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1.
Environ Sci Pollut Res Int ; 27(2): 1776-1788, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31758477

RESUMO

This is the first nationwide survey of bisphenol A (BPA), methylparaben, ethylparaben, propylparaben, butylparaben, and o-phenylphenol, in Egypt's water. Five hundred fifty-five water samples were collected from source water (SW, 109 samples) and drinking water (DW, 446 samples) of twenty-three Egyptian governorates. These chemicals were determined by direct ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) analysis of a filtered aliquot of samples. The impacts of the measured concentrations on the aquatic organisms and human health were evaluated as well. BPA, methylparaben, propylparaben, and butylparaben were frequently detected in SW and DW, while ethylparaben and o-phenylphenol were not detected whatsoever. The most frequently detected endocrine-disrupting chemical (EDC) was BPA in SW and methylparaben in DW. The recorded highest concentrations of BPA and methylparaben in SW and BPA and methylparaben, propylparaben, and butylparaben in DW were the highest worldwide. Of the investigated twenty-three governorates, the SW and DW of Aswan, Red Sea, Cairo, Sharqia, and Damietta were free of the studied EDCs. Contrarily, BPA, MeP, PrP, and BuP were detected in Sohag's SW and DW. A detection ratio > 70% was recorded in SW of Faiyum, Dakahlia, and Ismailia, and > 90% in DW of Sohag, Port Said, Dakahlia, and Faiyum. The environmental risk assessment results excluded any human health risk even in the worst-case scenario and showed that BPA represents the highest risk to the aquatic organisms.


Assuntos
Água Potável/análise , Disruptores Endócrinos/análise , Poluentes Químicos da Água/análise , Cromatografia Líquida , Egito , Monitoramento Ambiental , Humanos , Medição de Risco , Espectrometria de Massas em Tandem
2.
J Stroke Cerebrovasc Dis ; 29(3): 104592, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31883782

RESUMO

BACKGROUND: Definitive treatment of carotid dissection-related strokes is currently unproved. The best endovascular technique in this setting remains to be established. OBJECTIVE: To report our experience in endovascular treatment of internal carotid artery dissection presenting with acute strokes. METHODS: Consecutive patients with acute strokes due to internal carotid artery dissection treated with endovascular therapy at our hospital between January 2008 and July 2019 were included. Patients were assigned to endovascular treatment according to clinical-radiologic mismatch, NIHSS greater than or equal to 5, and within 6 hours after symptom onset. The endovascular technique is described. Intracranial recanalization, carotid dilatation, and clinical outcomes were retrospectively analyzed. RESULTS: Seven patients met the inclusion criteria. The mean age was 55 years; 5 patients (71.4%) were male. 71.4% had tandem occlusion strokes, while 28.6% had hemodynamic strokes. The mean onset-to-puncture time was 3.92 hours. Stent-assisted angioplasty for internal carotid artery was done for 85.7% of patients with a mean of 1.6 deployed stents. Dilatation was successful in 83.3% of them. Successful overall recanalization rate was 85.7%. No major complications were encountered. Minor complications occurred in 42.8% of cases. The mean NIHSS score decreased from 13.7 preoperative to 5 after 3 days. Good functional outcome (mRS 0-2) was found in 85.7% of patients at 3 months. No recurrent strokes identified over an average of 40.86 months follow-up. CONCLUSION: Our study provides evidence that endovascular therapy for internal carotid artery dissection-related strokes has high rates of reperfusion and favorable outcomes. Stent-assisted angioplasty of carotid dissection is thought to be safe and effective.


Assuntos
Angioplastia com Balão , Isquemia Encefálica/etiologia , Dissecação da Artéria Carótida Interna/terapia , Artéria Carótida Interna , Acidente Vascular Cerebral/etiologia , Trombectomia , Adulto , Idoso , Angioplastia com Balão/efeitos adversos , Angioplastia com Balão/instrumentação , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/fisiopatologia , Artéria Carótida Interna/diagnóstico por imagem , Artéria Carótida Interna/fisiopatologia , Dissecação da Artéria Carótida Interna/complicações , Dissecação da Artéria Carótida Interna/diagnóstico por imagem , Dissecação da Artéria Carótida Interna/fisiopatologia , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Recidiva , Estudos Retrospectivos , Fatores de Risco , Stents , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/fisiopatologia , Trombectomia/efeitos adversos , Fatores de Tempo , Tempo para o Tratamento , Resultado do Tratamento
3.
Psychol Psychother ; 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31692159

