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1.
Joana Pinheiro Darlene Rodrigues Pedro Fernandes Alexandre Pereira Lurdes Trigo 《Reports of Practical Oncology and Radiotherapy》2018,23(5):322-330
Introduction
The incidence of breast carcinoma (BC) has increased in the last years. Between 2 and 12% of patients diagnosed with BC will develop bilateral breast carcinoma (BBC). The treatment of these carcinomas is more aggressive than unilateral BC.Purpose
To perform a retrospective qualitative analysis of BBC patients whose treatment has included brachytherapy (BT) and to present a revised literature on this issue.Material and methods
The cases of BBC whose treatment included brachytherapy were revised. The literature on this issue was refreshed.Results
Five women, aged between 54 and 78 at the time of the diagnosis, submitted to conservative surgery followed by external radiotherapy (RT) with boost of BT or exclusive BT (APBI), in the IPO-P BT Service between 2003 and 2016.Discussion
The patients with BBC have slightly higher rates of local recurrences, mostly in the tumor bed, where there is a higher risk of local recurrence. Patients treated with BT had lower rates of recurrences than those treated with photons and electrons.Conclusions
BBC represents a complex challenge for doctors, because in some cases there is a tendency to use more aggressive treatments and, at the same time, it is not easy to achieve the timing for the correct treatment. 相似文献2.
Felipe F.B. Tuon Khaiany Lino Florencio Clóvis Arns da Cunha Jaime Luis Lopes Rocha 《Revista iberoamericana de micología》2018,35(2):63-67
Background
Posaconazole is used for the prophylaxis of invasive fungal disease (IFD). Previous studies have shown it to be cost-effective compared to fluconazole/itraconazole. However, posaconazole has never been economically evaluated in developing countries.Aims
The aim of the present study was to perform a cost-effectiveness analysis of posaconazole compared to fluconazole in public (SUS) and private hospitals (PHS) in Brazil.Methods
A cost-effectiveness simulation was conducted on the basis of a pivotal study on the use of posaconazole in acute myeloid leukemia (AML) patients, adjusting the costs to Brazilian data.Results
A pharmacoeconomic analysis was performed on a hypothetical sample of 100 patients in each drug group. The total cost of posaconazole use alone was USD$ 220,656.31, whereas that for fluconazole was USD$ 83,875.00. Our results showed that patients with IFD remain hospitalized for an additional 12 days, at an average cost of USD$ 850.85 per patient per day. The total money spent by PHS for 100 patients for 100 days was USD$ 342,318.00 for the posaconazole group and USD$ 302,039.00 for the fluconazole group. An analysis of sensitivity (10%) revealed no intergroup difference.Conclusions
In Brazil posaconazole is cost-effective, and should be considered for the prophylaxis of patients with AMD/myelodysplasia (AML/MDS) undergoing chemotherapy. 相似文献3.
Tomohei Nakao Hiroko Fukushima Takashi Fukushima Ryoko Suzuki Sho Hosaka Yuni Yamaki Chie Kobayashi Atsushi Iwabuchi Kazuo Imagawa Aiko Sakai Toko Shinkai Kouji Masumoto Shingo Sakashita Tomohiko Masumoto Masashi Mizumoto Ryo Sumazaki Hideyuki Sakurai 《Reports of Practical Oncology and Radiotherapy》2018,23(5):442-450
Aim
To assess the feasibility of transferring to the University of Tsukuba Hospital for proton beam therapy (PBT) during intensive chemotherapy in children with Ewing sarcoma family of tumors (ESFT) who had been diagnosed and started their first-line treatment at prefectural or regional centers for pediatric oncology.Background
The treatment of ESFT relies on a multidisciplinary approach using intensive neoadjuvant and adjuvant chemotherapies with surgery and radiotherapy. Multi-agent chemotherapy comprising vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide (VDC-IE) is widely used for ESFT, and the interval between each course is very important for maintaining the intensity and effect of chemotherapy.Materials and methods
Clinical information of patients who received PBT and VDC-IE between April 2009 and May 2016 was collected retrospectively. The intervals between each course of VDC-IE and adverse events were assessed.Results
Fifteen patients were evaluated. No delays in the intervals of chemotherapy due to transfer were observed. There were no adverse events caused during/just after transfer and no increases in adverse events. The estimated 4-year overall and event-free survival rates were 94.6% and 84.8%, respectively.Discussion
Although the results of efficacy are preliminary, survival rates were comparable with past studies. More experience and follow-up are required to further assess the efficacy of PBT for patients with ESFT.Conclusion
Multidisciplinary therapy for children with ESFT involving transfer to our hospital for PBT during VDC-IE was feasible without treatment delay or an increase in adverse events. 相似文献4.
