11 research outputs found
Prevalência e fatores associados aos sintomas urinários na doença de Parkinson
The authors present a cross-sectional study involving 61 patients with idiopathic Parkinson's disease (PD) who were consecutively examined and compared to a control group with 74 subjects. Only patients who fulfilled the standard diagnostic criteria for PD and whose brain magnetic resonance imaging was normal were included. The objective of the study was to evaluate the prevalence of inferior urinary tract symptoms in PD and to study the possible association between clinical factors to urinary dysfunction. ln the patient group, 39.3% presented urinary symptoms when compared to 10.8% in the control group. All symptomatic patients presented irritative symptoms. The most common irritative symptom PD was nocturia, followed by frequency and urinary incontinence. Around 25% of the patients presented functional obstructive symptoms determined by the disease. The most frequent obstructive symptom was incomplete emptying of the bladder. Only the age of the patients and control group were correlated with urinary dysfunction.Trata-se de estudo clĂnico transversal, envolvendo 61 pacientes com doença de Parkinson idiopática (DP) examinados consecutivamente e comparados a 74 indivĂduos do grupo controle. Foram incluĂdos apenas pacientes com DP que preencheram os critĂ©rios de diagnĂłstico estabelecidos. A ressonância magnĂ©tica do encĂ©falo e a ultra-sonografia da prĂłstata foram utilizadas como critĂ©rios de exclusĂŁo. O objetivo do estudo foi avaliar a prevalĂŞncia de sintomas do trato urinário inferior na DP e verificar associações entre sexo, idade e fatores clĂnicos Ă s disfunções urinárias. Sintomatologia urinária foi encontrada em 39,3% dos parkinsonianos e 10,8% do grupo controle. Todos os pacientes sintomáticos apresentavam sintomas irritativos e 25% destes tinham sintomas obstrutivos. A sintomatologia urinária nĂŁo estava associada ao sexo, duração e gravidade da doença, hipotensĂŁo postural e sintomas ortostáticos, assim como com os sinais cardeais e tratamento com a levodopa.35936
Phase II study of capecitabine in substitution of 5-FU in the chemoradiotherapy regimen for patients with squamous cell carcinoma of the anal canal
Introdução: O carcinoma de cĂ©lulas escamosas (CEC) do canal anal Ă© uma neoplasia pouco frequente, correspondendo a 1-5% dos tumores intestinais. Entretanto, o risco de CEC do canal anal vem crescendo. O tratamento padrĂŁo do CEC de canal anal nos estádios II-III consiste em 5-fluorouracil infusional associado a mitomicina-C e radioterapia, desde 1974. Estudos clĂnicos com o objetivo de identificar novos esquemas terapĂŞuticos mais convenientes para câncer do canal anal devem continuar. MĂ©todos: Pacientes com CEC de canal anal T2-4N0M0 ou T (qualquer) N1-3M0, com bom performance clĂnico, função renal e hematolĂłgica normais foram tratados com capecitabina 825 mg/m2 12/12 horas durante a radioterapia associada a dose Ăşnica de mitomicina-C 15 mg/m2 no Dia 1. O objetivo primário do estudo foi determinar a taxa de controle local em 6 meses da associação de capecitabina, mitomicina-C e radioterapia em pacientes com câncer do canal anal. Os objetivos secundários foram determinar a taxa de toxicidade aguda graus 3-4, conforme os critĂ©rios da CTCaev4.0, taxa de resposta completa 6 semanas apĂłs tĂ©rmino da quimio-radioterapia, sobrevida global e livre de progressĂŁo e taxa de colostomia em 1 ano. O tamanho da amostra foi calculado usando a ferramenta \"estágio Ăşnico de Fleming\". Considerando 85% de eventos esperados (taxa de controle local em 6 meses), 1 desvio padrĂŁo e 5% de erro alfa, o tamanho ideal da amostra foi de 51 pacientes. Resultados: De novembro/2010 a fevereiro/2014, 51 pacientes foram incluĂdos, sendo avaliados 43 pacientes. Dezessete pacientes (39,5%) tinham estádio II, 11 (25,6%) estádio IIIA e 15 (34,9%) estádio IIIB. O seguimento mediano foi de 23,1 meses. Entre os pacientes que foram avaliados em 6 meses, 3 (7%) apresentaram resposta clĂnica parcial, 37 (86%) tiveram resposta clĂnica completa e 3 (7%) apresentaram progressĂŁo de doença. O controle loco-regional em 6 meses foi de 86%. Em