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1.
Crit Rev Oncol Hematol ; 147: 102888, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32018126

RESUMO

BACKGROUND: The purpose of this study was to analyze the efficacy of PARP inhibitor on solid tumors. METHODS: For this study, the following databases were searched for articles published from its inception until July 2019: PubMed, Web of Science, EBSCO, and Cochrane library, of which the main conclusion was the overall survival (OS) and progression-free survival (PFS). RESULTS: We conducted a meta-analysis and the results showed that PARP inhibitor increased the patients' PFS (HR: 0.51, p < 0.001), PFS with BRCA1/2 mutations (HR: 0.32, p < 0.001), OS (HR: 0.74, p < 0.001), OS with BRCA1/2 mutations (HR: 0.78, p = 0.03), complete response (CR) (RR: 1.89, p = 0.10), partial response (PR) (RR: 1.34, p = 0.01), overall response rate (ORR) (RR: 1.42, p = 0.001) respectively. The main adverse events (AEs) observed were decreased appetite. CONCLUSIONS: PARP inhibitors may prolong survival. PARP inhibitors were more favorable for BRCA1/2 mutations in ovarian cancer patients. Additionally, the overall safety factor was controllable.


Assuntos
Antineoplásicos/uso terapêutico , Proteína BRCA1/genética , Proteína BRCA2/genética , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/genética , Inibidores de Poli(ADP-Ribose) Polimerases/uso terapêutico , Adenosina Difosfato Ribose , Inibidores Enzimáticos/farmacologia , Inibidores Enzimáticos/uso terapêutico , Feminino , Humanos , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/patologia , Poli(ADP-Ribose) Polimerases , Prognóstico , Sobrevida , Resultado do Tratamento
2.
Crit Rev Oncol Hematol ; 147: 102887, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32018127

RESUMO

Postmastectomy radiation therapy (PMRT) has been shown to reduce the risk of locoregional recurrence (LRR), in patients with locally advanced breast cancer who are considered of high-risk because of large tumors (>5 cm) or presence of axillary lymph-node involvement, as well as to reduce breast cancer mortality. However, controversy still remains with respect to indication of PMRT in case of early-stages invasive tumors. This review aims to analyze the impact that PMRT has on final results in women with breast tumors in different scenarios that would otherwise be considered as early breast cancer, such as extensive DCIS, tumors without axillary lymph-node involvement or with minimal microscopic nodal-involvement. The existence of risk factors including young age, premenopausal status, and presence of lymphovascular invasion (LVI), high grade or tumor size >2 cm has been associated with an increased risk of LRR in these patients at early-stages and advises to consider PMRT in selected cases.


Assuntos
Neoplasias da Mama/radioterapia , Radioterapia Adjuvante , Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Excisão de Linfonodo , Mastectomia , Futilidade Médica , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Estudos Retrospectivos , Sobrevida
3.
Crit Rev Oncol Hematol ; 147: 102880, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32045847

RESUMO

Post-mastectomy radiation therapy (PMRT) is standard therapy for advanced breast cancer. However, given the lower risk of recurrence, PMRT administration remains controversial in select patients with limited nodal disease. We performed a review of the literature that focuses on the effect of PMRT in breast cancer patients with 1-3 positive lymph nodes, mainly examining loco-regional recurrence (LRR) and overall survival (OS). Most studies, including a large meta-analysis by the EBCTCG, showed a significant improvement in LRR rates among patients receiving PMRT. While most studies demonstrated a trend towards OS improvement, only few studies showed a statistically significant OS or breast cancer-specific survival benefit for PMRT. As such, individualized treatment decisions are recommended, taking into consideration clinicopathological findings. Future studies with large sample sizes and long follow-up times are still needed to better assess the role of PMRT in patients with limited nodal involvement.