Background
Transforming growth factor beta (TGF-β) is a multipurpose cytokine, which plays a role in many cellular functions such as proliferation, differentiation, migration, apoptosis, cell adhesion and regulation of epithelial to mesenchymal transition. Despite many studies having observed the effect that TGF-β plays in colorectal cancer, its role in the colorectal stem cell population has not been widely observed.Method
This systematic review will analyse the role of TGF-β in the stem cell population of colorectal cancer.Results
The effects on the stem cell phenotype are through the downstream proteins involved in activation of the TGF-β pathway. Its involvement in the initiation of the epithelial to mesenchymal transition (EMT), the effect of colorectal invasion and metastasis regulated through the Smad protein involvement in the EMT, initiation of angiogenesis, promotion of metastasis of colorectal cancer to the liver and its ability to cross-talk with other pathways.Conclusion
TGF-β is a key player in angiogenesis, tumour growth and metastasis in colon cancer. 相似文献5.
María Yicel Bautista Hernandez Pomponio José Lujan Castilla Abril Antonia Quézada Bautista 《Reports of Practical Oncology and Radiotherapy》2018,23(4):276-283
Aim
To evaluate whether hypofractionation with integrated boost to the tumour bed using intensity-modulated radiation therapy is an acceptable option and to determine whether this treatment compromises local control, toxicity and cosmesis.Background
Retrospective studies have demonstrated that patients who are treated with HF and integrated boost experience adequate local control, a dosimetric benefit, decreased toxicity and acceptable cosmesis compared with conventional fractionation.Materials and methods
A retrospective, observational and longitudinal study was conducted from January 2008 to June 2015 and included 34 patients with breast cancer (stage 0–II) who were undergoing conservative surgery.The prescribed doses were 45?Gy in 20 fractions (2.25?Gy/fraction) to the breast and 56?Gy in 20 fractions (2.8?Gy/fraction) to the tumour bed.Results
Thirty-four patients were included. The mean follow-up was 49.29 months, and the mean age was 52 years. The mean percentage of PTV from the mammary region that received 100% of the prescribed dose was 97.89% (range 95–100), and the mean PTV percentage of the tumour bed that received 100% of the dose was 98% (95–100).The local control and the overall survival were 100%, and the cosmesis was good in 82% of the patients. Grade 1 acute toxicity was present in 16 patients (47%), and grade 1 chronic toxicity occurred in 6 cases (18%).Conclusion
The results of the present study demonstrate that hypofractionation with integrated boost using intensity-modulated radiation therapy is an acceptable option that provides excellent local control and low toxicity. 相似文献6.
Nayana Damiani Macedo Aline Rodrigues Buzin Isabela Bastos Binotti Abreu de Araujo Breno Valentim Nogueira Tadeu Uggere de Andrade Denise Coutinho Endringer Dominik Lenz 《Tissue & cell》2017,49(1):22-27
Objective
The current study proposes an automated machine learning approach for the quantification of cells in cell death pathways according to DNA fragmentation.Methods
A total of 17 images of kidney histological slide samples from male Wistar rats were used. The slides were photographed using an Axio Zeiss Vert.A1 microscope with a 40x objective lens coupled with an Axio Cam MRC Zeiss camera and Zen 2012 software. The images were analyzed using CellProfiler (version 2.1.1) and CellProfiler Analyst open-source software.Results
Out of the 10,378 objects, 4970 (47,9%) were identified as TUNEL positive, and 5408 (52,1%) were identified as TUNEL negative. On average, the sensitivity and specificity values of the machine learning approach were 0.80 and 0.77, respectively.Conclusion
Image cytometry provides a quantitative analytical alternative to the more traditional qualitative methods more commonly used in studies. 相似文献7.
Feliciano Villar Montserrat Celdrán Rodrigo Serrat Josep Fabà Teresa Martínez 《Revista espa?ola de geriatría y gerontología》2019,54(1):12-18
Objectives
The study had three objectives: (a) To determine how staff perceives the frequency of different sexual expressions in long-term care facilities for older people; (2) to quantify policies aimed at guaranteeing residents’ sexual rights in such institutions, and (3) to determine factors influencing the presence of these kind of policies.Methods
A total of 160 Directors of Nursing and 623 technical staff from Spanish long term care residential facilities completed a self-administered questionnaire including ítems to assess the experience and estimated frequency of different sexual expressions, an inventory of policies regarding sexual expression, and the Spanish version of the Person-Centred Care Assessment Tool.Results
Certain sexual behaviours, such as kisses and hugs, or masturbation, are very frequent in nursing homes. Many participants have reported to staff members on having witnessed inappropriate sexual behaviours, such as exhibitionism (39%) or unwanted touching (27%). Policies in relation to guaranteeing residents’ sexual rights were the most frequently mentioned. In contrast, there were fewer participants who mentioned policies regarding training or availability of helpful materials and resources. Factors such as occupational level (Directors of Nursing vs.technical staff), personal education, the centre commitment to person-centred care, and estimated frequency of sexual behaviour were associated with a higher presence of sexual expression policies.Conclusion
Although sexual behaviours among residents are quite frequent, there is still room for improvement in policies that support residents’ expression of sexuality. Person-centred care models might help to guarantee sexual rights of older people living in long-term care facilities. 相似文献8.
9.
Objective
A new method was presented to prepare clinical-grade human adipose-derived stromal stem cells (ASCs) and its safety in vitro, such as biological characteristics and genetic features alteration were investigated.Methods
The morphology of the ASCs which were cultured in vitro using serum-free medium was observed. Cell cycle and CD markers profile were tested by flow cytometry, while karyotype was analyzed by the chromosome G-banding technology. Growth factors expression was tested by ELISA and tumor-related genes were analyzed by the real-time PCR, respectively.Results
ASCs were adult stem cells with spindle shape. The proliferation ratio of ASCs began to slow down after 10 passages, and was significant after 15 passages. Cell cycle analysis revealed that the percentage of G2 phase and S phase cells was stable. There was no obvious missing, translocation or dislocation in terms of karyotype. Expression level of tumor relevant genes and cytokines at different passages had no significant difference.Conclusions
The clinical-grade ASCs prepared with this new method, less than ten passages, was safe for clinical trials. 相似文献10.
Jesus Fortún Francesca Gioia Patricia Muñoz Javier Graus Elia Gómez-García de la Pedrosa Pilar Martín-Dávila Ana Saiz Antonio Vena Santiago Moreno 《Revista iberoamericana de micología》2018,35(3):159-161
Background
T2 magnetic resonance imaging (T2MR) is a new method for the diagnosis of invasive candidiasis, although most studies have analyzed its role in patients with candidemia or not infection.Case report
We present the case of a patient with arteritis and thrombosis of the hepatic graft resulted from an undocumented fungal infection in the explanted liver.T2MR in serum was a suitable diagnostic tool for the diagnosis of the deep-seated invasive candidiasis in the absence of candidemia or the isolation of the yeast in culture.Conclusions
T2MR allowed the diagnosis of deep-seated invasive candidiasis in an immunodepressed patient without candidemia, even before the onset of symptoms. 相似文献11.
Marta Liszka Włodzimierz Samborski 《Reports of Practical Oncology and Radiotherapy》2018,23(5):378-383
Aim
Isokinetic assessment of biomechanical parameters of the shoulder joint at the operated side versus non-operated side in patients treated surgically for breast cancer according to the type of surgery performed.Background
Despite significant progress in medicine, comprehensive cancer therapy may still cause a number of undesired structural and functional effects. The most frequent complications include long-term weakening of muscles within the shoulder and upper extremity at the operated side.Materials and methods
The study enrolled 57 patient, divided into two groups: mastectomy and BCT. Diagnostic tests were carried out on the groups to assess biomechanical parameters (peak torque, power, total work) of the shoulder joint in internal and external rotation.Results
The results of the isokinetic test revealed a considerable reduction of dynamic properties of the muscle groups responsible for the function of the shoulder joint at the operated side. The deficits observed, depending on the angular speed and plane of rotation, were from 22.3% to 32.7% and from 23.1% to 29.4% for muscle power and total work, respectively. The least noticeable loss was that of muscular torque, ranging from 6.5% to 18.3%.Conclusion
None of the treatment methods applied ensured a full release of the restriction within the shoulder and upper limb. The deficits observed may constitute a serious disorder of the musculoskeletal system; therefore, a clinical study of biomechanical parameters of the shoulder joint may be an important control of patients’ functional status after breast cancer treatment. 相似文献12.
