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1.
Hematol Oncol Stem Cell Ther ; 12(4): 194-203, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31319058

RESUMO

OBJECTIVE/BACKGROUND: Patients with follicular lymphoma (FL) with early therapy failure (ETF) within 2 years of frontline therapy have poor overall survival (OS). We recently reported the results of autologous stem cell transplantation (ASCT) in patients from the Grupo Español de Linfomas y Trasplantes de Médula Ósea (GELTAMO) registry treated with rituximab prior to ASCT and with ETF after first-line immunochemotherapy, leading to 81% 5-year OS since ASCT. We explored whether ASCT is also an effective option in the pre-rituximab era-that is, in patients treated in induction and rescued only with chemotherapy. METHODS: ETF was defined as relapse/progression within 2 years of starting first-line therapy. We identified two groups: the ETF cohort (n = 87) and the non-ETF cohort (n = 47 patients receiving ASCT but not experiencing ETF following first-line therapy). RESULTS: There was a significant difference in 5-year progression-free survival between the ETF and non-ETF cohorts (43% vs. 57%, respectively; p = .048). Nevertheless, in patients with ETF with an interval from first relapse after primary treatment to ASCT of <1 year, no differences were observed in 5-year progression-free survival (48% vs. 66%, respectively; p = .44) or in 5-year OS (69% vs. 77%, p = .4). Patients in the ETF cohort transplanted in complete remission showed a plateau in the OS curves, at 56%, beyond 13.7 years of follow-up. CONCLUSION: ASCT may be a curative option for ETF in patients who respond to rescue chemotherapy, without the need for immunotherapy or other therapies, and should be considered as an early consolidation, especially in patients with difficult access to rituximab.

2.
Br J Haematol ; 185(3): 480-491, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30793290

RESUMO

The use of immunochemotherapy has improved the outcome of follicular lymphoma (FL). Recently, complete response at 30 months (CR30) has been suggested as a surrogate for progression-free survival. This study aimed to analyse the life expectancy of FL patients according to their status at 30 months from the start of treatment in comparison with the sex and age-matched Spanish general population (relative survival; RS). The training series comprised 263 patients consecutively diagnosed with FL in a 10-year period who needed therapy and were treated with rituximab-containing regimens. An independent cohort of 693 FL patients from the Grupo Español de Linfomas y Trasplante Autólogo de Médula Ósea (GELTAMO) group was used for validation. In the training cohort, 188 patients were in CR30, with a 10-year overall survival (OS) of 53% and 87% for non-CR30 and CR30 patients, respectively. Ten-year RS was 73% and 100%, showing no decrease in life expectancy for CR30 patients. Multivariate analysis indicated that the FL International Prognostic Index was the most important variable predicting OS in the CR30 group. The impact of CR30 status on RS was validated in the independent GELTAMO series. In conclusion, FL patients treated with immunochemotherapy who were in CR at 30 months showed similar survival to a sex- and age-matched Spanish general population.

3.
J Oncol Pharm Pract ; : 1078155217743069, 2017 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-29207936

RESUMO

Allogeneic hematopoietic stem cell transplantation and checkpoint blockade therapy are immune-based salvage therapies for Hodgkin's lymphoma; however, the use of programmed death 1 blocking agents in the allogeneic stem cell transplantation setting could augment the incidence of steroid refractory graft-versus-host disease. Few studies suggest that that nivolumab is safe in patients previously treated with an allogeneic stem cell transplantation. Likewise, there are very limited data on the use of nivolumab before allogeneic stem cell transplantation. Here, we report a case of fatal graft-versus-host disease in a patient who underwent allogeneic stem cell transplantation 26 days after the last administration of nivolumab. Careful monitoring and close clinical assessment of atypical presentation for graft-versus-host disease in these patients, interval of time from nivolumab administration to allogeneic stem cell transplantation, drug dosage adjustments or more effective allo prophilaxys should been evaluated in prospective clinical trial.

