RESUMO
OBJECTIVES: The clinical outcomes of multiple myeloma (MM) patients are highly variable in the real-world setting. Some MM patients may have clinical endings that do not abide by the book. We aim to describe features of MM patients with extreme survivals in real-world practice. METHODS: This retrospective study enrolled 941 patients consecutively visited a national medical center, China, between July 1995 and December 2021. Among patients, we identified two groups of MM patients with extreme survivals, 56 were in the long-term remission (LR) group with progression-free survival (PFS) ≥ 60 months, and 82 were in the rapid progression (RP) group with PFS ≤ 6 months. RESULTS: CRAB features, of which hypercalcemia, renal insufficiency, and anemia were more common in the RP group, except for bone disease, with a comparable incidence at diagnosis in both groups (88.8 vs 85.7%, P = 0.52). High-risk cytogenetics was detected in 45.7% of patients in the RP group. Of note, 14.3% of MM patients in the LR group harbored del (17p). According to the Revised International Staging System (R-ISS), 9% of patients belonged to stage I in the RP group, and 19% of patients in the LR group were found in stage III. There were 8 (15.7%) patients in the LR group only achieved partial response (PR) as the best response. Median time to best response (TBR) for LR and RP group patients was 4.6 and 1.4 months, respectively. CONCLUSIONS: The disparities in the survivals of MM patients indicated that some unexpected factors have influenced the outcomes in the real-world setting.
Assuntos
Mieloma Múltiplo , Humanos , Mieloma Múltiplo/complicações , Mieloma Múltiplo/diagnóstico , Mieloma Múltiplo/epidemiologia , Prognóstico , Estudos Retrospectivos , Intervalo Livre de Doença , SobrevidaRESUMO
This guide has been developed as part of the World Health Organization's Global Initiative for Childhood Cancer, known as "Cure All Americas," with the primary purpose of alleviating the challenges faced by pediatric oncology patients. Its mission is to ensure that these young patients enjoy a full and high-quality life while receiving comprehensive nutritional care throughout the course of their illness. In Latin America and the Caribbean, the prevalence of malnutrition in children and adolescents diagnosed with cancer is alarmingly high at the time of diagnosis. Malnutrition not only undermines recovery prospects but also deteriorates the quality of life for these patients. This guide is aimed at the multidisciplinary pediatric oncology care team, including medical professionals, nutritionists, nurses, and other specialists. Drawing from the most robust scientific evidence, it addresses essential aspects such as nutritional screening, risk assessment, nutritional care planning, and the promotion of a healthy lifestyle for cancer survivors. It is worth emphasizing that this guide represents a milestone in the battle against childhood cancer in the region, as it seeks to significantly enhance the quality of life for pediatric patients affected by this disease. By providing healthcare professionals with the necessary tools and knowledge to address malnutrition and its impact on cancer treatment, we are taking a significant step towards a more hopeful future for the children and adolescents facing this challenging battle. The guide is an essential resource that offers comprehensive support in addressing the nutritional and health challenges of these young patients, thereby contributing to more effective treatment and a more promising prognosis.
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Doenças não Transmissíveis , Doença Crônica , Saúde da Criança , Neoplasias , Saúde Mental , Sobrevida , Nutrição da Criança , AméricaRESUMO
[EXTRACTO]. La Organización Panamericana de la Salud (OPS) ha impulsado esta iniciativa en la Región de las Américas desde un primer momento, para lo cual se hizo un análisis integral de la situación y se elaboró una serie de perfiles del cáncer infantil específicos para cada país. Hasta la fecha, 18 Estados Miembros de la OPS se han comprometido a implementarla, utilizando para ello el marco CureAll ("curar a todas las per- sonas"). Dicho marco se concentra en fortalecer los sistemas de salud mediante cuatro pilares: centros de excelencia (C), cobertura universal (U), esquemas de tratamiento (R) y sistemas de evaluación y seguimiento (E), así como la promoción de tres factores facilitadores fundamentales: abogar por la causa (A), y mejorar el financiamiento (L) y la gobernanza (L). La implementación de esta iniciativa en América Latina y el Caribe requiere una estrategia colaborativa y multifacética en la que participen los gobiernos, las organizaciones no gubernamentales, los profesionales de la salud y la sociedad civil. En este número especial de la Revista Panamericana de Salud Pública se destacan algunos de los avances más importantes en la Región, como la reducción de las tasas de abandono del tratamiento en Perú; las mejoras en los programas de derivación para la detec- ción temprana en los países andinos y en Panamá y República Dominicana; y los avances en la legislación sobre el cáncer infantil en Argentina, Brasil y Perú. Además, el establecimiento de la plataforma mundial de la OMS y el hospital St. Jude para el acceso a medicamentos contra el cáncer infantil en Ecuador, el país pionero de esta iniciativa en América Latina y el Caribe, ha sido el resultado de la colaboración para abordar las necesidades insatisfechas en materia de medicamentos esenciales y medios de diagnóstico, y mejorar las normas de atención oncológica para pacientes pediátricos y adolescentes.
