Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.520
Filtrar
1.
Medicine (Baltimore) ; 99(22): e20457, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32481453

RESUMO

BACKGROUND: The prevalence of chronically refractory wounds and ulcers is growing rapidly. However, the treatment options are not completely effective. Ozone has been demonstrated as being useful in promoting wound healing as well as adverse events in individual studies. Consequently, it is necessary to conduct a meta-analysis of high-quality trials to find out whether ozone therapy is effective and safe in these chronic wounds. METHODS: We will search the Cochrane Library, PubMed, the Web of Science, Embase, CBM, and the Chinese Clinical Registry website without restriction on language, date, or study setting. Randomized controlled trials of ozone therapy for chronical wounds or ulcers will be retrieved in diverse databases from inception to May 2020. The primary outcome of the meta-analysis is the proportion of participants with completely healed wounds; time to achieve complete ulcer healing; change in wound size. The secondary outcomes include the incidence of adverse events, amputation, quality of life, length of hospital stay, and cost. Two reviewers will adopt the Cochrane Collaboration's risk of bias tool to assess the randomized controlled trials and all relevant data will be analyzed by utilizing the Review Manager software V5.3.0. RESULTS: This study will offer a high-quality synthesis of the effectiveness and safety of ozone for treating chronically refractory wounds and ulcers. CONCLUSION: This systematic review and meta-analysis will find out the available evidence to assess whether ozone therapy is beneficial to wound healing and side effects, producing evidence reference for clinical practice on the treatment of wound care.


Assuntos
Metanálise como Assunto , Ozônio/uso terapêutico , Revisões Sistemáticas como Assunto , Úlcera/terapia , Cicatrização , Doença Crônica , Humanos
2.
Medicine (Baltimore) ; 99(18): e19836, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32358354

RESUMO

INTRODUCTION: Acute hemorrhagic rectal ulcer (AHRU) is a rare entity which has most frequently been described in Japan and Taiwan literature. This study characterizes 11 AHRUs identified and managed at an urban acute care hospital in the United States of America (USA). METHODS: A total of 2253 inpatients underwent colonoscopy. In 1172 patients (52%), colonoscopy was performed for evaluation of lower gastrointestinal (LGI) bleeding. Eleven (0.9%) of the 1172 patients with LGI bleeding had AHRU. RESULTS: AHRU is characterized by a sudden onset of painless and massive lower rectal bleeding in elderly, bedridden patients (pts) with major underlying diseases. The endoscopic findings were classified into 4 types. All 11 ulcers were located in the distal rectum within 10 cm of the dentate line. All 11 patients required blood transfusion (mean = 3.7 units; range 2-9 units). Seven patients responded to blood, plasma, and platelet transfusions. The other 4 patients required endoscopic hemostasis.Three patients died within a month of colonoscopy from comorbidities. None had bleeding as a cause of death. Eight surviving patients did not have recurrent bleeding. CONCLUSION: AHRU does exist in the USA and should be considered as an important cause of acute lower GI bleeding in elderly, critically ill, and bedridden patients. AHRU should be recognized and managed correctly.


Assuntos
Colonoscopia/estatística & dados numéricos , Hemorragia Gastrointestinal/cirurgia , Hemostase Endoscópica/métodos , Doenças Retais/cirurgia , Úlcera/cirurgia , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Transfusão de Sangue , Feminino , Hemorragia Gastrointestinal/diagnóstico , Hospitais Urbanos , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Retais/diagnóstico , Reto/irrigação sanguínea , Reto/cirurgia , Úlcera/diagnóstico , Estados Unidos
3.
Anticancer Res ; 40(5): 2701-2706, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32366415

