Tumor sincrônico colorretal e renal: uma rara incidência

Introduction: Colorectal cancer is a common malignant disease of the gastrointestinal tract. The number of cases has increased due to the use of new techniques and technology for early diagnosis of the disease. Kidney cell carcinoma accounts for between 2% and 3% of cases of cancers. Clear cell carcinoma is the most frequent histological subtype in the population and may be related to nonpolypoid hereditary syndromes. Synchrony tumor between these two types of cancers is of very rare occurrence and of multifactorial but indefinite etiopathogenesis. Objective: This article aims to discuss the occurence of concomitant colorectal and renal carcinomas which is a very rare condition in the world population. Methodology: The data related to the case report were obtained from the patient's medical records at Hospital Regional do Gama-DF (HRG-DF) between November 2016 and May 2017, this period of screening until the moment post-rectosigmoidectomy. For a review and discussion of the article, such as databases Lilacs, Scielo, Medline, BVS and PubMed, in addition to consulting periodicals. Conclusion: The main treatment is a surgical resection of the affected region with margins free of neoplasias. The prognosis of the disease, in general, depends on the degree of stage in a physical situation, the cell type, the fluid of differentiation of the tumor, and surgical extension.Introdução: O câncer colorretal é a doença maligna mais comum do trato gastrointestinal. O número de casos tem aumentado devido ao uso de novas técnicas e tecnologia para diagnóstico precoce da doença. Já o carcinoma de células renais representa entre 2% e 3% dos casos de cânceres. O carcinoma de células claras é o subtipo histológico mais frequente na população e pode estar relacionado a síndromes hereditárias não polipoides. O tumor sincrônico entre esses dois tipos de cânceres é de ocorrência bastante rara e de etiopatogenia multifatorial, mas ainda indefinida. Objetivo: Este artigo é um relato de caso e tem o intuito de discutir e relatar a sincronia entre um câncer colorretal e um carcinoma renal cujo caso apresenta rara incidência na população mundial. Metodologia: Os dados obtidos referentes ao relato de caso foram colhidos do prontuário da paciente no Hospital Regional do Gama-DF (HRG-DF) entre os meses de novembro de 2016 e maio de 2017, período este, de rastreio até o momento pós- retossigmoidectomia. Para a revisão e discussão deste artigo foram utilizadas as bases de dados Lilacs, Scielo, Medline, BVS e PubMed, além de consulta a periódicos. Conclusão: O principal tratamento é a ressecção cirúrgica da região acometida com as margens livres de neoplasias. O prognóstico da doença, em geral, depende do grau de estádio no qual se encontra a doença, o tipo celular, o nível de diferenciação do tumor e a extensão cirúrgica

Impact of cluster set resistance training on strength, functional capacity, metabolic and inflammatory state in older hemodialysis subjects: A randomized controlled clinical trial

Background and aims: Hemodialysis-associated neuromuscular dysfunction appears to be counteracted by resistance training (RT) in older patients with chronic kidney disease (CKD). Thus, the aim of the present study was to evaluate the impact of cluster-set RT protocol on anthropometric parameters, functional capacities, and biochemical variables in older patients with CKD. Methods and results: Seventy-eight older patients (age: 57.55 ± 4.06 years) with CKD undergoing maintenance hemodialysis participated, and were randomly divided into control group (CG, N = 26), traditional RT (RT, N = 26) and cluster-set RT (RT-CS, N = 26) groups. Participants completed 24 weeks of RT three times per week, 1 h and 30 min before the hemodialysis session. Patients from the RT-CS group displayed increased adherence as compared to the RT group (66.35 % versus 61.73 %, p < 0.0001). There was an improvement of all anthropometric variables, handgrip strength, timed up and-go (TUG) and six-minute walking test (6MWT) following both training protocols when compared to control group and pre-intervention values. Fasting blood glucose decreased for both RT and RT-CS groups as compared with pre-intervention, without differences between training protocols and CG. Glycated hemoglobin, inflammatory cytokines, and triglycerides decreased in RT and RT-CS groups as compared with pre-intervention and CG, without differences between them. Furthermore, the RT-CS protocol resulted in a greater number of people who were responsive to training when compared to traditional training. Conclusions: RT-CS is a clinically valuable tool to improve anthropometric parameters, handgrip strength, TUG, 6MWT, fasting blood glucose, and cytokines in CKD older patients