4.
Cancer Med ; 6(12): 2766-2774, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29076254

RESUMO

Overall survival (OS) is the gold-standard end point for studies evaluating autologous stem cell transplantation (ASCT) in follicular lymphoma (FL), but assessment may be elusive due to the lengthy disease course. We analyzed the validity of two earlier end points, proposed in the setting of first-line chemo-/immunotherapy, as surrogates for OS-progression-free survival (PFS) status at 24 months (PFS24) and complete response at 30 months (CR30) post-ASCT. We also have investigated the clinical features of patients with early progression after ASCT. Data were available for 626 chemosensitive FL patients who received ASCT between 1989 and 2007. Median follow-up was 12.2 years from ASCT. In the PFS24 analysis, 153 (24%) patients progressed within 24 months and 447 were alive and progression-free at 24 months post-ASCT (26 who died without disease progressions within 24 months were excluded). Early progression was associated with shorter OS (hazard ratio [HR], 6.8; P = 0.00001). In the subgroup of patients who received an ASCT in the setting or relapse after being exposed to rituximab, the HR was 11.3 (95% CI, 3.9-30.2; P < 0.00001). In the CR30 analysis, 183 of 596 (31%) response-evaluable patients progressed/died with 30 months post-ASCT. The absence of CR30 was associated with shorter OS (HR, 7.8; P < 0.00001), including in patients with prior rituximab (HR, 8.2). PFS24 and CR30 post-ASCT are associated with poor outcomes and should be primary end points. Further research is needed to identify this population to be offered alternative treatments.


Assuntos
Linfoma Folicular/cirurgia , Transplante de Células-Tronco , Adolescente , Adulto , Idoso , Antineoplásicos/uso terapêutico , Bases de Dados Factuais , Progressão da Doença , Intervalo Livre de Doença , Determinação de Ponto Final , Feminino , Humanos , Imunoterapia/métodos , Estimativa de Kaplan-Meier , Linfoma Folicular/mortalidade , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Sistema de Registros , Estudos Retrospectivos , Fatores de Risco , Espanha , Transplante de Células-Tronco/efeitos adversos , Transplante de Células-Tronco/mortalidade , Fatores de Tempo , Transplante Autólogo , Resultado do Tratamento , Adulto Jovem
5.
Br J Haematol ; 178(5): 699-708, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28782811

RESUMO

The diagnostic criteria for follicular lymphoma (FL) transformation vary among the largest series, which commonly exclude histologically-documented transformation (HT) mandatorily. The aims of this retrospective observational multicentre study by the Spanish Grupo Español de Linfoma y Transplante Autólogo de Médula Ósea, which recruited 1734 patients (800 males/934 females; median age 59 years), diagnosed with FL grades 1-3A, were, (i) the cumulative incidence of HT (CI-HT); (ii) risk factors associated with HT; and (iii) the role of treatment and response on survival following transformation (SFT). With a median follow-up of 6·2 years, 106 patients developed HT. Ten-year CI-HT was 8%. Considering these 106 patients who developed HT, median time to transformation was 2·5 years. High-risk FL International Prognostic Index [Hazard ratio (HR) 2·6, 95% confidence interval (CI): 1·5-4·5] and non-response to first-line therapy (HR 2·9, 95% CI: 1·3-6·8) were associated with HT. Seventy out of the 106 patients died (5-year SFT, 26%). Response to HT first-line therapy (HR 5·3, 95% CI: 2·4-12·0), autologous stem cell transplantation (HR 3·9, 95% CI: 1·5-10·1), and revised International Prognostic Index (HR 2·2, 95% CI: 1·1-4·2) were significantly associated with SFT. Response to treatment and HT were the variables most significantly associated with survival in the rituximab era. Better therapies are needed to improve response. Inclusion of HT in clinical trials with new agents is mandatory.


Assuntos
Antineoplásicos/uso terapêutico , Transformação Celular Neoplásica/patologia , Linfoma Folicular/tratamento farmacológico , Linfoma Folicular/patologia , Rituximab/uso terapêutico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Transformação Celular Neoplásica/efeitos dos fármacos , Progressão da Doença , Feminino , Humanos , Linfoma Folicular/mortalidade , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Medição de Risco/métodos , Espanha/epidemiologia , Análise de Sobrevida , Adulto Jovem
6.
Leuk Lymphoma ; 57(1): 134-42, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-25811675