Assuntos
Saúde da Criança , Neoplasias , Sobrevida , Sobreviventes de Câncer , América Latina , Região do Caribe , Saúde da Criança , Neoplasias , Análise de Sobrevida , América Latina , Região do Caribe , Saúde da Criança , Região do CaribeRESUMO
[EXTRAIT]. Since its launch the Pan American Health Organization (PAHO) is implementing GICC in the Region of the Americas which began with a comprehensive situational analysis and a series of country-specific childhood cancer profiles. To date, 18 PAHO Member States have commit- ted to implementing the GICC, using the CureAll framework. This framework focuses on strengthening health systems through four pillars: Centers of Excellence (C), Universal Coverage (U), Treatment Regimens (R), and Evaluation and Monitoring systems (E); and through the promotion of three key facilitators: Advocacy (A), Financing (L), and Governance (L). GICC implementation in LAC involves a collaborative and multifaceted strategy, engaging governments, non-governmental organizations, healthcare professionals, and civil society. This special supplement of the Pan American Journal of Public Health highlights some of the significant advances in the Region such as reduced rates of treatment abandonment in Peru; improvements in early detection referral programs in Andean countries, the Dominican Republic, and Panama; and progress made in legislation for pediatric cancer in Argentina, Brazil, and Peru. In addition, the establishment of the WHO/ St Jude Global Platform for Access to Childhood Cancer Medicines in Ecuador, the pioneering country for this initiative in LAC, has resulted from collaborative work to address an unmet need in essential medicines and diagnostics and improve care standards for children and adolescents affected by cancer.
Assuntos
Saúde da Criança , Neoplasias , Análise de Sobrevida , América Latina , Região do Caribe , Saúde da Criança , Sobrevida , Sobreviventes de Câncer , Neoplasias , América Latina , Região do Caribe , Sobreviventes de Câncer , Saúde da Criança , Região do CaribeRESUMO
I would like to express my sincere gratitude to be given such an honorable opportunity. I am more than happy to share my personal experience as one example of the diversity of women in hematology. After graduating from Tohoku University, I began my residency training at Japanese Red Cross Musashino Hospital and Tokyo Metropolitan Bokutoh Hospital, which are extremely busy designated hospitals in Tokyo. Both had highly active emergency care centers, and I believe that the rigorous training I received there not only honed my basic patient care skills, but also increased my physical and mental strength. Since I referred many patients to National Cancer Center Hospital, I found it amusing that Dr. Fukuda recruited me based on the recommendation of those patients. I was so fortunate to have many opportunities to contribute as a primary investigator in meaningful nationwide clinical studies. At present, I appreciate my country life as a community hematologist-oncologist. I also did not expect that I would have continuing opportunities to collaborate with researchers nationwide thanks to rapid progress in remote communications, and nothing would make me happier than to continue participating in projects on cancer survivorship.
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Oncologistas , Sobrevivência , Humanos , Feminino , Sobrevida , HospitaisRESUMO
eLife has published a special issue containing articles that examine how cancer prevention, control, care and survivorship were impacted by the COVID-19 pandemic.
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COVID-19 , Pandemias , Humanos , Aprendizagem , SobrevidaRESUMO
A 28-day Prostate Cancer-Patient Empowerment Program (PC-PEP) developed through patient engagement was successful at promoting mental and physical health. Thirty prostate cancer patients from Halifax, Canada participated in the 28-day PC-PEP intervention in early 2019. PC-PEP encompassed daily patient education and empowerment videos, prescribed physical activities (including pelvic floor exercises), a mostly plant-based diet, stress reduction techniques, intimacy education, social connection, and support. Quantitative exit surveys and semi-structured interviews (conducted in focus groups of ten) were used to assess perceived factors that facilitated or impeded adherence to the program. The program received high praise from the patients and was deemed extremely useful by the participating men, who rated it 9 out of 10. Patients expressed that the multifaceted, online, home-based nature of the program helped them adhere to it better than they would have had to a single or less comprehensive intervention. Feedback from the participants indicated that the program, when viewed as a whole, was perceived as greater than the sum of its individual parts. Furthermore, the program addressed various issues, including emotional vulnerability and distress, physical fitness, urinary incontinence, challenges in expressing emotions, perceived lack of control over healthcare decisions, emotional fragility, and hesitancy to discuss prostate cancer-related matters in social settings. Patients highly (9.6/10) endorsed integrating the program into the standard care regimen from the very beginning of diagnosis. However, challenges such as work commitments were noted. Patients' high endorsement of PC-PEP suggests that its implementation into the standard of care from day one of diagnosis may be warranted.
Assuntos
Neoplasias da Próstata , Sobrevivência , Masculino , Humanos , Participação do Paciente , Sobrevida , Neoplasias da Próstata/terapia , Pesquisa QualitativaRESUMO
A cancer diagnosis and its subsequent treatments are life-changing events, impacting the patient and their family. Treatment options available for cancer care are developing at pace, with more patients now able to achieve a cancer cure. This is achieved through the development of novel cancer treatments, surgery, and modern imaging, but also as a result of better understanding treatment/surgical trauma, rescue after complications, perioperative care, and innovative interventions like pre-habilitation, enhanced recovery, and enhanced post-operative care. With more patients living with and beyond cancer, the role of survivorship and quality of life after cancer treatment is gaining importance. The impact cancer treatments can have on patients vary, and the "scars" treatments leave are not always visible. To adequately support patients through their cancer journeys, we need to look past the short-term interactions they have with medical professionals and encourage them to consider their lives after cancer, which often is not a reflection of life before a cancer diagnosis.
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Neoplasias , Sobrevivência , Humanos , Qualidade de Vida , Sobrevida , Neoplasias/cirurgia , Cuidados Pós-OperatóriosRESUMO
OBJECTIVE: Systematic understanding of patients' unmet needs is essential for providing effective supportive care. This study sought to compare the unmet needs of patients with cancer identified by health care providers (HCPs) among four major healthcare systems. METHODS: HCPs (n = 247) participated in the International Psycho-Oncology Society (IPOS) Survivorship Online Survey, evaluating their patients' unmet needs. The country of HCPs was grouped into four major healthcare systems: Beveridge model, Bismarck model, National Health Insurance model, and out-of-pocket model. RESULTS: Most HCPs were from countries with the Bismarck model. Substantial levels (> 50%) of unmet needs in all domains are reported across the four healthcare systems. Pediatric patients/survivors living in countries under out-of-pocket healthcare model were evaluated to have less unmet needs for managing decline in physical or cognitive functioning and insomnia/sleep difficulty/fatigue, than those in countries under Beveridge, Bismarck, and National Health Insurance models. Moreover, middle-aged patients/survivors under Beveridge and National Health Insurance models were likely to have greater unmet needs for dealing with cancer-related financial concerns than those under Bismarck model. CONCLUSION: This study provides valuable insights into the unmet needs of patients with cancer in different healthcare systems, highlighting the significance of targeted interventions to address the unique needs of patients across diverse healthcare systems. Further investigation is warranted to identify the system factors associated with patients' unmet needs, enabling the development of effective healthcare policies and interventions to comprehensively address the multifaceted needs of patients with cancer.
