RESUMO
Mortality from locally advanced and metastatic cancer remains high despite advances in our understanding of the molecular basis of the disease and improved adjuvant therapies. Recently, there has been an increased interest in cancer metabolomics, and in particular, the potential for targeting glucose metabolism, for therapeutic gain. This interest stems from the fact that cancer cells metabolize glucose very differently from normal cells. Cancer cells preferentially switch to aerobic glycolysis rather than oxidative phosphorylation as their means of glucose metabolism. This metabolic switch is believed to enhance cancer cell survival. Several therapeutic agents that target tumor metabolism have shown significant cancer cell cytotoxicity in preclinical studies, and some have progressed to clinical trials. In this review, we discuss the alteration of carbohydrate metabolism seen in cancer cells, the underlying mechanisms, and opportunities for targeting cancer metabolism for therapeutic purposes.
Assuntos
Antineoplásicos/farmacologia , Metabolismo Energético/fisiologia , Glucose/metabolismo , Neoplasias/tratamento farmacológico , Neoplasias/metabolismo , Animais , HumanosAssuntos
Desidratação/complicações , Hipotensão Intracraniana/diagnóstico , Imageamento por Ressonância Magnética/métodos , Adolescente , Desidratação/diagnóstico , Diagnóstico Diferencial , Humanos , Hipotensão Intracraniana/etiologia , Hipotensão Intracraniana/fisiopatologia , Pressão Intracraniana/fisiologia , Masculino , Postura/fisiologia , Punção Espinal/métodosAssuntos
Ureter/lesões , Ferimentos Penetrantes/etiologia , Traumatismos Abdominais/diagnóstico , Traumatismos Abdominais/etiologia , Adolescente , Anastomose Cirúrgica , Cultura , Feminino , Humanos , Índia , Intestinos/lesões , Intestinos/cirurgia , Ureter/cirurgia , Ferimentos Penetrantes/diagnóstico , Ferimentos Penetrantes/cirurgiaRESUMO
BACKGROUND: Though penetrating arrow injuries are a rarity in the West, they are still seen frequently among the tribal population of India. This study was performed with the aim of documenting the clinical profile of injuries caused by arrows, the varied modes of clinical presentation and their management at a university hospital. METHODS: A retrospective study of indoor records of 70 patients admitted over a period of 5 years at the Sir Sayajirao General Hospital (SSGH), Baroda, Gujarat, India, was carried out. RESULTS: A majority of patients were males (n=67), the median age being 36 years. The median delay in presentation to the hospital was 11 h. Median TRISS score was 98.2%. There were three mortalities. Major wound infection (n=1), intestinal fistula (n=1) and multiple organ dysfunction syndrome (n=2) were the noteworthy complications. CONCLUSION: Arrow injury and its astute management is still relevant in this century. Delay in treatment and a poor TRISS score adversely affects survival. Optimal exploration, adequate mobilisation, minimising haemorrhage and repair are the building blocks of successful treatment.
Assuntos
Ferimentos Penetrantes/epidemiologia , Traumatismos Abdominais/complicações , Traumatismos Abdominais/epidemiologia , Traumatismos Abdominais/cirurgia , Adolescente , Adulto , Idoso , Anti-Infecciosos/uso terapêutico , Desbridamento/métodos , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Traumatismo Múltiplo/epidemiologia , Traumatismo Múltiplo/cirurgia , Estudos Retrospectivos , Técnicas de Sutura , Traumatismos Torácicos/complicações , Traumatismos Torácicos/epidemiologia , Traumatismos Torácicos/cirurgia , Ferimentos Penetrantes/complicações , Ferimentos Penetrantes/cirurgiaRESUMO
We report a rare case of posttraumatic chronic mycotic pseudoaneurysm of the ascending aorta presenting with acute rupture. The uniqueness of the case lies in its unusual etiology, presentation, and management with direct repair of the aorta without using cardiopulmonary bypass.
Assuntos
Aneurisma Infectado/cirurgia , Aorta/patologia , Ruptura Aórtica/cirurgia , Adulto , Aneurisma Infectado/tratamento farmacológico , Aneurisma Infectado/etiologia , Antibacterianos/uso terapêutico , Aorta/cirurgia , Ruptura Aórtica/etiologia , Corpos Estranhos , Hemorragia/etiologia , Hemorragia/cirurgia , Humanos , Masculino , Esterno/lesões , Resultado do TratamentoRESUMO
Hemoglobin Q-India is a very rare alpha-chain structural variant caused by the mutation AAG-->GAG (Asp-->His) in the position of codon 64 of the alpha1 gene. Usually it presents in the heterozygous form with electrophoretic mobility in the position of hemoglobin S (HbS) at alkaline pH along with the double bands of HbA2. High-performance liquid chromatography (HPLC) retention time of 4.76 minutes for this abnormal Hb variant identifies it to be HbQ-India. Only isolated case reports exist in literature to describe this rare entity. On cellulose acetate electrophoresis at alkaline pH, the HbQ band can easily be misinterpreted as HbS or HbD if careful screening of the patient for sickle cell with solubility test or sickling test is not done and the abnormal HbA2 band is overlooked. We report a case and emphasize the importance of careful screening with electrophoresis and HPLC in the diagnosis of this rare condition
Assuntos
Saúde da Família , Hemoglobinopatias/diagnóstico , Hemoglobinas Anormais/genética , Adulto , Cromatografia Líquida de Alta Pressão , Diagnóstico Diferencial , Eletroforese , Variação Genética , Humanos , Masculino , LinhagemAssuntos
Bezoares , Estômago , Bezoares/psicologia , Bezoares/cirurgia , Comportamento Compulsivo , Feminino , Humanos , Pessoa de Meia-Idade , RecidivaRESUMO
We report the case of an 18-month-old boy with a congenital anterior urethral diverticulum containing an elliptical stone at the penoscrotal junction, with urinary retention and extravasation of urine. Initial management consisted of an open suprapubic cystostomy. Three weeks after resolution of extravasation, diverticulectomy with removal of the stone by urethroplasty was done after ruling out associated obstructing anterior urethral valves.
