Staphylococcus aureus is associated with a pejorative outcome. Recognizing the clinical and paraclinical signs of these infections is essential for a specific and early therapeutic management.


Asunto(s)
Infecciones Comunitarias Adquiridas/diagnóstico , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Osteomielitis/diagnóstico , Infecciones Estafilocócicas/diagnóstico , Enfermedad Aguda , Adolescente , Antibacterianos/administración & dosificación , Niño , Preescolar , Terapia Combinada , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/terapia , Desbridamiento/métodos , Femenino , Humanos , Masculino , Osteomielitis/microbiología , Osteomielitis/terapia , Estudios Retrospectivos , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/terapia
6.
Nutrients ; 13(7)2021 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-34371826

RESUMEN

BACKGROUND: Sarcopenia is a major health problem in older adults. Exercise and nutrient supplementation have been shown to be effective interventions but there are limited studies to investigate their effects on the management of sarcopenia and its possible underlying mechanisms. Here, we studied T cell gene expression responses to interventions in sarcopenia. METHODS: The results of this study were part of a completed trial examining the effectiveness of a 12-week intervention with exercise and nutrition supplementation in community-dwelling Chinese older adults with sarcopenia, based on the available blood samples at baseline and 12 weeks from 46 randomized participants from three study groups, namely: exercise program alone (n = 11), combined-exercise program and nutrition supplement (n = 23), and waitlist control group (n = 12). T cell gene expression was evaluated, with emphasis on inflammation-related genes. Real-time PCR (RT-PCR) was performed on CD3 T cells in 38 selected genes. Correlation analysis was performed to relate the results of gene expression analysis with lower limb muscle strength performance, measured using leg extension tests. RESULTS: Our results showed a significant improvement in leg extension for both the exercise program alone and the combined groups (p < 0.001). Nine genes showed significant pre- and post-difference in gene expression over 12 weeks of intervention in the combined group. Seven genes (RASGRP1, BIN1, LEF1, ANXA6, IL-7R, LRRN3, and PRKCQ) showed an interaction effect between intervention and gene expression levels on leg extension in the confirmatory analysis, with confounder variables controlled and FDR correction. CONCLUSIONS: Our findings showed that T cell-specific inflammatory gene expression was changed significantly after 12 weeks of intervention with combined exercise and HMB supplementation in sarcopenia, and that this was associated with lower limb muscle strength performance.


Asunto(s)
Suplementos Dietéticos , Ejercicio Físico/fisiología , Expresión Génica/genética , Sarcopenia/terapia , Linfocitos T/metabolismo , Valeratos/administración & dosificación , Anciano , Anciano de 80 o más Años , Terapia Combinada , Análisis Factorial , Femenino , Humanos , Vida Independiente , Extremidad Inferior/fisiopatología , Masculino , Fuerza Muscular/genética , Músculo Esquelético/fisiopatología , Entrenamiento de Fuerza/métodos , Sarcopenia/genética , Resultado del Tratamiento
7.
Med Sci Monit ; 27: e929898, 2021 Aug 27.
Artículo en Inglés | MEDLINE | ID: mdl-34449759

RESUMEN

BACKGROUND The digestive tract is the most common site of extranodal involvement in diffuse large B cell lymphoma (DLBCL) and its prognostic evaluation is different from that of ordinary DLBCL. Currently, for gastrointestinal lymphoma, in addition to the Ann Arbor staging system, the Lugano and the TNM staging systems are commonly used. However, there is no effective prognostic model to identify poor prognosis in patients with localized gastrointestinal diffuse large B cell lymphoma (GI-DLBCL). MATERIAL AND METHODS This study included 82 patients with GI-DLBCL that had a median follow-up of 75 months, and developed a model (HLAMA) with 5 variables: hemoglobin, age, lactate dehydrogenase (LDH), serum albumin, and the maximum intra-abdominal lesion diameter (MIALD). The specific indicators are: HGB <105 g/L (2 points); LDH ≥300 U/L; age ≥75 years, ALB <38 g/L, MIALD ≥4 cm (each scoring 1 point). We also developed a simplified model, which includes only 3 variables (HGB, LDH, and age). RESULTS HLAMA model and the simplified model both demonstrated good ability to predict prognosis of patients with GI-DLBCL (P<0.001), performing better than the IPI score as it could distinguish low-risk groups in relatively elderly patients (60-75 years old). CONCLUSIONS This study established a prognostic model for diffuse large B cell lymphoma of the gastrointestinal tract. Both the HLAMA model and its simplified version are similar to the IPI score, but could be considered better as they can provide a simpler and more accurate prognostic assessment in patients with GI-DLBCL. For patients with localized GI-DLBCL, our model could distinguish high-risk patients.


Asunto(s)
Neoplasias Gastrointestinales/patología , Linfoma de Células B Grandes Difuso/patología , Modelos Estadísticos , Estadificación de Neoplasias/normas , Anciano , Terapia Combinada , Femenino , Estudios de Seguimiento , Neoplasias Gastrointestinales/terapia , Humanos , Linfoma de Células B Grandes Difuso/terapia , Masculino , Persona de Mediana Edad , Pronóstico , Tasa de Supervivencia
9.
World J Surg Oncol ; 19(1): 253, 2021 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-34446046

RESUMEN

BACKGROUND: The impact of primary tumour location on the prognosis of patients with peritoneal metastasis (PM) arising from colorectal cancer (CRC) after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is rarely discussed, and the evidence is still limited. METHODS: Patients with PM arising from CRC treated with CRS and HIPEC at the China National Cancer Center and Huanxing Cancer Hospital between June 2017 and June 2019 were systematically reviewed. Clinical characteristics, pathological features, perioperative parameters, and prognostic data were collected and analysed. RESULTS: A total of 70 patients were divided into two groups according to either colonic or rectal origin (18 patients in the rectum group and 52 patients in the colon group). Patients with PM of a colonic origin were more likely to develop grade 3-4 postoperative complications after CRS+HIPEC (38.9% vs 19.2%, P = 0.094), but this difference was not statistically significant. Patients with colon cancer had a longer median overall survival (OS) than patients with rectal cancer (27.0 vs 15.0 months, P = 0.011). In the multivariate analysis, the independent prognostic factors of reduced OS were a rectal origin (HR 2.15, 95% CI 1.15-4.93, P = 0.035) and incomplete cytoreduction (HR 1.99, 95% CI 1.06-4.17, P = 0.047). CONCLUSION: CRS is a complex and potentially life-threatening procedure, and we suggest that the indications for CRS+HIPEC in patients with PM of rectal origin be more restrictive and that clinicians approach these cases with caution.


Asunto(s)
Neoplasias Colorrectales , Hipertermia Inducida , Neoplasias Peritoneales , Neoplasias Colorrectales/tratamiento farmacológico , Terapia Combinada , Procedimientos Quirúrgicos de Citorreducción , Humanos , Quimioterapia Intraperitoneal Hipertérmica , Neoplasias Peritoneales/tratamiento farmacológico , Pronóstico , Tasa de Supervivencia
10.
BMJ Case Rep ; 14(8)2021 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-34353827

RESUMEN

We present two 85-year-old men, with a similar history of prostate cancer treated more than 10 years ago with radiotherapy, who were in remission, but sought medical care at a time, due to alarm sign and symptoms. Case 2 resulted in a locally advanced secondary radiation-induced sarcoma of the penile base. Case 1 suffered from a round, 2 cm soft-tissue lesion with spiculated borders at the ureterovesical junction responsible for ipsilateral iliac vein compression and urinary obstruction without proven biochemical prostate cancer relapse, raising concerns about recurrence or secondary tumour. Both patients followed an oncological geriatric assessment and were 'vulnerable' at their presentation. Hence, we describe the effort to perform medical care adequacy regarding patient's frailty and the anatomic locations within the prior radiation field. In case 2, we got a pathological diagnose and followed sequential multimodal treatments without success. But in case 1, minimal intervention resulted in improvement.


