Assuntos
Granulomatose com Poliangiite/diagnóstico , Úlceras Orais/diagnóstico , Úlcera Cutânea/diagnóstico , Pele/patologia , Dorso , Biópsia , Ciclofosfamida/uso terapêutico , Quimioterapia Combinada , Glucocorticoides/uso terapêutico , Granulomatose com Poliangiite/tratamento farmacológico , Granulomatose com Poliangiite/imunologia , Granulomatose com Poliangiite/patologia , Humanos , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Úlceras Orais/tratamento farmacológico , Úlceras Orais/imunologia , Úlceras Orais/patologia , Valor Preditivo dos Testes , Prednisolona/uso terapêutico , Fatores de Risco , Pele/efeitos dos fármacos , Pele/imunologia , Úlcera Cutânea/tratamento farmacológico , Úlcera Cutânea/imunologia , Úlcera Cutânea/patologia , Resultado do TratamentoRESUMO
Amyopathic dermatomyositis (ADM) causes a severe pulmonary disease in 50% of patients and no validated therapeutic option is available. Mycophenolate mofetil permitted to control interstitial lung disease and pneumomediastinum in a patient with ADM. This drug has recently been used to treat interstitial lung disease in ADM, but its effectiveness has not been previously reported in case of pneumomediastinum. Patients with ADM need an accurate pulmonary surveillance and in case of pulmonary complications mycophenolate mofetil could be a new therapeutic option.
Assuntos
Dermatomiosite/tratamento farmacológico , Inibidores Enzimáticos/administração & dosagem , Doenças Pulmonares Intersticiais/tratamento farmacológico , Enfisema Mediastínico/tratamento farmacológico , Ácido Micofenólico/análogos & derivados , Adulto , Dermatomiosite/patologia , Humanos , Doenças Pulmonares Intersticiais/patologia , Masculino , Enfisema Mediastínico/patologia , Ácido Micofenólico/administração & dosagemRESUMO
Tobacco smoking is a major risk factor for lung cancer causing, among other effects, oxidative stress and lipid peroxidation. Malondialdehyde (MDA)-DNA adducts can be induced by direct DNA oxidation and by lipid peroxidation. We measured the relationship between bronchial MDA-DNA adducts and tobacco smoking, cancer status, and selected polymorphisms in 43 subjects undergoing a bronchoscopic examination for diagnostic purposes. MDA-DNA adducts were higher in current smokers than in never smokers (frequency ratio (FR) = 1.51, 95% confidence interval (CI) 1.01-2.26). MDA-DNA adducts were also increased in lung cancer cases with respect to controls, but only in smokers (FR = 1.70, 95% CI 1.16-2.51). Subjects with GA and AA cyclin D1 (CCND1) genotypes showed higher levels of MDA-DNA adducts than those with the wild-type genotype (FR = 1.51 (1.04-2.20) and 1.45 (1.02-2.07)). Lung cancer cases with levels of MDA-DNA adducts over the median showed a worse, but not statistically significant, survival, after adjusting for age, gender, and packyears (hazard ratio = 2.48, 95% CI 0.65-9.44). Our findings reinforce the role of smoking in lung carcinogenesis through oxidative stress. Subjects who carry at least one variant allele of the CCND1 gene could accumulate DNA damage for altered cell-cycle control and reduced DNA repair proficiency.