Assuntos
Neoplasias , Sobrevivência , Pessoa de Meia-Idade , Humanos , Criança , Psico-Oncologia , Sobrevida , Neoplasias/terapia , Pessoal de SaúdeRESUMO
Objective: To assess the efficacy of induction chemotherapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of FLT3-ITD(+) acute myeloid leukemia (AML) with normal karyotype. Methods: The clinical data of FLT3-ITD(+) AML patients with normal karyotype in the First Affiliated Hospital of Nanjing Medical University from Jan 2018 to March 2021 were retrospectively analyzed. Results: The study included 49 patients with FLT3-ITD(+)AML, 31 males, and 18 females, with a median age of 46 (16-59) years old. All patients received induction chemotherapy, and 24 patients received sequential allo-HSCT (transplantation group) . The median follow-up time was 465 days, the one-year overall survival (OS) from diagnosis was (70.0 ± 7.4) %, and one-year disease-free survival (DFS) was (70.3±7.4) %. The one-year OS was significantly different between the transplantation group and the non-transplantation group [ (85.2 ± 7.9) % vs (52.6 ± 12.3) %, P=0.049]. but one-year DFS [ (84.7 ± 8.1) % vs (55.2 ± 11.9) %, P=0.061] was not. No significance was found in one-year OS between patients with low-frequency and high-frequency FLT3-ITD(+) (P>0.05) . There were 12 patients with high-frequency FLT3-ITD(+) in the transplantation and the non-transplantation groups, respectively. The one-year OS [ (68.8 ± 15.7) % in the transplantation group vs (26.2 ± 15.3) % in the non-transplantation group, P=0.027] and one-year DFS [ (45.5 ± 21.3) % in the transplantation group vs (27.8±15.8) % in the non-transplantation group, P=0.032] were significantly different between the two groups. Conclusion: Induction chemotherapy followed by allo-HSCT can enhance the prognosis of FLT3-ITD(+) patients, particularly those with FLT3-ITD high-frequency mutation.
Assuntos
Quimioterapia de Indução , Leucemia Mieloide Aguda , Transplante Homólogo , Humanos , Leucemia Mieloide Aguda/terapia , Masculino , Feminino , Estudos Retrospectivos , Prognóstico , SobrevidaRESUMO
Introducción. El diagnóstico adecuado de los tumores de la unión esofagogástrica es esencial para el tratamiento de estos pacientes. La clasificación propuesta por Siewert-Stein define las características propias, factores de riesgo y estrategias quirúrgicas según la localización. El objetivo de este estudio fue describir las características de los pacientes con adenocarcinoma de la unión esofagogástrica tratados en nuestra institución. Métodos. Estudio retrospectivo, descriptivo, de corte longitudinal, que incluyó los pacientes con diagnóstico de adenocarcinoma de la unión esofagogástrica intervenidos quirúrgicamente en el Instituto Nacional de Cancerología, Bogotá, D.C., Colombia, entre enero de 2012 y mayo de 2017. Resultados. Se operaron 59 pacientes (84,7 % hombres), con una edad media de 62,5 años. En su orden de frecuencia los tumores fueron tipo II (57,6 %), tipo III (30,7 %) y tipo I (11,9 %). El 74,6 % recibieron neoadyuvancia y se realizó gastrectomía total en el 73 % de los pacientes. La concordancia diagnóstica moderada con índice Kappa fue de 0,56, difiriendo con la endoscópica en 33,9 %. El 10,2 % de los pacientes presentó algún tipo de complicación intraoperatoria. La supervivencia a tres años en los tumores tipo II fue del 89,6 % y del 100 % en aquellos con respuesta patológica completa. Conclusión. Es necesario el uso de diferentes estrategias para un proceso diagnóstico adecuado en los tumores de la unión esofagogástrica. En esta serie, los pacientes Siewert II, aquellos que recibieron neoadyuvancia y los que obtuvieron una respuesta patológica completa, tuvieron una mejor supervivencia a tres años
Introduction: Proper diagnosis of gastroesophageal junction tumors is essential for the treatment of these patients. The classification proposed by Siewert-Stein defines its own characteristics, risk factors and surgical strategies according to the location. This study describes the characteristics of patients with adenocarcinoma of the esophagogastric junction treated at our institution. Methods. Retrospective, descriptive, longitudinal study, which includes patients diagnosed with adenocarcinoma of the esophagogastric junction who underwent surgery at the National Cancer Institute in Bogotá, Colombia, between January 2012 and May 2017. Results. Fifty-nine patients (84.7% men) were operated on, with a mean age of 62.5 years. In their order of frequency, the tumors were type II (57.6%), type III (30.7%) and type I (11.9%). 74.6% received neoadjuvant therapy and total gastrectomy was performed in 73% of the cases. The moderate diagnostic concordance with the Kappa index was 0.56, differing from the endoscopic one in 33.9%. 10.2% of the patients presented some type of intraoperative complication. Three-year survival in type II tumors was 89.6% and 100% in those with complete pathologic response. Conclusion. The use of different strategies is necessary for an adequate diagnostic process in tumors of the esophagogastric junction. In this series, Siewert II patients, those who received neoadjuvant therapy, and those who obtained a complete pathological response had a better three-year survival
Assuntos
Humanos , Neoplasias Esofágicas , Junção Esofagogástrica , Neoplasias Gástricas , Sobrevida , ClassificaçãoRESUMO
This letter to the editor aims to address claims made by Bailey et al. [2023. Appeasement: Replacing Stockholm syndrome as a definition of a survival strategy. European Journal of Psychotraumatology, 14(1), 2161038] about the history of the concept of appeasement in relation to mammalian survival responses as well as the fawn response, by offering a brief overview and analysis of the literature.
Appeasement in political and foreign policy, social justice, ethology, psychology, and communication studies (multiple mammalian and avian species) feature elements of coregulation.The original conceptualisation of the fawn response may result in the misperception that it is unrelated to coregulation.Appeasement and coregulation can occur whether the vulnerable party initiating the appeasement is in a state that supports affiliative, distress, or shutdown behaviour.
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Transtornos de Estresse Traumático , Sobrevida , Humanos , Transtornos de Estresse Traumático/psicologiaRESUMO
Contributing to a much-needed 'outward turn' in interpreting studies, this intervention examines the role of interpreting and interpreters in (re)articulating the welcome 'voice' of a developing nation in the global South. Against the backdrop of reform and opening-up (ROU), China, the world's largest developing country, is increasingly open and keen to engage globally. Such elements as openness, integration, and international engagement represent vital components of the overarching ROU metadiscourse that justifies China's sociopolitical system and multifarious policies and decisions. As part of a series of digital humanities (DH) informed empirical studies exploring the part played by interpreting in rendering China's ROU metadiscourse, this study zooms in on the government interpreters' mediation of Beijing's international engagement and global involvement discourses. Unlike CDA which often foregrounds the negative themes (e.g. injustice, oppression, dominance, and hegemony), an innovative corpus-based positive discourse analysis (PDA) is introduced and applied, drawing on 20 years of China's press conferences. This article points to the interpreters' visibility and agency in facilitating and strengthening China's discourse through (over)producing core lexical items and salient collocational patterns. Following the trends of interdisciplinarity and digital humanities, this corpus-based PDA study illustrates ultimately how a major non-Western developing country from the global South communicates its discourse bilingually in front of the international community. The potential impact and implications of the interpreter-in(tro)duced discursive changes are discussed vis-à-vis the ever shifting and delicate East-West power balance from the perspective of (geo)politics.
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Mudança Climática , Países em Desenvolvimento , Política , Justiça Social , Humanos , China , Internacionalidade , Sobrevida , Justiça AmbientalRESUMO
INTRODUCTION: Haematological malignancies are a heterogenous group of blood and lymphatic cancers. Survivorship care is a similarly diverse term concerning patients' health and wellbeing from diagnosis to end of life. Survivorship care for patients with haematological malignancies has traditionally been consultant-led and secondary care-based, although shifts away from this model have been occurring, largely via nurse-led clinics and interventions with some remote monitoring. However, there remains a lack of evidence regarding which model is most appropriate. Although previous reviews exist, patient populations, methodologies, and conclusions are varied, and further high-quality research and evaluation has been recommended. AIMS: The aim of the scoping review this protocol describes is to summarise current evidence on the provision and delivery of survivorship care for adult patients diagnosed with a haematological malignancy, and to identify existing gaps to inform future research. METHODOLOGY: A scoping review will be carried out utilising Arksey and O'Malley's guidelines as its methodological framework. Studies published in the English language from December 2007 to the present will be searched on bibliographic databases, including Medline, CINAHL, PsycInfo, Web of Science, and Scopus. Papers' titles, abstracts, and full text will predominantly be screened by one reviewer with a second reviewer blind screening a proportion. Data will be extracted using a customised table developed in collaboration with the review team, and presented in tabular and narrative format, arranged thematically. Studies included will contain data regarding adult (25+) patients diagnosed with any haematological malignancy in combination with aspects related to survivorship care. The survivorship care elements could be delivered by any provider within any setting, but should be delivered pre- or post-treatment, or to patients on a watchful waiting pathway. REGISTRATION: The scoping review protocol has been registered on the Open Science Framework (OSF) repository Registries (https://osf.io/rtfvq; DOI: 10.17605/OSF.IO/RTFVQ).
