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1.
Eur Rev Med Pharmacol Sci ; 28(6): 2127-2143, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38567575

RESUMO

OBJECTIVE: Nutrition plays a significant role in preserving the balance of the human body. Considering each person's particular characteristics, diet can directly and indirectly alter the body's immune response. The purpose of this study is to draw attention to the connection between a vegetarian diet and its impact on oral health. MATERIALS AND METHODS: To determine the connection between a vegetarian diet and dental health, a search of the literature was conducted on the PubMed, Scopus, and Web of Science databases. English language and a publication year between January 1, 2013, and March 1, 2023, were the inclusion criteria for the search. RESULTS: There were 167 articles in total that addressed the subject of interest, and 18 of them were chosen for qualitative analysis. CONCLUSIONS: This study suggests that a vegetarian diet may alter oral health, namely periodontal health, tooth erosion, and oral microbiome. Even if the data collected prevents the effect of a vegetarian diet on oral health from being confirmed, this study acts as a starting point for future, more focused research.


Assuntos
Dieta Vegetariana , Saúde Bucal , Humanos , Dieta , Estado Nutricional , Bibliometria
2.
Eur Rev Med Pharmacol Sci ; 27(21): 10651-10660, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37975390

RESUMO

OBJECTIVE: This review evaluates the relationship between saliva and dental erosion. The acidic environment that can be established in the mouth leads to dental erosion. Acid pH, low salivary flow, systemic pathologies of patients, intake of acidic foods, and poor oral hygiene contribute to an oral environment that favors the development of dental erosion. MATERIALS AND METHODS: A literature search was performed on PubMed, Scopus, and Web of Science databases to assess the role of saliva and dental erosion. The inclusion criteria for the search were: year of publication from January 1st, 2013, to March 1st, 2023, and English language. RESULTS: A total of 3,597 articles covering our topic were found, of which 15 were selected for qualitative analysis. CONCLUSIONS: Saliva protects against erosion by neutralizing and removing intrinsic and extrinsic acids, promoting the formation of an acquired protective film, and providing mineral substrates for remineralization by maintaining homeostasis in the digestive tract and oral cavity.


Assuntos
Saliva , Erosão Dentária , Humanos , Alimentos , Minerais , Boca , Concentração de Íons de Hidrogênio
3.
Eur Rev Med Pharmacol Sci ; 27(17): 8039-8054, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37750633

RESUMO

OBJECTIVE: Some of the most significant aspects in orthodontics for achieving favorable treatment outcomes include correct bracket positioning and a shorter period to accomplish bracket bonding. Two different brackets bonding techniques - direct and indirect bonding - are described in the literature. The aim of this review is to evaluate the differences, advantages, and disadvantages of the two techniques. MATERIALS AND METHODS: A literature search was conducted on PubMed, Scopus, and Web of Science databases in a period from January 2013 to April 2023 with English language restriction using the following Boolean keywords: "orthodontic bracket* AND (bonding OR placement)". RESULTS: A total of 3,820 articles were identified by the electronic search, and after duplicate removal, screening, and eligibility, a total of 11 papers were included for the qualitative analysis. CONCLUSIONS: Indirect bonding is more predictable and precise than direct bonding. Indirect bonding has a greater impact on minimizing bracket placement errors than direct bonding, but it still takes longer to complete than the traditional procedure. However, further studies on the differences between direct and indirect bonding, as well as digital bonding, are needed.


Assuntos
Assistência Odontológica , Apego ao Objeto , Humanos , Bases de Dados Factuais
4.
Crit Rev Oncol Hematol ; 187: 104035, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37244324

RESUMO

The present white paper, referring to the 4th Assisi Think Tank Meeting on breast cancer, reviews state-of-the-art data, on-going studies and research proposals. <70% agreement in an online questionnaire identified the following clinical challenges: 1: Nodal RT in patients who have a) 1-2 positive sentinel nodes without ALND (axillary lymph node dissection); b) cN1 disease transformed into ypN0 by primary systemic therapy and c) 1-3 positive nodes after mastectomy and ALND. 2. The optimal combination of RT and immunotherapy (IT), patient selection, IT-RT timing, and RT optimal dose, fractionation and target volume. Most experts agreed that RT- IT combination does not enhance toxicity. 3: Re-irradiation for local relapse converged on the use of partial breast irradiation after second breast conserving surgery. Hyperthermia aroused support but is not widely available. Further studies are required to finetune best practice, especially given the increasing use of re-irradiation.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/radioterapia , Neoplasias da Mama/tratamento farmacológico , Mastectomia , Excisão de Linfonodo , Biópsia de Linfonodo Sentinela , Mastectomia Segmentar , Axila/patologia , Linfonodos/patologia
5.
Front Med (Lausanne) ; 10: 1059712, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36744131

RESUMO

Background: The glioblastoma's bad prognosis is primarily due to intra-tumor heterogeneity, demonstrated from several studies that collected molecular biology, cytogenetic data and more recently radiomic features for a better prognostic stratification. The GLIFA project (GLIoblastoma Feature Analysis) is a multicentric project planned to investigate the role of radiomic analysis in GB management, to verify if radiomic features in the tissue around the resection cavity may guide the radiation target volume delineation. Materials and methods: We retrospectively analyze from three centers radiomic features extracted from 90 patients with total or near total resection, who completed the standard adjuvant treatment and for whom we had post-operative images available for features extraction. The Manual segmentation was performed on post gadolinium T1w MRI sequence by 2 radiation oncologists and reviewed by a neuroradiologist, both with at least 10 years of experience. The Regions of interest (ROI) considered for the analysis were: the surgical cavity ± post-surgical residual mass (CTV_cavity); the CTV a margin of 1.5 cm added to CTV_cavity and the volume resulting from subtracting the CTV_cavity from the CTV was defined as CTV_Ring. Radiomic analysis and modeling were conducted in RStudio. Z-score normalization was applied to each radiomic feature. A radiomic model was generated using features extracted from the Ring to perform a binary classification and predict the PFS at 6 months. A 3-fold cross-validation repeated five times was implemented for internal validation of the model. Results: Two-hundred and seventy ROIs were contoured. The proposed radiomic model was given by the best fitting logistic regression model, and included the following 3 features: F_cm_merged.contrast, F_cm_merged.info.corr.2, F_rlm_merged.rlnu. A good agreement between model predicted probabilities and observed outcome probabilities was obtained (p-value of 0.49 by Hosmer and Lemeshow statistical test). The ROC curve of the model reported an AUC of 0.78 (95% CI: 0.68-0.88). Conclusion: This is the first hypothesis-generating study which applies a radiomic analysis focusing on healthy tissue ring around the surgical cavity on post-operative MRI. This study provides a preliminary model for a decision support tool for a customization of the radiation target volume in GB patients in order to achieve a margin reduction strategy.

7.
Clin Transl Oncol ; 22(12): 2236-2243, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32418156

RESUMO

PURPOSE: Metastasis-directed therapy (MDT) is an investigational treatment option in patients with oligorecurrent prostate cancer (PCa). The aim of this retrospective study is to report oncologic outcome and toxicity of elective nodal radiotherapy (ENRT) in PCa patients affected by pelvic nodal oligorecurrence. METHODS: 41 consecutive patients were treated with salvage radiotherapy. At biochemical recurrence after primary treatment, oligorecurrent disease was detected by positron emission tomography (PET) in 94% of the patients. Image-guided intensity modulated radiation therapy (IMRT) was delivered using tomotherapy. 83% of the patients received androgen deprivation therapy (ADT) in combination with ENRT. Survival analysis was performed with Kaplan-Meier method, log-rank test was used to analyze associations between survival end-points and clinical parameters. Multivariate analysis was performed using Cox proportional hazards regression models. Toxicity was registered according to Common Terminology Criteria for Adverse Events (CTCAE) v4.0. RESULTS: The median at follow-up was 33.6 months. At 3 years, overall survival (OS), cancer-specific survival (CSS), and biochemical progression-free survival (b-PFS) were 89%, 92%, and 53%, respectively. At univariate analysis, all survival end-points were correlated with the number of positive pelvic lymph nodes at oligorecurrence (≤ 3 vs > 3). Biochemical-PFS was correlated with PSA (p = 0.034) and PSA doubling time (p = 0.004) at oligorecurrence. At multivariate analysis, no independent variable was statistically significant. No patient experienced grade ≥ 2 late toxicity after radiotherapy. CONCLUSIONS: The number of metastatic lymph nodes and PSA doubling time seems to be important prognostic factors in the pelvic oligorecurrent setting. Salvage radiotherapy combined with short-course ADT might be a valid treatment strategy.