Morbidity dynamics in proton–photon or photon radiation therapy for locally advanced prostate cancer
Evgeny V. Khmelevsky Irina N. Kancheli Vladimir S. Khoroshkov Andrey D. Kaprin 《Reports of Practical Oncology and Radiotherapy》2018,23(1):21-27
Aim
This study evaluated the frequency and long-term dynamics of early and late post irradiation damage after proton–photon or photon therapy for locally advanced prostate cancer.Background
The results of a randomized study of proton–photon or photon therapy using several fractionation regimes were analyzed in 272 patients with high and intermediate risk of progression.Materials and methods
Three variants of proton boost fractionation were studied sequentially: 3.0 (8 daily fractions), 4.0 (5 fractions, 3 or 5 fractions/week), and 5.5 (3 fractions, 3 fractions/week) Gy(RBE).Results
A significant decrease in the severity of both acute and late gastrointestinal injuries is achievable with a proton beam. The dynamics of late gastrointestinal and genitourinary toxicity over a 10-year period were generally characterized by a decrease in severity of morbidity by 30% and 15%, respectively.Conclusions
Local irradiation with a fractional dose of 3.0–5.5 Gy(RBE) and a cumulative dose of 28.0–28.8 Gy(RBE) for protons significantly reduces the early and late rectitis severity, but does not reduce the risk of lower urinary tract injuries. Fractionation regimens do not significantly differ in toxicity levels. 相似文献13.
José Luis Barrios Andrés Leyre Mónica López-Soria Ana Alastruey Izquierdo Jaime Echevarría Ecenarro Raquel Feijoó Lera Jesus Garrido Fierro Francisco Javier Cabrerizo Nuñez Andrés Canut Blasco 《Revista iberoamericana de micología》2018,35(2):92-96
Background
Although fortunately very rare in countries with a temperate climate, certain factors, such as clinical or pharmacological immunosuppression, may cause Fusarium-related fungal infections to become an emerging problem. Moreover, Fusarium is one of the most important etiological agents in exogenous endophthalmitis, which is often favored by the disruption of the epithelial barriers.Aims
The aim of this series of clinical cases is to identify characteristic clinical findings that may allow an early diagnosis and more efficient management of this ophthalmologic emergency.Methods
Three cases of endophthalmitis due to Fusarium solani and Fusarium oxysporum, diagnosed in 2009, 2010, and 2014 in patients from two different health regions belonging to the same health system and separated by around 43 miles, are presented. The Fusarium isolates were initially identified microscopically and the species subsequently confirmed by sequencing the elongation factor alpha (EFα) and internal transcribed spacers (ITS). Susceptibility to antifungal agents was determined using the EUCAST broth dilution method.Results
Evolution was poor as two of the three patients progressed to phthisis bulbi despite surgical measures and broad-spectrum antifungal antibiotic therapy.Conclusions
It is essential to rapidly instigate multidisciplinary measures to combat suspected endophthalmitis due to Fusarium given the poor prognosis of this type of infection. 相似文献14.
