RESUMO
AIMS: This work aims to evaluate the efficacy of nutritional supplementation with a glutamine-enriched oligomeric diet (GEOD) compared to a standard polymeric diet (SPD) in terms of oncology treatment-related diarrhea (OTRD) (frequency and consistency of stools), gastrointestinal toxicity, and functional and nutritional progress. METHODS: This prospective cohort study compared two groups of patients with rectal cancer in treatment with neoadjuvant chemotherapy and radiotherapy who were at risk of malnutrition. Patients were randomized to receive either 400 ml of GEOD or of SPD from the start of radiotherapy to 30 days after its completion. RESULTS: Eighty patients were recruited, 40 per arm. The GEOD arm had improved stool consistency and a greater reduction in the number of stools compared to the SPD arm (p < 0.001). The relative risk (RR) of developing diarrhea in the GEOD arm was 0.059 (95% CI 0.015-0.229). There was a reduced risk of developing intestinal mucositis in the GEOD arm compared to the SPD arm [RR 0.202 (95% CI 0.102 - 0.399)]. The GEOD arm had greater improvements in functional and nutritional status (p < 0.001). CONCLUSIONS: GEOD had a protective effect in terms of the development of gastrointestinal toxicity associated with chemotherapy and radiotherapy treatment in patients with rectal cancer.
Assuntos
Glutamina , Neoplasias Retais , Humanos , Estudos Prospectivos , Neoplasias Retais/tratamento farmacológico , Neoplasias Retais/radioterapia , Dieta , Diarreia/etiologiaRESUMO
PURPOSE: To compare the clinical outcomes of single-fraction high-dose-rate (HDR) brachytherapy and single-fraction low-dose-rate (LDR) brachytherapy as the sole treatment for primary prostate cancer. MATERIAL AND METHODS: A quasi-randomized study that allocated, from March 2008 to February 2012, 129 low and intermediate risk prostate cancer patients to one single-fraction HDR of 19 Gy (61 patients) or to a 145 Gy 125 I LDR permanent implant (68 patients. Biochemical relapse-free survival (bRFS) and overall survival (OS) were compared using the Kaplan-Meier method and Cox regression analysis. RESULTS: After a median follow-up of 72 months in the HDR group, 26 patients relapsed, and after a median follow-up of 84 months in the LDR group, 7 patients relapsed (p < 0.0001). The 5-year bRFS was significantly better for the LDR group than for the HDR group (93.7% and 61.1%, respectively) (p < 0.0001). The 5-year OS also was significantly better in the LDR group (95.5% vs. 89.9%) (p = 0.0436). CONCLUSIONS: Permanent LDR prostate implant brachytherapy offers better clinical outcomes than single-fraction HDR for prostate cancer.
Assuntos
Braquiterapia , Neoplasias da Próstata , Masculino , Humanos , Próstata/patologia , Estudos Prospectivos , Braquiterapia/métodos , Dosagem Radioterapêutica , Recidiva Local de Neoplasia/radioterapiaRESUMO
No disponible
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Humanos , Masculino , Feminino , Idoso de 80 Anos ou mais , Serviços Hospitalares de Assistência Domiciliar , Furosemida/administração & dosagem , Injeções Subcutâneas , Estudos Retrospectivos , Insuficiência Cardíaca/epidemiologiaRESUMO
Whipple's disease is a rare bacterial, chronic and multisystemic disease, produced by the gram-positive bacillus Tropheryma whipplei. The clinical manifestations are varied and diagnosis is often delayed. The four cardinal symptoms are arthralgias, weight loss, diarrhea and abdominal pain. The classic symptoms could be preceded up to three quarters by different joint manifestations that evolve intermittently. The average time to diagnosis is 6 years. We present the case of a young patient with recurrent febrile episodes and associated joint disease, in whom the absence of digestive symptoms led to a diagnostic laparoscopy since this entity was not suspected before.
Assuntos
Endoscopia por Cápsula , Doença de Whipple , Antibacterianos , Diarreia , Humanos , TropherymaRESUMO
No disponible
Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Fraturas do Fêmur/diagnóstico por imagem , Osteíte Deformante , Displasia Fibrosa Poliostótica , Radiografia/métodosRESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Parada Cardíaca/complicações , Pelve/lesões , Insuficiência Respiratória/complicações , Insuficiência Respiratória/diagnóstico , Embolia Gordurosa/complicações , Embolia Gordurosa/diagnóstico , Embolia Gordurosa/patologia , Acidentes de Trabalho , Acidentes de Trânsito , Escala de Coma de GlasgowRESUMO
El objetivo principal de la presente investigación es analizar el impacto del poder en las atribuciones causales; concretamente, se analizan las que realiza el observador ante el éxito y el fracaso de personas que difieren en el poder que poseen en su trabajo. Los resultados muestran que tanto los éxitos como los fracasos de las personas con alto poder, se explican mediante atribuciones controlables internas, específicamente, refiriéndose al esfuerzo de persona poderosa. Sin embargo, la explicación de los resultados logrados por personas con bajo poder presenta un patrón diferente. Mientras que el éxito se atribuye al esfuerzo del subordinado, el fracaso, a su poca habilidad. Los resultados se analizan en relación con hallazgos anteriores y a su implicación en el mantenimiento del statu quo.