Asunto(s)
Neoplasias Primarias Secundarias , Neoplasias de la Próstata , Anciano , Terapia Combinada , Humanos , Masculino , Recurrencia Local de Neoplasia/radioterapia , Prostatectomía , Neoplasias de la Próstata/radioterapia , Neoplasias de la Próstata/cirugía
11.
Medicine (Baltimore) ; 100(33): e26958, 2021 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-34414963

RESUMEN

BACKGROUND: Hepatocellular carcinoma (HCC) ranks as the sixth most common cancer and the second leading cause of cancer-related death worldwide, local and systemic therapies are beneficial for those who have more advanced disease or are not suitable for radical treatment. We aim to investigate the clinical outcomes of transarterial chemoembolization (TACE) plus sorafenib compared with sorafenib monotherapy for intermediate-advanced HCC. METHODS: A systematic search according to preferred reporting items for systematic reviews and meta-analyses guidelines in the PubMed database was conducted from inception to December 31, 2020 for published studies comparing survival outcomes and tumor response between TACE + sorafenib and sorafenib alone for intermediate-advanced HCC. RESULTS: Five eligible cohort studies and a randomized controlled trial with a total of 3015 patients were identified. We found that the TACE + sorafenib group had a significantly better overall survival (OS) (hazard ratio, 0.77; 95% confidence interval [CI] 0.66-0.88, P < .001) than those treated with sorafenib. Median OS ranged from 7.0 to 22.0 months with TACE + sorafenib and from 5.9 to 18.0 months with sorafenib. The combination of TACE + sorafenib had a significantly better time to progression (hazard ratio, 0.74; 95% CI 0.65-0.82, P < .001) than those treated with sorafenib. Median time to progression ranged from 2.5 to 5.3 months with TACE + sorafenib and from 2.1 to 2.8 months with sorafenib. The results showed the TACE + sorafenib group had a higher disease control rate (log odds ratio, 0.52; 95% CI 0.25-0.80, P = .0002), objective response rate (log odds ratio, 0.85; 95% CI 0.37-1.33, P = .0006) than sorafenib group. Hand-foot skin reaction, diarrhea, fatigue, vomiting, and alanine aminotransferase (ALT) elevation were common adverse events. The adverse events were similar between the 2 groups excluding elevated ALT. CONCLUSION: Although the TACE + sorafenib group had a higher elevated ALT, the combination of TACE + sorafenib had an OS benefit compared with sorafenib in the treatment of intermediate-advanced HCC. Further research is necessary to affirm this finding and clarify whether certain subgroups benefit from different combinations between TACE and sorafenib.


Asunto(s)
Antineoplásicos/uso terapéutico , Carcinoma Hepatocelular/terapia , Quimioembolización Terapéutica/métodos , Neoplasias Hepáticas/terapia , Sorafenib/uso terapéutico , Carcinoma Hepatocelular/tratamiento farmacológico , Terapia Combinada , Humanos , Neoplasias Hepáticas/tratamiento farmacológico
12.
Undersea Hyperb Med ; 48(3): 297-321, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34390634

RESUMEN

Refractory osteomyelitis is defined as a chronic osteomyelitis that persists or recurs after appropriate interventions have been performed or where acute osteomyelitis has not responded to accepted management techniques [1]. To date, no randomized clinical trials examining the effects of hyperbaric oxygen (HBO2) therapy on refractory osteomyelitis exist, and the number of new osteomyelitis clinical trials conducted over the past decade has been limited. However, based on a comprehensive review of the scientific literature, the addition of HBO2 therapy to routine surgical and antibiotic treatment of previously refractory osteomyelitis appears to be both safe and ultimately improves infection resolution rates. In most cases, the best clinical results are obtained when HBO2 treatment is administered in conjunction with culture-directed antibiotics and initiated soon after clinically indicated surgical debridement. Where extensive surgical debridement or removal of fixation hardware is relatively contraindicated (e.g., cranial, spinal, sternal, or pediatric osteomyelitis), a trial of culture-directed antibiotics and HBO2 therapy prior to undertaking more than limited surgical interventions provides a reasonable prospect for osteomyelitis cure. HBO2 therapy is ordinarily delivered on a once daily basis, five-seven days per week, for 90-120 minutes using 2.0-3.0 atmospheres absolute (ATA) pressure. Where prompt clinical improvement is seen, the existing regimen of antibiotics and HBO2 therapy should be continued for approximately four to six weeks. Typically, 20-40 HBO2 sessions are required to achieve sustained therapeutic benefit. In contrast, if prompt clinical response is not noted or osteomyelitis recurs after this initial treatment period, then continuation of the current antibiotic and HBO2 treatment regimen is unlikely to be effective. Instead, clinical management strategies should be reassessed and additional surgical debridement and/or modification of antibiotic therapy considered. Subsequent reinstitution of HBO2 therapy will again help maximize the overall chances for treatment success in these persistently refractory patients.


