RESUMO
Se realiza un estudio de las 2 entidades clínicas que presentan un diagnóstico diferencial con la degeneración macular asociada a la enfermedad (DMAE) húmeda, que son la vasculopatía coroidea polipoidea idiopática y la proliferación angiomatosa retiniana. Analizamos sus entidades clínicas y características funduscópicas, así como sus diferencias con la DMAE. Presentamos 2 casos clínicos representativos de estas 2 entidades. Se estudian las posibilidades terapéuticas y los resultados, y las últimas publicaciones referidas a ellas, comparándolas y haciendo un estudio estadístico de las últimas publicaciones(AU)
We performed a study of the two clinical entities with a differential diagnosis with wet age-related macular degeneration, namely, idiopathic polypoidal choroidal vasculopathy (IPCV) and retinal angiomatous proliferation. We analyze the clinical and funduscopic characteristics of these entities as well as their differences with wet age-related macular degeneration. We present two cases that are representative of these two entities. The therapeutic possibilities, results and the latest publications are analyzed and compared. A statistical analysis of the latest publications is also presented(AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Degeneração Macular Exsudativa/complicações , Degeneração Macular Exsudativa/diagnóstico , Degeneração Macular Exsudativa/terapia , Degeneração Macular/diagnóstico , Degeneração Macular/terapia , Diagnóstico Diferencial , Inibidores da Angiogênese/uso terapêutico , Degeneração Macular Exsudativa/tratamento farmacológico , Degeneração Macular Exsudativa/fisiopatologia , Degeneração Macular Exsudativa , Degeneração Macular/tratamento farmacológico , Degeneração Macular/fisiopatologia , Degeneração Macular , Acuidade Visual , Acuidade Visual/fisiologia , Corticosteroides/uso terapêuticoRESUMO
We performed a study of the two clinical entities with a differential diagnosis with wet age-related macular degeneration, namely, idiopathic polypoidal choroidal vasculopathy (IPCV) and retinal angiomatous proliferation. We analyze the clinical and funduscopic characteristics of these entities as well as their differences with wet age-related macular degeneration. We present two cases that are representative of these two entities. The therapeutic possibilities, results and the latest publications are analyzed and compared. A statistical analysis of the latest publications is also presented.
Assuntos
Inibidores da Angiogênese/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Neovascularização de Coroide/tratamento farmacológico , Degeneração Macular Exsudativa/tratamento farmacológico , Corticosteroides/uso terapêutico , Idoso , Bevacizumab , Capilares/efeitos dos fármacos , Capilares/patologia , Corioide/irrigação sanguínea , Neovascularização de Coroide/cirurgia , Terapia Combinada , Angiofluoresceinografia , Humanos , Fotocoagulação a Laser , Masculino , Oftalmoscopia , Fotoquimioterapia , Ranibizumab , Vasos Retinianos/efeitos dos fármacos , Vasos Retinianos/patologia , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Fator A de Crescimento do Endotélio Vascular/fisiologia , Degeneração Macular Exsudativa/classificação , Degeneração Macular Exsudativa/patologia , Degeneração Macular Exsudativa/cirurgiaRESUMO
BACKGROUND: Thirty percent to ninety percent of cancer patients suffer from pain, including neuropathic pain (NP), which results in great burden for cancer patients. Thus, it was of great interest to determine NP prevalence in cancer patients in Spain, to raise awareness of the condition, and aiming to improve management of cancer NP. PATIENTS AND METHODS: A 1-month follow-up prospective epidemiological multicenter study was conducted to assess prevalence and management of NP in Spanish oncologic units. The first 10 cancer patients at each unit diagnosed with NP by the validated Douleur Neuropathique 4 questionnaire (DN4) were recruited. RESULTS: Of 8615 screened patients, 2567 (30%) suffered from pain. From these, 33% had NP according to investigators and 19% according to DN4 test. Three hundred and sixty-six patients (mean age 62.6 years; 61.2% male) were recruited. Pain decrease at 1 month was greater in patients with metastases (P<0.01) and depended on treatment (P<0.05), with 'oxycodone' showing 50.4% pain relief. CONCLUSIONS: NP prevalence in cancer pain is 33%. DN4 reports only about half the cancer NP cases diagnosed by clinicians. Pharmaceutical treatment of cancer pain, including NP, has a greater effect in patients with metastases and seems to depend on the specific treatment used.