relação Ă s toxicidades graus 3-4, observaram-se diarreia grau 3, em 4,6% dos pacientes, radiodermite grau 3, em 23,2%, vĂ´mitos grau 3, em 2,3%, plaquetopenia graus 3-4, em 6,9%, leucopenia grau 3, em 6,9%, e linfopenia grau 3, em 11,6%. Um paciente HIV positivo (2,3%) apresentou choque sĂ©ptico grau 4, pneumonia grau 4, meningoencefalite herpĂ©tica grau 4 e sĂndrome de ativação macrofágica grau 4. A taxa de colostomia foi de 18,6%. ConclusĂŁo: Capecitabina e mitomicina-C sĂŁo um tratamento bem tolerado em pacientes com carcinoma de canal anal, com controle loco-regional em 6 meses em 86% dos pacientes. Palavras-chave: carcinoma de cĂ©lulas escamosas, câncer anal, capecitabina, radioterapia, mitomicina-cBackground: Squamous cell carcinoma (SCC) of the anal canal is an uncommon malignancy accounting for 1-5% of intestinal tumors; however, its incidence has been increasing. Treatment for stage II and III anal canal SCC is infusional 5-fluorouracil associated with mitomycin and radiotherapy, since 1974. More convenient treatments for patients are needed. Methods: Patients with SCC of anal cancer T2-4N0M0 or T (any) N1-3M0, with good performance status, normal blood, and renal function were treated with capecitabine 825 mg/m2 bid during radiotherapy associated with a single dose of mitomycin 15 mg/m2 on day 1. Primary objective was local control rate at 6 months determined by clinical examination and radiological assessment. Sample size was calculated using Fleming single stage design. Results: From november/2010 to february/2014 51 patients were initially included, however 43 patients were assessed. Seventeen patients (39.5%) were stage II, 11 patients (25.6%) stage IIIA, and 15 patients (34.9%) stage IIIB. Four patients (9.3%) were HIV-positive, while 39 (90.7%) were HIV-negative. Median follow-up was 23.1 months. Among patients who finished the treatment and were reevaluated at 6 months 3 patients (7%) presented partial response, 37 patients (86%) had complete response, and 3 patients developed progression of the disease (7%). Regarding grade 3-4 toxicities, 10 patients (23.2%) had grade 3 radiodermitis, 3 patients (6.9%) had grade 3-4 thrombocytopenia, 5 (11.6%) had grade 3 lymphopenia, 1 patient (2.3%) had grade 3 vomiting, 2 patients (4.6%) had grade 3 diarrhea and 3 patients (6.9%) had grade 3 leukopenia. One HIV+ patient had septic shock, pneumonia, herpetic encephalitis and macrophage activation syndrome. Colostomy rate was 18.6%. Conclusions: Capecitabine and mitomycin with radiotherapy seem to be a safe treatment for SCC of the anal cancer, with a complete response rate in 6 months of 86
Replacing 5-fluorouracil by capecitabine in localised squamous cell carcinoma of the anal canal: systematic review and meta-analysis
Phase II study of capecitabine in substitution of 5-FU in the chemoradiotherapy regimen for patients with squamous cell carcinoma of the anal canal.
Combination therapy in high-risk stage II or stage III colon cancer: current practice and future prospects
Colon cancer represents the second leading cause of cancer-related deaths. For
patients who have undergone curative surgery, adjuvant therapy can reduce the
risk of recurrence and death from relapsed or metastatic disease. Postoperative
chemotherapy with a 5-fluorouracil-based regimen combined with oxaliplatin is
the current standard of care for stage III patients. However, there is still
controversy in stage II disease about the real impact of adjuvant monotherapy or
combined therapy on survival. Better identification of a subgroup of patients
with a higher risk of recurrence can select patients who might benefit from
adjuvant therapy. For the elderly population, there is a well-established role
for postoperative therapy, although the most appropriate regimen remains to be
defined. Targeted agents for combined adjuvant therapy in stage II and III colon
cancer is a promising area, but to date, there is no evidence supporting its use
in this setting. Results from large prospective trials with targeted therapy
have been disappointing and new drugs and strategies are needed to define the
role of these types of agents in the adjuvant scenario of colon cancer