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1.
Vet Clin North Am Small Anim Pract ; 49(6): 981-991, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31581985

RESUMO

Surgery is the mainstay of therapy for canine and human solid cancers. Alarmingly, evidence suggests that the process of surgery may exacerbate metastasis and accelerate the kinetics of cancer progression. Understanding the mechanisms by which cancer progression is accelerated as a result of surgery may provide pharmacologic interventions. This review discusses surgery-induced cancer progression. It focuses on immunomodulatory properties of anesthesia and opioids and evidence that studies evaluating the role of opioids in tumor progression are indicated. It concludes by discussing why companion animals with spontaneously arising cancer are an ideal model for clinical trials to investigate this phenomenon.


Assuntos
Analgésicos Opioides/uso terapêutico , Doenças do Cão/tratamento farmacológico , Manejo da Dor/veterinária , Dor/veterinária , Animais , Progressão da Doença , Cães , Metástase Neoplásica , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Neoplasias/cirurgia , Neoplasias/veterinária , Dor/tratamento farmacológico , Manejo da Dor/métodos , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/veterinária
2.
Medicine (Baltimore) ; 98(41): e17540, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593132

RESUMO

To analyze the clinicopathological characteristics of pelvic masses after hysterectomy for benign diseases, and to analyze the related factors of benign and malignant pelvic masses.This study retrospectively analyzed the patients undergone reoperation for pelvic mass subsequently to hysterectomy for benign disease from January 2012 to December 2016 in Peking Union Medical College Hospital.A total of 247 patients were enrolled in this study, of which 34.01% were diagnosed with malignant tumors, and 65.99% benign tumors. Comparing the clinicopathological data of patients with benign and malignant pelvic masses, significant differences were found between the 2 groups with regard to their ages of having hysterectomy and pelvic mass resection, and the time intervals between the onset of pelvic mass and hysterectomy. In addition, patients with malignant masses tended to complain of abdominal distension and abdominal pain, while most of those with benign masses were diagnosed during physical examination. Patients with malignant pelvic masses had medical imagines of mixed masses, extraovarian derivation, as well as elevated carbohydrate antigen-125 (CA 125). Multivariate analysis showed that ages of having hysterectomy, physical examination results, abnormal defecation, cystic and solid masses, and elevated CA 125 level were independent risk factors for benign and malignant pelvic masses.For patients having pelvic masses following hysterectomy for benign diseases, if they had hysterectomy later in their lives, and their masses were not found during physical examination, and had abnormal defecation, mixed cystic solid mass as well as elevated serum CA 125, it is suggested that special attention should be paid to the possibility of malignant tumors.


Assuntos
Histerectomia/métodos , Neoplasias/cirurgia , Neoplasias Pélvicas/cirurgia , Adulto , Idoso , Antígeno Ca-125/sangue , Defecação/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neoplasias/patologia , Neoplasias Pélvicas/epidemiologia , Neoplasias Pélvicas/metabolismo , Neoplasias Pélvicas/patologia , Reoperação , Estudos Retrospectivos , Fatores de Risco
3.
Adv Gerontol ; 32(3): 397-404, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31512427

RESUMO

The cancer incidence increase in elderly patients determines the actuality of this study, because oncological illnesses are often accompanied by mental disturbances. This article considers clinical psychological risk factors of the posttraumatic stress disorder (PTSD) onset in prostate and rectal cancer elderly patients after surgical treatment. The study results showed that lack of social support, deficit of the successful stress coping experience in the past, maladaptive internal disease model, and destructive personality profile proved to be statistically significant risk factors and consequently psychotherapeutic interventions targets in PTSD treatment and prevention. Consideration of the elderly oncology patient clinical, psychological and social characteristics allows to elaborate effective personalized strategies of the complex medical-psychological care in geriatric medicine.