Assuntos
Irradiação Linfática , Recidiva Local de Neoplasia/radioterapia , Neoplasias da Próstata/radioterapia , Terapia de Salvação/métodos , Idoso , Antagonistas de Androgênios/uso terapêutico , Terapia Combinada/métodos , Humanos , Estimativa de Kaplan-Meier , Linfonodos/patologia , Irradiação Linfática/efeitos adversos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/tratamento farmacológico , Tomografia por Emissão de Pósitrons , Intervalo Livre de Progressão , Modelos de Riscos Proporcionais , Antígeno Prostático Específico/metabolismo , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/tratamento farmacológico , Estudos Retrospectivos , Terapia de Salvação/efeitos adversos
8.
Brain Behav Immun ; 67: 230-245, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28890155

RESUMO

The microbiota-gut-brain axis (MGBA) regulates the reciprocal interaction between chronic inflammatory bowel and psychiatric disorders. This interaction involves multiple pathways that are highly debated. We examined the behavioural, biochemical and electrophysiological alterations, as well as gut microbiota composition in a model of antibiotic-induced experimental dysbiosis. Inflammation of the small intestine was also assessed. Mice were exposed to a mixture of antimicrobials for 2weeks. Afterwards, they received Lactobacillus casei DG (LCDG) or a vehicle for up to 7days via oral gavage. Perturbation of microbiota was accompanied by a general inflammatory state and alteration of some endocannabinoidome members in the gut. Behavioural changes, including increased immobility in the tail suspension test and reduced social recognition were observed, and were associated with altered BDNF/TrkB signalling, TRPV1 phosphorylation and neuronal firing in the hippocampus. Moreover, morphological rearrangements of non-neuronal cells in brain areas controlling emotional behaviour were detected. Subsequent probiotic administration, compared with vehicle, counteracted most of these gut inflammatory, behavioural, biochemical and functional alterations. Interestingly, levels of Lachnospiraceae were found to significantly correlate with the behavioural changes observed in dysbiotic mice. Our findings clarify some of the biomolecular and functional modifications leading to the development of affective disorders associated with gut microbiota alterations.


Assuntos
Antibacterianos/administração & dosagem , Depressão/microbiologia , Endocanabinoides/metabolismo , Microbioma Gastrointestinal/efeitos dos fármacos , Hipocampo/metabolismo , Inflamação/microbiologia , Neuroglia/metabolismo , Animais , Comportamento Animal/efeitos dos fármacos , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Depressão/metabolismo , Disbiose/complicações , Disbiose/metabolismo , Disbiose/microbiologia , Hipocampo/efeitos dos fármacos , Inflamação/complicações , Inflamação/metabolismo , Mucosa Intestinal/metabolismo , Intestinos/efeitos dos fármacos , Intestinos/microbiologia , Masculino , Camundongos Endogâmicos C57BL , Neuroglia/efeitos dos fármacos , Neurônios/efeitos dos fármacos , Neurônios/metabolismo , Probióticos/administração & dosagem
9.
Cancer Radiother ; 20(4): 292-8, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27344537

RESUMO

PURPOSE: Ductal carcinoma in situ represents 15 to 20% of all breast cancers. Breast-conserving surgery and whole breast irradiation was performed in about 60% of the cases. This study reports local recurrence rates in patients with ductal carcinoma in situ treated by breast-conserving surgery and whole breast irradiation with or without boost and/or tamoxifen and compares different therapeutic options in two European countries. PATIENTS AND METHODS: From 1998 to 2007, 819 patients with pure ductal carcinoma in situ were collected, both in France (266) and Italy (553). Median age was 56. All underwent breast-conserving surgery and whole breast irradiation; 391 (48%) received a boost (55% in France and 45% in Italy, P=0.017) and 173 (22.5%) tamoxifen (4.5% in France and 32% in Italy, P<0.0001). RESULTS: With a 90-month median follow-up, there were 51 local recurrences (6.2%), including 27 invasive (53%). The 5- and 10-year local recurrence rates were 4% and 8.6%. Two patients developed axillary recurrence and 12 (1.5%) metastases (seven after invasive local recurrence); 41 (5%) patients had contralateral breast cancer. In the multivariate analysis, high nuclear grade and lack of tamoxifen are the most powerful predictors of local recurrence, with 2.6 (95% confidence interval [95% CI]: 1.74-3.89, P=0.0012) and 2.85 (95% CI: 1.42-5.72, P=0.04) odds ratio (OR) estimates, respectively. Age, margin status and boost did not influence local recurrence rates. CONCLUSIONS: This study confirms the ductal carcinoma in situ treatment heterogeneity among countries and the unfavourable prognostic role of nuclear grade. Tamoxifen reduces local recurrence rates and might be considered for some subgroups of patients, but further confirmation is required. The boost usefulness still remains unclear.


Assuntos
Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/terapia , Carcinoma Intraductal não Infiltrante/terapia , Mastectomia Segmentar , Recidiva Local de Neoplasia/patologia , Tamoxifeno/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/patologia , Carcinoma Intraductal não Infiltrante/patologia , Quimioterapia Adjuvante , Feminino , Seguimentos , França , Humanos , Itália , Metástase Linfática , Pessoa de Meia-Idade , Dosagem Radioterapêutica , Radioterapia Adjuvante , Estudos Retrospectivos
10.
Breast ; 25: 45-50, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26547836

RESUMO

PURPOSE: Our study evaluated brain natriuretic peptide (BNP) changes over time after adjuvant radiotherapy (RT) in women with left-sided breast cancer investigating its correlation with heart dosimetric parameters. METHODS: Forty-three patients underwent clinical cardiac examination, electrocardiogram (ECG), echocardiography and BNP measurement before RT (T0) and 1 (T1), 6 (T6) and 12 months (T12) after. After T12 cardiac assessment was performed annually in each patient. Mean values and standard deviation (SD) of BNP, left ventricular ejection fraction (LVEF), V20, V25, V30, V45 and mean dose were calculated. Normalized BNP (BNPn) was calculated as follows: BNPnT1 = BNPT1/BNPT0, BNPnT6 = BNPT6/BNPT0, BNPnT12 = BNPT12/BNPT0. Absolute BNP and BNPn values were used for data analysis. RESULTS: Median follow-up from the end of RT to the last check-up was 87 months (range 37-120 months). Minimum follow-up was 74 months except for two patients, who died at respectively 37 and 47 months after RT. In all patients LVEF did not change significantly (p = 0.22) after RT. BNP increased significantly (p < 0.001), particularly 1 and 6 months after RT. It slightly decreased after 12 months. BNP did not correlate with V20, V25, V30, V45, mean dose and MHD. All BNPn correlated significantly (p < 0.05) with V20, V25, V30, V45, mean dose and MHD. Four patients had a cardiac event; in the only subject who developed myocardial infarction, V20, V25, V30 and V45 were the highest and BNP increased from T1 and persisted high even at T12. CONCLUSION: Our results confirm that BNP could be a useful minimally invasive marker of early RT related cardiac impairment.


Assuntos
Coração/efeitos da radiação , Peptídeo Natriurético Encefálico/sangue , Neoplasias Unilaterais da Mama/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Cardiotoxicidade/sangue , Eletrocardiografia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Radioterapia Adjuvante/efeitos adversos , Volume Sistólico/efeitos da radiação , Neoplasias Unilaterais da Mama/sangue , Função Ventricular Esquerda/efeitos da radiação
12.
Br J Cancer ; 111(2): 395-406, 2014 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-24918814

RESUMO

BACKGROUND: Glyoxalase I (GI) is a cellular defence enzyme involved in the detoxification of methylglyoxal (MG), a cytotoxic byproduct of glycolysis, and MG-derived advanced glycation end products (AGEs). Argpyrimidine (AP), one of the major AGEs coming from MG modifications of proteins arginines, is a pro-apoptotic agent. Radiotherapy is an important modality widely used in cancer treatment. Exposure of cells to ionising radiation (IR) results in a number of complex biological responses, including apoptosis. The present study was aimed at investigating whether, and through which mechanism, GI was involved in IR-induced apoptosis. METHODS: Apoptosis, by TUNEL assay, transcript and protein levels or enzymatic activity, by RT-PCR, western blot and spectrophotometric methods, respectively, were evaluated in irradiated MCF-7 breast cancer cells, also in experiments with appropriate inhibitors or using small interfering RNA. RESULTS: Ionising radiation induced a dramatic reactive oxygen species (ROS)-mediated inhibition of GI, leading to AP-modified Hsp27 protein accumulation that, in a mechanism involving p53 and NF-κB, triggered an apoptotic mitochondrial pathway. Inhibition of GI occurred at both functional and transcriptional levels, the latter occurring via ERK1/2 MAPK and ERα modulation. CONCLUSIONS: Glyoxalase I is involved in the IR-induced MCF-7 cell mitochondrial apoptotic pathway via a novel mechanism involving Hsp27, p53 and NF-κB.