Assuntos
Neoplasias/etiologia , Neuralgia/epidemiologia , Medição da Dor , Idoso , Idoso de 80 Anos ou mais , Analgésicos Opioides/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neuralgia/complicações , Neuralgia/tratamento farmacológico , Oxicodona/uso terapêutico , Espanha/epidemiologia , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Platinum resistant ovarian cancer is a current challenge in Oncology. Current approved therapies offer no more of a 20% of response. New therapeutic options are urgently needed. PATIENTS AND METHODS: Patients were treated with the combination of Pemetrexed 500 mg/m(2) d1 and Gemcitabine 1000 mg/m(2) d1,8 in a 21 days basis. RESULTS: 10 platinum-resistant ovarian cancer patients were treated under compassionate use. Mean previous chemotherapy lines were 3.3. Mean administered cycles were 4. Mean CA 125 decrease was on average of 47%, with one patient experiencing a 95% decrease in her CA 125 level. 1 patient had a complete clinical remission, and 2, had partial radiological responses. Mean Progression free survival was 16.5 weeks, and Overall Survival was 21.2 weeks. Treatment was well tolerated. CONCLUSIONS: Deemd to the observed activity, the combination of Pemetrexed and Gemcitabine deserves deeper investigation in platinum-resistant ovarian cancer patients.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Antígeno Ca-125/sangue , Desoxicitidina/administração & dosagem , Desoxicitidina/efeitos adversos , Desoxicitidina/análogos & derivados , Intervalo Livre de Doença , Resistencia a Medicamentos Antineoplásicos , Feminino , Glutamatos/administração & dosagem , Glutamatos/efeitos adversos , Guanina/administração & dosagem , Guanina/efeitos adversos , Guanina/análogos & derivados , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/sangue , Recidiva Local de Neoplasia/mortalidade , Neoplasias Ovarianas/sangue , Neoplasias Ovarianas/mortalidade , Pemetrexede , Compostos de Platina/uso terapêutico , Terapia de Salvação/efeitos adversos , Terapia de Salvação/métodos , Análise de Sobrevida , Resultado do Tratamento , GencitabinaRESUMO
INTRODUCTION: Platinum resistant ovarian cancer is a current challenge in Oncology. Current approved therapies offer no more of a 20% of response. New therapeutic options are urgently needed. PATIENTS AND METHODS: Patients were treated with the combination of Pemetrexed 500 mg/m(2) d1 and Gemcitabine 1000 mg/m(2) d1,8 in a 21 days basis. RESULTS: 10 platinum-resistant ovarian cancer patients were treated under compassionate use. Mean previous chemotherapy lines were 3.3. Mean administered cycles were 4. Mean CA 125 decrease was on average of 47%, with one patient experiencing a 95% decrease in her CA 125 level. 1 patient had a complete clinical remission, and 2, had partial radiological responses. Mean Progression free survival was 16.5 weeks, and Overall Survival was 21.2 weeks. Treatment was well tolerated. CONCLUSIONS: Deemd to the observed activity, the combination of Pemetrexed and Gemcitabine deserves deeper investigation in platinum-resistant ovarian cancer patients (AU)
No disponible
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico , Resistencia a Medicamentos Antineoplásicos , Compostos Organoplatínicos/uso terapêutico , Terapia de Salvação/métodos , Análise de Sobrevida , Antígeno Ca-125/sangue , Glutamatos/efeitos adversos , Guanina/efeitos adversos , Intervalo Livre de Doença , Desoxicitidina/efeitos adversos , Recidiva Local de Neoplasia/sangue , Recidiva Local de Neoplasia/mortalidade , Neoplasias Ovarianas/sangue , Neoplasias Ovarianas/mortalidade , Resultado do TratamentoRESUMO
Breast cancer is the most common type of cancer among women, and clinicians have long recognized its heterogeneity. Its detection and treatment in early stages allow for reduction of mortality. Despite the advances and new strategies for combining surgical, radiotherapy, and chemotherapy options, however, the percentage of patients developing metastases and advanced stages remains high. Even though serum tumor markers have been used for the early diagnosis of metastases, their systematic determination has not had an effect on survival. Methods that are more reliable are needed to detect metastases earlier than with the common clinical methods and thus start treatment before overt relapse. Early indicators of response or resistance to treatment are also an issue in clinical practice. Imaging techniques are time consuming, and it is difficult to detect changes that indicate response limited to therapy, and approaches to defining changes in tumor mass are time and resource consuming. In contrast, detection of circulating tumor cells (CTC) could be a useful tool in early detection of relapse and response to systemic chemotherapy. Extremely sensitive techniques are available that are easily applied to peripheral blood samples, which might provide enormous research possibilities in this area.