Asunto(s)
Antibacterianos/uso terapéutico , Oxigenación Hiperbárica/métodos , Osteomielitis/terapia , Adulto , Animales , Niño , Enfermedad Crónica , Estudios de Cohortes , Terapia Combinada/métodos , Desbridamiento , Humanos , Oxigenación Hiperbárica/estadística & datos numéricos , Osteomielitis/clasificación , Osteomielitis/microbiología , Selección de Paciente , Recurrencia , Factores de Tiempo
13.
Medicine (Baltimore) ; 100(29): e26650, 2021 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-34398022

RESUMEN

RATIONAL: Epidermal growth factor receptor (EGFR) 20 exon insertion is the second most common EGFR aberrations in non-small cell lung cancer (NSCLC). Despite some novel EGFR inhibitors, clinically obtainable management for this subset of patients remains an unmet need. there are no previous reports of upfront combination therapy with immunotherapy and chemotherapy for lung adenocarcinoma with brain metastasis harboring EGFR 20 insertion. PATIENT CONCERNS: A 56-year-old man who sought care for dry cough was diagnosed with lung adenocarcinoma with brain metastases indicating a poor prognosis. DIAGNOSIS: Next-generation sequencing of lung biopsied tissue revealed an EGFR exon 20 in-frame insertion (P772_H773insYNP+H773Y). INTERVENTIONS: The patient started treatment of pemetrexed and carboplatin plus programmed cell death-1 inhibitor sintilimab in November 2019. OUTCOMES: The patient achieved partial responses both intra- and extra-cranially. After 6 cycles of treatment, the patient accepted sintilimab plus pemetrexed every 3 weeks as maintenance therapy, which was well-tolerated without any toxicity and is still ongoing after 18 months since initiation of 1st-line treatment. LESSONS: This is the first case report of the clinical benefit of upfront immune checkpoint inhibitors (ICIs) plus chemotherapy for a brain metastatic NSCLC patient harboring EGFR exon 20 insertion mutation. Further study is needed to validate the predictor involved in responders to ICIs-based therapy with EGFR mutations.


Asunto(s)
Adenocarcinoma/terapia , Neoplasias Encefálicas/terapia , Neoplasias Pulmonares/terapia , Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/secundario , Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/secundario , Terapia Combinada , Receptores ErbB/genética , Humanos , Inmunoterapia , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Resultado del Tratamiento
14.
Medicine (Baltimore) ; 100(29): e26699, 2021 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-34398042

RESUMEN

BACKGROUND: Endometriosis (EMs) affects about 10% of women of childbearing age. It is defined as functional endometrial tissue appearing in other parts of the uterine cavity, manifested by varying degrees of pelvic pain and pelvic mass, etc. Therefore, to improve the therapeutic effect of endometriosis, we must constantly explore new ways to treat the disease. The purpose of this study is to evaluate the effectiveness and safety of the combined use of laparoscopy and traditional Chinese medicine in the treatment of patients with EMs. METHODS: A systematic literature search will be conducted at China National Knowledge Infrastructure, WanFang databases, VIP, SinoMed, PubMed, Embase, Web of Science, and the Cochrane library. The search period limit is from the time the date of database establishment to June 21, 2021. To ensure the comprehensiveness of the search, relevant references and conference literature are also included. The risk of bias in the final included studies will be evaluated based on the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. The RevMan software will be employed to perform data synthesis and statistical analysis. RESULTS: The effectiveness and safety of laparoscopic surgery combined with traditional Chinese medicine decoction in the treatment of patients with EMs will be systematically evaluated. CONCLUSION: The results of this study will provide strong evidence for judging whether laparoscopy combined with traditional Chinese medicine decoction is an effective strategy for the treatment of patients with EMs.


Asunto(s)
Medicamentos Herbarios Chinos/uso terapéutico , Endometriosis/tratamiento farmacológico , Terapia Combinada , Medicamentos Herbarios Chinos/administración & dosificación , Endometriosis/cirugía , Femenino , Humanos , Laparoscopía , Fitoterapia , Proyectos de Investigación
15.
Photochem Photobiol Sci ; 20(8): 1087-1098, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34398442

RESUMEN

In this study, C-doped TiO2 nanoparticles (C-TiO2) were prepared and tested as a photosensitizer for visible-light-driven photodynamic therapy against cervical cancer cells (HeLa). X-ray diffraction and Transmission Electron Microscopy confirmed the anatase form of nanoparticles, spherical shape, and size distribution from 5 to 15 nm. Ultraviolet-visible light spectroscopy showed that C doping of TiO2 enhances the optical absorption in the visible light range caused by a bandgap narrowing. The photo-cytotoxic activity of C-TiO2 was investigated in vitro against HeLa cells. The lack of dark cytotoxicity indicates good biocompatibility of C-TiO2. In contrast, a combination with blue light significantly reduced the survival of HeLa cells: illumination only decreased cell viability by 30% (15 min of illumination, 120 µW power), and 60% when HeLa cells were preincubated with C-TiO2. We have also confirmed blue light-induced C-TiO2-catalyzed generation of reactive oxygen species in vitro and intracellularly. Oxidative stress triggered by C-TiO2/blue light was the leading cause of HeLa cell death. Fluorescent labeling of treated HeLa cells showed distinct morphological changes after the C-TiO2/blue light treatment. Unlike blue light illumination, which caused the appearance of large necrotic cells with deformed nuclei, cytoplasm swelling, and membrane blebbing, a combination of C-TiO2/blue light leads to controlled cell death, thus providing a better outcome of local anticancer therapy.


Asunto(s)
Carbono/química , Nanopartículas , Fototerapia , Titanio/química , Titanio/farmacología , Neoplasias del Cuello Uterino/patología , Supervivencia Celular/efectos de los fármacos , Supervivencia Celular/efectos de la radiación , Terapia Combinada , Femenino , Células HeLa , Humanos
16.
Pan Afr Med J ; 39: 15, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34394806

RESUMEN

Primary musculoskeletal echinococcosis is rare and accounts for 2-3% of the patients with hydatid disease. We report a case of giant primary hydatid cysts of the thigh and the gluteal region in an 82-year-old female, who presented with a painful multiple palpable mass. The diagnosis was confirmed by imaging and serology. Total resection was performed through an extended lateral approach of the thigh and intraoperative findings revealed infected giant hydatid cysts. The postoperative outcome was uneventful. Albendazole drug (400mg per day) was given for the next 3 months. At 6 months follow-up, the patient was satisfied with no complications or recurrence.


Asunto(s)
Albendazol/administración & dosificación , Antihelmínticos/administración & dosificación , Equinococosis/diagnóstico , Anciano de 80 o más Años , Nalgas/parasitología , Terapia Combinada , Equinococosis/terapia , Femenino , Estudios de Seguimiento , Humanos , Muslo/parasitología
17.
Medicine (Baltimore) ; 100(30): e26753, 2021 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-34397719

