ARTICULAR PAIN IS CORRELATED WITH ULTRASOUND POWER DOPPLER FINDINGS?

Universidade Federal de São Paulo, Div Rheumatol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Radiol, São Paulo, BrazilUniv Politecn Marche, Div Rheumatol, Jesi, ItalyUniversidade Federal de São Paulo, Div Rheumatol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Radiol, São Paulo, BrazilWeb of Scienc

Mammography-based screening program: preliminary results from a first 2-year round in a Brazilian region using mobile and fixed units

RLH, TBS and ALF made substantial contributions to the conception and design of the article, the acquisition, analysis and interpretation of the data, and drafting of the article. ECM, JSCM and NB made substantial contributions to the conception and design of the study.Background: Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer deaths among women worldwide. The use of mobile mammography units to offer screening to women living in remote areas is a rational strategy to increase the number of women examined. This study aimed to evaluate results from the first 2 years of a government-organized mammography screening program implemented with a mobile unit (MU) and a fixed unit (FU) in a rural county in Brazil. The program offered breast cancer screening to women living in Barretos and the surrounding area. Methods: Based on epidemiologic data, 54 238 women, aged 40 to 69 years, were eligible for breast cancer screening. The study included women examined from April 1, 2003 to March 31, 2005. The chi-square test and Bonferroni correction analyses were used to evaluate the frequencies of tumors and the importance of clinical parameters and tumor characteristics. Significance was set at p < 0.05. Results: Overall, 17 964 women underwent mammography. This represented 33.1% of eligible women in the area. A mean of 18.6 and 26.3 women per day were examined in the FU and MU, respectively. Seventy six patients were diagnosed with breast cancer (41 (54%) in the MU). This represented 4.2 cases of breast cancer per 1000 examinations. The number of cancers detected was significantly higher in women aged 60 to 69 years than in those aged 50 to 59 years (p < 0.001) or 40 to 49 years (p < 0.001). No difference was observed between women aged 40 to 49 years and those aged 50 to 59 years (p = 0.164). The proportion of tumors in the early (EC 0 and EC I) and advanced (CS III and CS IV) stages of development were 43.4% and 15.8%, respectively. Conclusions: Preliminary results indicate that this mammography screening program is feasible for implementation in a rural Brazilian territory and favor program continuation

Genetic and biochemical biomarkers related to oxidative stress in patients with schizophrenia

We evaluated the association of glutathione S-transferase polymorphisms (GSTT1 and GSTM1) and oxidative stress biomarkers in patients with schizophrenia. A total of 162 subjects were studied: 53 had schizophrenia (Total Study Group-TSG), and 109 without the disorder (Total Control Group-TCG). To analyze oxidative stress, TSG was distributed into treatment-responsive schizophrenia (N = 26) and treatment-resistant (N = 27) versus control group (N = 36). Peripheral blood collection for analysis of polymorphisms, malondialdehyde (MDA) and trolox equivalent antioxidant capacity (TEAC); a questionnaire or a medical record for clinical profile and lifestyle was also applied. Frequency of genotypes did not differ significantly between the groups. The patients had a significantly reduced frequency of the combination GSTT1-null/GSTM1-present (13 versus 30%) and significantly higher plasma MDA levels, but similar TEAC values. Smoking, diabetes mellitus (DM), systemic arterial hypertension (SAH) and family history (FH) significantly prevailed in patients (TSG) compared to controls (TCG). High sensitivity and specificity values for MDA (area under the curve >0.90) were observed. Reduced frequency of the combination GSTT1-null/GSTM1-present in patients suggests exposure to oxidative stress, represented by increased MDA and mainly aggravated by smoking, SAH, DM and FH. High sensitivity and specificity identifies the potential of MDA as a marker of oxidative stress in schizophrenia182CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQsem informaçãoWe thank the CNPq (National Council for Scientific and Technological Development) for financial support as well as FAMERP (Medical School of São José do Rio Preto, SP), NPBIM (Research Center in Biochemistry and Molecular Biology - FAMERP) and LQBOA (Bio-Organic and Environmental Chemistry LaboratoryIBILCE/UNESP) for supporting the researc

Efficacy and safety of rechallenge treatment with gefitinib in patients with advanced non-small cell lung cancer

Objectives Although patients with advanced non-small cell lung cancer (NSCLC) and an activating epidermal growth factor receptor (EGFR) mutation benefit from the use of EGFR-tyrosine kinase inhibitors (TKI), most of them progress within 12 months from treatment start due to acquired resistance. In clinical practice, many physicians frequently offer these patients retreatment with EGFR-TKIs after a chemotherapy break, based on small or retrospective studies. Materials and methods A phase II trial was conducted in patients with stage III/IV NSCLC, to assess the efficacy, safety and impact on quality of life (QoL) and disease-related symptoms of gefitinib rechallenge. Eligible patients had initially responded to first-line gefitinib and progressed after second-line chemotherapy. Results Of 61 enrolled patients, 73.8% were female, 100% had EGFR-mutated adenocarcinoma and 67.2% were never-smokers. Thirty-two (52.5%) patients obtained a clinical benefit, with 3 (4.9%) achieving a partial response and 29 (47.5%) having stable disease. Median progression-free survival was 2.8 months, overall survival 10.2 months and duration of gefitinib treatment 3.6 months. The most common all grade-adverse events were diarrhea (27.6%), nausea and/or vomiting (20.3%), rash (14.7%) and dyspnea (10.3%); no new toxicities were apparent. Conclusion Findings from this study indicate that gefitinib rechallenge offers modest benefit and may be taken into consideration only for patients for whom no other treatment option exists

Syndrome of inappropriate anti-diuretic hormone secretion in cancer patients: results of the first multicenter Italian study

Background: Hyponatremia in cancer patients is often caused by the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The aim of this observational multicenter study was to analyze the medical and economic implications of SIADH in this setting. Methods: This study included 90 oncological patients from 28 Italian institutions that developed SIADH between January 2010 and September 2015. Data on clinical–pathological characteristics, anticancer therapies, hyponatremia, and related treatments were statistically analyzed. Results: The majority were lung cancer patients (73%) with metastatic disease at the onset of hyponatremia (83%). A total of 76 patients (84%) were hospitalized because of SIADH and less than half (41%) received tolvaptan for SIADH treatment. The duration of hospitalization was significantly longer in patients who did not receive tolvaptan and in those who do not reach sodium normalization during hospitalization. Patients who experienced a second episode of hyponatremia following tolvaptan dose modification/discontinuation presented a significantly lower serum sodium value at the time of hospitalization and minimum sodium value during hospitalization compared with patients who had not experienced another episode. The severity of hyponatremia, defined as minimum sodium value during hospitalization with a cut-off value of 110 mmol/l, and not obtaining sodium correction during hospitalization significantly correlated with overall survival rate. Conclusions: Hyponatremia due to SIADH could result in longer hospitalization and in a decreased overall survival when not adequately treated, and tolvaptan represents an effective treatment with a potential effect of both improving overall survival and decreasing duration of hospitalization