Assuntos
Proteínas de Choque Térmico HSP27/metabolismo , Lactoilglutationa Liase/antagonistas & inibidores , NF-kappa B/metabolismo , RNA Interferente Pequeno/metabolismo , Proteína Supressora de Tumor p53/metabolismo , Apoptose/efeitos da radiação , Neoplasias da Mama/enzimologia , Neoplasias da Mama/genética , Neoplasias da Mama/metabolismo , Neoplasias da Mama/radioterapia , Técnicas de Cultura de Células , Proteínas de Choque Térmico , Humanos , Lactoilglutationa Liase/genética , Lactoilglutationa Liase/metabolismo , Células MCF-7 , Chaperonas Moleculares , Estresse Oxidativo/efeitos da radiação , Espécies Reativas de Oxigênio/metabolismo
13.
Strahlenther Onkol ; 188(12): 1074-9, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23111470

RESUMO

BACKGROUND AND PURPOSE: Radiotherapy (RT) of reconstructed breasts was associated with major complications and poor cosmetic outcome. The present study assessed complication rates, the link between risk factors and prosthesis removal, as well as cosmetic outcomes. PATIENTS AND METHODS: From 1997 to 2009, 101 consecutive patients received RT after breast reconstruction because of risk factors for relapse (92) or because relapse had occurred (9). At RT, 90 patients had temporary tissue expanders and 11 had permanent implants. Twelve patients underwent neo-adjuvant chemotherapy; all patients received adjuvant chemo- and/or hormone therapy. RESULTS: At a median follow-up of 50 months, late toxicities occurred in 28 patients: pain in 7, lymphedema in 6, G1 cutaneous toxicity in 5, and subcutaneous toxicity in 19 (2G1, 9G2, 7G3, 1G4), with more than one side effect in 12. In 8 patients the prosthesis ruptured (3), was displaced (3), was displaced and ruptured (1), or lost shape (1). Capsular contracture was classified in 89 patients as IA in 14, IB in 47, II in 10, III in 11, and IV in 7. Twelve prostheses (11.9%) were removed. The only significant factor for prosthesis removal was age (p = 0.007). Judgments of cosmetic results were available from 81 physicians and 84 patients. Outcome was excellent/good in 58/81 physician judgments and in 57/84 patient evaluations. Overall inter-rater agreement on outcome was good (κ-value 0.64; 95% CI: 0.48-0.79). CONCLUSION: RT to reconstructed breasts was associated with low rates of late toxicity and prosthesis removal. Cosmetic outcomes were, on the whole, good to excellent.


Assuntos
Implantes de Mama , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Mamoplastia/métodos , Complicações Pós-Operatórias/etiologia , Dispositivos para Expansão de Tecidos , Adulto , Fatores Etários , Idoso , Neoplasias da Mama/patologia , Estudos de Coortes , Terapia Combinada , Remoção de Dispositivo , Estética , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/prevenção & controle , Recidiva Local de Neoplasia/radioterapia , Estadiamento de Neoplasias , Complicações Pós-Operatórias/cirurgia , Radioterapia Adjuvante , Reoperação , Fatores de Risco , Resultado do Tratamento
14.
J Clin Pharm Ther ; 36(5): 592-601, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21070297

RESUMO

WHAT IS KNOWN AND OBJECTIVE: The efficacy of sibutramine has been demonstrated in randomized trials in obese/overweight patients including those with type 2 diabetes mellitus (T2DM). Our objective was to evaluate the effects of 1-year treatment with sibutramine compared to placebo on body weight, glycaemic control, lipid profile, and inflammatory parameters in type 2 diabetic patients. METHODS: Two hundred and forty-six patients with uncontrolled T2DM [glycated haemoglobin (HbA(1c) ) > 8·0%] in therapy with different oral hypoglycaemic agents or insulin were randomized to take 10 mg of sibutramine or placebo for 12 months. We evaluated at baseline, and after 3, 6, 9, and 12 months these parameters: body weight, body mass index (BMI), HbA(1c) , fasting plasma glucose (FPG), post-prandial plasma glucose (PPG), fasting plasma insulin (FPI), homeostasis model assessment insulin resistance index (HOMA-IR), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), triglycerides (Tg), leptin, tumour necrosis factor-α (TNF-α), adiponectin (ADN), vaspin, high sensitivity C-reactive protein (Hs-CRP). RESULTS AND DISCUSSION: We observed a decrease of body weight after 9 and 12 months in the group treated with sibutramine, but not in the control group. Regarding glycaemic and lipid profile, although there are differences seen over time within each of the groups, we did not obtain any significant differences between the two groups. Both placebo and sibutramine gave a similar improvement of HOMA-IR, leptin, TNF-α, ADN, and Hs-CRP. No vaspin variations were observed in either group. WHAT IS NEW AND CONCLUSION: Sibutramine resulted in a decrease in body weight at 9 months and at 12 months that was not observed with placebo. Although there were differences seen over time within each of the groups, there were no significant differences between groups for any other parameter that we measured.


