High 15-f-2t-isoprostane Levels In Patients With A Previous History Of Nonmelanoma Skin Cancer: The Effects Of Supplementary Antioxidant Therapy

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Background. Phase I of this study was aimed at comparing the profiles of oxidative stress biomarkers in patients with history of nonmelanoma skin cancer (NMSC), previously treated with surgery, to the healthy subjects. Phase II aimed to evaluate the effects of supplementary antioxidant therapy on the levels of biomarkers in the case group. Materials and Methods. In Phase I, oxidative stress biomarkers were measured in blood samples obtained from 24 healthy subjects and 60 patients with history of NMSC previously treated with surgery. In Phase II, the 60 patients with history of NMSC were randomized into two subgroups, one receiving placebo (n = 34) and the other (n = 26) receiving vitamin C, vitamin E, and zinc supplementation for 8 weeks, followed by reevaluation of biomarkers. Results. In Phase I, patients with history of NMSC showed increased plasma concentrations of all biomarkers, but only 15-F-2t-isoprostane was significantly higher than in the healthy subjects. Risk of NMSC increased by 4% for each additional 1 pg/mL increase in 15-F-2t-isoprostane. In Phase II, supplementation did not significantly reduce levels of oxidative stress biomarkers. Conclusion. Patients with history of NMSC had significantly high 15-F-2t-isoprostane plasma levels; supplementation did not result in significant reduction of oxidative stress biomarkers. This trial was registered with ClinicalTrials.gov (ID NCT02248584).Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)CNPq [482958/2011-1

High 15-f-2t-isoprostane levels in patients with a previous history of nonmelanoma skin cancer: the effects of supplementary antioxidant therapy

Phase I of this study was aimed at comparing the profiles of oxidative stress biomarkers in patients with history of nonmelanoma skin cancer (NMSC), previously treated with surgery, to the healthy subjects. Phase II aimed to evaluate the effects of supplementary antioxidant therapy on the levels of biomarkers in the case group. In Phase I, oxidative stress biomarkers were measured in blood samples obtained from 24 healthy subjects and 60 patients with history of NMSC previously treated with surgery. In Phase II, the 60 patients with history of NMSC were randomized into two subgroups, one receiving placebo (n = 34) and the other (n = 26) receiving vitamin C, vitamin E, and zinc supplementation for 8 weeks, followed by reevaluation of biomarkers. Results. In Phase I, patients with history of NMSC showed increased plasma concentrations of all biomarkers, but only 15-F-2t-isoprostane was significantly higher than in the healthy subjects. Risk of NMSC increased by 4% for each additional 1 pg/mL increase in 15-F-2t-isoprostane. In Phase II, supplementation did not significantly reduce levels of oxidative stress biomarkers. Patients with history of NMSC had significantly high 15-F-2t-isoprostane plasma levels; supplementation did not result in significant reduction of oxidative stress biomarkers. This trial was registered with ClinicalTrials.gov (ID NCT02248584)2015CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP482958/2011-1sem informaçã

High 15-f2t-isoprostane Levels In Patients With A Previous History Of Nonmelanoma Skin Cancer: The Effects Of Supplementary Antioxidant Therapy.

Phase I of this study was aimed at comparing the profiles of oxidative stress biomarkers in patients with history of nonmelanoma skin cancer (NMSC), previously treated with surgery, to the healthy subjects. Phase II aimed to evaluate the effects of supplementary antioxidant therapy on the levels of biomarkers in the case group. In Phase I, oxidative stress biomarkers were measured in blood samples obtained from 24 healthy subjects and 60 patients with history of NMSC previously treated with surgery. In Phase II, the 60 patients with history of NMSC were randomized into two subgroups, one receiving placebo (n = 34) and the other (n = 26) receiving vitamin C, vitamin E, and zinc supplementation for 8 weeks, followed by reevaluation of biomarkers. In Phase I, patients with history of NMSC showed increased plasma concentrations of all biomarkers, but only 15-F2t-isoprostane was significantly higher than in the healthy subjects. Risk of NMSC increased by 4% for each additional 1 pg/mL increase in 15-F2t-isoprostane. In Phase II, supplementation did not significantly reduce levels of oxidative stress biomarkers. Patients with history of NMSC had significantly high 15-F2t-isoprostane plasma levels; supplementation did not result in significant reduction of oxidative stress biomarkers. This trial was registered with ClinicalTrials.gov (ID NCT02248584).201596356

Polymyxin B versus colistin use for treatment of Gram-negative infections : an analysis of safety, clinical outcomes and pharmacoeconomy

Orientador: Patricia MorielDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: O emergente crescimento dos casos de infecções nosocomiais, especialmente nas Unidades de Terapia Intensiva (UTI), causadas por bactérias gram-negativas levou a reintrodução do uso das polimixinas no combate a estes patógenos. Este trabalho teve como objetivo avaliar o impacto clínico e econômico da utilização da polimixina B e colistina no tratamento de pacientes internados em UTIs. Foi realizado um estudo retrospectivo observacional, com duração de 36 meses, em arquivo eletrônico e prontuários de pacientes adultos internados nas UTIs de um hospital universitário no interior de São Paulo, e que utilizaram a colistina ou polimixina-b. Os defechos avaliados foram nefrotoxicidade e a mortalidade de 30 dias após o início do tratamento. A função renal foi avaliada através do monitoramento da concentração plasmática de creatinina, seguindo os critérios estabelecidos pelo Acute Kidney Injure (AKIN), sendo definido como injúria renal o aumento de 1,5 vezes no valor da creatinina em relação ao início do tratamento. Um total de 197 pacientes foram analisados quanto a nefrotoxicidade, sendo que deste, 109 foram estudados quanto ao desfecho clínico, uma vez que 88 pacientes foram excluídos por não apresentarem infecções causadas por patógenos sensíveis às polimixinas. Secreção traqueal foi a amostra clínica mais frequente, seguido por sangue. Infecções causadas por A. baumannii foram as mais prevalentes, e apresentaram elevada taxa de resistência frente a praticamente todas as classes de antibióticos testadas (aminoglicosídeos, quinolonas e beta-lactâmicos), com exceção das polimixinas que apresentaram excelente taxa de susceptibilidade (>95%). A nefrotoxicidade foi similar em ambos os grupos (20,2% Vs. 18,4% para os pacientes tratados com polimixina B e colistina, respectivamente; p>0,05), e foi identificada como fator de risco para mortalidade para os pacientes tratados com a colistina (p 95%) and less often for amikacin and gentamicin. Nephrotoxicity was similar for both groups (20,2 % Vs. 18,4% for patients treated with polymyxin B and colistin, respectively; p>0,05). For patients treated with colistin, nephrotoxicity was associated with the long-term treatment (p0,05). Furthermore, cost of colistin therapy was higher than polymyxin B. High dosis of polymyxins may be related with increase survival, without increasing nephrotoxicity risk. Both antibiotics shown a similar nephrotoxicity, despite the time to onset was significantly lower in patients treated with colistin. Regarding the 30-day mortality, even it was not statistically different, patients treated with colistin shown a better outcome despite it was associated with a higher costMestradoPatologia ClinicaMestre em Ciências Médicas02P4353/2015164796/2014-2CAPESCNP

Colistin and polymyxin B for treatment of nosocomial infections in intensive care unit patients: pharmacoeconomic analysis

The emergence and rapid spread of multidrug-resistant gram-negative bacteria related to nosocomial infections is a growing worldwide problem, and polymyxins have become important due to the lack of new antibiotics. To evaluate the outcomes and pharmacoeconomic impact of using colistin and polymyxin B to treat nosocomial infections. Setting Neurosurgical, cardiovascular, or transplantation intensive care unit (ICU) at the Clinical Hospital of the University of Campinas (SAo Paulo, Brazil). A retrospective cohort study was conduct in patients in the ICU. The renal function was determined daily during treatment by measuring the serum creatinine. A cost minimization analysis was performed to compare the relative costs of treatment with colistin and polymyxin B. Main outcomes measure The outcomes were 30-day mortality and frequency and onset of nephrotoxicity after beginning treatment. Fifty-one patients treated with colistin and 51 with polymyxin B were included. 30-day mortality was observed in 25.49% and 33.33% of patients treated with colistin and polymyxin B, respectively; Nephrotoxicity was observed in 43.14% and 54.90% of patients in colistin and polymyxin B groups, respectively; and onset time of nephrotoxicity was 9.86 +/- 13.22days for colistin and 10.68 +/- 9.93days for polymyxin B group. Colistin treatment had a lower cost per patient compared to the cost for polymyxin B treatment (USD $13,389.37 vs. USD$13,639.16, respectively). We found no difference between 30-day mortality and nephrotoxicity between groups; however, colistin proved to be the best option from a pharmacoeconomic point of view4117480CAPES - Coordenação de Aperfeiçoamento de Pessoal e Nível SuperiorCNPQ - Conselho Nacional de Desenvolvimento Científico e Tecnológico164796/2014-2; 02P4353/2015Sem informaçã

Clinical Study High 15-F 2t -Isoprostane Levels in Patients with a Previous History of Nonmelanoma Skin Cancer: The Effects of Supplementary Antioxidant Therapy

Background. Phase I of this study was aimed at comparing the profiles of oxidative stress biomarkers in patients with history of nonmelanoma skin cancer (NMSC), previously treated with surgery, to the healthy subjects. Phase II aimed to evaluate the effects of supplementary antioxidant therapy on the levels of biomarkers in the case group. Materials and Methods. In Phase I, oxidative stress biomarkers were measured in blood samples obtained from 24 healthy subjects and 60 patients with history of NMSC previously treated with surgery. In Phase II, the 60 patients with history of NMSC were randomized into two subgroups, one receiving placebo ( = 34) and the other ( = 26) receiving vitamin C, vitamin E, and zinc supplementation for 8 weeks, followed by reevaluation of biomarkers. Results. In Phase I, patients with history of NMSC showed increased plasma concentrations of all biomarkers, but only 15-F 2t -isoprostane was significantly higher than in the healthy subjects. Risk of NMSC increased by 4% for each additional 1 pg/mL increase in 15-F 2t -isoprostane. In Phase II, supplementation did not significantly reduce levels of oxidative stress biomarkers. Conclusion. Patients with history of NMSC had significantly high 15-F 2t -isoprostane plasma levels; supplementation did not result in significant reduction of oxidative stress biomarkers. This trial was registered with ClinicalTrials.gov (ID NCT02248584)