RESUMO

BACKGROUND/AIM: Oral mucositis, which occurs frequently in the treatment of cancer, is a major problem. In this study, we aimed to develop a rat model of oral mucositis induced by cancer chemotherapy for quantitative measurement. MATERIALS AND METHODS: A model animal of oral mucositis was prepared by injecting an acetic acid aqueous solution into the buccal mucosa of rats to which a 5-FU solution had been previously administered. The doses of 5-FU and acetic acid were examined, and a treatment experiment using Kenalog® was performed. RESULTS: The optimal dose of the 5-FU solution and the optimal concentration of the acetic acid aqueous solution were 40 mg/kg and 25%, respectively. Treatment with Kenalog® confirmed that this model mimics immunocompromised oral mucositis. CONCLUSION: Compared with a mouse model, oral mucositis can be easily observed in this model and provides a large amount of oral mucosal tissue.


Assuntos
Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Neoplasias/tratamento farmacológico , Estomatite/induzido quimicamente , Animais , Peso Corporal/efeitos dos fármacos , Modelos Animais de Doenças , Fluoruracila/efeitos adversos , Fluoruracila/uso terapêutico , Contagem de Leucócitos , Masculino , Ratos Wistar , Estomatite/sangue , Úlcera/induzido quimicamente
4.
Vasc Endovascular Surg ; 54(5): 423-429, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32323631

RESUMO

OBJECTIVE: To evaluate the technical success and short-term outcome of patients with penetrating aortic ulcers (PAUs) and saccular aneurysms (SAs) of the aortic arch treated with the jailed coiling technique. METHODS: A retrospective review of 9 patients (mean age 70 years, 9 males) treated for PAUs and SAs of the aortic arch between 2018 and 2019 at our institution. Treatment included thoracic endovascular aneurysm repair (TEVAR) with a short (1cm) proximal landing zone, followed by coiling of aneurysm through a jailed extraluminal catheter. RESULTS: All 9 patients underwent TEVAR followed by jailed coiling of the lumen of the aneurysms. Debranching of supra-aortic vessels was performed in 4 patients in order to create a proximal landing zone of at least 10 mm. Technical success was achieved in all cases. Coils were placed accurately within the aneurysm lumen in all patients. No distal embolization occurred. One patient expired in the perioperative period from a cardiac event. No patient developed spinal cord ischemia or stroke in the perioperative period. Mean follow-up was 10 months (range 3-18). On follow-up imaging, complete thrombosis of the aneurysm lumen was seen in all patients. None experienced enlargement of ulcer dimensions and none required reintervention. CONCLUSION: PAUs and SAs of the aortic arch with a very short landing zone can be treated successfully by jailed coiling of the aneurysm and TEVAR. The procedure is technically feasible and can be performed with minimal morbidity. Long-term durability of the repair needs to be determined.


Assuntos
Aneurisma da Aorta Torácica/terapia , Doenças da Aorta/terapia , Implante de Prótese Vascular , Embolização Terapêutica , Procedimentos Endovasculares , Úlcera/terapia , Idoso , Aneurisma da Aorta Torácica/diagnóstico por imagem , Doenças da Aorta/diagnóstico por imagem , Doenças da Aorta/mortalidade , Implante de Prótese Vascular/efeitos adversos , Embolização Terapêutica/efeitos adversos , Embolização Terapêutica/instrumentação , Embolização Terapêutica/mortalidade , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Úlcera/diagnóstico por imagem , Úlcera/mortalidade
6.
Medicine (Baltimore) ; 99(12): e19500, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32195950

