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1.
J Clin Diagn Res ; 11(2): SD01-SD02, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28384953

RESUMO

Haemangiomas are most common non-malignant vascular tumours of infancy. Here, we describe an antenatally detected mass over the neck causing compressive respiratory compromise at birth requiring resuscitative measures at birth. The mass showed increased vascularity on Contrast Enhanced Computed Tomography (CECT) with extension upto superior mediastinum. Surgical excision was required following failure to medical measures with steroids and propranolol. Histopathology confirmed it to be a venous haemangioma. This case highlights that these benign lesions may reach large sizes and antenatal detection may help in planning effective delivery and resuscitative measures.

2.
J Microbiol Methods ; 90(3): 267-72, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22677607

RESUMO

The objective of this study was to adapt and evaluate two in vitro botulinum neurotoxin (BoNT) detection methods, including the Botulinum Toxin ELISA and the Endopep MS (a mass spectrometric-based endopeptidase method), for use with drinking water samples. The method detection limits (MDL) of the ELISA and Endopep MS were 260 pg/mL and 21 pg/mL of BoNT/A complex toxin, respectively. Since toxin could be present in water samples at highly dilute concentrations, large volume (100-L) samples of municipal tap water from five US municipalities having distinct water compositions were dechlorinated, spiked with 5 µg BoNT/A, and subjected to tangential-flow ultrafiltration (UF) using hollow fiber dialyzers. The recovery efficiency of BoNT/A using UF and quantified by ELISA ranged from 11% to 36% while efficiencies quantified by MS ranged from 26% to 55%. BoNT/A was shown to be stable in dechlorinated municipal tap water stored at 4°C for up to four weeks. In addition, toxin present in UF-concentrated water samples was also shown to be stable at 4°C for up to four weeks, allowing holding of samples prior to analysis. Finally, UF was used to concentrate a level of toxin (7 pg/mL) which is below the MDL for direct analysis by both ELISA and Endopep MS. Following UF, toxin was detectable in these samples using both in vitro analysis methods. These data demonstrate that UF-concentration of toxin from large volume water samples followed by use of existing analytical methods for detection of BoNT/A can be used in support of a monitoring program for contaminants in drinking water.


Assuntos
Toxinas Botulínicas Tipo A/análise , Água Potável/análise , Ensaios Enzimáticos , Animais , Toxinas Botulínicas Tipo A/química , Calibragem , Estabilidade Enzimática , Ensaio de Imunoadsorção Enzimática/normas , Limite de Detecção , Modelos Lineares , Espectrometria de Massas , Camundongos , Camundongos Endogâmicos ICR , Padrões de Referência , Ultrafiltração , Microbiologia da Água
3.
J Indian Assoc Pediatr Surg ; 16(2): 66-8, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21731236

RESUMO

Pancreas is a rare location for desmoplastic small round cell tumor. The present case highlights the dilemma in diagnosis and ascertaining the site of tumor origin. Morphologic and immunohistochemical features were complemented with the molecular markers and tumor origin which was initially nebulous was subsequently confirmed on exploratory laparotomy.

4.
Int J Radiat Oncol Biol Phys ; 79(1): 202-7, 2011 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-20399028

RESUMO

PURPOSE: To evaluate the prognostic factors and treatment outcome of patients with Askin-Rosai tumor of the chest wall treated at a single institution. METHODS AND MATERIALS: Treatment comprised multiagent chemotherapy and local therapy, which was either in the form of surgery alone, radical external-beam radiotherapy (EBRT) alone, or a combination of surgery and EBRT. Thirty-two patients (40%) were treated with all three modalities, 21 (27%) received chemotherapy and radical EBRT, and 19 (24%) underwent chemotherapy followed by surgery only. RESULTS: One hundred four consecutive patients aged 3-60 years were treated at the Tata Memorial Hospital from January 1995 to October 2003. Most (70%) were male (male/female ratio, 2.3:1). Asymptomatic swelling (43%) was the most common presenting symptom, and 25% of patients presented with distant metastasis. After a median follow-up of 28 months, local control, disease-free survival, and overall survival rates were 67%, 36%, and 45%, respectively. Median time to relapse was 25 months, and the median survival was 76 months. Multivariate analysis revealed age ≥18 years, poor response to induction chemotherapy, and presence of pleural effusion as indicators of inferior survival. Fifty-six percent of patients with metastatic disease at presentation died within 1 month of diagnosis, with 6-month and 5-year actuarial survival of 14% and 4%, respectively. CONCLUSION: Primary tumor size, pleural effusion, response to chemotherapy, and optimal radiotherapy were important prognostic factors influencing outcome. The combination of neoadjuvant chemotherapy, surgery, and radiotherapy resulted in optimal outcome.


Assuntos
Tumores Neuroectodérmicos Primitivos Periféricos/terapia , Neoplasias Torácicas/terapia , Parede Torácica , Adolescente , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Criança , Pré-Escolar , Radioisótopos de Cobalto/uso terapêutico , Terapia Combinada/métodos , Terapia Combinada/mortalidade , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Tumores Neuroectodérmicos Primitivos Periféricos/mortalidade , Tumores Neuroectodérmicos Primitivos Periféricos/patologia , Tumores Neuroectodérmicos Primitivos Periféricos/secundário , Derrame Pleural/mortalidade , Prognóstico , Dosagem Radioterapêutica , Indução de Remissão , Taxa de Sobrevida , Neoplasias Torácicas/mortalidade , Neoplasias Torácicas/patologia , Carga Tumoral , Adulto Jovem
5.
Head Neck ; 30(8): 1020-6, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18383528

RESUMO

BACKGROUND: Osteosarcoma of the head and neck region is a rare tumor and is a therapeutic challenge because of its aggressive nature and complex anatomical location. Standard management guidelines are lacking due to paucity of published data. METHODS: Fifty patients with head and neck osteosarcoma treated at our institute from 1995 to 2004 were reviewed. RESULTS: There were 32 men and 18 women (median, 30 years). Mandible (56%) was the most common site. Chondroblastic (46%) was the most common histopathological variant. Treatment comprised multimodality approach using surgery (100%), radiotherapy (36%), and chemotherapy (58%). After a median follow-up of 16.6 months, 46% were alive and disease free. Median overall survival was 45.7 months, and progression-free survival was 13.7 months. Mandible and maxilla were favorable sites. Postoperative adjuvant radiotherapy improved local control in patients with adverse prognostic factors. CONCLUSIONS: Surgery remains the mainstay of the treatment of head and neck osteosarcoma. Adjuvant radiotherapy improves outcome in patients with adverse factors.


Assuntos
Neoplasias Ósseas/mortalidade , Neoplasias Ósseas/terapia , Neoplasias de Cabeça e Pescoço/mortalidade , Neoplasias de Cabeça e Pescoço/terapia , Osteossarcoma/mortalidade , Osteossarcoma/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/patologia , Quimioterapia Adjuvante , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Osteossarcoma/patologia , Prognóstico , Radioterapia Adjuvante
6.
Int J Radiat Oncol Biol Phys ; 72(3): 728-36, 2008 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-18374512

RESUMO

PURPOSE: To evaluate the efficacy of intensity-modulated radiotherapy (IMRT) in reducing the acute toxicities associated with conventional RT (CRT) in children with nasopharyngeal carcinoma. PATIENTS AND METHODS: A total of 36 children with nonmetastatic nasopharyngeal carcinoma, treated at the Tata Memorial Hospital between June 2003 and December 2006, were included in this study. Of the 36 patients, 28 were boys and 8 were girls, with a median age of 14 years; 4 (11%) had Stage II and 10 (28%) Stage III disease at presentation. All patients had undifferentiated carcinoma and were treated with a combination of chemotherapy and RT. Of the 36 patients, 19 underwent IMRT and 17 underwent CRT. RESULTS: After a median follow-up of 27 months, the 2-year locoregional control, disease-free, and overall survival rate was 76.5%, 60.6%, and 71.3%, respectively. A significant reduction in acute Grade 3 toxicities of the skin (p = 0.006), mucous membrane (p = 0.033), and pharynx (p = 0.035) was noted with the use of IMRT. The median time to the development of Grade 2 toxicity was delayed with IMRT (skin, 35 vs. 25 days, p = 0.016; mucous-membrane, 39 vs. 27 days, p = 0.002; and larynx, 50 vs. 28 days, p = 0.009). The duration of RT significantly influenced disease-free survival on multivariate analysis (RT duration >52 days, hazard ratio = 5.49, 95% confidence interval, 1.14-26.45, p = 0.034). The average mean dose to the first and second planning target volume was 71.8 Gy and 62.5 Gy with IMRT compared with 66.3 Gy (p = 0.001) and 64.4 Gy (p = 0.046) with CRT, respectively. CONCLUSION: The results of our study have shown that IMRT significantly reduces and delays the onset of acute toxicity, resulting in improved tolerance and treatment compliance for children with nasopharyngeal carcinoma. Also, IMRT provided superior target coverage and normal tissue sparing compared with CRT.