Assuntos
Neoplasias , Transtornos de Estresse Pós-Traumáticos , Adaptação Psicológica , Idoso , Comorbidade , Humanos , Masculino , Neoplasias/complicações , Neoplasias/reabilitação , Neoplasias/cirurgia , Apoio Social , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/reabilitação
4.
Ther Umsch ; 76(4): 199-207, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31498040

RESUMO

Principles of modern oncologic surgery Abstract. A substantial proportion of patients seeking surgery suffer from malignant tumors, leading to big challenges for surgeons. The diversity of oncological disease patterns has become more complex in recent years, partly due to advances in molecular pathological diagnostics. As a result, a simple and universally valid treatment concept is not possible. Interdisciplinary therapy must concentrate on identifying and localizing the primary tumor, treating each case individually in accordance with its stage. By the same token, the fundamental objective of a complete resection of the tumor together with its lymph nodes must be pursued in order to reach a high cure rate. Surgical therapy is still an indispensable part of modern oncological treatment - despite rapid progress in conservative oncology. In the last decade a trend towards laparoscopic surgery, partially even in robotic assisted procedures, has evolved. Thus perioperative morbidity and mortality have been reduced due to less invasive surgical techniques. Even at an advanced stage of cancer with metastases a therapy approach involving surgery with curative intention has been established for many types of malignant tumors. At the beginning of any treatment, the therapy concept must be planned within the framework of an interdisciplinary tumor conference. Likewise in palliative oncology, surgery is of importance. This is particularly the case with inaccessible gastrointestinal tumors. By employing bypass procedures, quality of life can be improved considerably, when every other therapy option has been exhausted. The following article aims to offer an overview of the principles of oncological surgery.


Assuntos
Neoplasias , Humanos , Neoplasias/cirurgia , Complicações Pós-Operatórias , Qualidade de Vida , Procedimentos Cirúrgicos Robóticos , Resultado do Tratamento
5.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(9): 869-875, 2019 Sep 25.
Artigo em Chinês | MEDLINE | ID: mdl-31550827

RESUMO

Objective: To summarize the characteristics of abdominal-pelvic unplanned reoperation (URO) in a cancer hospital. Methods: Retrospectively descriptive cohort research was adopted. The classification of diseases was based on ICD-10, and surgical classification was based on ICD-9-CM-3. Medical record summary database from 2008 to 2018 in Beijing Cancer Hospital was collected, and all URO information of abdominal-pelvic surgery was retrieve. The time of URO, disease type, surgery type and cause were statistically analyzed. Distribution of main disease incidence and constituent ratio, and the application of major surgery and surgery type composition ratio were analyzed as well. Results: From 2008 to 2018, a total of 46854 cases underwent abdominal-pelvic surgery (including gastrointestinal, hepatic-biliary-pancreatic, gynecological, urological, or esophageal cancer surgery) and 713 patients received URO (1.52%), including 486 males and 227 females (2.14:1.00) with a mean age of (58.1±12.2) years. A total of 246 patients (34.50%) had comorbidity, and with comorbidity: without comorbidity was 1.13:1.00. The hospital stay was (44.5±43.0) days, and the total cost was (178000±112000) yuan. There were 22 deaths (3.09%). The median interval between URO and the first operation was 8 (0 to 131) days. The highest rate of URO was 2.45% (89/3629) in 2012, while the lowest was 0.95% (53/5596) in 2015. The top 3 major cancer types of URO included colorectal cancer (222 cases, 31.14%), gastric cancer (166 cases, 23.28%) and esophageal cancer (45 cases, 6.31%). The cancer types with the highest URO rate included pancreatic cancer (3.97%, 30/756), gastric cancer (1.81%, 166/9171) and colorectal cancer (1.80%, 222/12333). The top 3 surgical procedures resulting in URO were rectal resection (109 cases, 15.29%), total gastrectomy (79 cases, 11.08%), and total pancreatectomy (64 cases, 8.98%). Focusing on 497 URO cases from 2012 to 2018, 465 cases (93.56%) followed relatively difficult grade III and IV surgery, while only 32 cases (6.44%) followed grade I and II surgery. The top 5 main causes of URO were bleeding (225 cases, 31.56%), anastomotic leak (225 cases, 31.56%), infection (89 cases, 12.48%), intestinal obstruction (53 cases, 7.43%), and wound dehiscence (35 cases, 4.91%), adding up to a total of 87.94% of all URO. Conclusion: This study summarizes the epidemiology of abdominal - pelvic URO in our cancer institution, providing the solid baseline for future investigation of URO and the subsequent formulation of corresponding prevention and intervention measures.