RESUMO

BACKGROUND: Lesions of herpes labialis are caused by the herpes simplex virus type 1 and cause pain and aesthetic compromise. It is characterized by the formation of small vesicles that coalesce and rupture forming extremely painful ulcers, that evolve to crusts, dry desquamations until their complete remission. Currently the treatment of these lesions is done with acyclovir. Although it diminishes the symptomatology, it causes viral resistance and does not prevent the recurrence of the lesions. It is known that antimicrobial photodynamic therapy (aPDT) has numerous advantages, among them: the reduction of the time of remission, and does not cause resistance. This protocol will determine the effectiveness of PDT in lesions of herpes labialis. MATERIALS AND METHODS: A total of 30 patients with herpes labialis in the prodromal stage of vesicles, ulcers, and crusts will be selected to participate in the study and randomized into 2 groups: G1 control and G2 experimental. After signing Research Ethics Committee and TA, patients in group G1 will undergo the standard gold treatment for herpes labialis with acyclovir and simulated PDT treatment. Patients in the experimental G2 group will be treated simulating the gold standard treatment of herpes labialis (placebo) and PDT. In all patients, saliva samples will be collected for analysis of cytokines, and will be performed exfoliative cytology in the lesions. The pain will be assessed through a pain scale and a questionnaire of quality of life related to oral health (OHIP-14) will be given to them. Patients will continue to be followed up after 7 days, 1 month, 3 months, and 6 months; if there is a recurrence of the lesion, they will contact the researchers.Clinical registration: clinicaltrials.gov - NCT04037475. Registered on July 2019.


Assuntos
Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Herpes Labial/terapia , Fotoquimioterapia/métodos , Aciclovir/efeitos adversos , Adulto , Antivirais/efeitos adversos , Feminino , Herpes Labial/patologia , Herpes Labial/virologia , Herpesvirus Humano 1/isolamento & purificação , Herpesvirus Humano 1/efeitos da radiação , Humanos , Masculino , Dor/etiologia , Estudos Prospectivos , Qualidade de Vida , Recidiva , Úlcera/patologia , Escala Visual Analógica , Adulto Jovem
7.
Medicine (Baltimore) ; 99(9): e19357, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118778

RESUMO

BACKGROUND: Vonoprazan is a potassium-competitive acid blocker (P-CAB) that is frequently used in Japan for Helicobacter pylori (H. pylori) eradication, treatment of gastroesophageal reflux disease, and treatment of post endoscopic submucosal dissection (ESD) complications. We sought to determine if vonoprazan was superior to proton pump inhibitors (PPIs) for treating ESD-induced ulcers (as assessed by ulcer healing and shrinkage ratios) and preventing delayed bleeding over various treatment durations (2, 4, and 8 weeks). METHODS: We collected randomized controlled trials (RCTs) and observational studies that discussed the effectiveness of vonoprazan and PPIs on ESD-induced ulcers and bleeding from PubMed, Cochrane Library, ClinicalTrials.gov, and Google Scholar. Studies were selected according to pre-established eligibility criteria and data were extracted separately by 2 researchers with double-check. We used the Cochrane risk of bias tool to assess RCTs and the Newcastle-Ottawa Quality Assessment Scale to assess observational studies. Meta-analyses, based on the random-effects model, were conducted to compare differences in ulcer shrinkage ratios (%) and odds ratios (ORs) for ulcer healing and delayed bleeding. Publication bias was evaluated using funnel plots and Egger regression test. Heterogeneity was assessed using I statistics. A sensitivity analysis was conducted to check the robustness of results. The evidential quality of the findings was assessed using the GRADE profiler. RESULTS: Thirteen studies were included in this meta-analysis. The OR effect sizes of vonoprazan relative to PPIs for ulcer healing were 1.33 (P = .13) with a 95% CI (0.33-3.21) at 4 weeks and 1.48 (P = .09) with a 95% CI (0.81-5.20) at 8 weeks. The overall effect size for the shrinkage ratio was 12.24% (P = .16) with a 95% CI (-4.96-29.44) at 2 weeks. The effect size of its subgroup of H. pylori-positive patients was 19.51% (P < .001) with a 95% CI (11.91-27.12). The overall OR for the occurrence of delayed bleeding was 0.66 (P = .26) with a 95% CI (0.32-1.35). After excluding combination drug studies, the overall ORs between vonoprazan and PPIs on ulcer healing and delayed bleeding were 1.44 and 0.76, respectively. CONCLUSION: During the first 2 weeks of treatment, vonoprazan was more effective than PPIs for treating H. pylori-positive patients with ESD-induced gastric ulcers.