RESUMO

Biopsy samples of lymph nodes from 38 patients with CLL were analyzed. We found differential expression in 1092 genes in two different subgroups: 418 overexpressed in one subgroup and 674 in another. Molecular pathways identified in one subgroup appear to be characterized by greater dependence of signaling by cytokines and activation of the NFkB pathway, while in the other seem to depend on cell cycle. Despite having found a differential expression between both subgroups, none of these genes reached FDR < 0.25. We have not found significant association with survival or any prognostic factors. Analysis of the differences between normal lymph node and CLL in 253 genes with difference in the intensity of expression revealed upregulated genes different to BCR: CD40, TCL1, IL-7, and PAX5. Using large-scale molecular analysis, we may obtain information about molecular mechanisms of CLL pathogenesis and may contribute to the identification of new therapeutic targets.


Assuntos
Biomarcadores Tumorais , Leucemia Linfocítica Crônica de Células B/diagnóstico , Leucemia Linfocítica Crônica de Células B/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Análise por Conglomerados , Biologia Computacional/métodos , Feminino , Perfilação da Expressão Gênica , Humanos , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Linfonodos/metabolismo , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Terapia de Alvo Molecular , Estadiamento de Neoplasias , Prognóstico , Transdução de Sinais
7.
Biomed Res Int ; 2014: 531087, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24795884

RESUMO

The aim of this study was to assess the effects of short-term esmolol therapy on coronary artery structure and function and plasma oxidative stress in spontaneously hypertensive rats (SHR). For this purpose, 14-month-old male SHR were treated for 48 hours with esmolol (SHR-E, 300 µ g/kg/min). Age-matched untreated male SHR and Wistar Kyoto rats (WKY) were used as hypertensive and normotensive controls, respectively. At the end of intervention we performed a histological study to analyze coronary artery wall width (WW), wall-to-lumen ratio (W/L), and media cross-sectional area (MCSA). Dose-response curves for acetylcholine (ACh) and sodium nitroprusside were constructed. We also assessed several plasma oxidative stress biomarkers, namely, superoxide scavenging activity (SOSA), nitrites, and total antioxidant capacity (TAC). We observed a significant reduction in WW (P < 0.001), W/L (P < 0.05), and MCSA (P < 0.01) and improved endothelium-dependent relaxation (AUC(SHR-E) = 201.2 ± 33 versus AUC(SHR) = 97.5 ± 21, P < 0.05) in SHR-E compared with untreated SHR; no differences were observed for WW, MCSA, and endothelium-dependent relaxation by ACh at higher concentrations (10(-6) to 10(-4) mol/l) for SHR-E with respect to WKY. SOSA (P < 0.001) and nitrite (P < 0.01) values were significantly higher in SHR-E than in untreated SHR; however, TAC did not increase after treatment with esmolol. Esmolol improves early coronary artery remodeling in SHR.


Assuntos
Vasos Coronários/efeitos dos fármacos , Hipertensão/metabolismo , Óxido Nítrico/metabolismo , Propanolaminas/farmacologia , Superóxido Dismutase/metabolismo , Animais , Antioxidantes/análise , Disponibilidade Biológica , Vasos Coronários/patologia , Masculino , Estresse Oxidativo/efeitos dos fármacos , Ratos , Ratos Endogâmicos SHR , Ratos Endogâmicos WKY
10.
Med Hypotheses ; 81(4): 695-700, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23953967