Assuntos
Institutos de Câncer , Neoplasias , Reoperação , Universidades , Idoso , Institutos de Câncer/estatística & dados numéricos , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Neoplasias/cirurgia , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Universidades/estatística & dados numéricos
6.
Rozhl Chir ; 98(8): 308-311, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31462051

RESUMO

The following review is dedicated to the impact of psychological factors on the genesis and development of malignant diseases. People suffering from stress, anxiety and depression have a higher risk of tumour occurrence and its faster growth. The prognosis is also influenced by the marital status; married patients have a better overall survival and cancer-specific survival compared to unmarried patients.


Assuntos
Depressão , Neoplasias , Oncologia Cirúrgica , Humanos , Estado Civil , Neoplasias/psicologia , Neoplasias/cirurgia , Prognóstico
7.
Anticancer Res ; 39(8): 4253-4258, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366514

RESUMO

Different entities can be the cause of scalp neoplasia. In a phenotype with multiple cystic scalp lesions, the diagnosis must be made with particular caution because the appearance of apparently benign tumors does not necessarily correspond to the biological behaviour of the lesions. This case report describes diagnosis and therapy of a patient with multiple cystic tumors confined to the scalp. Diagnosis of benign lesions all over the scalp allowed an aesthetically pleasing surgical treatment result. Long-term follow-up control was offered to the patient because the histological diagnosis identified further small tumors of the same type as the large lesions, so further neoplasms are likely to develop.


Assuntos
Cisto Epidérmico/cirurgia , Neoplasias/cirurgia , Neoplasias Cutâneas/cirurgia , Adulto , Cisto Epidérmico/diagnóstico , Cisto Epidérmico/diagnóstico por imagem , Cisto Epidérmico/fisiopatologia , Feminino , Humanos , Neoplasias/diagnóstico , Neoplasias/diagnóstico por imagem , Neoplasias/fisiopatologia , Couro Cabeludo/diagnóstico por imagem , Couro Cabeludo/fisiopatologia , Couro Cabeludo/cirurgia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/fisiopatologia
8.
Presse Med ; 48(7-8 Pt 2): e219-e231, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31447333

RESUMO

Image-guided ablation is performed by percutaneously introducing ablation probes to deliver energy into a tumor to destroy it in a controlled and localized fashion. Ablation modalities can be broadly classified as thermal or non-thermal based on the mechanism of tumor destruction and are performed using different types of image guidance for planning, delivering and follow-up of the treatment. Ablation is performed in a minimally invasive fashion, providing greater residual organ preservation with minimal morbidity to the patient. Image-guided ablation is being used in the clinic for the treatment of primary and metastatic tumors, and this article reviews state of the art for the treatment of malignancies in the liver, lung, kidney and musculoskeletal tissue.


Assuntos
Ablação por Cateter/métodos , Neoplasias/cirurgia , Cirurgia Assistida por Computador/métodos , Ablação por Cateter/efeitos adversos , Tecido Conjuntivo/patologia , Tecido Conjuntivo/cirurgia , Humanos , Rim/patologia , Rim/cirurgia , Fígado/patologia , Fígado/cirurgia , Pulmão/patologia , Pulmão/cirurgia , Sistema Musculoesquelético/patologia , Sistema Musculoesquelético/cirurgia , Neoplasias/diagnóstico , Neoplasias/patologia , Especificidade de Órgãos , Complicações Pós-Operatórias/etiologia , Cirurgia Assistida por Computador/efeitos adversos , Resultado do Tratamento
9.
J Clin Pathol ; 72(10): 689-695, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31262953

RESUMO

AIMS: Rapid procurement of a wide variety of metastatic and primary cancers and normal tissues after death through rapid autopsy opens largely unexplored avenues in cancer research. We describe a high-volume rapid research autopsy programme at a large academic medical centre. METHODS: Advanced-stage cancer patients, most commonly inpatients in palliative care facilities, were approached to participate in a cancer research autopsy programme with the goal of acquiring multidimensionally annotated tissue for cancer research. On death of an enrolled patient, a predetermined notification plan was enacted, with the medical oncologist/clinical research coordinator informing a team of pathologists, researchers and allied staff. Quality assurance metrics were measured. Thereafter, tissues were annotated in a tissue bioinformatics database and linked to electronic patient records. All banked tissues were reviewed for tumour integrity, including DNA and RNA quality. RESULTS: Over 100 rapid research autopsies from diverse cancer sites were performed, and specimens were procured and annotated with detailed clinical information, including treatment and response. Tissues were successfully enabling studies of tumour immunology, xenografts, genomics and proteomics. CONCLUSIONS: Large-scale rapid procurement and biobanking of cancer tissues from a rapid autopsy programme is feasible. Multidisciplinary integration between health and administrative staff from medical oncology, palliative care, pathology and biospecimen sciences is critical for the success of this challenging endeavour.


Assuntos
Oncologia , Neoplasias/patologia , Patologia Cirúrgica , Bancos de Tecidos , Adulto , Idoso , Idoso de 80 Anos ou mais , Autopsia , Feminino , Genômica , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/cirurgia , Cuidados Paliativos , Proteômica , Adulto Jovem
10.
J Cancer Res Clin Oncol ; 145(9): 2199-2209, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31309302

RESUMO

PURPOSE: Radiofrequency (RF) ablation therapy is of great interest in cancer therapy as it is non-ionizing radiation and can effectively penetrate into the tissue. However, the current RF ablation technique is invasive that requires RF probe insertion into the tissue and generates a non-specific heating. Recently, RF-responsive nanomaterials such as gold nanoparticles (AuNPs) and iron oxide nanoparticles (IONPs) have led to tremendous progress in this area. They have been found to be able to absorb the RF field and induce a localized heating within the target, thereby affording a non-invasive and tumor-specific RF ablation strategy. In the present study, for the first time, we used a hybrid core-shell nanostructure comprising IONPs as the core and AuNPs as the shell (IO@Au) for targeted RF ablation therapy. Due to the magnetic core, the nanohybrid can be directed toward the tumor through a magnet. Moreover, IONPs enable the nanohybrid to be used as a magnetic resonance imaging (MRI) contrast agent. RESULTS: In vitro cytotoxicity experiment showed that the combination of IO@Au and 13.56-MHz RF field significantly reduced the viability of cancer cells. Next, during an in vivo experiment, we demonstrated that magnetically targeting of IO@Au to the tumor and subsequent RF exposure dramatically suppressed the tumor growth. CONCLUSION: Therefore, the integration of targeting, imaging, and therapeutic performances into IO@Au nanohybrid could afford the promise to improve the effectiveness of RF ablation therapy.


Assuntos
Ablação por Cateter/métodos , Compostos Férricos/química , Ouro/química , Hipertermia Induzida/métodos , Nanopartículas de Magnetita/uso terapêutico , Neoplasias/cirurgia , Ablação por Radiofrequência/métodos , Animais , Compostos Férricos/uso terapêutico , Ouro/uso terapêutico , Imagem por Ressonância Magnética/métodos , Nanopartículas de Magnetita/química , Masculino , Nanopartículas Metálicas/química , Nanopartículas Metálicas/uso terapêutico , Camundongos , Camundongos Endogâmicos BALB C , Terapia de Alvo Molecular/métodos , Nanocompostos/química , Nanocompostos/uso terapêutico , Nanoconchas/química , Nanoconchas/uso terapêutico , Neoplasias/patologia , Células Tumorais Cultivadas
11.
Medicine (Baltimore) ; 98(27): e16040, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277097

RESUMO

BACKGROUND: Intraoperative blood salvage as a blood-saving strategy has been widely used in surgery. Considering its theoretic risk of malignant tumor cells being reinfused and the corresponding blood metastases, the safety of intraoperative blood salvage in cancer surgery remains controversial. METHODS: Following the Preferred Reporting Items for Systemic Review and Meta-Analysis (PRISMA), we searched the Cochrane Library, MEDLINE and EMBASE to November 2017. We included only studies comparing intraoperative blood salvage with allogeneic blood transfusion. RESULTS: This meta-analysis included 9 studies with 4354 patients with 1346 patients in the intraoperative blood salvage group and 3008 patients in the allogeneic blood transfusion group. There were no significant differences in the 5-year overall survival outcome (odds ratio [OR] 1.12; 95% confidence interval [CI], 0.80-1.58), 5-year disease-free survival outcome (OR 1.08; 95% CI 0.86-1.35), or 5-year recurrence rate (OR 0.86; 95% CI 0.71-1.05) between the 2 study groups. Subgroup analysis also showed no significant differences in the 5-year overall survival outcome (OR 0.97; 95% CI 0.57-1.67) of hepatocellular carcinoma patients in liver transplantation. CONCLUSIONS: For patients with malignant disease, intraoperative blood salvage did not increase the tumor recurrence rate and had comparable survival outcomes with allogeneic blood transfusion.


Assuntos
Transfusão de Sangue Autóloga/efeitos adversos , Recuperação de Sangue Operatório/efeitos adversos , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Recidiva Local de Neoplasia/etiologia , Neoplasias/cirurgia , Estudos Retrospectivos , Análise de Sobrevida
12.
Br J Anaesth ; 123(2): 135-150, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31255291

RESUMO

Surgery is an important treatment modality for the majority of solid organ cancers. Unfortunately, cancer recurrence following surgery of curative intent is common, and typically results in refractory disease and patient death. Surgery and other perioperative interventions induce a biological state conducive to the survival and growth of residual cancer cells released from the primary tumour intraoperatively, which may influence the risk of a subsequent metastatic disease. Evidence is accumulating that anaesthetic and analgesic interventions could affect many of these pathophysiological processes, influencing risk of cancer recurrence in either a beneficial or detrimental way. Much of this evidence is from experimental in vitro and in vivo models, with clinical evidence largely limited to retrospective observational studies or post hoc analysis of RCTs originally designed to evaluate non-cancer outcomes. This narrative review summarises the current state of evidence regarding the potential effect of perioperative anaesthetic and analgesic interventions on cancer biology and clinical outcomes. Proving a causal link will require data from prospective RCTs with oncological outcomes as primary endpoints, a number of which will report in the coming years. Until then, there is insufficient evidence to recommend any particular anaesthetic or analgesic technique for patients undergoing tumour resection surgery on the basis that it might alter the risk of recurrence or metastasis.


Assuntos
Analgesia/métodos , Anestesia/métodos , Neoplasias/cirurgia , Avaliação de Resultados da Assistência ao Paciente , Assistência Perioperatória/métodos , Humanos
13.
Vet Clin North Am Small Anim Pract ; 49(5): 949-966, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31202538

RESUMO

Over the past decade, interventional oncology techniques have become integrated into the treatment plans of companion animals with cancer on a regular basis. Although procedures such as stenting are performed commonly, other less frequently utilized techniques for locoregional therapy, such as embolization and ablation, are emerging and demonstrating promise. Tumor ablation techniques are categorized into two subgroups: chemical ablation and energy-based ablation. Increased utilization of ablation will allow for the determination of specific indications and evaluation of outcomes for these techniques.


Assuntos
Técnicas de Ablação/veterinária , Doenças do Gato/cirurgia , Doenças do Cão/cirurgia , Neoplasias/veterinária , Técnicas de Ablação/métodos , Animais , Gatos , Cães , Neoplasias/cirurgia
14.
J Surg Oncol ; 120(3): 348-358, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31197851

RESUMO

BACKGROUND: We describe a multidisciplinary approach for comprehensive care of amputees with concurrent targeted muscle reinnervation (TMR) at the time of amputation. METHODS: Our TMR cohort was compared to a cross-sectional sample of unselected oncologic amputees not treated at our institution (N = 58). Patient-Reported Outcomes Measurement Information System (NRS, PROMIS) were used to assess postamputation pain. RESULTS: Thirty-one patients underwent amputation with concurrent TMR during the study; 27 patients completed pain surveys; 15 had greater than 1 year follow-up (mean follow-up 14.7 months). Neuroma symptoms occurred significantly less frequently and with less intensity among the TMR cohort. Mean differences for PROMIS pain intensity, behavior, and interference for phantom limb pain (PLP) were 5.855 (95%CI 1.159-10.55; P = .015), 5.896 (95%CI 0.492-11.30; P = .033), and 7.435 (95%CI 1.797-13.07; P = .011) respectively, with lower scores for TMR cohort. For residual limb pain, PROMIS pain intensity, behavior, and interference mean differences were 5.477 (95%CI 0.528-10.42; P = .031), 6.195 (95%CI 0.705-11.69; P = .028), and 6.816 (95%CI 1.438-12.2; P = .014), respectively. Fifty-six percent took opioids before amputation compared to 22% at 1 year postoperatively. CONCLUSIONS: Multidisciplinary care of amputees including concurrent amputation and TMR, multimodal postoperative pain management, amputee-centered rehabilitation, and peer support demonstrates reduced incidence and severity of neuroma and PLP.