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Neoplasias Hematológicas , Sobrevivência , Humanos , Adulto , Sobrevida , Neoplasias Hematológicas/terapia , Consultores , Bases de Dados Bibliográficas , Literatura de Revisão como AssuntoRESUMO
El perfil molecular de los gliomas permite garantizar la precisión del diagnóstico, informar el pronóstico e identificar opciones de tratamiento. Esta revisión tiene como objetivo exponer que con la secuenciación de próxima generación (NSG) el diagnóstico de los pacientes con oligodendrogliomas puede ser más exacto. Además, con un dispositivo de diagnóstico in vitro, basado en la NSG (F1CDx), en el que se utilizan los bloques de parafina de gliomas para analizar hasta 395 genes relacionados con cáncer (incluido IDH 1 y 2), se puede también informar la pérdida de la totalidad del brazo corto del cromosoma 1 y del brazo largo del cromosoma 19 (codeleción 1p/19q), a diferencia de la hibridación fluorescente in situ (FISH) que detecta desde la más mínima deleción, lo cual los hace sensibles pero no específicos ya que el FISH es incapaz de distinguir entre la pérdida de la totalidad del brazo del cromosoma y una deleción focal. Esta distinción es importante ya que la sobrevida es inferior en tumores con deleción parcial en relación con los oligodendrogliomas, que tienen por definición la pérdida total de ambos cromosomas. Se hace también alusión a otras plataformas genómicas como GlioSeq y GLIO-DNA panel, que pueden cumplir la misma función. En conclusión, la F1CDx puede determinar con precisión 1p/19q con una concordancia del 96.7% frente a FISH. Los casos en que el FISH dio positivo y no concordaban con F1CDx, era porque no se trataba de oligodendrogliomas. F1CDx también analiza todos los genes que permiten la aproximación más exacta al diagnóstico de oligodendroglioma.
Molecular profiling of gliomas helps ensure diagnostic accuracy, inform prognosis, and identify treatment options. This review aims to show that with next generation sequencing (NGS) the diagnosis of patients with oligodendrogliomas can be more accurate. In addition, with an in vitro diagnostic device, based on NSG (F1CDx), in which glioma paraffin blocks are used to analyze up to 395 cancer-related genes (including IDH 1 and 2), it is also possible to report the loss of the entire short arm of chromosome 1 and the long arm of chromosome 19 (1p/19q codeletion), unlike fluorescence in situ hybridization (FISH) that detects even the slightest deletion, making them sensitive but not specific, as FISH is unable to distinguish between the loss of the entire arm of the chromosome and a focal deletion. This distinction is important since survival is lower in tumors with partial deletion compared to oligodendrogliomas, which by definition have the total loss of both chromosomes. Reference is also made to other genomic platforms such as GlioSeq and GLIO-DNA panel, which can fulfill the same function. In conclusion, the F1CDx can accurately determine 1p/19q with a concordance of 96.7% against FISH. The cases in which the FISH was positive and did not agree with F1CDx, it was because they were not oligodendrogliomas. F1CDx also analyzes all the genes that allow the most accurate approach to the diagnosis of oligodendroglioma.