Assuntos
Ressecção Endoscópica de Mucosa/efeitos adversos , Inibidores da Bomba de Prótons/normas , Pirróis/normas , Sulfonamidas/normas , Úlcera/tratamento farmacológico , Adulto , Ressecção Endoscópica de Mucosa/instrumentação , Ressecção Endoscópica de Mucosa/métodos , Humanos , Estudos Observacionais como Assunto/estatística & dados numéricos , Complicações Pós-Operatórias , Inibidores da Bomba de Prótons/uso terapêutico , Pirróis/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Sulfonamidas/uso terapêutico , Úlcera/etiologia
8.
PLoS One ; 15(2): e0225267, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32084158

RESUMO

Non-healing chronic ulcers are a serious complication of diabetes and are a major healthcare problem. While a host of treatments have been explored to heal or prevent these ulcers from forming, these treatments have not been found to be consistently effective in clinical trials. An understanding of the changes in gene expression in the skin of diabetic patients may provide insight into the processes and mechanisms that precede the formation of non-healing ulcers. In this study, we investigated genome wide changes in gene expression in skin between patients with type 2 diabetes and non-diabetic patients using next generation sequencing. We compared the gene expression in skin samples taken from 27 patients (13 with type 2 diabetes and 14 non-diabetic). This information may be useful in identifying the causal factors and potential therapeutic targets for the prevention and treatment of diabetic related diseases.


Assuntos
Diabetes Mellitus Tipo 2/genética , Expressão Gênica , Genoma Humano , Pele/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Sinalização do Cálcio/genética , Diabetes Mellitus Tipo 2/patologia , Feminino , Regulação da Expressão Gênica , Humanos , Inflamação/genética , Masculino , Pessoa de Meia-Idade , Pseudogenes/genética , RNA Longo não Codificante/genética , Análise de Sequência de RNA , Úlcera , Cicatrização , Adulto Jovem
9.
Medicine (Baltimore) ; 99(3): e18764, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32011464

RESUMO

RATIONALE: Epstein-Barr virus (EBV)-associated T-cell lymphoproliferative disorder (LPD) usually occurs in children and young adults. Gastrointestinal involvement is rare. EBV-associated T-cell lymphoproliferative disorder manifesting as intestinal ulcers poses diagnostic challenges clinically and pathologically because of the atypical manifestations. We concluded that some indicators according to our case and literatures, which might be helpful to the diagnosis of EBV-associated LPD manifested as intestinal ulcers. PATIENT CONCERNS: Here we present a 26-year-old man with complaints of diarrhea and abdominal pain that had persisted for 1 year. Multiform and multifocal deep ulcers were discovered in the colonoscopy. Cell atypia was not obvious but colitis with crypt distortion was found in pathology. DIAGNOSES: According to the symptoms, laboratory examinations, colonoscopy and pathology results, Crohn Disease was diagnosed. INTERVENTIONS: Infliximab therapy was initiated based on the diagnosis of Crohn Disease. OUTCOMES: After the fifth course of therapy, intermittent fever and hematochezia occurred. Physical examination revealed swollen tonsils and ulcers, and purulent exudate from the right tonsil and palatoglossal arch were observed. Biopsies obtained through colonoscopy and nasopharyngoscopy demonstrated EBV-associated T-cell proliferation disease (level 3). After that, the tissue sample from the first colonoscopy was reexamined immunohistochemically. The result suggested EBV-associated T-cell proliferation disease (level 1). LESSONS: When we confront with patients with multiform and multifocal deep intestinal ulcers, not only the common diseases such as Crohn Disease and intestinal tuberculosis should be considered, EBV-associated T-cell proliferation disease should be considered as well. Repeated multiple biopsy, gene rearrangement, EBV DNA quantitative analysis result, EBV-encoded RNA(EBER) and experienced pathologists might be helpful to the diagnosis.