RESUMEN

ABSTRACT: Triptorelin has been used after surgery in deep infiltrating endometriosis. This post-hoc analysis aimed to evaluate symptom control between patients receiving 1-3 triptorelin injections and those receiving 4-6 injections within 24 months of conservative surgery for deep infiltrating endometriosis, in the real-world.Included patients were divided into two groups (received up to 3 months injections in group A, 4-6 injections in group B) based on the numbers of triptorelin (Diphereline, 3.75 mg intramuscular injection once every 28 days for up to 24 weeks) administration. Evolution in score of pain intensity at 3, 6, 9, 12, 18, and 24 months after primary triptorelin administration and symptom improvement/recurrence rates between two groups were compared. Symptoms of pain intensity were assessed using a visual analogue scale (VAS) with a range from 0 to 10 cm. An improvement in symptoms was defined as a reduction of at least 3 cm or 3 units from pre-surgery levels.156 patients in group A and 228 in group B. Pain symptom score (mean ±â€Šstandard deviation) diminished to a nadir at 3-months for group A and 6-months for group B; at 6-months nadir scores were significantly lower in group B (0.9 ±â€Š1.7 vs 0.4 ±â€Š1.2 respectively, P = .002). No significant difference for pain symptom scores between both groups at 24-months (P = .269). The 6-month and 24-month cumulative improvement rates of pain (80.6% vs 89.8%, P = .014 and 82.6% vs 90.7%, P = .025) and gastro-intestinal symptoms (61.0% vs 80.8%, P = .022 and 61.0% vs 83.3%, P = .008) were significantly higher in group B, whereas there was no significant difference in rates of menstrual disorders and urinary symptoms. There is no significant difference for 12-months and 24-months cumulative recurrence rates of total symptoms between both groups (11.3% vs 13.8%, P = .568 and 16.1% vs 26.0%, P = .094).In women with deep infiltrating endometriosis, longer treatment with triptorelin following conservative surgery was associated with a decrease in symptom intensity and greater improvement of pain symptoms in the short-term and greater improvement of gastro-intestinal symptoms in the long-term.Trial registration number: ClinicalTrials.gov, NCT01942369.


Asunto(s)
Endometriosis/tratamiento farmacológico , Luteolíticos/administración & dosificación , Índice de Severidad de la Enfermedad , Pamoato de Triptorelina/administración & dosificación , Adulto , Terapia Combinada , Endometriosis/cirugía , Femenino , Humanos , Estudios Prospectivos
18.
Am Fam Physician ; 104(2): 171-178, 2021 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-34383430

RESUMEN

Breast cancer is the leading cause of death from cancer in women worldwide, and the second most common cause of death from cancer in women in the United States. Risk assessment tools can identify the risk of breast cancer, and patients at high risk may be candidates for risk-reducing medications. The choice of medication varies with menopausal status. Breast cancer treatment depends on the stage. Stage 0 is ductal carcinoma in situ, which is noninvasive but progresses to invasive cancer in up to 40% of patients. Ductal carcinoma in situ is treated with lumpectomy and radiation or with mastectomy. If ductal carcinoma in situ is estrogen receptor-positive, patients may also receive endocrine therapy. Early invasive stages (I, IIa, IIb) and locally advanced stages (IIIa, IIIb, IIIc) are nonmetastatic and have three treatment phases. The preoperative phase uses systemic endocrine or immunotherapies when tumors express estrogen, progesterone, or ERBB2 receptors. Preoperative chemotherapy may also be used and is the only option when tumors have none of those three receptors. There are two options for the surgical phase with similar survival rates; a lumpectomy with radiation if the tumor can be excised completely with good cosmetic results, or a mastectomy. Sentinel lymph node biopsy is also performed when there is suspected nodal disease. The postoperative phase includes radiation, endocrine therapy, immunotherapy, and chemotherapy. Postmenopausal women should also be offered postoperative bisphosphonates. Stage IV (metastatic) breast cancer is treatable but not curable. Treatment goals include improving the length and quality of life.


Asunto(s)
Neoplasias de la Mama/terapia , Manejo de la Enfermedad , Neoplasias de la Mama/diagnóstico , Terapia Combinada/métodos , Femenino , Humanos , Estadificación de Neoplasias
19.
J Tradit Chin Med ; 41(4): 499-506, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34392641

RESUMEN

OBJECTIVE: To explore the clinical efficacy of the combination of Traditional Chinese and Western Medicines for the treatment of coronavirus disease 2019 (COVID-19). METHODS: Studies were identified in six popular medical databases. RESULTS: Thirteen studies were included. The results showed that combined treatment with Traditional Chinese and Western Medicines can reduce the probability of progression from mild to severe disease [RR = 0.34, 95% confidence interval (CI) (0.18, 0.65)] (P = 0.001) and improve the clinical cure rate [RR = 0.17, 95% CI (0.05, 0.28)] (P = 0.004). The use of an integrated treatment strategy shortened the time to the remission of fever [WMD = -1.27, 95% CI (-1.67, -0.92)](P < 0.001) and improved the incidences of the disappearance of fever and fatigue [RR = 1.25, 95% CI (1.06, 1.47) (P = 0.007); RR = 1.49, 95% CI (1.13, 1.97) (P = 0.004)]. CONCLUSION: A combined treatment strategy is effective for COVID-19.


Asunto(s)
COVID-19/tratamiento farmacológico , Medicina China Tradicional , SARS-CoV-2 , Terapia Combinada , Humanos
20.
J Immunol ; 207(5): 1298-1309, 2021 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-34362833

RESUMEN

Intralesional therapy is a promising approach for remodeling the immunosuppressive tumor microenvironment while minimizing systemic toxicities. A combinatorial in situ immunomodulation (ISIM) regimen with intratumoral administration of Fms-like tyrosine kinase 3 ligand (Flt3L), local irradiation, and TLR3/CD40 stimulation induces and activates conventional type 1 dendritic cells in the tumor microenvironment and elicits de novo adaptive T cell immunity in poorly T cell-inflamed tumors. However, the impact of ISIM on myeloid-derived suppressor cells (MDSCs), which may promote treatment resistance, remains unknown. In this study, we examined changes in the frequencies and heterogeneity of CD11b+Ly-6CloLy-6G+ polymorphonuclear (PMN)-MDSCs and CD11b+Ly-6ChiLy-6G- monocytic (M)-MDSCs in ISIM-treated tumors using mouse models of triple-negative breast cancer. We found that ISIM treatment decreased intratumoral PMN-MDSCs, but not M-MDSCs. Although the frequency of M-MDSCs remained unchanged, ISIM caused a substantial reduction of CX3CR1+ M-MDSCs that express F4/80. Importantly, these ISIM-induced changes in tumor-residing MDSCs were not observed in Batf3-/- mice. ISIM upregulated PD-L1 expression in both M-MDSCs and PMN-MDSCs and synergized with anti-PD-L1 therapy. Furthermore, ISIM increased the expression of IFN regulatory factor 8 (IRF8) in myeloid cells, a known negative regulator of MDSCs, indicating a potential mechanism by which ISIM decreases PMN-MDSC levels. Accordingly, ISIM-mediated reduction of PMN-MDSCs was not observed in mice with conditional deletion of IRF8 in myeloid cells. Altogether, these findings suggest that ISIM holds promise as a multimodal intralesional therapy to alter both lymphoid and myeloid compartments of highly aggressive poorly T cell-inflamed, myeloid-enriched tumors resistant to anti-PD-L1 therapy.


Asunto(s)
Células Dendríticas/inmunología , Inmunoterapia/métodos , Factores Reguladores del Interferón/metabolismo , Neoplasias Mamarias Animales/terapia , Proteínas de la Membrana/uso terapéutico , Células Supresoras de Origen Mieloide/inmunología , Linfocitos T/inmunología , Animales , Antígeno B7-H1 , Factores de Transcripción con Cremalleras de Leucina de Carácter Básico/genética , Antígenos CD40/metabolismo , Línea Celular Tumoral , Terapia Combinada , Resistencia a Medicamentos , Regulación de la Expresión Génica , Humanos , Inyecciones Intralesiones , Factores Reguladores del Interferón/genética , Activación de Linfocitos , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Trasplante de Neoplasias , Radioterapia , Proteínas Represoras/genética , Receptor Toll-Like 3/metabolismo , Microambiente Tumoral
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