Assuntos
Depressores do Apetite/farmacologia , Ciclobutanos/farmacologia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Inflamação/tratamento farmacológico , Obesidade/tratamento farmacológico , Obesidade/epidemiologia , Adiponectina/sangue , Depressores do Apetite/efeitos adversos , Glicemia , Índice de Massa Corporal , Peso Corporal , Proteína C-Reativa/metabolismo , Comorbidade , Ciclobutanos/efeitos adversos , Diabetes Mellitus Tipo 2/metabolismo , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Hipoglicemiantes/farmacologia , Inflamação/metabolismo , Inflamação/patologia , Inflamação/fisiopatologia , Insulina/sangue , Resistência à Insulina , Leptina/sangue , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Obesidade/patologia , Obesidade/fisiopatologia , Placebos , Ensaios Clínicos Controlados Aleatórios como Assunto , Tiazolidinedionas/farmacologia , Fatores de Tempo
15.
Ann Oncol ; 22(4): 842-847, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21048040

RESUMO

BACKGROUND: As few data are available on irradiation of the draining nodes after conservative surgery (CS), this study was designed to identify patients with T1-T2 breast cancer and one to three positive axillary nodes who needed regional radiotherapy (RT). PATIENTS AND METHODS: Five hundred seventy-five patients were treated between 1988 and 2001 with CS and RT to the breast. All but three received adjuvant chemotherapy and/or hormone therapy. Risk factors for and the relationships between local, nodal and distant relapses were analyzed. RESULTS: At a median follow-up of 7.3 years, the 10-year probability of survival free of local relapse, nodal relapse and distant metastases were 92.8%, 94.0% and 84.9%, respectively. Independent predictors of local relapse were the positive/excised node ratio, margin status and age. Predictors of nodal relapse were tumor grade, hormone receptor and margin status. Significant risk factors for distant metastases were tumor stage, grade, hormone receptor and margin status. Local and nodal relapses were related significantly with distant metastases. Only local and distant relapses were linked by temporal sequence (P=0.03). CONCLUSIONS: Overall relapse rates were low in these patients and different mechanisms appeared to underlie local, nodal or distant relapse.


Assuntos
Neoplasias da Mama/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/terapia , Terapia Combinada , Feminino , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Recidiva , Fatores de Risco
16.
J Clin Pharm Ther ; 35(5): 565-79, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20831680