RESUMO

Epiphyseal cartilage is hyaline cartilage tissue with a gelatinous texture, and it is responsible for the longitudinal growth of the long bones in birds and mammals. It is located between the epiphysis and the diaphysis. Epiphyseal cartilage also is called a growth plate or physis. It is protected by three bone components: the epiphysis, the bone bar of the perichondrial ring and the metaphysis. The epiphysis, which lies over the epiphyseal cartilage in the form a cupola, contains a juxtaposed bone plate that is near the epiphyseal cartilage and is in direct contact with the epiphyseal side of the epiphyseal cartilage. The germinal zone corresponds to a group of cells called chondrocytes. These chondrocytes belong to a group of chondral cells, which are distributed in rows and columns; this architecture is commonly known as a growth plate. The growth plate is responsible for endochondral bone growth. The aim of this study was to elucidate the causal relationship between the juxtaposed bone plate and epiphyseal cartilage in mammals. Our hypothesis is that cells from the germinal zone of the epiphyseal side of the epiphyseal cartilage are involved in forming a second ossification front that is responsible for the origin of the juxtaposed bone plate. We report the following: (a) The juxtaposed bone plate has a morphology and function that differs from that of the epiphyseal trabeculae; (b) on the epiphyseal edge of the epiphyseal cartilage, a new ossification front starts on the chondrocytes of the germinal area, which forms the juxtaposed bone plate. This ossification front is formed by chondrocytes from the germinal zone through a process of mineralisation and ossification, and (c) the process of mineralisation and ossification has a certain morphological analogy to the process of ossification in the metaphyseal cartilage of amphibians and differs from the endochondral ossification process in the metaphyseal side of the growth plate. The close relationship between the juxtaposed bone plate and the epiphyseal cartilage, in which the chondrocytes that migrate from the germinal area play an important role in the mineralisation and ossification process of the juxtaposed bone plate, supports the hypothesis of a new ossification front in the epiphyseal layer of the epiphyseal plate. This hypothesis has several implications: (a) epiphyseal cartilage is a morphological entity with two different ossification fronts and two different functions, (b) epiphyseal cartilage may be a morphological structure with three parts: perichondrial ring, metaphyseal ossification front or growth plate, and epiphyseal ossification front, (c) all disease (traumatic or dysplastic) that affects some of these parts can have an impact on the morphology of the epiphyseal region of the bone, (d) there is a certain analogy between metaphyseal cartilage in amphibians and mammalian epiphyseal cartilage, although the former is not responsible for bone growth, (e) comparative histological and anatomy studies are also warranted, to shed light on the phylogenetic study of epiphyseal cartilage throughout the changes that occur in the animal species.


Assuntos
Desenvolvimento Ósseo/fisiologia , Lâmina de Crescimento/anatomia & histologia , Lâmina de Crescimento/fisiologia , Modelos Biológicos , Osteogênese/fisiologia , Animais , Lâmina de Crescimento/cirurgia , Técnicas Histológicas , Humanos , Microcirurgia , Ratos
11.
Summa psicol. UST ; 10(1): 91-101, jul. 2013. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-713269

RESUMO

El presente trabajo tuvo como objetivo evaluar el efecto de un programa de intervención en la adherencia autoreportada a la dieta prescrita para pacientes diabéticos. Dado el costo y consecuencias de esta enfermedad, resulta muy importante lograr este objetivo que constituye la piedra angular del tratamiento. Desde la perspectiva interconductual,se diseñó un programa de intervención que se aplicó a 90 pacientes diabéticos captados en distintos centros de salud de la ciudad de México. El programa constó de una fase de pre-evaluación, en la que se midió el peso y se registraron prácticas alimenticias; una intervención en dos bloques, el primero educativo y el segundo en el que se entrenó en el manejo de algunas técnicas conductuales; y una fase de post-evaluación. Se encontró que cada bloque de intervención tuvo un efecto positivo en la adherencia autoreportada a la dieta y, por ende, el programa en su totalidad fue efectivo en esta muestra de pacientes. Los resultados se corroboraron con las medidas de peso en las que también se encontró una diferencia estadísticamente significativa entre el pre-test y el post-test. Se sugiere continuar buscando estrategias cada vez más efectivas para el logro de este objetivo.


The purpose of the present study was to assess the effect of an intervention program on the self-reported adherence to a prescribed diet for diabetic patients. Because of the impact and consequences of this chronic illness, it is important to make the necessary efforts in order to achieve this dietary adherence goal, since diet is one of the main bases for the treatment of diabetes. According to an interbehavioral approach, an intervention program was designed and applied to ninety diabetic patients from different Mexican public health institutions. This program was developed in three stages. The first stage consisted of a pre-test to assess body weight and habits related to daily meals. The second stage comprehended an intervention divided in two parts, the first one to provide patients with useful knowledge about diabetes and nutrition and the second one to train several behavioral techniques a post-test was applied to participants. Results showed that each intervention’s part had a positive effect on self-reported adherence to diet, and so the complete program. These results were supported by weight data. In this sense, it was found a statistically significant difference between pre and post-test values. It is suggested to continue these efforts in order to contribute on the solution of this public health problem.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Cooperação do Paciente , Psicoterapia , /dietoterapia , /psicologia , /terapia , Modelos Psicológicos
12.
Hypertens Res ; 36(5): 408-13, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23364336