Assuntos
Neoplasias Nasofaríngeas/radioterapia , Dosagem Radioterapêutica , Radioterapia Conformacional , Radioterapia de Intensidade Modulada/métodos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Neoplasias Nasofaríngeas/mortalidade , Neoplasias Nasofaríngeas/patologia , Estadiamento de Neoplasias , Estudos Retrospectivos , Taxa de Sobrevida , Sobreviventes
8.
Clin Orthop Relat Res ; 459: 82-91, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17417098

RESUMO

Successful management of osteosarcoma with limb salvage surgery is a challenging problem in the developing world. We report our early results with low-cost chemotherapy (without methotrexate) and low-cost limb salvage surgery. We prospectively collected data for 135 patients with histologically proven high-grade osteosarcoma of the extremities given neoadjuvant chemotherapy and treated with limb salvage surgery between January 2000 and February 2004. A locally designed and fabricated stainless steel customized megaprosthesis was used in 78 patients. Disease status and function was evaluated at followup ranging from 24 to 72 months. Followup data were available for 120 of the 135 patients. There were eight infections, four prosthesis breakages and three loosenings. Eighteen patients had local recurrence; 17 of these patients also developed lung metastases. Seventy-three patients (61%) were disease-free at followup. The group of 34 patients with 100% necrosis had better disease-free survival (79%). According to a modified Enneking system, the average functional score was 25.5 of 30 (85%) for the lower extremity and 20 of 30 (66%) for the shoulder. Our preliminary results suggest osteosarcoma can be managed well in a developing country in a cost-effective way. Limb salvage surgery has now become the standard of care.


Assuntos
Antineoplásicos/administração & dosagem , Neoplasias Ósseas/terapia , Salvamento de Membro/métodos , Osteossarcoma/terapia , Adolescente , Adulto , Ossos do Braço , Neoplasias Ósseas/patologia , Criança , Estudos de Coortes , Intervalo Livre de Doença , Feminino , Humanos , Índia , Fixadores Internos , Ossos da Perna , Salvamento de Membro/economia , Masculino , Metotrexato/administração & dosagem , Osteossarcoma/patologia , Estudos Retrospectivos , Resultado do Tratamento
9.
J Am Coll Nutr ; 26(1): 49-56, 2007 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17353583

RESUMO

OBJECTIVE: To assess serum albumin, total cholesterol, retinol, zinc and hemoglobin in children who had completed treatment for acute lymphoblastic leukemia (ALL) and Non-Hodgkin's lymphoma (NHL). METHODS: The above parameters were analyzed in 105 ALL and NHL and 108 age and sex-matched controls. Serum albumin, serum cholesterol and hemoglobin were estimated by colorimetric methods. Serum retinol was estimated by HPLC and serum zinc was estimated by atomic emission spectrophotometer (ICP-AES). Comparisons were made to stage of treatment (maintenance 6 with post-therapy), type of treatment (chemotherapy and radiation with only chemotherapy) and type of malignancy (ALL with NHL). RESULTS: Only serum albumin in patients included at Maintenance(6) was significantly higher (t = 2.31, p = 0.05) than post-therapy patients. No significant difference in serum values was observed by type of treatment. Only total cholesterol was significantly higher in NHL patients than in ALL patients (t = 1.954, p = 0.05). Patients had comparable serum levels to that of controls. However, in patients and controls more than 75% children had deficient serum retinol levels, (< than 0.6989 micromol/l, or 20 microg/dl). Further, 75% patients and 54.7% controls had serum retinol levels less than 0.3439 micromol/l or 10 microg/dl. CONCLUSION: The results of the present study indicate that cancer and its treatment did not have any long-lasting effect on serum albumin, total cholesterol, retinol, zinc and hemoglobin. Majority of subjects had low serum retinol suggestive of depleted liver reserves. The deficient serum retinol levels (< than 0.6989 micromol/l, or 20 microg/dl) in at least 75% of the patients and controls probably reflect poor dietary intake. A higher percentage of patients with low serum retinol levels may also be attributed to the possibility of urinary losses of retinol that occur during episodes of infection while on immunosuppressive anti-cancer drug therapy.