Assuntos
Doença de Crohn/virologia , Infecções por Vírus Epstein-Barr/complicações , Transtornos Linfoproliferativos/virologia , Tonsilite/virologia , Úlcera/virologia , Adulto , Colonoscopia , Diagnóstico Diferencial , Humanos , Masculino
11.
Int J Syst Evol Microbiol ; 70(3): 1963-1968, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31985393

RESUMO

A Gram-stain positive, pleomorphic, oxidase-negative, non-motile isolate from the ulcer of a farmed Atlantic salmon (Salmo salar), designated strain T11bT, was subjected to a comprehensive taxonomic investigation. A comparative analysis of the 16S rRNA gene sequence showed highest similarities to the type strains of Pseudarthrobacter siccitolerans (98.1 %) and Arthrobacter methylotrophus and Pseudarthrobacter phenanthrenivorans (both 98.0 %). The highest ANI value observed between the assembled genome of T11bT and the publicly available Pseudarthrobacter and Arthrobacter type strain genomes were 81.15 and 80.99 %, respectively. The major respiratory quinone was menaquinone MK-9(H2). The polyamine pattern contained predominantly spermidine. The polar lipid profile consisted of the major lipids diphosphatidylglycerol, phosphatidylglycerol, monogalactosyl-diacylglycerol and dimannosylglyceride. Minor amouts of trimannosyldiacylglycerol and phosphatidylinositol were also detected. The peptidoglycan was of the type A3α l-Lys-l-Ser-l-Thr-l-Ala (A11.23). In the fatty acid profile, anteiso and iso branched fatty acids predominated (anteiso C15 : 0, iso C16 : 0, anteiso C17 : 0). Moderate to low DNA-DNA similarities, physiological traits as well as unique traits in the fatty acid pattern distinguished strain T11bT from the next related species. All these data point to the fact that strain T11bT represents a novel species of the genus Arthrobacter for which we propose the name Arthrobacter ulcerisalmonis sp. nov. The type strain is T11bT (=CIP 111621T=CCM 8854T=LMG 30632T=DSM 107127T).


Assuntos
Arthrobacter/classificação , Doenças dos Peixes/microbiologia , Filogenia , Salmo salar/microbiologia , Úlcera/microbiologia , Animais , Aquicultura , Arthrobacter/isolamento & purificação , Técnicas de Tipagem Bacteriana , Composição de Bases , Parede Celular/química , Chile , DNA Bacteriano/genética , Ácidos Graxos/química , Hibridização de Ácido Nucleico , Peptidoglicano/química , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Vitamina K 2/análogos & derivados , Vitamina K 2/química
12.
Vasc Endovascular Surg ; 54(3): 288-291, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31896319

RESUMO

We present a case of an 87-year-old female with new-onset hoarseness of unclear etiology. Imaging demonstrated a penetrating aortic ulcer (PAU) in the proximal descending thoracic aorta with an associated pseudoaneurysm that enlarged to a depth of 32 mm over 2 years. This patient was diagnosed with hoarseness being secondary to left recurrent laryngeal nerve (LRLN) palsy, a variant of Ortner syndrome. Patient was treated with endovascular stent-grafting successfully covering of the PAU and pseudoaneurysm with zone 3 proximal landing zone. The patient had moderate improvement in hoarseness after 1 year of follow-up. Endovascular repair is indicated for symptomatic patients with PAUs complicated by enlarging pseudoaneurysms or rupture. Endovascular treatment is effective with low procedural morbidity and mortality. In this case, the PAU and associated pseudoaneurysm at the level of the ligamentum arteriosum caused compression on the LRLN, resulting in a nerve palsy and hoarseness. This case highlights the importance of vascular imaging for patients presenting with unclear etiology of hoarseness or other signs of LRLN palsy. Therefore, aortic arch abnormalities, a variant of Ortner syndrome, even though rare, should be on the differential diagnosis of new onset hoarseness.


