Gastric cancer treated with pressurized intraperitoneal aerosol chemotherapy: revising an option for peritoneal carcinomatosis

Aim: Gastric cancer is the cancer with the highest rate of peritoneal metastization and this type of spread is associated with a higher death rate compared to distant organ metastasis. The systemic chemotherapy has a minimal effect in peritoneal metastasis so new types of treatment have emerged. The authors revised the main studies done in pressurized intraperitoneal aerosol chemotherapy (PIPAC) and presented the main conclusions. Methods: A PubMed search was conducted focusing on PIPAC in gastric cancer. The MeSH database was searched with the terms: “Gastric cancer [MeSH] and intraperitoneal aerosol chemotherapy”. Results: Seven studies were analyzed. All the studies performed the technique with aerosol of doxorubicin and cisplatin. All cases were well tolerated, with minor adverse effects. Patients presented resolution of their abdominal symptoms and regression of macroscopic carcinomatosis. Cytoreductive surgery or hypertermic intraperitoneal chemotherapy could be performed in some patients with good response to PIPAC. The peritonitis caused by the chemotherapy was well tolerated. Conclusion: PIPAC can induce remission in end-stage and resistant disease with acceptable side effects, good safety levels for patients and health professionals, and quality of life improvement.info:eu-repo/semantics/publishedVersio

Gastric Cancer and Angiogenesis: Is VEGF a Useful Biomarker to Assess Progression and Remission?

Gastric cancer (GC) has high mortality owing to its aggressive nature. Tumor angiogenesis plays an essential role in the growth, invasion, and metastatic spread of GC. The aim of this work was to review the angiogenic biomarkers related to the behavior of GC, documented in the literature. A search of the PubMed database was conducted with the MeSH terms: "Stomach neoplasms/blood [MeSH] or stomach neoplasms/blood supply [MeSH] and angiogenic proteins/blood [Major]". A total of 30 articles were initially collected, and 4 were subsequently excluded. Among the 26 articles collected, 16 examined the role of vascular endothelial growth factor (VEGF), 4 studied endostatin, 3 investigated angiopoietin (Ang)-2, 2 studied the Ang-like protein 2 (ANGTPL2), and 1 each examined interleukin (IL)-12, IL-8, and hypoxia inducible factor. Regarding VEGF, 6 articles concluded that the protein was related to lymph node metastasis or distant metastases. Five articles concluded that VEGF levels were elevated in the presence of GC and decreased following tumor regression, suggesting that VEGF levels could be a predictor of recurrence. Four articles concluded that high VEGF levels were correlated with poor prognosis and lower survival rates. Ang-2 and ANGTPL2 were elevated in GC and associated with more aggressive disease. Endostatin was associated with intestinal GC. VEGF is the most extensively studied angiogenic factor. It is associated with the presence of neoplastic disease and lymph node metastasis. It appears to be a good biomarker for disease progression and remission, but not for diagnosis. The data regarding other biomarkers are inconclusive.info:eu-repo/semantics/publishedVersio

Endocardite por Escherichia Coli: Quando o Improvável Acontece

Homem, 88 anos, recorre à urgência por astenia generalizada, anorexia e diminuição do débito urinário. Estava febril, hipotenso e com auscultação cardiopulmonar normal. Analiticamente apresentava leucocitose, creatinina de 3,1 mg/dL e leucocitúria. O doente foi internado por lesão renal aguda e medicado com ciprofloxacina assumindo uma infeção urinária. Foi isolada uma Escherichia coli na urocultura e 2 amostras de hemoculturas e o antibiótico foi alterado para meropenem de acordo com o antibiograma. Pela febre persistente e aumento dos parâmetros inflamatórios, foi realizado ecocardiograma transtorácico ao dia 14 de internamento, que revelou uma vegetação na válvula mitral, tendo-se adicionado à antibioterapia a gentamicina e vancomicina. Um acidente vascular cerebral isquémico, com transformação hemorrágica e plegia esquerda, e uma perfuração severa da válvula mitral posterior, complicaram o curso clínico. O estado clínico gradualmente melhorou e o doente transitou para uma unidade de reabilitação ao fim de 59 dias de internamento. Este caso pretende exemplificar como a endocardite é ainda uma entidade muitas vezes de difícil diagnóstico associada a complicações graves e obrigando a internamento prolongado

Angiogenic factors: role in esophageal cancer, a brief review

Esophageal cancer has an aggressive behavior with rapid tumor mass growth and frequently poor prognosis; it is known as one of the most fatal types of cancer worldwide. The identification of potential molecular markers that can predict the response to treatment and the prognosis of this cancer has been subject of a vast investigation in the recent years. Among several molecules, various angiogenic factors that are linked to the tumor development, growth, and invasion, such as VEGF, HGF, angiopoietin-2, IL-6, and TGF-B1, were investigated. In this paper, the authors sought to review the role of these angiogenic factors in prognosis and hypothesize how they can be used as a treatment target.info:eu-repo/semantics/publishedVersio