RESUMO

OBJECTIVES: Social cognitive impairment is considered to be a psychopathological cornerstone in adolescent females with borderline personality disorder. The aim is to compare the social cognitive performance in adolescent females with borderline personality traits and healthy adolescent females, and to assess the social cognitive performance in relation to the severity of borderline personality features. DESIGN: A case-control study was conducted on 30 adolescent females who fulfilled the diagnostic criteria of DSM-IV of borderline personality traits, compared to 30 matched healthy volunteer adolescent females. METHODS: Borderline Personality Questionnaire (BPQ) was used to rate borderline personality features. Reading the Mind in the Eyes test (RMET) and Movie for the Assessment of Social Cognition (MASC) were applied to assess social cognitive abilities. RESULTS: The scores of RMET and some domains of MASC showed a highly significant difference between the patient and control groups. Scores of RMET and some domains of MASC showed significant correlation with impulsiveness, emptiness, relationship patterns, and quasi-psychotic states subscales of BPQ. CONCLUSIONS: Adolescent females with borderline personality traits had lower social cognitive performance compared to healthy adolescent females. The intensity of this social cognitive deficit was evident to be related to impulsivity, emptiness, pattern of relationships, and quasi-psychotic states.

4.
Curr Diabetes Rev ; 15(4): 340-345, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30813879

RESUMO

Diabetic polyneuropathy (DPN) is a complex and multifactorial entity in which various factors besides hyperglycemia play an important role. Symptoms of DPN are sensory, motor or autonomic. Intensive research proved that oxidative stress is the common denominator for the four major destructive pathways of hyperglycemia including increased hexosamine pathway flux, activation of Protein kinase-C (PKC) pathway, increased Advanced Glycated End-products (AGEs) formation, and increased Polyol Pathway flux. National data in Egypt confirms that more than 60% of Egyptian diabetic patients suffer from neuropathy. The most common complications of DPN are Cardiac Autonomic Neuropathy (CAN), diabetic foot and ulcers, neuromuscular disability, and anxiety. In addition, DPN affects the Quality of Life (QoL). According to common clinical practice, the common diagnostic tools are bed-side diagnosis and electrophysiological tests. Early diagnosis is critical to improve the prognosis of DPN and therapeutic intervention in the early phase. In this review, we provide a clear understanding of the pathogenesis, early diagnosis and the good management of DPN. Since the pathogenesis of DPN is multifactorial, its management is based on combination therapy of symptomatic; either pharmacological or non-pharmacological treatments, and pathogenic treatment. Alpha Lipoic Acid (ALA) is a potent anti-oxidant that has several advantages as a pathogenic treatment of DPN. So, in clinical practice, ALA may be prescribed for patients with early neuropathic deficits and symptoms. Patient education has an important role in the managemement of DPN.


Assuntos
Neuropatias Diabéticas/diagnóstico , Neuropatias Diabéticas/patologia , Neuropatias Diabéticas/terapia , Consenso , Egito , Humanos , Qualidade de Vida
5.
Postgrad Med J ; 95(1120): 61-66, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30709868

RESUMO

BACKGROUND: Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a major development in the prevention of cardiovascular disease (CVD) and is one of the most significant discoveries since the development of statin therapy. Administration of two human monoclonal antibodies to PCSK9 (alirocumab and evolocumab) can significantly reduce low-density lipoprotein cholesterol (LDL-c) concentrations, thus improving lipid management. Accordingly, guidelines on the specific indications for alirocumab and evolocumab usage have been released. This multicentre study aimed to estimate the proportion of patients treated for an acute myocardial infarction (MI) who could be considered for PCSK9 inhibitors under the current National Institute for Health and Care Excellence (NICE) lipid targets criteria. METHODS: The records of 596 patients in two large hospitals in Liverpool, UK were analysed. Information was collected on lipid profiles during and after admission, lipid-lowering therapy and previous CVD. RESULTS: At least 2.2% of patients were eligible for PCSK9 inhibitors post-MI under the current NICE guidance. Additionally, 29% of patients failed to achieve LDL-c concentrations <2.0 mmol/L despite maximum statin therapy and failed to meet eligibility for PCSK9 inhibitors as per the NICE criteria. This cohort represents a group of patients 'in limbo', in which statin therapy alone is not sufficient to reduce LDL-c. CONCLUSIONS: PCSK9 inhibitors are expensive and so their use must be highly selective. At present, in a real-world setting with ezetimibe underprescribing, ~2% of patients are eligible and a further 30% are deprived of benefit and improved outcomes by lack of optimisation and/or potential use of PCSK9 inhibitors.


Assuntos
Síndrome Coronariana Aguda/tratamento farmacológico , Anticorpos Monoclonais/uso terapêutico , Anticolesterolemiantes/uso terapêutico , Doenças Cardiovasculares/prevenção & controle , Pró-Proteína Convertase 9/antagonistas & inibidores , Idoso , Anticorpos Monoclonais Humanizados , LDL-Colesterol/efeitos dos fármacos , Feminino , Humanos , Masculino , Guias de Prática Clínica como Assunto , Prevenção Secundária , Resultado do Tratamento , Reino Unido
6.
Eur J Gastroenterol Hepatol ; 31(6): 685-691, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30640743

RESUMO

BACKGROUND: Liver stiffness increases after the development of hepatocellular carcinoma (HCC). Transient elastography for liver stiffness measurement (LSM) using fibroscan is a simple noninvasive method of proven efficacy. This study aims to assess the changes in LSM following HCC treatment. PATIENTS AND METHODS: This study included 150 patients with hepatitis C virus related HCC attending the multidisciplinary HCC clinic, Kasr Al-Ainy Hospital between March 2014 and October 2015 who underwent either transarterial chemoembolization (TACE) or microwave ablation (MWA). Baseline LSM was carried out 3 and 6 months after treatment. The response rate was calculated according to the modified Response Evaluation Criteria in Solid Tumors criteria; overall survival and LSM changes were then compared between the two procedures. RESULTS: MWA showed higher rates of complete ablation (77.4%) than did TACE (31.7%) (P=0.004). Increase in LSM 3 and 6 months after treatment was statistically significant in the TACE group (P<0.001) but not in the MWA group (P=0.4). Patients who showed complete ablation had statistically significant lower baseline LSM than those with incomplete ablation, and their 6 months increase in LSM was also significantly lower. Logistic regression revealed that with each unit increase in baseline stiffness, 3% reduction in the odds of complete ablation is expected, and this did not change after controlling for the type of treatment. Child-Pugh class, number, and size of HCCs were our independent prognostic factors by Cox proportional analysis. CONCLUSION: The increase in LSM is significant after TACE than after MWA. Moreover, lower pre-ablation LSM is a predictor of complete ablation.

7.
Breast Cancer Res Treat ; 174(1): 179-185, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30478787

RESUMO

PURPOSE: Patients with Her2-positive breast cancer treated with trastuzumab have higher rates of cardiotoxicity (CT). Left-breast radiation might increase the risk for CT from cardiac exposure to radiation. The goal of our study is to evaluate the contribution of radiotherapy (RT) in the development of CT in breast cancer patients receiving trastuzumab. METHODS: Two hundred and two patients were treated with RT and trastuzumab from 2000 to 2014. The RT plans for left-side disease were recalled from archives. The heart, each chamber, and left anterior descending artery (LAD) were independently contoured. New dose-volume histograms (DVH) were generated. Their serial left-ventricular ejection fractions (LVEF) were studied. CT for left and right side were compared using Fisher's exact test. The DVH data were correlated with the predefined cardiac events using actuarial Cox regression analysis. RESULTS: Compared to the right sided, the left-side cases showed statistically significant development of arrhythmia (14.2%) versus (< 1%) (p < 0.001). Cardiac ischemia was found in 10 patients in left and one patient in right side (p = 0.011). The equivalent uniform dose (EUD) to the left ventricle (LV), right ventricle (RV), and LAD was significantly associated with decrease in LVEF by > 10% (p = 0.037, p = 0.023 and p = 0.049, respectively). CONCLUSIONS: Among patients treated for left-sided lesions, there were no significant differences in EF decline. However, there was a higher rate of ischemia and arrhythmia compared to those with right-sided disease. The EUD index of LV, RV, and LAD could be considered as a parameter to describe the risk of radiation-induced CT.


Assuntos
Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/radioterapia , Cardiotoxicidade/etiologia , Quimiorradioterapia/efeitos adversos , Quimiorradioterapia/métodos , Adulto , Idoso , Antineoplásicos Imunológicos/efeitos adversos , Cardiotoxicidade/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Órgãos em Risco , Radioterapia/efeitos adversos , Trastuzumab/efeitos adversos
8.
Psiquiatr. salud ment ; XXXV(3/4): i:159-f:168, 20181201.
Artigo em Espanhol | LILACS-Express | ID: biblio-1000084

RESUMO

Introducción / antecedentes La conducta suicida en el trastorno delirante (TD) ha sido escasamente estudiada. Objetivo Profundizar en el conocimiento de las características demográficas, ambientales, psicosociales y clínicas del suicido en un grupo de pacientes con TD con la finalidad de contribuir a generar y sugerir estrategias que contribuyan a realizar nuevos estudios de mayor nivel explicativo. Método Estudio epidemiológico descriptivo retrospectivo de Registro de Casos en el Dispensario de Psiquiatría e Higiene Mental de Córdoba sobre pacientes con TD según criterios DSM-IV-TR. Aquellos pacientes que cumplieron con los criterios de inclusión definidos constituyeron nuestra muestra final de 261 casos, de ellos 26 casos presentaron evidencias de intento de suicidio. Las variables sobre las que se recogió información en base a protocolos, fueron agrupadas con el orden siguiente: I. Sociodemográficos y generales. II. Factores de riesgo del TD (familiares y personales). III. Cuadro Clínico y el Diagnóstico del TD (Presentación, Sintomatología, Funcionalidad y Discapacidad, utilización de los recursos sanitarios, tratamiento, problemas psicosociales, evolución y curso) y medios letales utilizados. Resultados La edad media de los pacientes fue de 47 años y el 60% fueron hombres. Los datos sociodemográficos muestran que los pacientes con intento de suicidio residían en núcleos rurales (46,2%), no tenían estudios en un 15,4%, un 57,7% no trabajaba y un 26,9% recibía una pensión por enfermedad o jubilación laboral. El subtipo persecutorio con 8 casos, fue el más frecuente, seguido de los subtipos de grandiosidad (6 casos) y celotípico (6 casos), mixto (3 casos), erotomaníaco (2 casos) y somático (1 caso).Discusión y conclusión Son necesarios futuros estudios prospectivos para investigar los factores de protección, de riesgo y/o asociados al suicidio en el TD. Palabras clave: Trastorno delirante, paranoia, conducta suicida, series de casos.

9.
J Biosci Bioeng ; 126(2): 241-248, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29650365

RESUMO

We reported previously that tobacco plants transformed with the human UDP-galactose transporter 1 gene (hUGT1) had enhanced growth, displayed characteristic traits, and had an increased proportion of galactose (hyper-galactosylation) in the cell wall matrix polysaccharides. Here, we report that hUGT1-transgenic plants have an enhanced hardness. As determined by breaking and bending tests, the leaves and stems of hUGT1-transgenic plants were harder than those of control plants. Transmission electron microscopy revealed that the cell walls of palisade cells in leaves, and those of cortex cells and xylem fibers in stems of hUGT1-transgenic plants, were thicker than those of control plants. The increased amounts of total cell wall materials extracted from the leaves and stems of hUGT1-transgenic plants supported the increased cell wall thickness. In addition, the cell walls of the hUGT1-transgenic plants showed an increased lignin contents, which was supported by the up-regulation of lignin biosynthetic genes. Thus, the heterologous expression of hUGT1 enhanced the accumulation of cell wall materials, which was accompanied by the increased lignin content, resulting in the increased hardness of the leaves and stems of hUGT1-trangenic plants. The enhanced accumulation of cell wall materials might be related to the hyper-galactosylation of cell wall matrix polysaccharides, most notably arabinogalactan, because of the enhanced UDP-galactose transport from the cytosol to the Golgi apparatus by hUGT1, as suggested in our previous report.


Assuntos
Dureza/fisiologia , Proteínas de Transporte de Monossacarídeos/genética , Plantas Geneticamente Modificadas/fisiologia , Tabaco/genética , Parede Celular/metabolismo , Citosol/metabolismo , Galactanos/metabolismo , Galactose/metabolismo , Complexo de Golgi/metabolismo , Humanos , Lignina/metabolismo , Folhas de Planta/metabolismo , Caules de Planta/metabolismo , Plantas Geneticamente Modificadas/genética , Polissacarídeos/metabolismo , Tabaco/fisiologia
10.
Int J Mol Sci ; 19(2)2018 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-29462933

RESUMO

Soybean agglutinin (SBA), is a non-fiber carbohydrate related protein and a major anti-nutritional factor. Integrins, transmembrane glycoproteins, are involved in many biological processes. Although recent work suggested that integrins are involved in SBA-induced cell-cycle alterations, no comprehensive study has reported whether integrins are involved in SBA-induced cell apoptosis (SCA) in IPEC-J2. The relationship between SBA and integrins are still unclear. We aimed to elucidate the effects of SBA on IPEC-J2 cell proliferation and cell apoptosis; to study the roles of integrins in IPEC-J2 normal cell apoptosis (NCA) and SCA; and to illustrate the relationship and connection type between SBA and integrins. Thus, IPEC-J2 cells were treated with SBA at the levels of 0, 0.125, 0.25, 0.5, 1.0 or 2.0 mg/mL to determine cell proliferation and cell apoptosis. The cells were divided into control, SBA treated groups, integrin inhibitor groups, and SBA + integrin inhibitor groups to determine the integrin function in SCA. The results showed that SBA significantly (p < 0.05) lowered cell proliferation and induced cell apoptosis in IPEC-J2 (p < 0.05). Inhibition of any integrin type induced the cell apoptosis (p < 0.05) and these integrins were involved in SCA (p < 0.05). Even SBA had no physical connection with integrins, an association was detected between SBA and α-actinin-2 ACTN2 (integrin-binding protein). Additionally, SBA reduced the mRNA expression of integrins by down regulating the gene expression level of ACTN2. We concluded an evidence for the anti-nutritional mechanism of SBA by ACTN2 with integrins. Further trials are needed to prove whether ACTN2 is the only protein for connecting SBA with integrin.


Assuntos
Aglutininas/farmacologia , Apoptose/efeitos dos fármacos , Integrinas/metabolismo , Lectinas de Plantas/farmacologia , Soja/química , Actinina/genética , Actinina/metabolismo , Animais , Linhagem Celular , Integrinas/genética , Mucosa Intestinal/efeitos dos fármacos , Mucosa Intestinal/metabolismo , Suínos
11.
Pract Radiat Oncol ; 8(2): 71-80, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29339047

RESUMO

PURPOSE: When treating breast cancer with radiation therapy, the impact of treatment position on heart and lung dose-volume parameters (DVPs) is largely dependent on the maximal heart distance (MHD) and central lung distance (CLD). We evaluate how much heart and lung sparing can be achieved using the semilateral decubitus (SLD) position without and with breath hold compared with the standard supine position for left-sided breast cancer patients. A secondary aim was to investigate the impact of MHD and CLD on heart and lung DVPs. METHODS AND MATERIALS: Thirty-five left-sided breast cancer patients were simulated in supine, free breathing SLD, and SLD with breath hold positions. A dosimetry plan was developed for each of these and 3 plans were compared for target coverage and organs at risk sparing. A correlation between CLD, MHD, and planning target volume, and heart and ipsilateral lung DVPs was tested. RESULTS: SLD breath hold position showed a significant reduction in percentage of heart receiving ≥5 Gy (V5Gy), V10Gy, V25Gy, V30Gy, mean dose and maximum dose (P < .001), ipsilateral lung V20Gy, and mean dose compared with supine (P < 001) and free breathing SLD (P = .003 and .006). There was also a significant reduction in the heart DVPs (P < .001) and ipsilateral lung DVPs (P < .001 and .007) with free breathing SLD compared with the supine position. SLD with or without breath hold were associated with significant reduction in MLD (P < .001) and CLD (P = .030 and .003) compared with the supine position. CONCLUSION: Treatment plans for patients in the SLD position with or without breath hold for left-sided breast cancer patients demonstrated a superior heart and lung sparing compared with the supine position due to significant reduction in MHD and CLD. MHD and CLD are important simulation factors that affect the heart and lung DVP.


Assuntos
Neoplasias da Mama/radioterapia , Pulmão/fisiologia , Radiometria/métodos , Neoplasias da Mama/patologia , Suspensão da Respiração , Feminino , Coração/fisiologia , Humanos
12.
Trop Anim Health Prod ; 50(1): 137-142, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28942476

RESUMO

Various methods are being employed to detect early pregnancy in domestic animals. This study aimed to predict early pregnancy in buffaloes via measuring the corpus luteum (CL) diameter, the luteal blood flow (LBF) area, the uterine blood flow (UBF) vascularization area, and progesterones in saliva and serum for non-pregnant (NPBs, N = 12) and pregnant (PBs, N = 12) buffaloes. The results revealed that the CL diameter and the luteal color blood flow blue and red (P = 0.0001) areas of the pregnant animals kept increasing from day 1 to day 35 of the gestation period, but it decreased in NPBs on day 21 after reaching a peak from ovulation to day 18. Interestingly, the UBF of the pregnant buffaloes (PBs) kept increasing (P = 0.0001) from ovulation to day 42. The difference of the CL diameter (P = 0.03) and the LBF color blue vascularization area (P = 0.002) between PBs and NPBs became clear from day 14 after ovulation, though the difference of UBF between PBs and NPBs became markedly obvious from day 7 after breeding. Both saliva (P = 0.001) and serum (P = 0.0001) progesterones of PBs continued increasing (P = 0.0001) from day 14 to day 35, but those of NPBs started decreasing (P = 0.0001) from day 14 and reached low values on day 21. Therefore, measuring saliva progesterone in addition to the high LBF (day 14) and UBF (day 7) of the pregnant buffaloes using a Doppler ultrasound could be applicable as noninvasive methods to detect early pregnancy and to improve reproductive management of buffaloes.


Assuntos
Búfalos/fisiologia , Corpo Lúteo/irrigação sanguínea , Testes de Gravidez/veterinária , Progesterona/metabolismo , Fluxo Sanguíneo Regional , Útero/irrigação sanguínea , Animais , Egito , Feminino , Gravidez , Testes de Gravidez/métodos , Progesterona/sangue , Saliva/química
13.
Artigo em Inglês | MEDLINE | ID: mdl-28556634

RESUMO

This tutorial shows the resection of a bulla by uniportal video assisted thoracoscopic surgery in bullous lung disease. This disease is a benign condition requiring treatment in cases of severe dyspnea, spontaneous secondary pneumothorax, repeated infection, hemoptysis, and an increase in bulla size. The uniportal VATS approach results in less pain, better cosmoses, and a quicker recovery for the patient.


Assuntos
Pneumopatias/cirurgia , Cirurgia Torácica Vídeoassistida/métodos , Adulto , Humanos , Pneumopatias/complicações , Masculino , Pneumotórax/cirurgia , Resultado do Tratamento
14.
Am J Clin Oncol ; 40(6): 590-597, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26083558

RESUMO

PURPOSE: This study aimed to assess the association between pretreatment c-Met overexpression in local-regional advanced cervical cancer patients treated definitively with concurrent chemoradiation therapy (CRT) and treatment outcomes including overall survival (OS), progression-free survival (PFS), distant metastases (DM) control, and local-regional control (LC). PATIENTS AND METHODS: This Institutional Review Board-approved study included cervical cancer patients treated definitively and consecutively with CRT. Evaluation of cytoplasmic immunoreactivity for c-Met was performed and scored semiquantitatively by 3 pathologists, blinded to the treatment outcomes, and incorporated both the intensity and percentage of immunoreactivity in invasive carcinoma (H score). Treatment outcomes were reviewed and reported. Outcomes were stratified by c-Met overexpression and tumor characteristics. OS, PFS, LC, and DC rates were obtained via the Kaplan-Meier method and differences between groups were evaluated by the log-rank test. Hazard ratios were obtained via Cox regression for both univariate and multivariate analyses. RESULTS: The 5-year OS, PFS, LC, and DC were 57.18%, 48.07%, 72.11%, and 62.85%, respectively. Ten (35.7%) and 18 patients (64.3%) had c-Met H index >30 and<30, respectively. c-Met overexpression was significantly associated with worse 3- and 5-year OS (P=0.003), PFS (P=0.002), LC (P=0.01), and DC (P=0.0003). Patients with c-Met overexpression had a hazard ratio of 6.297, 5.782, 6.28, and 18.173 for the risks of death, disease progression, local recurrence, and DM, respectively. CONCLUSION: c-Met overexpression could be a potential predictive marker and therapeutic target for local-regional advanced cervical cancer patients treated definitively with CRT.


Assuntos
Carcinoma/metabolismo , Proteínas Proto-Oncogênicas c-met/metabolismo , Neoplasias do Colo do Útero/metabolismo , Adulto , Idoso , Carcinoma/mortalidade , Carcinoma/patologia , Carcinoma/terapia , Quimiorradioterapia , Intervalo Livre de Doença , Feminino , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Terapia de Alvo Molecular , Metástase Neoplásica , Prognóstico , Modelos de Riscos Proporcionais , Taxa de Sobrevida , Resultado do Tratamento , Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/terapia
15.
J Cancer Res Clin Oncol ; 142(5): 949-58, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26762850

RESUMO

PURPOSE: Cluster of differentiation (CD) 44 is a cell surface receptor that correlates with the development of drug resistance in epithelial ovarian cancer (EOC). Here, we prospectively investigated the clinical impact of CD44 expression on the development of chemoresistance, and on disease-free and overall survival in EOC. METHODS: This study included patients with primary serous EOC that was at International Federation of Gynecology and Obstetrics stages IIIB-IVA and tumors that were CD44 positive and negative in a 1:1 ratio. All patients underwent primary surgical cytoreduction, followed by six cycles of combined paclitaxel and carboplatin chemotherapy every 3 weeks. The treatment was considered complete after the chemotherapy had finished. All patients were followed up for 24 months after completing their chemotherapy. RESULTS: Of the 96 patients with serous EOC at stages IIIB-IVA, 51 % of the tumors were negative for the expression of CD44 and 49 % showed variable CD44 expression. Patients who had CD44-positive tumors had statistically significant shorter disease-free (p ≤ 0.001) and overall survival (p ≤ 0.001) intervals compared with patients with CD44-negative tumors. The hazard ratio for death was 6.8 (95 % confidence interval 2.4-19.2, p ≤ 0.001) among the patients with CD44-positive tumors. A multivariate analysis showed that carboplatin-resistant or carboplatin-refractory EOC was the only independent predictive factor for death. CONCLUSIONS: CD44 expression contributes to the development of carboplatin resistance in advanced serous EOC, and it may contribute to worse prognoses for patients, but it is neither an independent predictor of survival nor of recurrence.


Assuntos
Biomarcadores Tumorais/metabolismo , Cistadenocarcinoma Seroso/patologia , Resistencia a Medicamentos Antineoplásicos , Receptores de Hialuronatos/metabolismo , Recidiva Local de Neoplasia/patologia , Neoplasias Epiteliais e Glandulares/patologia , Neoplasias Ovarianas/patologia , Adulto , Idoso , Antineoplásicos/uso terapêutico , Carboplatina/uso terapêutico , Carcinoma Epitelial do Ovário , Cistadenocarcinoma Seroso/tratamento farmacológico , Cistadenocarcinoma Seroso/metabolismo , Cistadenocarcinoma Seroso/mortalidade , Feminino , Seguimentos , Humanos , Técnicas Imunoenzimáticas , Pessoa de Meia-Idade , Gradação de Tumores , Invasividade Neoplásica , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/metabolismo , Recidiva Local de Neoplasia/mortalidade , Estadiamento de Neoplasias , Neoplasias Epiteliais e Glandulares/tratamento farmacológico , Neoplasias Epiteliais e Glandulares/metabolismo , Neoplasias Epiteliais e Glandulares/mortalidade , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/metabolismo , Neoplasias Ovarianas/mortalidade , Prognóstico , Estudos Prospectivos , Taxa de Sobrevida
16.
J Biosci Bioeng ; 121(5): 573-83, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26507776

RESUMO

We reported previously that tobacco plants transformed with the human UDP-galactose transporter 1 gene (hUGT1-transgenic plants) displayed morphological, architectural, and physiological alterations, such as enhanced growth, increased accumulation of chlorophyll and lignin, and a gibberellin-responsive phenotype. In the present study, we demonstrated that hUGT1 expression altered the monosaccharide composition of cell wall matrix polysaccharides, such as pectic and hemicellulosic polysaccharides, which are biosynthesized in the Golgi lumen. An analysis of the monosaccharide composition of the cell wall matrix polysaccharides revealed that the ratio of galactose to total monosaccharides was significantly elevated in the hemicellulose II and pectin fractions of hUGT1-transgenic plants compared with that of control plants. A hyper-galactosylated xyloglucan structure was detected in hemicellulose II using oligosaccharide mass profiling. These results indicated that, because of the enhanced UDP-galactose transport from the cytosol to the Golgi apparatus by hUGT1, galactose incorporation in the cell wall matrix polysaccharides increased. This increased galactose incorporation may have contributed to increased galactose tolerance in hUGT1-transgenic plants.


Assuntos
Parede Celular/química , Parede Celular/metabolismo , Galactose/metabolismo , Proteínas de Transporte de Monossacarídeos/genética , Proteínas de Transporte de Monossacarídeos/metabolismo , Tabaco/citologia , Tabaco/genética , Transporte Biológico , Citosol/metabolismo , Expressão Gênica , Glucanos/metabolismo , Complexo de Golgi/metabolismo , Humanos , Pectinas/química , Pectinas/metabolismo , Plantas Geneticamente Modificadas/genética , Polissacarídeos/química , Polissacarídeos/metabolismo , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Tabaco/metabolismo , Xilanos/metabolismo
17.
Asian Pac J Cancer Prev ; 16(2): 613-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25684496

RESUMO

BACKGROUND: Hepatocellular carcinoma (HCC) is the commonest primary malignant cancer of the liver in the world. Insulin-like growth factor-1 (IGF-1) levels reflect hepatic function and are inversely correlated with the severity of background chronic liver disease. OBJECTIVE: This study evaluated whether basal serum IGF-1 levels can predict prognosis of HCC patients according to different risks of disease progression. MATERIALS AND METHODS: A total of 89 patients with hepatocellular carcinoma (HCC) were recruited in 3 groups: Group I, 30 HCC patients receiving sorafinib; Group II, 30 HCC patients with best supportive care; and Group III include 29 patients undergoing transcatheter arterial chemoembolization (TACE). All patients were investigated for serum levels of AST, ALP, Bb, Cr, BUN, AFP and IGF-I. RESULTS: Patients with disease control had significantly higher baseline IGF-1 levels 210 (185-232.5) ng/mL (p value<0.01) than did patients without disease control. Low basal IGF-1 levels were associated with advanced HCC, such as multiple tumors and advanced stage, and low IGF-1 levels predicted shorter TTP and overall survival in patients treated with TACE. CONCLUSIONS: The levels of serum IGF-1, expressed as continuous values, may be helpful for accurately assessing hepatic function and the prognostic stratification of patients with HCC.


Assuntos
Biomarcadores Tumorais/sangue , Carcinoma Hepatocelular/sangue , Fator de Crescimento Insulin-Like I/análise , Neoplasias Hepáticas/sangue , Niacinamida/análogos & derivados , Compostos de Fenilureia/uso terapêutico , Antineoplásicos/uso terapêutico , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Ensaio de Imunoadsorção Enzimática , Feminino , Seguimentos , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Niacinamida/uso terapêutico , Prognóstico , Sorafenibe , Taxa de Sobrevida
18.
World J Gastroenterol ; 20(45): 17075-83, 2014 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-25493019

RESUMO

AIM: To identify possible maternal risk factors for hepatitis B virus (HBV) acquisition and assess the efficacy of immunoprophylaxis given to infants born to hepatitis B virus surface antigen (HBsAg) positive mothers. METHODS: Screening of 2000 pregnant females was carried out using rapid test and confirmed by enzyme immunoassay. A questionnaire consisting of 20 questions about the possible risk factors for acquisition of HBV infection was filled for every pregnant HBsAg positive female in addition to at least 2 pregnant HBsAg negative females for each positive case. Infants of HBsAg positive women were offered passive and active immunoprophylaxis within the 1st 48 h after birth, in addition to 2nd and 3rd doses of HBV vaccine after 1 and 6 mo respectively. Infants were tested for HBsAg and hepatitis B surface antibodies (HBsAb) at six months of age. RESULTS: HBsAg was confirmed positive in 1.2% of tested pregnant women. Risk factors significantly associated with HBV positivity were; history of injections (OR = 5.65), history of seeking medical advice in a clinic (OR = 7.02), history of hospitalization (OR = 6.82), history of surgery (OR = 4) and family history of hepatitis (OR = 3.89) (P < 0.05). Dropout rate was 28% for HBsAg women whose rapid test was not confirmed and could not be reached to provide immunoprophylaxis for thier newborns. Immunoprophylaxis failure was detected in only one newborn (3.7%) who tested positive for HBsAg at 6 mo of age; and vaccine failure (seronegative to HBsAb after 4 doses of the vaccine) was detected in another one (3.7%). The success rate of the immunoprophylaxis regimen was 92.6%. CONCLUSION: This pilot study shows that a successful national program for prevention of perinatal transmission of HBV needs to be preceded by an awareness campaign to avoid a high dropout rate.


Assuntos
Vacinas contra Hepatite B/administração & dosagem , Hepatite B/prevenção & controle , Hepatite B/transmissão , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Biomarcadores/sangue , Distribuição de Qui-Quadrado , Egito/epidemiologia , Feminino , Hepatite B/sangue , Hepatite B/diagnóstico , Hepatite B/epidemiologia , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Humanos , Esquemas de Imunização , Razão de Chances , Pacientes Desistentes do Tratamento , Projetos Piloto , Gravidez , Complicações Infecciosas na Gravidez/sangue , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Prevalência , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Fatores de Risco , Estudos Soroepidemiológicos , Fatores de Tempo , Resultado do Tratamento
19.
Case Rep Oncol ; 4(3): 467-9, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22114571

RESUMO

The present case study describes our experience in treating a young woman diagnosed with a relapsing case of diffuse large cell lymphoma, who was heavily pre-treated with chemotherapy and radiotherapy. Our only chance to improve her survival was by using high-dose chemotherapy, followed by peripheral stem cell rescue. Unfortunately, in this patient, collecting sufficient stem cells for bone marrow transplantation proved to be very difficult since she had already been heavily treated with chemotherapy and radiotherapy. Currently, granulocyte colony-stimulating factor (G-CSF) alone or G-CSF plus chemotherapy are the most commonly used treatments for stem cell mobilization. However, 5-30% of patients do not respond to these agents. Plerixafor is a new hematopoietic stem cell-mobilizing drug that antagonizes the binding of chemokine stromal cell-derived factor-1α to CXC chemokine receptor 4. It is indicated in combination with G-CSF to mobilize hematopoietic stem cells to the peripheral blood for collection and subsequent autologous transplantation in patients with non-Hodgkin's lymphoma and multiple myeloma [Kessans et al.: Pharmacotherapy 2010;30:485-492; Jantunen: Expert Opin Biol Ther 2011;11:1241-1248]. Based on our findings, we consider plerixafor to be a very efficient and practical solution to mobilize and collect stem cells among all patients in such a situation, enabling us to proceed to autologous bone marrow transplantation and peripheral stem cell rescue in order to improve the patients' overall survival.

20.
J Med Phys ; 36(4): 205-12, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22228929

RESUMO

The improvement in conformal radiotherapy techniques enables us to achieve steep dose gradients around the target which allows the delivery of higher doses to a tumor volume while maintaining the sparing of surrounding normal tissue. One of the reasons for this improvement was the implementation of intensity-modulated radio therapy (IMRT) by using linear accelerators fitted with multi-leaf collimator (MLC), Tomo therapy and Rapid arc. In this situation, verification of patient set-up and evaluation of internal organ motion just prior to radiation delivery become important. To this end, several volumetric image-guided techniques have been developed for patient localization, such as Siemens OPTIVUE/MVCB and MVision megavoltage cone beam CT (MV-CBCT) system. Quality assurance for MV-CBCT is important to insure that the performance of the Electronic portal image device (EPID) and MV-CBCT is suitable for the required treatment accuracy. In this work, the commissioning and clinical implementation of the OPTIVUE/MVCB system was presented. The geometry and gain calibration procedures for the system were described. The image quality characteristics of the OPTIVUE/MVCB system were measured and assessed qualitatively and quantitatively, including the image noise and uniformity, low-contrast resolution, and spatial resolution. The image reconstruction and registration software were evaluated. Dose at isocenter from CBCT and the EPID were evaluated using ionization chamber and thermo-luminescent dosimeters; then compared with that calculated by the treatment planning system (TPS- XiO 4.4). The results showed that there are no offsets greater than 1 mm in the flat panel alignment in the lateral and longitudinal direction over 18 months of the study. The image quality tests showed that the image noise and uniformity were within the acceptable range, and that a 2 cm large object with 1% electron density contrast can be detected with the OPTIVUE/MVCB system with 5 monitor units (MU) protocol. The registration software was accurate within 2 mm in the anterior-posterior, left-right, and superior-inferior directions. The additional dose to the patient from MV-CBCT study set with 5 MU at the isocenter of the treatment plan was 5 cGy. For Electronic portal image device (EPID) verification using two orthogonal images with 2 MU per image the additional dose to the patient was 3.8 cGy. These measured dose values were matched with that calculated by the TPS-XiO, where the calculated doses were 5.2 cGy and 3.9 cGy for MVCT and EPID respectively.

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