RESUMO

Certain ß-adrenergic blockers have proven useful in the regression of ventricular remodeling when administered as long-term treatment. However, early regression of left ventricular hypertrophy (LVH) has not been reported, following short-term administration of these drugs. We tested the hypothesis that short-term administration of the cardioselective ß-blocker esmolol induces early regression of LVH in spontaneously hypertensive rats (SHR). Fourteen-month-old male SHRs were treated i.v. with vehicle (SHR) or esmolol (SHR-E) (300 µg kg(-1) min(-1)). Age-matched vehicle-treated male Wistar-Kyoto (WKY) rats served as controls. After 48 h, left ventricular morphology and function were assessed using M-mode echocardiograms (left ventricular mass index (LVMI), ejection fraction and transmitral Doppler (early-to-atrial filling velocity ratio (E/A), E-wave deceleration time (Edec time)). The standardized uptake value (SUV) was applied to evaluate FDG (2-deoxy-2[18F]fluoro-D-glucose) uptake by the heart using PET/CT. Left ventricular subendocardial and subepicardial biopsies were taken to analyze changes in cross-sectional area (CSA) of left ventricular cardiomyocytes and the fibrosis was expressed as collagen volume fraction (CVF). LVMI was lower in SHR-E with respect to SHR (P=0.009). There were no significant differences in EF, E/A ratio or Edec time in SHR-E compared with SHR (P=0.17, 0.55 and P=0.80, respectively). PET acquisitions in SHR-E showed lower (18)F-FDG uptake than SHR (P=0.003). Interestingly, there were no significant differences in SUV in either SHR-E or WKY (P=0.63). CSA in subendocardial and subepicardial regions was minor in SHR-E with respect to SHR (P<0.001), and there were no significant differences in CVF between both groups. Esmolol reverses early LVH in the SHR model of stable compensated ventricular hypertrophy. This is the first study to associate early regression of LVH with administration of a short-term ß-blocker.


Assuntos
Antagonistas de Receptores Adrenérgicos beta 1/administração & dosagem , Hipertensão/complicações , Hipertrofia Ventricular Esquerda/tratamento farmacológico , Propanolaminas/administração & dosagem , Animais , Avaliação Pré-Clínica de Medicamentos , Fluordesoxiglucose F18 , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/etiologia , Masculino , Ratos , Ratos Endogâmicos SHR , Ratos Endogâmicos WKY , Ultrassonografia
13.
J Pediatr Orthop ; 32(6): 613-20, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22892625

RESUMO

BACKGROUND: An anatomo-functional system has been described for the normal hip of some young mammals. This system includes the ligamentum teres, the transverse acetabular ligament, and the meniscoid of the hip. PURPOSE: This report analyzes morphologic changes in the anatomo-functional system of young rats in an experimental model of hip luxation, and on the initial pathodynamics of luxation produced experimentally. METHODS: Hyperextension of the left knee was induced in 58 young rats through fixation of the tibia and femur with Kirschner wire. Radiographic, macroscopic, and microscopic parameters were analyzed for 3 study periods (group 1: 4 d, group 2: 1 wk, group 3: 2 wk), and macroscopic parameters were studied in a late group (group 4: 6 wk). RESULTS: Breaks in the Shenton line were observed from group 1 (subluxation) onward (luxation). Hypertrophy of the round and transverse acetabular ligaments of the acetabulum and meniscoid, progressive elevation of the meniscoid, and fibrosis of the fibrofatty (pulvinar) tissue occurred from group 1 onward. Radiographic and morphometric studies showed triplane innominate bone deformation (anterior bending, lateral tilt, and rotation of the ischium), which resulted in decreased joint space. As time progressed, the increase in these injuries was accompanied by morphologic changes in the acetabulum, posterosuperior displacement and reorientation of the acetabulum and extrusion of the femoral head. CONCLUSIONS: Under the conditions of this study, the temporospatial morphologic changes in the acetabulum due to injury of the anatomo-functional system, and the triplane pelvic deformity in the initial period of the injury, produced femoral head extrusion of the acetabulum. RELEVANT SYMPTOMS: These disorders may help us understand the pathogenic and clinical phenomena that appear in early stages of hip luxation disease.