Assuntos
Neoplasias da Mama/sangue , Neoplasias da Mama/patologia , Testes Hematológicos/métodos , Células Neoplásicas Circulantes , Feminino , Imunofluorescência , Humanos , Imuno-Histoquímica , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
Breast cancer is the most common type of cancer among women, and clinicians have long recognized its heterogeneity. Its detection and treatment in early stages allow for reduction of mortality. Despite the advances and new strategies for combining surgical, radiotherapy, and chemotherapy options, however, the percentage of patients developing metastases and advanced stages remains high. Even though serum tumor markers have been used for the early diagnosis of metastases, their systematic determination has not had an effect on survival. Methods that are more reliable are needed to detect metastases earlier than with the common clinical methods and thus start treatment before overt relapse. Early indicators of response or resistance to treatment are also an issue in clinical practice. Imaging techniques are time consuming, and it is difficult to detect changes that indicate response limited to therapy, and approaches to defining changes in tumor mass are time and resource consuming. In contrast, detection of circulating tumor cells (CTC) could be a useful tool in early detection of relapse and response to systemic chemotherapy. Extremely sensitive techniques are available that are easily applied to peripheral blood samples, which might provide enormous research possibilities in this area (AU)
No disponible
Assuntos
Humanos , Feminino , Neoplasias da Mama/sangue , Neoplasias da Mama/patologia , Testes Hematológicos/métodos , Testes Hematológicos , Células Neoplásicas Circulantes , Células Neoplásicas Circulantes/metabolismo , Células Neoplásicas Circulantes/patologia , Imunofluorescência/métodos , Imunofluorescência , Imuno-Histoquímica/métodos , Imuno-Histoquímica , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
Lung cancer is a major health problem due to its incidence and mortality. The risk factors, the existence of a preclinical phase, and the relationship between stage at diagnosis and survival are known. A number of strategies that aim to diagnose lung cancer in its earliest stages, based principally on imaging studies, are therefore being tested. Several drugs aimed at reducing the probability of developing lung cancer in the at-risk population are also under study. At the present time, the results obtained have not been encouraging and we do not have a clear strategy either for early diagnosis or for the use of chemopreventive agents.
Assuntos
Quimioprevenção/métodos , Neoplasias Pulmonares/prevenção & controle , Programas de Rastreamento/métodos , Ensaios Clínicos como Assunto , Feminino , Humanos , Masculino , Recidiva Local de Neoplasia/prevenção & controle , Segunda Neoplasia Primária/prevenção & controleRESUMO
Lung cancer is a major health problem due to its incidence and mortality. The risk factors, the existence of a preclinical phase, and the relationship between stage at diagnosis and survival are known. A number of strategies that aim to diagnose lung cancer in its earliest stages, based principally on imaging studies, are therefore being tested. Several drugs aimed at reducing the probability of developing lung cancer in the at-risk population are also under study. At the present time, the results obtained have not been encouraging and we do not have a clear strategy either for early diagnosis or for the use of chemopreventive agents (AU)
No disponible