Assuntos
Neoplasias da Mama/patologia , Neoplasias da Mama/radioterapia , Linfonodos/patologia , Mastectomia , Neoplasias da Mama/cirurgia , Humanos , Metástase Linfática , Recidiva Local de Neoplasia/prevenção & controle , Estadiamento de Neoplasias , Radioterapia Adjuvante , Estudos Retrospectivos , Risco , Sobrevida
4.
Nonlinear Dynamics Psychol Life Sci ; 24(1): 79-104, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31855552

RESUMO

Psychologists have had a long-standing interest in the connections between group processes and team performance. The biopsychosocial perspective has piqued an interest in the connection between team processes and performance and coordinated and synchronized physiological arousal levels among team members. Studies of synchronization in work teams have been stalled by the lack of a metric that captures the total synchronization within teams of three or more people. This study examined how synchronized physiological arousal does in fact connect to team performance and related group process outcomes by utilizing the SE coefficient developed by Guastello and Peressini. Forty-three groups of 3 to 8 participants (total N = 197) participated in a survival simulation. Synchroniza-tion coefficients were produced for three task segments: watching an orientation video together, an individual decision task, and a group decision task. Primary results showed: (a) Synchronization was greater in larger groups across the three task segments. (b) A combination of the three synchronization coefficients - higher during the team task and lower otherwise - was correlated with higher workload ratings for performance demands, greater team dissatisfaction, and lower demands for time-sharing between the individual and the team.


Assuntos
Processos Grupais , Análise e Desempenho de Tarefas , Tomada de Decisões , Humanos , Sobrevida , Carga de Trabalho
5.
Expert Opin Investig Drugs ; 28(11): 941-949, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31590579

RESUMO

Introduction: Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the burden of disease is increasing globally. Until recently, systemic therapies for HCC were limited and prognosis for advanced disease generally poor.Area covered: This article describes some recent phase I and II clinical trials for the treatment of HCC. We performed a search on Pubmed with keywords hepatocellular carcinoma, phase I clinical trial, phase II clinical trial, and immunotherapy. We also searched https://clinicaltrials.gov and identified relevant trials listed as active. Studies in progress or recently reported were conducted using novel therapies based on targets identified through molecular profiling of tumors or based on insights into immune system dysregulation in HCC. We also identified studies using drugs targeting recently discovered biomarkers such as endoglin or aldo-keto reductase 1c3. The major outcomes were safety and efficacy as measured by response rate, progression-free survival or overall survival.Expert opinion: HCC is a heterogeneous disease resulting from aberrations in intracellular signaling and immune system dysregulation. Thus, a multisystem approach will be required to deliver personalized therapy. Combination therapies are likely to be future options; it is also possible that modulation of the microbiome might form part of future treatment paradigms.


Assuntos
Antineoplásicos/administração & dosagem , Carcinoma Hepatocelular/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , Animais , Antineoplásicos/efeitos adversos , Antineoplásicos/farmacologia , Biomarcadores Tumorais/metabolismo , Carcinoma Hepatocelular/patologia , Drogas em Investigação/administração & dosagem , Drogas em Investigação/efeitos adversos , Drogas em Investigação/farmacologia , Humanos , Imunoterapia , Neoplasias Hepáticas/patologia , Terapia de Alvo Molecular , Sobrevida
6.
Med Sci Monit ; 25: 7826-7835, 2019 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-31626606

RESUMO

BACKGROUND Previous studies have reported that ARHGEF39 might be frequently upregulated in different cancer types and relevant to cancer progression. However, the expression pattern and clinicopathological features of ARHGEF39 in patients with hepatocellular carcinoma (HCC) needs further exploration. MATERIAL AND METHODS ARHGEF39 expression level of HCC in The Cancer Genome Atlas (TCGA) dataset was analyzed. Quantitative real-time polymerase chain reaction and immunohistochemistry were employed to determine ARHGEF39 mRNA and protein levels in our own study collected HCC tissues and matched non-cancerous tissues. Moreover, the association of ARHGEF39 expression with the clinicopathological factors and prognosis of HCC were investigated. RESULTS The level of ARHGEF39 in HCC tissues was significantly higher than that in adjacent normal tissues (P<0.05) from TCGA database. High level of ARHGEF39 was a significant prognostic factor of poor overall survival (OS) (TCGA, P=0.006). Consistently, the expression levels of ARHGEF39 mRNA and protein in HCC specimens were significantly higher than those in adjacent liver specimens (P<0.05) from our cohort. Further analysis revealed that high ARHGEF39 level was significantly associated with poor OS (P<0.001) and short disease-free survival (DFS) (P<0.001). Cox multivariate analysis indicated that ARHGEF39 was an independent, unfavorable prognostic factor (P=0.000) of OS and DFS. CONCLUSIONS ARHGEF39 might act as an oncogene in the progression of HCC and might serve as a promising potential prognostic indicator and therapeutic target for HCC.


Assuntos
Carcinoma Hepatocelular/genética , Fatores de Troca de Nucleotídeo Guanina Rho/genética , Fatores de Troca de Nucleotídeo Guanina Rho/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/genética , Carcinoma Hepatocelular/metabolismo , Linhagem Celular Tumoral , Bases de Dados Genéticas , Intervalo Livre de Doença , Feminino , Regulação Neoplásica da Expressão Gênica/genética , Fatores de Troca do Nucleotídeo Guanina/genética , Fatores de Troca do Nucleotídeo Guanina/metabolismo , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Fígado/metabolismo , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/metabolismo , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Sobrevida , Transcriptoma/genética
7.
Nutr. hosp ; 36(5): 1067-1073, sept.-oct. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184628

RESUMO

Introducción: la hipovitaminosis D tiene una prevalencia del 50,4% en personas mayores, población en aumento a nivel mundial, en la cual la deficiencia de vitamina D (< 30 mg/dl) podría ser un factor de riesgo para disminuir la sobrevida de esta población. Objetivo: determinar si niveles séricos de vitamina D menores a 30 ng/ml tienen impacto en la sobrevida, medida a través de la mortalidad general y por causas específicas, considerando un periodo de seguimiento de nueve años en personas mayores autovalentes con capacidades cognitivas adecuadas. Método: corresponde a un estudio retrospectivo longitudinal, con un seguimiento de nueve años. Se realizó el seguimiento a 418 personas mayores de la comuna de Santiago, los cuales fueron incorporados el año 2004 para participar en un estudio referente a la suplementación de vitamina D y fuerza muscular. Resultados: niveles de vitamina D bajo 30 ng/dl aumentan en casi tres veces la probabilidad de fallecer (OR = 2,77; IC = 1,81-3,85), mientras que igual nivel de vitamina D se asocia a un doble riesgo de morir por causas cardiovasculares (OR = 1,78; IC = 1,21-2,09) en el modelo no ajustado. Para la mortalidad por cáncer y por caídas no se obtuvo ningún resultado significativo. La vitamina D no actuaría como factor protector ante la mortalidad. Conclusión: el poseer niveles de vitamina D bajo 30 ng/dl podría ser un factor de riesgo de mortalidad general


Background: hypovitaminosis D has a prevalence of 50,4% in older persons. This population has grown globally in an impressive way during the last 20 years. In addition, the deficiency of vitamin D (< 30 ng/ml) could raise the risk of mortality in this population. Objectives: to know whether vitamin D levels less than 30 ng/ml have an impact on mortality for overall causes, cardiovascular causes, cancer or injuries (falls) in a follow-up period of nine years in elderly subjects. Methods: a retrospective longitudinal study with nine years period of observation; 418 elderly subjects were followed, and they were recruited in 2004 to participate in a study about vitamin D supplementation and muscle strength. Results: vitamin D levels below 30 ng/dl increase by almost three times the probability of dying (OR = 2.77, IC = 1.81-3.85), while the same level of vitamin D is associated with a double risk of dying from cardiovascular causes (OR = 1.78, CI = 1.21-2.09) in the unadjusted model. For cancer mortality and falls, no significant results were obtained. Vitamin D would not act as a protective factor against mortality. Conclusions: vitamin D levels less than 30 ng/ml could be a risk factor for general mortality


Assuntos
Humanos , Composição Corporal/efeitos dos fármacos , Deficiência de Vitamina D/epidemiologia , Sarcopenia/epidemiologia , Sobrevida , Fatores de Risco , Estado Nutricional , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/dietoterapia , Estudos Retrospectivos , Densitometria , Índice de Massa Corporal , Estudos Longitudinais , Causas de Morte , Deficiência de Vitaminas/epidemiologia , Chile/epidemiologia
8.
Elife ; 82019 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-31549964

RESUMO

Early life adversity can affect an individual's health, survival, and fertility for many years after the adverse experience. Whether early life adversity also imposes intergenerational effects on the exposed individual's offspring is not well understood. We fill this gap by leveraging prospective, longitudinal data on a wild, long-lived primate. We find that juveniles whose mothers experienced early life adversity exhibit high mortality before age 4, independent of the juvenile's own experience of early adversity. These juveniles often preceded their mothers in death by 1 to 2 years, indicating that high adversity females decline in their ability to raise offspring near the end of life. While we cannot exclude direct effects of a parent's environment on offspring quality (e.g., inherited epigenetic changes), our results are completely consistent with a classic parental effect, in which the environment experienced by a parent affects its future phenotype and therefore its offspring's phenotype.