O perfil molecular de gliomas ajuda a garantir a precisão do diagnóstico, informar o prognóstico e identificar as opções de tratamento. Esta revisão tem como objetivo mostrar que com o sequenciamento de próxima geração (NSG) o diagnóstico de pacientes com oligodendrogliomas pode ser mais preciso. Além disso, com um dispositivo de diagnóstico in vitro baseado em NSG (F1CDx), no qual blocos de parafina de glioma são usados para analisar até 395 genes relacionados ao câncer (incluindo IDH 1 e 2), também é possível relatar a perda do todo o braço curto do cromossomo 1 e o braço longo do cromossomo 19 (codeleção 1p/19q), ao contrário da hibridização fluorescente in situ(FISH) que detecta desde a menor deleção, o que os torna sensíveis, mas não específicos, pois o FISH é incapaz de distinguir entre a perda de todo o braço do cromossomo e uma deleção focal. Essa distinção é importante, pois a sobrevida é menor nos tumores com deleção parcial em relação aos oligodendrogliomas, que por definição apresentam a perda total de ambos os cromossomos. Também é feita referência a outras plataformas genômicas, como GlioSeq e painel GLIO-DNA, que podem cumprir a mesma função. Em conclusão, o F1CDx pode determinar com precisão 1p/19q com uma concordância de 96,7% versus FISH. Os casos em que FISH foi positivo e não concordaram com F1CDx, foi porque não eram oligodendrogliomas. O F1CDx também analisa todos os genes que permitem a abordagem mais precisa para o diagnóstico de oligodendroglioma.
Assuntos
Humanos , Glioma , Oligodendroglioma , Sobrevida , Técnicas In Vitro , Diagnóstico , NeoplasiasRESUMO
La leucemia linfoblástica aguda constituye la neoplasia infantil más frecuente. Los tratamientos actuales posibilitan más del 80% de supervivencia libre de enfermedad por cinco años. En el 2000, se probó un protocolo de quimioterapia llamado leucemia linfoblástica intercontinental Berlín-Frankfurt-Münster (ALLIC BFM). El proceso investigativo se realizó mediante la metodología PRISMA, con el propósito de sistematizar la información acerca de la supervivencia de los pacientes pediátricos con leucemia linfoblástica aguda tratados con el uso del protocolo de quimioterapia ALLIC BFM en sus versiones de 2002 o 2009. La supervivencia global en pacientes donde se utilizó el protocolo de 2002 fue del 52% al 91,7% y la libre de enfermedad fue del 45% a 83,3%; mientras que, con el uso del protocolo 2009 se reportó una supervivencia global del 71,1% al 90% y la libre de enfermedad fue del 69,4% al 90,3%. Los principales factores que afectaron la supervivencia fueron las complicaciones relacionadas con el tratamiento, los pacientes de alto riesgo y la medicación insuficiente.
Acute lymphoblastic leukemia is the most common childhood neoplasia. Current treatments allow more than 80% disease-free survival for five years. In 2000, a chemotherapy protocol called Berlin-Frankfurt-Münster intercontinental lymphoblastic leukemia (ALLIC BFM) was tested. The investigative process was carried out using the PRISMA methodology. This study aimed to systematize the information about the survival of pediatric patients with acute lympho-blastic leukemia treated with the ALLIC BFM chemotherapy protocol in its 2002 or 2009 versions. 52% to 91.7% of patients showed an overall survival in patients where the 2002 proto-col was used, and disease-free was from 45% to 83.3%; while, with the use of the 2009 protocol, an overall survival of 71.1% to 90% was reported, and disease-free survival was 69.4% to 90.3%. The main factors affecting survival were treatment-related complications, high-risk patients, and insufficient medication.
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Humanos , Masculino , Feminino , Pré-Escolar , Criança , População , Sobrevida , Leucemia , Pacientes , Terapêutica , Tratamento FarmacológicoRESUMO
Action is an important arbitrator as to whether an individual or a species will survive. Yet, action has not been well integrated into the study of psychology. Action or motor behavior is a field apart. This is traditional science with its need for specialization. The sequence in a typical laboratory experiment of see â decide â act provides the rationale for broad disciplinary categorizations. With renewed interest in action itself, surprising and exciting anomalous findings at odds with this simplified caricature have emerged. They reveal a much more intimate coupling of vision and action, which we describe. In turn, this prompts us to identify and dwell on three pertinent theories deserving of greater notice.