Assuntos
Falso Aneurisma/complicações , Aneurisma da Aorta Torácica/complicações , Rouquidão/etiologia , Úlcera/complicações , Paralisia das Pregas Vocais/etiologia , Idoso de 80 Anos ou mais , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular , Procedimentos Endovasculares , Feminino , Rouquidão/diagnóstico , Rouquidão/fisiopatologia , Humanos , Recuperação de Função Fisiológica , Resultado do Tratamento , Úlcera/diagnóstico por imagem , Úlcera/cirurgia , Paralisia das Pregas Vocais/diagnóstico por imagem , Paralisia das Pregas Vocais/fisiopatologia , Qualidade da Voz
13.
Sci Rep ; 10(1): 1349, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31992828

RESUMO

Several studies have demonstrated potential roles for apelin/APJ signaling in the regulation of oxidative stress associated with ischemia-reperfusion (I/R) injury in several organs. Objective was to assess the role of apelin/APJ signaling in the development of pressure ulcers (PUs) formation after cutaneous I/R injury in mice. We identified that cutaneous I/R injury increased the expression of apelin in the skin at I/R site. Administration of apelin significantly inhibited the formation of PUs. The reductions of blood vessels, hypoxic area and apoptosis in I/R site were inhibited by apelin injection. Oxidative stress signals in OKD48 mice and the expressions of oxidative stress related genes in the skin were suppressed by apelin injection. H2O2-induced intracellular ROS and apoptosis in endothelial cells and fibroblasts were suppressed by apelin in vitro. Furthermore, MM07, biased agonist of APJ, also significantly suppressed the development of PUs after cutaneous I/R, and the inhibitory effect of MM07 on PUs formation was higher than that in apelin. We conclude that apelin/APJ signaling may inhibit cutaneous I/R injury-induced PUs formation by protecting the reduction of vascularity and tissue damage via suppression of oxidative stress. Exogenous application of apelin or MM07 might have therapeutic potentials against the development of PUs.


Assuntos
Receptores de Apelina/metabolismo , Apelina/metabolismo , Traumatismo por Reperfusão/metabolismo , Transdução de Sinais , Pele/irrigação sanguínea , Pele/metabolismo , Úlcera/etiologia , Úlcera/metabolismo , Animais , Apelina/genética , Receptores de Apelina/genética , Apoptose/genética , Citocinas/genética , Citocinas/metabolismo , Modelos Animais de Doenças , Imunofluorescência , Expressão Gênica , Camundongos , Estresse Oxidativo , Espécies Reativas de Oxigênio/metabolismo , Traumatismo por Reperfusão/etiologia , Traumatismo por Reperfusão/patologia , Úlcera/patologia
14.
Harefuah ; 159(1): 21-24, 2020 Jan.
Artigo em Hebraico | MEDLINE | ID: mdl-31930802

RESUMO

INTRODUCTION: We report a case of a patient who presented with bilateral chronic painful necrotic leg ulcers. A skin biopsy revealed histopathological findings compatible with calciphylaxis, a rare phenomenon accompanied by high morbidity and mortality. Treatment options are limited and are based mainly on case reports and small series, so further research is needed in this area. This case highlights the importance of a skin biopsy in the diagnosis of chronic ulcers.