Woman's double work journey and life quality: the influence of the economic level on conciliation strategies between the labor time and the family time

A intensa participação da mulher no espaço público, com possibilidades incontestáveis de inserção no mercado de trabalho, tem provocado um custo no desenvolvimento de sua vida cotidiana, em virtude dos conflitos que surgem na conciliação do tempo laboral e familiar. Ou seja, à medida que a mulher assume responsabilidades extra-familiares, intensifica-se a ocorrência do fenômeno da dupla jornada de trabalho, diante da existência dos papéis e das prescrições sociais sexistas. A partir daí, tornam-se importantes os estudos que visem analisar esse vínculo trabalho/família, avaliando suas inter-relações e identificando suas contradições, a fim de gerar conhecimentos aplicáveis à melhoria do ambiente laboral e familiar da mulher trabalhadora. Nessa perspectiva, esta pesquisa examinou o padrão e a contribuição do trabalho feminino em três aspectos dimensionais: trabalho, trabalhador e ambiente de trabalho, como também suas estratégias de conciliação do uso do tempo e seus possíveis efeitos sobre a qualidade de vida. Fizeram parte do universo da pesquisa mulheres contratadas pela Universidade Federal de Viçosa - UFV, de diferentes níveis sociais, das quais 103 participaram da amostra, tendo sido submetidas a entrevistas por meio de questionários. Os resultados mostraram que todas as mulheres assumiam uma dupla jornada de trabalho, variando apenas sua intensidade. No caso das mulheres do nível de apoio e parte do intermediário, as responsabilidades na execução do trabalho doméstico eram quase que totais, enquanto as entrevistadas que tinham o nível superior transferiam para a empregada doméstica esse trabalho, o que contribui para reforçar o preconceito de que trabalho doméstico é “coisa” de mulher. Outro aspecto identificado foi que as mulheres que tinham o nível superior estendiam o trabalho profissional para o âmbito doméstico, tendo sido questionado se esse tempo estaria ou não implicando uma tripla jornada de trabalho. Do ponto de vista estatístico, as variáveis que tiveram maior associação com a dupla jornada estavam relacionadas com o perfil pessoal e familiar, o ambiente de trabalho e a qualidade de vida das mulheres entrevistadas. Para reduzir a ação dos fatores negativamente associados com a dupla jornada de trabalho, torna-se necessária a adoção de mecanismos interdisciplinares, de acordo com as características e relações do grupo familiar, para um equilíbrio mais eqüitativo de gênero na reprodução social. Tudo isto conjugado com jornadas de trabalho mais flexíveis, salários dignos, eficiente rede de serviços de apoio à unidade familiar, oportunidades de lazer cultural e comunitário, visando o fortalecimento dos vínculos e da comunicação intra e extra familiar, bem como a redução dos fatores de tensão, conflitos/estresse, de forma a promover o capital social, para que a emancipação da mulher não seja contrária à melhoria da qualidade de vida da família.The woman's intense participation in the public space, with incontestable possibilities for inserting in labor market, has been provoking a cost in the development of her daily life due to the conflicts that appear in conciliation of the labor time and family time. That is, as the woman takes extra-family responsibilities, the occurrence of the phenomenon of the work double journey intensifies due to either the existence of the roles and the sexist social prescriptions. Therefore, the studies that seek to analyze the work/family linkage, by evaluating its interrelations and identifying its contradictions become important in order to generate knowledge applicable to the improvement of the labor and family environment of the working woman. Under this perspective, this research examined the pattern and the contribution of the feminine work in three dimensional aspects: work, worker and work environment as well as its strategies for conciliation of the time use and its possible effects on life quality. The research universe consisted of different social level women hired by the Universidade Federal de Viçosa – UFV. From those, a total of 103 women participated in the sample, having been submitted to interviews by means of questionnaires. The results showed that all women assumed a work double journey, just varying its intensity. For those women of the support level case and those of the intermediate one, the responsibilities in execution of the domestic work were almost total, while the superior level interviewees used to transfer this work to the domestic maid, so contributing to reinforce the preconception that the domestic work is a “woman's thing." Another identified aspect was that the superior level women used to extend the professional work to the domestic ambit, having been questioned if this time would be or not implying a triple work journey. Under the statistical viewpoint, the variables showing a higher association with the double journey were related to both personal and family profile, the work environment and the life quality of the interviewed women. To reduce the action of the factors negatively associated with the double work journey, it was necessary to adopt the inter-disciplinary mechanisms according to the characteristics and relationships of the family group, for a more equitable balance of the gender in social reproduction. This, conjugated with more flexible work journeys, worthy wages, efficient net of support services to the family unit, opportunities for cultural and community leisure, aiming to the strengthening of the linkages and the intra and extra-family communication, as well as the reduction of the tension factors, conflicts/stress, in such a way to promote the social capital, so that the woman's emancipation would not be contrary to the improvement of the family life quality

Núcleos de Ensino da Unesp: artigos 2007

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Núcleos de Ensino da Unesp: artigos 2008

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq