RESUMO
Over the past 20 years, high-risk human papilloma-virus (HPV) infection has been established as a risk factor for developing head and neck squamous cell carcinoma, independent of tobacco and alcohol use. In particular, HPV is strongly associated with the development of oropharyngeal cancer and a small minority of oral cavity cancers. In this review, we summarize what is currently known about the biology of HPV, the mechanisms by which it effects malignant transformation, and the potential impact of HPV status on the clinical management of persons with head and neck cancer.
Assuntos
Alphapapillomavirus/patogenicidade , Carcinoma de Células Escamosas/virologia , Neoplasias de Cabeça e Pescoço/virologia , Infecções por Papillomavirus/patologia , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Transformação Celular Neoplásica , Neoplasias de Cabeça e Pescoço/mortalidade , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Neoplasias Orofaríngeas/mortalidade , Neoplasias Orofaríngeas/patologia , Neoplasias Orofaríngeas/virologia , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/virologia , Fatores de Risco , Taxa de SobrevidaRESUMO
Detoxification is the medical care that safely carries the patient through withdrawal. It is normally not an end point but is a step toward rehabilitation. Protocols should be tailored to meet the needs of individual patients.
Assuntos
Alcoolismo/reabilitação , Drogas Ilícitas , Psicotrópicos , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Delirium por Abstinência Alcoólica/psicologia , Delirium por Abstinência Alcoólica/reabilitação , Alcoolismo/psicologia , Medicina de Família e Comunidade , Humanos , Drogas Ilícitas/efeitos adversos , Equipe de Assistência ao Paciente , Psicotrópicos/efeitos adversos , Síndrome de Abstinência a Substâncias/psicologia , Síndrome de Abstinência a Substâncias/reabilitação , Transtornos Relacionados ao Uso de Substâncias/psicologiaRESUMO
Urinary glycosaminoglycan excretion was examined in 25 individuals with bladder cancer in comparison to glycosaminoglycan excretion by eight normal individuals. Urinary glycosaminoglycan was isolated by gel filtration and quantified as macromolecular uronate concentration. Electrophoresis in calcium acetate and densitometry of Alcian blue-stained electrophoretograms were used to separate and quantify the relative amounts of individual glycosaminoglycans. Elevated excretion of macromolecular uronate was noted in 53% of the cancer cases. The highest levels were found among individuals with metastatic disease. Three electrophoretic bands were always detected in the control and cancer groups: chondroitin sulfate, heparan sulfate (both confirmed by chemical and enzymatic degradation), and a third band (Band 1) of unknown composition. A fourth band, corresponding to dermatan sulfate, was seen in some high-grade metastatic tumors. Band 1 excretion was elevated in a significant fraction of all patients. Seven of 12 metastatic cases but only two of 13 localized cases showed increased heparan sulfate excretion. Diagnostic limits were drawn from the observed distributions of normals, and with these limits 92% of the cancer cases, including 12 of 12 metastatic cases, could be identified. The results strongly suggest noninvasive urinary glycosaminoglycan analysis may well provide a new biochemical approach for detecting and monitoring the pathogeneses of bladder cancer.