Roseli Santos de Freitas Camila Mika Kamikawa Adriana Pardini Vicentini 《Revista iberoamericana de micología》2018,35(1):27-31
Background
Current methods for the production of Histoplasma capsulatum antigens are problematic in terms of standardization, specificity, stability, repeatability and reproducibility.Aims
In this study, we sought to optimize the methodology for producing H. capsulatum antigens, and to evaluate its applicability.Methods
Antigenic preparations obtained from 12 H. capsulatum isolates were evaluated by double immunodiffusion and immunoblotting assays against homologous and heterologous sera.Results
The evaluated and optimized protocol allowed a more stable production, as well as repeatable, reproducible, with shorter culture time and less costly. By double immunodiffusion and immunoblotting assays, the best pattern of reactivity was observed for antigens obtained with 33 days of culture from the isolates 200 and 406 against the M antigen and for the isolate 200 with 15 days against H antigen. The SDS-PAGE presented antigenic components of molecular masses between 17 and 119 kDa. The immunoblotting sensitivity was 95.5% and 100% with histoplasmosis sera from ill patients and sera from H. capsulatum infected but otherwise healthy patients, respectively, to the antigen derived from isolates 200 and 406.Conclusions
We suggest the employment of the antigen from isolate 200, with 15 or 30 days of culture, in the double immunodiffusion and immunoblotting assays due to its good ability to discriminate both sera from patients with histoplasmosis illness and histoplasmosis infection, in addition to its high specificity against heterologous sera. 相似文献15.
Bryan Ortiz Erika Pérez-Alemán Carmen Galo Gustavo Fontecha 《Revista iberoamericana de micología》2018,35(2):73-77
Background
Candiduria is a common infection among hospitalised patients. Although the clinical relevance of yeasts in urine is not clearly defined, fungal urinary tract infections have increased significantly in the last decades, becoming a growing public health problem. Candida albicans is the most commonly reported species in urinary infections, although other species of the genus are becoming particularly important, because some of them are linked with resistance to antifungal drugs.Aims
This study aimed to evaluate the frequency of Candida species causing candiduria in a hospital in Honduras.Methods
A simple and cost-effective PCR-RFLP approach was used, by amplifying a partial sequence of the ribosomal ITS1-ITS2 region and a subsequent digestion with the enzyme MspI.Results
During 2016, an analysis was performed on 73 urine samples from patients of different ages. Seven species were found. Candida albicans/dubliniensis was the most frequent species (30%); Candida glabrata (28.8%) was the most isolated among the rest of the species. Candida kefyr was the least frequent species found (2.5%).Conclusions
This study shows, for the first time in Honduras, the frequency of the Candida species isolated from urine using PCR-RFLP for their identification. This approach could be applied in future epidemiological studies at local and national level. 相似文献16.
Rogelio de J. Treviño-Rangel Byron A. Bodden-Mendoza Alexandra M. Montoya Hiram Villanueva-Lozano Mariana Elizondo-Zertuche Efrén Robledo-Leal Gloria M. González 《Revista iberoamericana de micología》2018,35(1):17-21
Background
Candida tropicalis is an increasingly important human pathogen which usually affects neutropenic oncology patients with common hematogenous seeding to peripheral organs and high mortality rates. Candida pathogenicity is facilitated by several virulence attributes, including secretion of hydrolytic enzymes; however, little is known regarding the C. tropicalis ability to secrete them and their role in the disease.Aims
To confirm by molecular means the identification of 187 clinical isolates (127 from blood, 52 from urine, and 8 from diverse clinical origins) phenotypically identified as C. tropicalis, and to investigate their in vitro aspartyl proteinase, phospholipase, esterase, hemolysin, DNase and coagulase activities.Methods
The molecular confirmation was performed by ITS sequencing, and the enzymatic determinations were conducted using plate assays with specific substrates, with the exception of coagulase, which was determined by the classical tube test.Results
The majority of the strains exhibited a very strong or strong activity of aspartyl proteinase, phospholipase and esterase. A 4.7% of the bloodstream isolates were hemolysin producers, and all were negative for the coagulase and DNase assays.Conclusions
Very strong activities of aspartyl proteinase, phospholipase and esterase profiles were detected, and a statistical association between phospholipase production and blood and urine isolates was found. 相似文献17.
Shahla Ebrahimi Moghadam Shahrokh Nasseri Seyedeh Somayeh Seyedi Hamid Gholamhosseinian Mehdi Momennezhad 《Reports of Practical Oncology and Radiotherapy》2018,23(5):369-377
Aim
Evaluation of application of EPID for rapid QC testing of linear accelerator.Background
Quality control of a linear accelerator device is a time and energy intensive process. In this study, attempts have been made to perform the linear accelerator quality control using electronic portal imaging device (EPID), which is mounted on most accelerators.Materials and methods
First, quality control and dosimetry parameters of the device were determined and measured based on standard protocols to ensure full calibration of the accelerator. Then, various features of EPID including spatial resolution and contrast resolution, the effect of buildup region, dose response and image uniformity were evaluated. In the next step, consistent with the parameters of linear accelerator quality control including field size, field flatness and symmetry, the light field coincidence with X-ray field, mechanical stability and multileaf collimator position accuracy test, the output images of device were obtained.After feeding images to the MATLAB software, their pixel content was analyzed. All measurements of the three photon beams were repeated three times.Results
The EPID image had a desirable resolution, contrast and uniformity and displayed high sensitivity to dose changes with linear dose response. Seven qualitative parameters of the linear accelerator were then controlled by EPID.Conclusions
The results of the linear accelerator quality control using the EPID were consistent with practice. Quality control using the EPID was more convenient and faster than conventional methods. 相似文献18.
Raphaël Jumeau Phuc Félix Nguyen-Tan Houda Bahig Xavier Liem Louise Lambert Matthieu Schmittbuhl Dany Simard Edith Filion 《Reports of Practical Oncology and Radiotherapy》2018,23(4):270-275
Aim
To develop a tool in order to guide pre-irradiation dental care (PIDC) for patients with oropharyngeal cancers.Background
Osteoradionecrosis of the jaws is a potential complication of radiotherapy (RT) for head and neck cancers. To prevent this complication, PIDC can involve multiple dental extractions as a preventative measure to avoid post-RT complications. However, there is no standardized tool to guide PIDC.Materials and methods
From January 2005 to October 2015, 120 head and neck cancer patients were prospectively included in a study investigating dysgeusia after RT. From this cohort, patients were enrolled according to the following inclusion criteria: histopathological confirmation of oropharyngeal squamous cell carcinoma; stage T1-4 N1-3 M0; ≤10 missing teeth. Individual teeth were retrospectively delineated on planning computed tomography and doses to dentition were assessed to generate templates.Results
Thirty-three patients were included. Molars received highest doses with a mean dose of 50?Gy (range; 19–75?Gy). Ipsi-lateral and contralateral wisdom teeth received RT dose superior to 50?Gy in 92% and 56% of cases, respectively. Patients with advanced disease (T4 or N2c-3) received higher mean doses on inferior and ipsi-lateral dental arches compared to other patients (T1-3 N0-2b): 42?Gy vs. 39?Gy and 44?Gy vs. 39?Gy (p?<?0.05), respectively.Conclusion
Pre-RT dose distribution templates are an objective way to prepare PIDC. Further studies with a larger cohort are needed to validate these templates. 相似文献19.
Michał Bijok Ewelina Gruszczynska Adam Kowalczyk Katarzyna Sikorska Agnieszka Walewska Pawel F. Kukolowicz 《Reports of Practical Oncology and Radiotherapy》2018,23(5):341-345
Aim
The aim of the study was to analyze the long-term stability of electron beams generated by the Novac11? IORT accelerator.Background
Novac11? (NRT®) is a mobile electron accelerator designed to irradiate small areas of tissue, up to 10?cm in diameter, with electron beams during surgical procedures. It is characterized by a great mobility guaranteed by a number of degrees of freedom enabling irradiation in the conditions of an operating theatre.Materials and methods
Over the period of January 2013 and September 2016, the measurement sessions of the output of clinically used beam qualities (6, 8 and 10?MeV) were carried out 41 times. Because of the unsatisfactory long-term stability, an extra procedure of tuning of the magnetron, suggested by the manufacturer, was introduced in October 2015, 15 measurements were performed since then. The output of the Novac11? accelerator was measured in the reference conditions recommended by the IAEA Report 398, the measurements of the charge in the ionization chamber at the reference depth were carried out with a Dose1? electrometer and a plane-parallel chamber PPC05? from IBA®.Results
The introduction of the tuning of the magnetron procedure resulted in satisfactory long-term stability of the measured outputs below 2%.Conclusions
After the introduction of the STV parameter tuning procedure, the long-term stability of the Novac11? output increased considerably and is within the values declared by the manufacturer. 相似文献20.
Katarzyna Cieślak Wojciech Golusiński 《Reports of Practical Oncology and Radiotherapy》2018,23(3):168-174