Assuntos
Linfoma não Hodgkin/sangue , Estado Nutricional , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangue , Oligoelementos/sangue , Vitamina A/sangue , Vitaminas/sangue , Adolescente , Antineoplásicos/efeitos adversos , Estudos de Casos e Controles , Criança , Pré-Escolar , Colesterol/sangue , Feminino , Hemoglobinas/análise , Humanos , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/radioterapia , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/radioterapia , Radioterapia/efeitos adversos , Albumina Sérica/análise , Oligoelementos/administração & dosagem , Vitamina A/administração & dosagem , Vitaminas/administração & dosagem , Zinco/administração & dosagem , Zinco/sangue
10.
Med Sci Monit ; 12(12): BR385-396, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17136003

RESUMO

BACKGROUND: Somatic and constitutional mutation screening of p53 in childhood sarcomas and retinoblastoma was investigated by a multitechnical approach to evaluate its role in the development/progression by somatic mutation events and/or genetic predisposition. MATERIAL/METHODS: The studies were carried out on a cohort of 100 sarcoma cases, i.e. Ewing's sarcoma (n=44), osteosarcoma (n=36), and rhabdomyosarcoma (n= 20), and on 50 retinoblastoma (Rb) cases. RESULTS: Constitutional allelic deletion was found by FISH in 4% of sarcoma cases. Overall, 20% of sarcoma tumors showed p53 rearrangement by PCR/SSCP and Southern blot. Allelic deletion of p53 was detected in 78% of sarcoma and 55% of Rb tumors. p53 protein expression was detected by immunohistochemistry in 20% of sarcoma tumors. CONCLUSIONS: This study for the first time provided evidence of p53 alteration through allelic deletion that are common primary somatic mutation events which occur irrespective of grade and stage and are hence probably associated with an early phase of tumorigenesis and/or tumor progression. The studies also explored the occurrence of de novo constitutional deletion of p53 in sporadic childhood sarcomas. This study in retinoblastoma provided evidence for the synergistic role of RB1 and p53, probably essential for the full-blown development of malignancy.


Assuntos
Genes p53 , Neoplasias da Retina/genética , Retinoblastoma/genética , Sarcoma/genética , Adolescente , Adulto , Sequência de Bases , Neoplasias Ósseas/genética , Criança , Pré-Escolar , Primers do DNA/genética , Feminino , Deleção de Genes , Dosagem de Genes , Mutação em Linhagem Germinativa , Humanos , Hibridização in Situ Fluorescente , Lactente , Recém-Nascido , Masculino , Osteossarcoma/genética , Mutação Puntual , Reação em Cadeia da Polimerase , Polimorfismo Conformacional de Fita Simples , Rabdomiossarcoma/genética , Sarcoma de Ewing/genética
11.
Indian J Cancer ; 42(2): 65-9, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16141504