Assuntos
Cotos de Amputação/inervação , Amputação/métodos , Amputação/reabilitação , Músculo Esquelético/inervação , Neoplasias/cirurgia , Transferência de Nervo/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/reabilitação , Neoplasias Ósseas/cirurgia , Estudos de Coortes , Continuidade da Assistência ao Paciente , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/reabilitação , Osteossarcoma/reabilitação , Osteossarcoma/cirurgia , Equipe de Assistência ao Paciente , Membro Fantasma/prevenção & controle , Sarcoma/reabilitação , Sarcoma/cirurgia , Adulto Jovem
15.
Int J Nanomedicine ; 14: 3893-3909, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31239663

RESUMO

Background: Photothermal and chemotherapy treatment has been frequently studied for cancer therapy; however, chemotherapy is equally toxic to both normal and cancer cells. The clinical application value of most kinds of photothermal transforming agents remains limited, due to their poor degradation and minimal accumulation in tumors. Materials and methods: We reported the synthesis of photothermal transforming agents (MoS2) and chemotherapeutic (doxorubicin, DOX) co-loaded electrospun nanofibers using blend electrospinning for the treatment of postoperative tumor recurrence. Results: Under the irradiation of an 808 nm laser, the as-prepared chitosan/polyvinyl alcohol/MoS2/DOX nanofibers showed an admirable photothermal conversion capability with a photothermal conversion efficiency of 23.2%. These composite nanofibers are in vitro and in vivo biocompatible. In addition, they could control the sustained release of DOX and the generated heat can sensitize the chemotherapeutic efficacy of DOX via enhancing its release rate. Their chemo-/photothermal combined therapy efficiency was systematically studied in vitro and in vivo. Instead of circulating with the body fluid, MoS2 was trapped by the nanofibrous matrix in the tumor and so its tumor-killing ability was not compromised, thus rendering this composite nanofiber a promising alternative for future clinical translation within biomedical application fields. Conclusion: Chitosan/polyvinyl alcohol/MoS2/DOX nanofibers showed an excellent photothermal conversion capability with a photothermal conversion efficiency of 23.2% and can completely inhibit the postoperative tumor reoccurrence.


Assuntos
Dissulfetos/química , Doxorrubicina/uso terapêutico , Molibdênio/química , Nanofibras/química , Nanotecnologia/métodos , Neoplasias/terapia , Fototerapia , Animais , Materiais Biocompatíveis/farmacologia , Morte Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Reagentes para Ligações Cruzadas/química , Doxorrubicina/farmacologia , Liberação Controlada de Fármacos , Células HT29 , Humanos , Camundongos Endogâmicos BALB C , Camundongos Nus , Nanofibras/ultraestrutura , Recidiva Local de Neoplasia/patologia , Neoplasias/sangue , Neoplasias/patologia , Neoplasias/cirurgia , Padrões de Referência , Resultado do Tratamento
16.
Pan Afr Med J ; 32: 83, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31223374

