Desempenho ocupacional e qualidade de vida de adolescentes em diferentes momentos do tratamento oncológico / Occupational performance and quality of life of adolescents at different times of cancer treatment

 O objetivo deste trabalho foi estudar o desempenho ocupacional e qualidade de vida em adolescentes com câncer e verificar se existem diferenças nestas duas áreas em adolescentes ainda em tratamento oncológico e adolescentes na fase de follow up, através da avaliação da funcionalidade, verificação do desempenho de papéis ocupacionais e avaliação da qualidade de vida e a qualidade de vida relacionada à saúde. Trata-se de pesquisa transversal, quantitativa e descritiva, com coleta de dados prospectiva e amostragem por conveniência. Os instrumentos de coleta de dados foram: uma ficha de caracterização, para coleta de dados sociodemográficos e clínicos; a Medida de Independência Funcional (MIF); a Lista de Papéis Ocupacionais; e o Pediatric Quality of Life Inventory (PedsQL), em suas versões PedsQL Generic Core Scales e PedsQL Cancer Module. Houve diferença significativa entre os grupos em relação às médias de pontuação total da MIF, com pontuação mais baixa no grupo Em tratamento; frequências de desempenho de papéis ocupacionais nos tempos passado (trabalhador e voluntário), presente (estudante, cuidador, serviço doméstico, amigo) e futuro (religioso); médias de pontuação total no PedsQL Cancer Module e nos domínios “Dores e Machucados”, “Náuseas e Vômitos”, “Ansiedade frente aos procedimentos” e “Dificuldades Cognitivas” e também nas médias de pontuação total no PedsQL Generic Core Scales, assim como em todos os seus domínios (“Saúde e Atividades”, “Sentimentos”, “Convívio com outras pessoas” e “Escola”), com pontuações inferiores no grupo Em tratamento, mostrando que adolescentes em tratamento oncológico se encontram em risco quanto ao seu desempenho ocupacional, no que diz respeito à independência funcional e ao envolvimento em papéis ocupacionais, bem como em relação à qualidade de vida, uma vez que apresentaram índices inferiores aos de adolescentes que já concluíram o tratamento.

Insights in Osteosarcoma by Proton Nuclear Magnetic Resonance Serum Metabonomics

Pediatric osteosarcoma outcomes have improved over the last decades; however, patients who do not achieve a full resection of the tumor, even after aggressive chemotherapy, have the worst prognosis. At a genetic level, osteosarcoma presents many alterations, but there is scarce information on alterations at metabolomic levels. Therefore, an untargeted nuclear magnetic resonance metabonomic approach was used to reveal blood serum alterations, when samples were taken from 21 patients with osteosarcoma aged from 12–20 (18, 86%) to 43 (3, 14%) years before any anticancer therapy were collected. The results showed that metabolites differed greatly between osteosarcoma and healthy control serum samples, especially in lipids, aromatic amino acids (phenylalanine and tyrosine), and histidine concentrations. Besides, most of the loading plots point to protons of the fatty acyls (-CH3 and -CH2-) from very-low- and low-density lipoproteins and cholesterol, as crucial metabolites for discrimination of the patients with osteosarcoma from the healthy samples. The relevance of blood lipids in osteosarcoma was highlighted when analyzed together with the somatic mutations disclosed in tumor samples from the same cohort of patients, where six genes linked to the cholesterol metabolism were found being altered too. The high consistency of the discrimination between osteosarcoma and healthy control blood serum suggests that nuclear magnetic resonance could be successfully applied for osteosarcoma diagnostic and prognostic purposes, which could ameliorate the clinical efficacy of therapy

High Expression of HULC Is Associated with Poor Prognosis in Osteosarcoma Patients.

Osteosarcoma (OS) is the most common primary bone cancer in childhood. OS is an aggressive disease, and metastatic patients evolve with very poor clinical outcomes. Genetically, OSs are extremely complex tumors, and the related metastatic process is not well understood in terms of the biology of the disease. In this context, long non-coding RNAs (lncRNAs) have emerged as an important class of gene expression regulators that play key roles in the invasion and metastasis of several human tumors. Here, we evaluated the expression of HULC, which is an lncRNA that is associated with the tumor metastatic process, and assessed its potential role as a prognostic marker in OS. HULC expression was evaluated in primary OS samples using real-time RT-PCR. HULC expression status was determined by receiver operating characteristic (ROC) analysis, and its association with survival was assessed using the Kaplan-Meier method. The HULC expression level was not significantly associated with the clinicopathological characteristics of the OS patients. However, our data demonstrated that higher levels of expression of HULC were associated with lower survival rates in OS patients, both in terms of overall and event-free survival. Elevated HULC expression was associated with poor clinical outcomes among the OS patients, which suggests that HULC could be a potential prognostic biomarker in OS

Clinicopathological characteristics of the osteosarcoma population.

<p>Clinicopathological characteristics of the osteosarcoma population.</p

<i>HULC</i> expression cut-off based on predictive probability of clinical outcome among the OS patients.

<p><i>HULC</i> expression cut-off based on predictive probability of clinical outcome among the OS patients.</p

COX regression model of the event-free survival for the OS patients.

<p>COX regression model of the event-free survival for the OS patients.</p

Associations between <i>HULC</i> expression and clinicopathological characteristics of the OS patients.

<p>Associations between <i>HULC</i> expression and clinicopathological characteristics of the OS patients.</p

Kaplan-Meier survival curves of the OS patients according to <i>HULC</i> expression.

<p>A: overall survival, B: event-free survival.</p

Shorter Maintenance Therapy in Childhood Acute Lymphoblastic Leukemia: The Experience of the Prospective, Randomized Brazilian GBTLI ALL-93 Protocol

Maintenance therapy is an important phase of the childhood ALL treatment, requiring 2-year long therapy adherence of the patients and families. Weekly methotrexate (MTX) with daily 6-mercaptopurine (6MP) constitutes the backbone of maintenance therapy. Reduction in the maintenance therapy could overweight problems related with poverty of children with ALL living in Limited-Income countries (LIC). Objective: To compare, prospectively, the EFS rates of children with ALL treated according to two maintenance regimens: 18 vs 24 months duration. Materials and Methods: From October 1993 to September 1999, 867 consecutive untreated ALL patients 10 years and high WBC at diagnosis). Overall death in remission rate was 6.85% (56 patients). Deaths during maintenance were 13 in group 1 and 12 in group 2, all due to infection. Over 15 years of follow-up, two patients both from Group 2 presented a second malignancy (Hodgkin’s disease and thyroid carcinoma) after 8.3 and 11 years off therapy, respectively. Conclusion: Six-month reduction of maintenance therapy in ALL children treated according to the GBTLI ALL-93 protocol, provided the same overall outcome as 2-year duration regimen