Assuntos
Acetábulo/patologia , Cabeça do Fêmur/patologia , Luxação do Quadril/fisiopatologia , Articulação do Joelho/fisiopatologia , Animais , Modelos Animais de Doenças , Feminino , Fêmur , Hipertrofia , Ratos , Ratos Sprague-Dawley , Tíbia , Fatores de Tempo
14.
Ginecol Obstet Mex ; 80(7): 467-72, 2012 Jul.
Artigo em Espanhol | MEDLINE | ID: mdl-22916640

RESUMO

Vasomotor symptoms are one of the main reasons for climateric women to consult a physician. Hormone therapy is the first treatment choice, but it is not indicated to all patients. Veralipride is an option for those who cannot or will not try hormone treatment. The Mexican Association for the Study of Climateric (AMEC) assembled an interdisciplinary group of medical experts so that they revised the medical literature on the subject and reached a consensus on veralipride indication, doses, counterindications and safety. The recommendations of the consensus conference on veralipride are: (1) Physicians must be familiar with its indication, side effects, pharmacokinetics and dosage. (2) Patients must be informed on other therapeutical options. (3) Patients' mental and neurological state must be evaluated, in particular to identify movement disorders, extrapyramidal symptoms (tremor or dystonia), anxiety and depression that can be mistaken for climateric symptoms. (4) Any adverse effect associated with the drug must be reported. (5) A random multicenter trial must be carried out in order to identify the frequency and severity of side effects, and (6) Written information on possible health risks when using the drug must be provided.


Assuntos
Menopausa , Sulpirida/análogos & derivados , Sistema Vasomotor/efeitos dos fármacos , Sistema Vasomotor/fisiopatologia , Feminino , Humanos , Americanos Mexicanos , Seleção de Pacientes , Sulpirida/uso terapêutico
15.
Reumatol. clín. (Barc.) ; 8(3): 141-142, mayo-jun. 2012.
Artigo em Espanhol | IBECS | ID: ibc-100162

RESUMO

La asociación del lupus eritematoso sistémico (LES) y la enfermedad inflamatoria intestinal es rara. Presentamos el caso de una mujer de 24 años con LES que comenzó con dolor abdominal y diarrea. No había datos de exacerbación de LES. Las pruebas complementarias mostraron hallazgos típicos de enfermedad de Crohn (AU)


A 24-year-old woman with systemic lupus erythematosus (SLE) presented abdominal pain and diarrhea. No evidence for an SLE flare was obtained. Colonoscopy and microscopic biopsy examination revealed findings typical of Crohn's disease. Despite the rarity of the combination, patients with SLE showing gastrointestinal manifestations might merit evaluation for Crohn disease (AU)


Assuntos
Humanos , Feminino , Adulto , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Doença de Crohn/complicações , Dor Abdominal/etiologia , Diarreia/complicações , Ciclofosfamida/uso terapêutico , Prednisona/uso terapêutico , Azatioprina/uso terapêutico , Mesalamina/uso terapêutico , Pancreatite/complicações , Lúpus Eritematoso Sistêmico/fisiopatologia , Doença de Crohn/fisiopatologia , Diarreia/diagnóstico , Pancreatite/tratamento farmacológico , Doença de Crohn/diagnóstico , Dor Abdominal/complicações , /métodos , Colonoscopia/métodos , Colonoscopia
16.
Reumatol Clin ; 8(3): 141-2, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22118801

RESUMO

A 24-year-old woman with systemic lupus erythematosus (SLE) presented abdominal pain and diarrhea. No evidence for an SLE flare was obtained. Colonoscopy and microscopic biopsy examination revealed findings typical of Crohn's disease. Despite the rarity of the combination, patients with SLE showing gastrointestinal manifestations might merit evaluation for Crohn disease.


Assuntos
Doença de Crohn/diagnóstico , Lúpus Eritematoso Sistêmico/complicações , Adulto , Doença de Crohn/complicações , Feminino , Humanos
17.
Reumatol. clín. (Barc.) ; 7(6): 397-400, nov.-dic. 2011. ilus
Artigo em Espanhol | IBECS | ID: ibc-91559

RESUMO

La artritis reumatoide (AR) es una de las causas más frecuentes de amiloidosis tipo AA. En la mayoría de los pacientes es asintomática y sólo cuando existen grandes depósitos en determinados órganos ocasiona problemas funcionales. Presentamos 2 pacientes con amiloidosis secundaria a AR, con afectación renal e intestinal, que respondieron al tratamiento con etanercept (AU)


Rheumatoid arthritis (RA) is one of the most common causes of AA amyloidosis. Most patients are asymptomatic and only when there are large deposits in certain organs, functional problems arise. We report two patients with amyloidosis secondary to RA, with renal and intestinal involvement, who responded to treatment with etanercept (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Amiloidose/tratamento farmacológico , Artrite Reumatoide/tratamento farmacológico , Anti-Inflamatórios não Esteroides/uso terapêutico , Biópsia/métodos , Transtornos Linfoproliferativos/tratamento farmacológico
18.
Reumatol. clín. (Barc.) ; 7(6): 404-406, nov.-dic. 2011. ilus
Artigo em Espanhol | IBECS | ID: ibc-91561

RESUMO

La esclerodermia localizada es una enfermedad del tejido conectivo generalmente limitada a la piel y tejido celular subcutáneo; sin embargo; puede progresar a grandes placas induradas, retraso del crecimiento, atrofia muscular e incluso deformidades en flexión o pobre cicatrización de las heridas. La morfea generalizada unilateral es una variante rara de la esclerodermia localizada descrita ocasionalmente en la literatura. Presentamos el caso de una niña con morfea generalizada unilateral que afectó al lado derecho del cuerpo (AU)


Localized scleroderma is a connective tissue disorder generally involving de entire dermis and usually limited to the subcutaneous tissue; however, it may progress to large indurated plaques, growth retardation, muscle atrophy, and even to flexion deformities or poorly healing ulcers. Unilateral generalized morphea is an extremely rare variant of localized scleroderma which has seldom been reported in the literature. We report the case of a girl who developed unilateral generalized morphea on the right side of the body (AU)


Assuntos
Humanos , Masculino , Adulto , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Anticorpos Monoclonais , Síndrome de Guillain-Barré/complicações , Fator de Necrose Tumoral alfa/administração & dosagem , Fator de Necrose Tumoral alfa , Metotrexato/uso terapêutico , Ceftriaxona/uso terapêutico , Vancomicina/uso terapêutico , Eletromiografia/métodos , Eletromiografia , Meningites Bacterianas/complicações , Anticorpos Monoclonais/efeitos adversos , Ampicilina/uso terapêutico , Imunoglobulinas/uso terapêutico , Hidrocortisona/uso terapêutico
19.
Reumatol Clin ; 7(6): 397-400, 2011.
Artigo em Espanhol | MEDLINE | ID: mdl-22078699

RESUMO

Rheumatoid arthritis (RA) is one of the most common causes of AA amyloidosis. Most patients are asymptomatic and only when there are large deposits in certain organs, functional problems arise. We report two patients with amyloidosis secondary to RA, with renal and intestinal involvement, who responded to treatment with etanercept.


Assuntos
Amiloidose/etiologia , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Doenças do Colo/etiologia , Imunoglobulina G/uso terapêutico , Nefropatias/etiologia , Receptores do Fator de Necrose Tumoral/uso terapêutico , Idoso , Amiloidose/diagnóstico , Artrite Reumatoide/complicações , Doenças do Colo/diagnóstico , Etanercepte , Feminino , Humanos , Nefropatias/diagnóstico , Masculino , Pessoa de Meia-Idade
20.
Reumatol Clin ; 7(6): 404-6, 2011.
Artigo em Espanhol | MEDLINE | ID: mdl-22078701

RESUMO

Localized scleroderma is a connective tissue disorder generally involving de entire dermis and usually limited to the subcutaneous tissue; however, it may progress to large indurated plaques, growth retardation, muscle atrophy, and even to flexion deformities or poorly healing ulcers. Unilateral generalized morphea is an extremely rare variant of localized scleroderma which has seldom been reported in the literature. We report the case of a girl who developed unilateral generalized morphea on the right side of the body.


Assuntos
Esclerodermia Localizada/diagnóstico , Criança , Feminino , Humanos
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