Assuntos
Papio , Sobrevida , Animais , Estudos Longitudinais , Estudos Prospectivos , Análise de Sobrevida
9.
Elife ; 82019 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-31500699

RESUMO

Queens of social insects make all mate-choice decisions on a single day, except in honeybees whose queens can conduct mating flights for several days even when already inseminated by a number of drones. Honeybees therefore appear to have a unique, evolutionarily derived form of sexual conflict: a queen's decision to pursue risky additional mating flights is driven by later-life fitness gains from genetically more diverse worker-offspring but reduces paternity shares of the drones she already mated with. We used artificial insemination, RNA-sequencing and electroretinography to show that seminal fluid induces a decline in queen vision by perturbing the phototransduction pathway within 24-48 hr. Follow up field trials revealed that queens receiving seminal fluid flew two days earlier than sister queens inseminated with saline, and failed more often to return. These findings are consistent with seminal fluid components manipulating queen eyesight to reduce queen promiscuity across mating flights.


Assuntos
Abelhas/fisiologia , Fatores Biológicos/metabolismo , Voo Animal , Sêmen/química , Comportamento Sexual Animal , Sobrevida , Visão Ocular/efeitos dos fármacos , Animais , Eletrorretinografia , Análise de Sequência de RNA
10.
World Neurosurg ; 131: e379-e391, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31369883

RESUMO

BACKGROUND: Pineal region tumors represent challenging surgical lesions with wide ranges of survival reported in different surgical series. In this article, we emphasize the role of complete microsurgical resection (CMR) to obtain a favorable long-term outcome of pineal region tumors. METHODS: We report a retrospective study of pineal region tumors operated on in Helsinki Neurosurgery between 1997 and 2015. Information was obtained from the hospital records, and an evaluation of the Finnish population register was conducted in July 2018 to determine the current status of the patients. RESULTS: A total of 76 pineal region tumors were operated on. The survival was 62% at a mean follow-up of 125 ± 105 months (range, 0-588 months), and the disease-related mortality was limited to 14 patients (18.4%). Up to July 2018, 29 patients had died. Two patients died 1 and 3 months after surgery of delayed thalamic infarctions, 12 patients of disease progression, and 15 had non-disease-related deaths. Only 1 patient was lost in the long-term follow-up. Ten of 14 disease-related deaths occurred during the first 5 years of follow-up: 5 diffuse gliomas, 3 germ cell tumors, 1 grade II-III pineal parenchymal tumor of intermediate differentiation, and 1 meningioma. CMR was linked to better tumor-free survival and long-term survival, with the exception of diffuse gliomas. CONCLUSIONS: CMR, in the setting of a multidisciplinary management of pineal region tumors, correlates with favorable survival and with minimal mortality. Surgically treated grade II-IV gliomas constitute a particular group with high mortality within the first 5 years independently of the microsurgical resection.


Assuntos
Neoplasias Encefálicas/cirurgia , Glioma/cirurgia , Neoplasias Meníngeas/cirurgia , Meningioma/cirurgia , Neoplasias Embrionárias de Células Germinativas/cirurgia , Glândula Pineal/cirurgia , Pinealoma/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Astrocitoma/mortalidade , Astrocitoma/patologia , Astrocitoma/cirurgia , Neoplasias Encefálicas/mortalidade , Neoplasias Encefálicas/patologia , Quimioterapia Adjuvante , Criança , Pré-Escolar , Feminino , Finlândia , Glioma/mortalidade , Glioma/patologia , Humanos , Lactente , Masculino , Neoplasias Meníngeas/mortalidade , Neoplasias Meníngeas/patologia , Meningioma/mortalidade , Meningioma/patologia , Microcirurgia , Pessoa de Meia-Idade , Neoplasias Embrionárias de Células Germinativas/mortalidade , Neoplasias Embrionárias de Células Germinativas/patologia , Procedimentos Neurocirúrgicos , Glândula Pineal/patologia , Pinealoma/mortalidade , Pinealoma/patologia , Radioterapia Adjuvante , Estudos Retrospectivos , Sobrevida , Carga Tumoral , Adulto Jovem
12.
Expert Rev Clin Pharmacol ; 12(9): 841-849, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31454267

RESUMO

Introduction: The receptor tyrosine kinase FLT3 is the most commonly mutated gene in acute myeloid leukemia (AML). FLT3-internal tandem duplication mutations are associated with an increased risk of relapse, and a number of small molecule inhibitors of FLT3 have been developed. The highly potent and selective FLT3 kinase inhibitor gilteritinib is the first tyrosine kinase inhibitor approved as monotherapy for the treatment of relapsed and/or refractory FLT3-mutated AML. Areas covered: We review the biology and prognostic significance of FLT3 mutations in AML and discuss the pharmacology, clinical efficacy, and toxicity profile of gilteritinib. We also summarize important differences among the various FLT3 inhibitors that are currently approved or under development and highlight areas of ongoing research. Expert opinion: Gilteritinib has been shown to improve survival compared to salvage chemotherapy in relapsed and/or refractory FLT3-mutated AML. Gilteritinib is orally available with a favorable toxicity profile and as such is quickly becoming the standard of care for this patient population. Ongoing clinical trials are evaluating gilteritinib in combination with frontline chemotherapy, in combination with other agents such as venetoclax and azacitidine for patients who are ineligible for standard induction therapy, and as a maintenance agent.


Assuntos
Compostos de Anilina/administração & dosagem , Antineoplásicos/administração & dosagem , Leucemia Mieloide Aguda/tratamento farmacológico , Pirazinas/administração & dosagem , Compostos de Anilina/efeitos adversos , Compostos de Anilina/farmacologia , Antineoplásicos/efeitos adversos , Antineoplásicos/farmacologia , Humanos , Leucemia Mieloide Aguda/genética , Mutação , Prognóstico , Inibidores de Proteínas Quinases/administração & dosagem , Inibidores de Proteínas Quinases/efeitos adversos , Inibidores de Proteínas Quinases/farmacologia , Pirazinas/efeitos adversos , Pirazinas/farmacologia , Recidiva , Sobrevida , Tirosina Quinase 3 Semelhante a fms/genética
13.
Rev. med. (Säo Paulo) ; 98(4): 267-272, jul.-ago. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1023532

RESUMO

Defensive and appetitive motivation systems have evolved to propitiate more sophisticated interactions with environment threats and needs, such as nutrients, water, reproduction, and temperature regulation. In contact with survival-relevant environmental stimuli, organisms change as a whole to maximize fitness to that occasion. In this paper, an overview on defensive systems is described, as well as some relevant aspects of defensive states, including their impacts over appetitive functions. A parallel between these characteristics and what is called threat-related disorders in the present paper is drawn and, finally, these similarities are used as basis for a theoretical proposition that at least part of these disorders can be seen as persistent states of defense.


Funções de sobrevivência e sistemas orgânicos relacionados evoluíram para propiciar interações mais sofisticadas com ameaças ambientais e necessidades individuais, tais como nutrientes, água, reprodução e regulação da temperatura. Apesar de o termo "sistema" sugerir ações independentes de circuitos em face de tais estímulos, evidências sugerem que os organismos se alteram como um todo em situações relevantes para a sobrevivência, maximizando sua adequação à ocasião. No presente artigo, é apresentada uma visão global de tais alterações organísmicas em face de ameaças, bem como o impaco dessas alterações sobre funções apetitivas. Traça-se, também, um paralelo entre essas características e os transtornos relativos a ameaças. Por fim, as similaridades apontadas servirão como base para uma proposição teórica segundo a qual ao menos parte desses transtornos pode ser entendida como estados permanentes de defesa.


Assuntos
Sobrevida/psicologia , Transtornos Mentais/psicologia
14.
J Nurs Adm ; 49(7-8): 372-376, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31335519

RESUMO

Creating nurse-driven protocols empower nurses to practice at the top of their scope and provide early interventions. This article describes the development and implementation of an evidence-based, nurse-driven resuscitation protocol for cardiac surgical patients who suffer cardiac arrest using a theoretical framework and leadership-driven process. Readers will gain knowledge of the collaborative process required to develop and implement a complex practice change. Process measures, outcomes, and lessons learned are presented.


Assuntos
Enfermagem Baseada em Evidências , Implementação de Plano de Saúde/organização & administração , Enfermeiras Administradoras , Ressuscitação/métodos , Parada Cardíaca , Humanos , Unidades de Terapia Intensiva , Melhoria de Qualidade , Ressuscitação/estatística & dados numéricos , Sobrevida
16.
Eur J Oncol Nurs ; 41: 1-6, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31358241

RESUMO

PURPOSE: This study examined the prognostic associations of pre-treatment quality of life (QoL) with overall survival (OS) and distant metastasis-free survival (DFMS) among patients with head and neck cancer (HNC) who underwent free flap reconstruction. METHODS: A cohort of 127 HNC patients who received free flap reconstruction between November 2010 and June 2014 at a hospital were recruited. Pre-treatment QoL was measured by the University of Washington Quality of Life Questionnaire, which contains six physical domains, including speech, swallowing, appearance, saliva, taste and chewing, as well as the six social-emotional domains of pain, activity, recreation, shoulder, mood, and anxiety. Cox regression analyses were performed. RESULTS: Results showed that pre-treatment QoL was predictive of OS and DMFS. Of the domains, swallowing, chewing, speech, taste, saliva, pain and shoulder were demonstrated to be significant predictors of OS. Additionally, swallowing, chewing, speech, pain and activity were demonstrated making significant contributions to DMFS. CONCLUSION: Our data supported that physical domains of pre-treatment QoL were predictors for OS and DFMS in HNC patients with free-flap reconstruction. Longitudinal studies are warranted to clarify the prognostic abilities of social-emotional domains. Information on pre-treatment QoL should be taken into account to individualize care plan for these patients, and hence prolong their survival.


Assuntos
Retalhos de Tecido Biológico , Neoplasias de Cabeça e Pescoço/cirurgia , Metástase Neoplásica/prevenção & controle , Cuidados Pré-Operatórios/psicologia , Qualidade de Vida/psicologia , Sobrevida/psicologia , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Procedimentos Cirúrgicos Reconstrutivos , Inquéritos e Questionários
17.
Expert Opin Investig Drugs ; 28(7): 583-592, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31215251

RESUMO

Introduction: PDAC is a lethal malignancy with a clear unmet need; almost all patients fail 1st, 2nd, and 3rd line multi-agent cytotoxic chemotherapy. The mammalian target of rapamycin (mTOR) has been identified as a key signaling node enhancing tumor survival and drug resistance in PDAC; hence, it is considered a promising therapeutic target. Areas covered: We comprehensively reviewed the evidence from preclinical and phase I and II clinical trials, based on the authors'clinical experience and a PubMed, Cochrane library, Embase, and Google Scholar search everolimus + pancreatic cancer. Expert opinion: Everolimus has not demonstrated efficacy in PDAC; however, an mTOR inhibitor in combination with stroma-targeted therapies may be a promising area to explore in clinical trials.


Assuntos
Carcinoma Ductal Pancreático/tratamento farmacológico , Everolimo/administração & dosagem , Neoplasias Pancreáticas/tratamento farmacológico , Animais , Antineoplásicos/administração & dosagem , Antineoplásicos/farmacologia , Carcinoma Ductal Pancreático/patologia , Resistencia a Medicamentos Antineoplásicos , Everolimo/farmacologia , Humanos , Terapia de Alvo Molecular , Neoplasias Pancreáticas/patologia , Sobrevida , Serina-Treonina Quinases TOR/antagonistas & inibidores , Serina-Treonina Quinases TOR/metabolismo
18.
Vet Clin North Am Small Anim Pract ; 49(5): 855-879, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31186126

RESUMO

Histiocytic sarcoma (HS) and hemangiosarcoma (HSA) are uncommon and aggressive neoplasms that develop much more frequently in dogs than in cats. Breed-specific predispositions have been identified for both cancers. The development of novel diagnostics is underway and may aid in earlier diagnosis. Therapeutic approaches to HS and HSA depend on the stage of disease and may include surgery, radiation therapy, and chemotherapy. Such interventions improve outcome; however, aside from a small number of clinical circumstances, both diseases are considered largely incurable. Continued efforts toward the identification of driver mutations and subsequent druggable targets may lead to improvements in long-term prognosis.


Assuntos
Doenças do Gato/patologia , Doenças do Gato/terapia , Doenças do Cão/patologia , Doenças do Cão/terapia , Hemangiossarcoma/veterinária , Sarcoma Histiocítico/veterinária , Animais , Doenças do Gato/epidemiologia , Gatos , Quimiorradioterapia Adjuvante/métodos , Quimiorradioterapia Adjuvante/veterinária , Doenças do Cão/epidemiologia , Cães , Hemangiossarcoma/epidemiologia , Hemangiossarcoma/patologia , Hemangiossarcoma/terapia , Sarcoma Histiocítico/patologia , Sarcoma Histiocítico/terapia , Cuidados Paliativos , Prognóstico , Radioterapia/métodos , Radioterapia/veterinária , Sobrevida
19.
Index enferm ; 28(1/2): 70-73, ene.-jun. 2019.
Artigo em Espanhol | IBECS | ID: ibc-184988

RESUMO

El cáncer de mama hereditario es un fenómeno que afecta de manera particular a mujeres jóvenes. Sus experiencias están fuertemente influenciadas por la convivencia con mujeres de sus familias que lo han padecido. Por esto vivir en sus hogares con "él", el cáncer de mama, da cuenta de la cercanía de este padecimiento en la cotidianidad de la vida. Este relato biográfico nos acerca a la experiencia de una mujer joven que padece cáncer de mama, quien ha convivido con "él" y las consecuencias de su tratamiento en la figura de su madre, una sobreviviente de la enfermedad. así, ante el diagnóstico, este hecho tuvo gran influencia en su firme decisión de sobrevivir con un cuerpo lo más parecido al anterior de la irrupción de la enfermedad. De esta manera la reconstrucción de sus senos se convirtió no solo en su fin último, sino también en la forma de sentir que venció la batalla contra el cáncer


Hereditary breast cancer is a phenomenon afflicting mainly young women. their experiences are strongly influenced by living altogether with female relatives who suffered it. Therefore, to live at home with "it", that breast cancer, reflects how close is the disease in their daily lives. This biographical correlate brings us a young woman's experience who suffers breast cancer, who lives with "it" and its treatment consequences looking into the mirror of her mother, a cancer survivor. So, in this way, given the diagnosis, this fact exerted great influence in her stubbornness to survive with a body resembling that one before disease. Hence, her breasts reconstruction became not only her ultimate end, but also a way to feel she won her battle against cancer


Assuntos
Humanos , Feminino , Neoplasias da Mama/genética , Mamoplastia , Neoplasias da Mama/psicologia , Sobrevida/psicologia
20.
J Clin Apher ; 34(5): 623-630, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31116457

RESUMO

Acquired thrombotic thrombocytopenic purpura (aTTP) is a serious disorder with arteriolar and capillary thrombosis for which the treatment usually requires plasma exchange with plasma as the replacement fluid. Management of patients who do not accept blood products is a serious challenge. We present the case of a Jehovah's Witness patient who achieved clinical response after treatment with plasma exchange using human albumin solution as the replacing fluid, high dose corticosteroids, and rituximab. The patient also received ADAMTS13 containing plasma cryoprecipitate and von Willebrand factor VIII concentrates. She had an exacerbation of her TTP in less than 3 weeks. She was treated with further plasma exchange with human albumin solution as the replacement fluid, high dose steroids, and rituximab. Bortezomib and N-acetylcysteine were added. The patient eventually improved clinically and achieved remission that is ongoing for more than 7 months. A review of the literature shows that all five previously reported cases of aTTP in Jehovah's Witnesses survived although none received plasma. Two were not even treated with plasma exchange. The experience of this case and those in the literature demonstrates that remission of aTTP may be achieved without using plasma or plasma exchange.


Assuntos
Testemunhas de Jeová , Troca Plasmática/métodos , Púrpura Trombocitopênica Trombótica/terapia , Albumina Sérica Humana/uso terapêutico , Feminino , Humanos , Soluções/química , Soluções/uso terapêutico , Sobrevida , Resultado do Tratamento
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