RESUMO

Introduction: Cancer is a growing concern in Mozambique. However, the country has limited facilities and few oncologists. Surgical oncologists are an unmet need. The aim of this study was to assess residents' knowledge in prevalent cancer domains and to identify and characterize prevalent cancers treated by surgery at Maputo Central Hospital, the largest hospital in Mozambique. The expectations were that the findings shall inform the development of a comprehensive curriculum in surgical oncology fellowship fit for the Hospital. Methods: To identify and characterize prevalent cancers, we performed a retrospective analysis of individual cancer patient registries of Maputo Central Hospital (MCH), Mozambique. Information was recorded into data collection sheets and analyzed with SPSS® 21. To assess MCH residents oncologic knowledge, we invited Twenty-six junior residents (49% of all residents) of different specialties to take a 30 item multiple choice written test used elsewhere in previous studies. The test focused on the domains of Basis of oncology, Radiotherapy, Pathology, Chemotherapy, Pain management, Surgical oncology and Clinical Pathway. The test was administered anonymously and without prior notice. We analyzed the overall test and topic performance of residents. Results: The study covered a period of 3 years and 203 patients. The most prevalent malignant tumors treated by general and thoracic surgery in MCH cancer registry were esophageal (7%), female breast (6.5%) and colorectal cancer (2.8%). Globally these malignancies were diagnosed at an advanced stage of the disease and required a multimodal treatment. The mean percent correct score of residents was 37.3%. The dimension with the highest percent correct score were clinical management (46%) and surgical oncology (28%) showed the lowest correct score. Conclusion: In Maputo, Mozambique esophageal, breast and colorectal cancer were the most prevalent malignancies treated, with surgery, by thoracic or general surgery in MCH. The test scores suggest that, among residents, the knowledge in oncology needs to be improved, rendering support to the need of a surgical oncology training tailored to suit the local needs. Specific training should take into account local cancer prevalence, resources, their quality and the support of surgical oncology services with volume and experience.


Assuntos
Competência Clínica , Internato e Residência/normas , Neoplasias/cirurgia , Oncologia Cirúrgica/educação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Currículo , Avaliação Educacional , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Moçambique , Estadiamento de Neoplasias , Neoplasias/epidemiologia , Neoplasias/patologia , Prevalência , Sistema de Registros , Estudos Retrospectivos , Adulto Jovem
17.
Pan Afr Med J ; 32: 90, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31223381

RESUMO

Introduction: Cervical cancer is ranked the 7th most common cancer in the world. Cancer of the cervix is the second most commonly diagnosed cancer after breast cancer and the third leading cause of cancer deaths among females in less developed countries. Incidence rates are highest in countries with low income. Nearly 90% of cervical cancer deaths occur in developing parts of the world. The study researchers therefore, carried out a retrospective study to determine the proportion of cervical cancer among other types of cancer in the cancer registry of the Bamenda Regional Hospital. Methods: The objective of this study was to determine the proportion of cervical cancer among other types of cancers in the cancer registry of the Bamenda Regional Hospital, North West Region of Cameroon from past records. We reviewed all records from the registry of patients who attended the Bamenda Regional Hospital to screen and/or be operated upon for cervical cancer and other types of cancer. Socio-demographic and clinical characteristics of cases were captured using a data collection sheet: age, type of cancer, stage of cancer, type of surgery carried out and date of surgery. Data were entered and analysed in Statistical Package for Social Sciences (SPSS) version 25 software. Results: 59 cancer cases were received in the center between 2012 and 2017. Of these, 31 (52%) had cervical cancer. Most patients who screened positive for cancer of the cervix were of the 50-54 age groups. Most of these patients (47.5%), were received at late stages (stages 3 and 4). Conclusion: Over half (52%) of the patients receiving cancer care in this center have cervical cancer and generally turn up late for management.


Assuntos
Neoplasias/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Camarões/epidemiologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias/patologia , Neoplasias/cirurgia , Sistema de Registros , Estudos Retrospectivos , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia , Adulto Jovem
18.
Anticancer Res ; 39(6): 2711-2714, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31177105

RESUMO

Perioperative oral/dental care has been introduced to cancer surgery patients as perioperative management using a multimodal approach. Several approaches were tested for managing perioperative oral/dental health care in this population. However, while the clinical impact of perioperative oral/dental care on patients with various types of malignancies has been evaluated, most previous studies have used and evaluated data obtained from relatively small sample sizes of fewer than 200 patients from individual institutions. Therefore, the recommendation of perioperative oral/dental care is controversial. Recent studies have shown that perioperative oral/dental care affects the cancer surgery outcomes. In addition, perioperative oral/dental care by dentistry professionals and the number of oral/dental care sessions have been shown to be important for this beneficial effect, even when patients were temporarily intubated. Further studies are, therefore, necessary to establish the optimal perioperative dental/oral care regiment and verify the beneficial effect of perioperative oral/dental care on cancer surgery outcomes. This review summarizes the background, current status, and future perspectives of perioperative oral/dental care for cancer surgery.


Assuntos
Assistência Odontológica/métodos , Neoplasias/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Feminino , Humanos , Masculino , Assistência Perioperatória , Tamanho da Amostra , Resultado do Tratamento
19.
J Surg Oncol ; 120(2): 125-131, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31111506

RESUMO

BACKGROUND: Patient perceptions and preferences related to postoperative surveillance are not yet well defined. METHODS: A cross-sectional analysis of the surveillance practice preferences and attitudes was undertaken based on subgroups derived from clustering participants for measures of well-being, including financial toxicity, emotional, family/social, and functional well-being. RESULTS: Among 212 participants, the average age was 58.1 years and most patients were female (57.1%) and white (90.2%). Common malignancies included melanoma/sarcoma (26.4%), thyroid (25.5%), breast (18.9%), gastrointestinal (18.4%), and lung (7.5%) cancer. Respondents within the highest well-being subgroup rated their perception of communication as being the highest more consistently compared with the other well-being subgroups (P = .005). Participants with the highest level of well-being felt more reassured by follow-up appointments (Subgroup 1, Med = 4.00, interquartile range (IQR) = 0.25 vs subgroup 4, Med = 3.75, IQR = 0.73, P = .023). In contrast, patients with the lowest sense of well-being had the highest level of nervousness related to surveillance (subgroup 1, Med = 1.60, IQR = 1.00 vs subgroup 4, Med = 2.20, IQR = 1.15, P < .001). There were no differences in surveillance frequency preferences among different well-being subgroups. CONCLUSION: Attitudes towards postoperative surveillance varied with regard to perception of provider communication, nervous anticipation, and assuredness depending on overall patient well-being. Providers should attempt to assess patient well-being as part of a tailored approach to postcancer surgery surveillance.


Assuntos
Atitude , Neoplasias/psicologia , Neoplasias/cirurgia , Preferência do Paciente , Vigilância da População , Análise por Conglomerados , Comunicação , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos
20.
Nutrients ; 11(4)2019 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-31010007

RESUMO

Malnutrition is prevalent in surgical patients and leads to comorbidities and a poorer postoperative course. There are no studies that compare the clinical outcomes of implementing a nutrition screening tool in surgical patients with standard clinical practice. An open, non-randomized, controlled study was conducted in general and digestive surgical hospitalized patients, who were either assigned to standard clinical care or to nutrition screening using the Control of Food Intake, Protein, and Anthropometry (CIPA) tool and an associated treatment protocol (n = 210 and 202, respectively). Length of stay, mortality, readmissions, in-hospital complications, transfers to critical care units, and reinterventions were evaluated. Patients in the CIPA group had a higher Charlson index on admission and underwent more oncological and hepatobiliary-pancreatic surgeries. Although not significant, a shorter mean length of stay was observed in the CIPA group (-1.48 days; p < 0.246). There were also fewer cases of exitus (seven vs. one) and fewer transfers to critical care units in this group (p = 0.068 for both). No differences were detected in other clinical variables. In conclusion, patients subjected to CIPA nutrition screening and treatment showed better clinical outcomes than those receiving usual clinical care. The results were not statistically significant, possibly due to the heterogeneity across patient groups.


Assuntos
Cirurgia Geral/métodos , Tempo de Internação , Desnutrição/diagnóstico , Programas de Rastreamento , Avaliação Nutricional , Estado Nutricional , Complicações Pós-Operatórias , Idoso , Idoso de 80 Anos ou mais , Antropometria , Cuidados Críticos , Proteínas na Dieta/administração & dosagem , Doenças do Sistema Digestório/cirurgia , Ingestão de Alimentos , Comportamento Alimentar , Feminino , Humanos , Masculino , Desnutrição/complicações , Desnutrição/dietoterapia , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Mortalidade , Neoplasias/cirurgia , Readmissão do Paciente , Transferência de Pacientes
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