RESUMO

BACKGROUND: The testes have been considered a sanctuary site for leukemic cells and testicular relapses used to account for a major proportion of the poor outcome of boys with acute lymphoblastic leukemia. With use of aggressive chemotherapy which includes intermediate or high dose methotrexate, the incidence of testicular relapses has declined. However once these patients have received cranial irradiation as a part of the front line protocol, high dose methotrexate needs to be avoided because of risk of developing leucoencephalopathy. AIM: To study the use of non cross resistant chemotherapeutic agents along with a regimen containing lower doses of methotrexate in patients of isolated testicular relapse (ITR). MATERIALS AND METHODS: This is a retrospective analysis of 12 consecutive patients with ITR treated with modified version of the CCG-112 protocol which consists of intensive systemic chemotherapy, cranial chemoprophylaxis along with testicular irradiation. RESULTS: One patient died of regimen related toxicity. Two patients relapsed in the bone marrow during maintenance. Of the nine patients who completed treatment, eight are alive and in remission. One patient had a bone marrow relapse two months after completing treatment. The Kaplan Meier estimates give us an Event Free Survival (EFS) of 66.7% at 10 yrs. CONCLUSIONS: Thus, though the incidence is very low, patients with ITR should be treated aggressively since they have an excellent chance of achieving a long term EFS.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Metotrexato/administração & dosagem , Recidiva Local de Neoplasia/terapia , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Neoplasias Testiculares/terapia , Transplante de Medula Óssea , Criança , Pré-Escolar , Terapia Combinada , Intervalo Livre de Doença , Humanos , Índia/epidemiologia , Injeções Espinhais , Masculino , Prontuários Médicos , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidade , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Radioterapia Adjuvante , Estudos Retrospectivos , Análise de Sobrevida , Neoplasias Testiculares/mortalidade , Neoplasias Testiculares/patologia
12.
Antimicrob Agents Chemother ; 47(8): 2706-9, 2003 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-12878548

RESUMO

Using six Enterococcus faecalis and five Enterococcus faecium strains, the ketolide ABT-773 (ABT), now known as cethromycin, was found to have in vivo efficacy against both erythromycin (ERY)-susceptible (Ery(s)) and -intermediate (Ery(i)) enterococci (ABT 50% protective doses [PD(50)s], 0.5 to 4.1 and 10.3 to 16.2 mg/kg of body weight, respectively). Against four highly Ery-resistant (Ery(r)) strains for which ABT MICs were low, ABT showed much greater activity (PD(50), 6.3 to 32.5 mg/kg) than ERY (PD(50), >200 mg/kg) but was not protective for strains for which ABT MICs were high. In conclusion, ABT-773 showed in vivo efficacy and considerably greater activity than ERY in a mouse peritonitis model.


Assuntos
Eritromicina/uso terapêutico , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Cetolídeos , Peritonite/tratamento farmacológico , Animais , Contagem de Colônia Microbiana , Enterococcus faecium/efeitos dos fármacos , Eritromicina/análogos & derivados , Eritromicina/farmacologia , Infecções por Bactérias Gram-Positivas/microbiologia , Dose Letal Mediana , Camundongos , Camundongos Endogâmicos ICR , Testes de Sensibilidade Microbiana , Peritonite/microbiologia
14.
Leuk Res ; 26(11): 989-92, 2002 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-12363466

RESUMO

The aim of this study was to assess the antibody response to combined passive active immunisation versus active immunisation along with interferon against Hepatitis B in 60 patients with acute lymphoblastic leukemia (ALL) between 1 and 21 years of age with negative Hepatitis B virus (HBV) serology at presentation. Thirty-one patients received combined passive active immunisation with human specific Hepatitis B immunoglobulin (HEPABIG-VHB Pharmaceuticals) and Hepatitis B vaccine (arm I) and 29 patients received active immunisation along with interferon (arm II). Protective antibody levels were detected in 89.6 and 21% patients, respectively, at the 6-month evaluation. Infection with HBV occurred in 17 and 59% patients, respectively, at the 6-month evaluation. Interferon, thus, failed to serve the role as a vaccine adjuvant. At the 9-month evaluation of patients who received immunoglobulin, protective antibody titers were lost in 8 out of 19 evaluable patients (42%) and of these, 3 patients became HBsAg reactive at this point of time. This study indicated that 47.3% patients undergoing aggressive chemotherapy responded to combined passive active prophylaxis with protective titers of antiHBs at the 9-month evaluation. However, the rate of HBV infection was greatly reduced to 27%. We suggest that usage of passive immunisation in the aggressive phase, followed by active immunisation after cessation of intense chemotherapy would be a better option to increase the rates of protective antibody levels in these immunocompromised patients with leukemia.


Assuntos
Vacinas contra Hepatite B/uso terapêutico , Hepatite B/prevenção & controle , Imunização Passiva , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Vacinação , Vacinas de DNA/uso terapêutico , Doença Aguda , Adolescente , Adulto , Criança , Pré-Escolar , Terapia Combinada , Hepatite B/complicações , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/análise , Humanos , Lactente , Interferon alfa-2 , Interferon-alfa/uso terapêutico , Proteínas Recombinantes
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