RESUMO

WHAT IS KNOWN: The increased risk of cardiovascular events in diabetic patients has been related to numerous metabolic and haemoreological factors. Some of these factors appear to be particularly evident during the post-prandial phases and to be related to peak plasma glucose level. AIM: To compare the effect of addition of pioglitazone and acarbose to sulphonylureas and metformin therapy on metabolic parameters and on markers of endothelial dysfunction and vascular inflammation in type 2 diabetic patients. MATERIALS AND METHODS: We enrolled 473 caucasian type 2 diabetic patients. All patients underwent measurements of height and body weight, body mass index (BMI), glycated haemoglobin (HbA1c) , fasting plasma glucose (FPG), post-prandial plasma glucose (PPG), fasting plasma insulin (FPI), post-prandial plasma insulin (PPI), homeostasis model assessment (HOMA index), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), triglycerides (Tg), sICAM-1, IL-6, high-sensitivity C reactive protein (hsCRP), sVCAM-1, sE-selectin and tumour necrosis factor (TNF-α). Assessments were made at start of titration, after 3 months [before a first oral glucose tolerance test (OGTT)], after 6 months and at the study end (before a second OGTT). RESULTS: Two-hundred and seventy four patients completed the study: 138 were randomized to double-blind treatment with pioglitazone and 136 with acarbose. Significant BMI and weight increase were observed after full treatment in the pioglitazone group relative to the acarbose group. A decrease in glycated haemoglobin was observed after the titration period in the pioglitazone group compared to both baseline value and the acarbose group. A decrease in glycated haemoglobin was also obtained after full treatment in the pioglitazone group when compared to the end of titration period and to the acarbose group. Significant decrease in FPG was obtained in the pioglitazone group after full treatment compared to the end of titration period. Post-prandial plasma glucose decrease was observed in acarbose group compared to the baseline value and to the end of titration period. Fasting plasma insulin decreased in the pioglitazone group after both the titration period and the full treatment period compared to both the baseline value and the acarbose group. The HOMA index decreased significantly after the full treatment in pioglitazone group compared to the end of titration period and to the acarbose group. Interleukin-6 and tumour necrosis factor-α decreased after full treatment in the pioglitazone group relative to the end of titration period. Significant hsCRP decrease was obtained after the titration period when compared to the baseline value in the pioglitazone group. High-sensitivity C reactive protein decreased in the pioglitazone group after full treatment compared to the end of titration period and to the acarbose group. WHAT IS NEW AND CONCLUSION: Pioglitazone reduces the inflammatory response to a glucose challenge more than acarbose in type 2 diabetic patients, already treated with maximal doses of sulphonylureas and metformin.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Compostos de Sulfonilureia/uso terapêutico , Tiazolidinedionas/uso terapêutico , Acarbose/administração & dosagem , Acarbose/uso terapêutico , Biomarcadores , Glicemia , Pressão Sanguínea/efeitos dos fármacos , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/metabolismo , Feminino , Teste de Tolerância a Glucose , Hemoglobinas Glicadas/metabolismo , Humanos , Hipoglicemiantes/administração & dosagem , Inflamação/sangue , Interleucina-6/sangue , Lipídeos/sangue , Masculino , Metformina/administração & dosagem , Metformina/uso terapêutico , Pessoa de Meia-Idade , Pioglitazona , Compostos de Sulfonilureia/administração & dosagem , Tiazolidinedionas/administração & dosagem , Fator de Necrose Tumoral alfa/sangue
17.
Horm Metab Res ; 42(1): 8-13, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19735057

RESUMO

The aim of this study was to evaluate the effect of an oral glucose tolerance test (OGTT) on the level of endothelial dysfunction and vascular inflammation markers in healthy subjects (H) and diabetic overweight patients (D). We enrolled 256 healthy subjects and 274 type 2 diabetic patients. We evaluated blood glucose (BG), soluble intercellular adhesion molecule-1 (sICAM-1), interleukin-6 (IL-6), high-sensitivity C reactive protein (hsCRP), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble E-selectin (sE-selectin), and tumor necrosis factor-alpha (TNF-alpha) at baseline and after OGTT. We observed that BG, sICAM-1, IL-6, hs-CRP, sVCAM-1, sE-selectin, and TNF-alpha values were higher in D group than in H group. In a large sample of adult healthy subjects and type 2 diabetics we observed that both answer to an OGTT with a significant increase in biomarkers of systemic low-grade inflammation and endothelial dysfunction such as hsCRP, IL-6, TNF-alpha, sICAM-1, sVCAM-1, and sE-selectin. Type 2 diabetics experienced, however, a more significant increase in TNF-alpha, and sE-selectin.


Assuntos
Biomarcadores/sangue , Doenças Cardiovasculares/imunologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Endotélio Vascular/imunologia , Endotélio/imunologia , Adulto , Glicemia , Proteína C-Reativa/metabolismo , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/imunologia , Feminino , Teste de Tolerância a Glucose , Humanos , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade , Fator de Necrose Tumoral alfa/sangue , Molécula 1 de Adesão de Célula Vascular/sangue
18.
Eur J Surg Oncol ; 35(2): 144-50, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18640810

RESUMO

AIM: To investigate, in a phase II prospective study, the efficacy of partial breast irradiation administered with high-dose-rate brachytherapy. METHODS: After conservative surgery 80 patients with low-risk early-stage breast cancer received 4 Gy twice a day for 4 days (total dose 32 Gy). Catheter implantation was performed during surgery in 15 cases and postoperatively, at a median of 8 weeks from surgery, in 65 patients. Adjuvant therapy was chemotherapy (8) and/or hormone therapy (61). RESULTS: Cosmetic results were good/excellent in 79 patients. Perioperative toxicity was very low. Acute skin toxicity developed in seven cases (six G1; one G2); late G3 cutaneous toxicity in one patient and late subcutaneous toxicity in five (three G1; two G2). Grade 1 teleangiectasia occurred in eight patients and grade 2 in one. Fat necrosis was symptomatic in one patient and asymptomatic in five. Only one patient presented pain after brachytherapy. A significantly (p=0.001) higher frequency of late toxicity was observed in patients implanted during surgery, the group, which included the only patient with a fair cosmetic result. No local or regional relapses have occurred to date. The median follow-up was 30 months (range 3-52). CONCLUSION: This strategy is a viable option in selected patients with early-stage breast cancer as it is feasible, reproducible and associated with very low perioperative and acute toxicity. The low incidence of late side effects will probably change as follow-up lengthens.


Assuntos
Braquiterapia/métodos , Neoplasias da Mama/radioterapia , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Relação Dose-Resposta à Radiação , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Prospectivos , Planejamento da Radioterapia Assistida por Computador/métodos , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento
19.
Int J Lab Hematol ; 31(3): 359-63, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18205844

RESUMO

A method based on immunomagnetic sorting of reticulocytes from peripheral blood was set up and combined to a commercial extraction kit for the isolation of total RNA from whole blood. This procedure resulted in high-quality RNA samples suitable for molecular analysis. We used this procedure to analyse erythroid-specific transcripts, starting from peripheral blood samples, to search for differently expressed mRNAs in patients with hereditary persistence of foetal haemoglobin. After erythrocyte lysis, CD15(+)and CD45(+) peripheral cells were negatively sorted to remove leucocyte populations that could have affected the subsequent screening procedure. The cell sorting and RNA extraction procedure was completed within 1-2 h of erythrocyte lysis, which represents a consistent saving of time compared with other procedures. Moreover, it produced 1 microg of total RNA per ml of blood samples, which is sufficient for molecular analysis. Therefore, our method is a reliable and efficient tool to isolate RNA from specific cell subpopulations poorly represented in peripheral blood, particularly when accurate detection and characterization of highly unstable and poorly expressed molecules is required.


Assuntos
Separação Celular/métodos , Reticulócitos/fisiologia , Citometria de Fluxo , Humanos , Antígenos Comuns de Leucócito/análise
20.
Q J Nucl Med Mol Imaging ; 50(4): 330-3, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17043630

RESUMO

AIM: Aim of the study was to assess whether [153Sm] EDTMP therapy at a low-dose is associated with platelet activation. METHODS: In 29 patients suffering from metastatic prostate cancer platelet count and various platelet function parameters have been monitored for 2 months after a single (the first) application of 1.1 GBq mCi [153Sm]EDTMP. RESULTS: After 3 days insignificant signs of platelet activation (increase in malondialdehyde, adenosine diphosphate-induced platelet aggregation, decreased platelet sensitivity) occur, normalizing rapidly. At the nadir of platelet count (3-4 weeks) platelet aggregation response in non-count adjusted samples is somewhat lower, while activity per cell (count adjusted samples) is unchanged. Platelet proteins do not change at all. Insignificant activation of platelet function at day 3 is interpreted as an indicator of mild oxidation injury, late aggregation response changes in non-adjusted samples seem only to reflect temporarily decreased number of circulating platelets. Samarium-153-EDTMP therapy at doses (1.1 GBq) used in the Vienna-protocol is not associated with a significantly altered functional behavior of platelets. CONCLUSIONS: We conclude that a single dose of 1.1 GBq 153Sm-EDTMP does not significantly affect in vivo and ex vivo platelet function.


Assuntos
Plaquetas/efeitos da radiação , Compostos Organometálicos/administração & dosagem , Compostos Organofosforados/administração & dosagem , Ativação Plaquetária/efeitos da radiação , Neoplasias da Próstata/sangue , Neoplasias da Próstata/radioterapia , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Compostos Organometálicos/efeitos adversos , Compostos Organofosforados/efeitos adversos , Contagem de Plaquetas , Lesões por Radiação/sangue , Lesões por Radiação/etiologia , Compostos Radiofarmacêuticos/administração & dosagem , Compostos Radiofarmacêuticos/efeitos adversos , Trombocitopenia/sangue , Trombocitopenia/etiologia
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