Assuntos
Calciofilaxia , Úlcera da Perna/diagnóstico , Biópsia , Humanos , Necrose , Úlcera
16.
Int J Radiat Oncol Biol Phys ; 106(3): 464-471, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31697990

RESUMO

PURPOSE: Our purpose was to assess the feasibility, safety, and efficacy of stereotactic ablative radiation therapy (SAbR) as an alternative for intracavitary/interstitial brachytherapy boost for locally advanced cervical cancer (LACC) after initial chemoradiation. METHODS AND MATERIALS: A single arm institutional phase II study of SAbR as a boost for LACC was conducted. Eligible patients had LACC FIGO 2009 stage IB2-IVB, performance status 0 to 3, and one of the following: medically unfit or refused intracavitary or tumor extent required interstitial brachytherapy for coverage. The cervix planning target volume boost (PTVboost) received 28 Gy in 4 fractions. RESULTS: The study was closed with 15 of 21 patients completed owing to concern for toxicity. Median follow-up for this cohort was 19 months. Patients had predominantly advanced stage (III-IV, 53%) with median Charlson comorbidity score of 4. Most tumors were large with a median SAbR boost PTV size of 139 cc (range, 51-268 cc). Tumor size and patient comorbidities probably contributed to the lower-than-expected 2-year local control, progression free, and overall survival of 70.1%, 46.7%, and 53.3%, respectively. The SAbR boost 2 year cumulative grade ≥ 3 toxicity of 26.7% was predominantly rectal (ulcer/fistula).The median SAbR PTV volume was 225 cc versus 95 cc for patients with and without grade ≥ 3 toxicity. On dosimetric analysis, only the percentage of rectal circumference receiving 15 Gy (PRC15) for the SAbR boost was associated with development of grade 3 ulcer or rectovaginal fistula (P = .04), with PRC15 > 62.7% being the strongest predictor of toxicity (AUC, 0.93; sensitivity, 100%; specificity, 90%). CONCLUSIONS: In this SAbR boost series suboptimal outcomes were probably related to patient selection and very large tumor volume. This approach may still be considered in patients with smaller tumors unable to undergo standard brachytherapy for cervix cancer.


Assuntos
Radiocirurgia/métodos , Neoplasias do Colo do Útero/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Braquiterapia , Quimiorradioterapia , Término Precoce de Ensaios Clínicos , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Avaliação de Estado de Karnofsky , Pessoa de Meia-Idade , Intervalo Livre de Progressão , Estudos Prospectivos , Radiocirurgia/efeitos adversos , Doenças Retais/etiologia , Fístula Retovaginal/etiologia , Reto/efeitos da radiação , Segurança , Sensibilidade e Especificidade , Carga Tumoral , Úlcera/etiologia , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/terapia
20.
Nat Prod Res ; 34(4): 541-544, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30362366

RESUMO

The rhizomes of Bergenia ciliata (B. ciliata, Family: Saxifragaceae) are widely used for treating gastric ulcers in folk medicine in Asia. It was hypothesized that anti-ulcer activity of B. ciliata is due to its anti-Helicobacter pylori (H. pylori) activity. The anti-H. pylori activity was investigated on six clinical bacterial isolates using agar well-diffusion and broth micro-dilution methods. The anti-H. pylori activity of amoxicillin (standard) was the highest (Zone of inhibition; ZI = 25 mm, minimum inhibitory concentration; MIC=0.125 µg/µL) whereas among all the extracts of the rhizomes, methanol extract showed the highest activity (ZI = 16 mm, MIC = 12.50 µg/µL). Bioassay guided isolation of methanol extract using chromatographic and crystallization techniques isolated bergenin (ZI = 21mm, MIC = 0.391µg/µL) as constituent responsible for anti-H. pylori activity. The present study describes for the first time anti-H. pylori activity and possible mechanism of anti-ulcer properties of rhizomes of B. ciliata.


Assuntos
Benzopiranos/isolamento & purificação , Helicobacter pylori/efeitos dos fármacos , Rizoma , Saxifragaceae/química , Úlcera/tratamento farmacológico , Antibacterianos/isolamento & purificação , Antibacterianos/farmacologia , Ásia , Benzopiranos/uso terapêutico , Humanos , Medicina Tradicional , Testes de Sensibilidade Microbiana , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Úlcera Gástrica/tratamento farmacológico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA