Predictive value of chemotherapy-induced neutropenia for the efficacy of oral fluoropyrimidine S-1 in advanced gastric carcinoma

Myelosuppression that occurs during chemotherapy has been reported to be a predictor of better survival in patients with breast or lung carcinomas. We evaluated the prognostic implications of chemotherapy-induced neutropenia in advanced gastric carcinoma. Data from a prospective survey of oral fluoropyrimidine S-1 for advanced gastric cancer patients in Japan were reviewed. We identified 1055 untreated patients with adequate baseline bone marrow function. During treatment with S-1, a total of 293 (28%) patients experienced grade 1 or higher neutropenia. The adjusted hazard ratio of death for the presence of neutropenia, as compared with the absence of such toxicity, from a multivariate Cox model was 0.72 (95% confidence interval, 0.54–0.95; P=0.0189) for grade 1 neutropenia, 0.63 (0.50–0.78; P<0.0001) for grade 2 neutropenia and 0.71 (0.51–0.98; P=0.0388) for grade 3–4 neutropenia. These findings suggest that the occurrence of neutropenia during chemotherapy is an independent predictor of increased survival in patients with advanced gastric cancer, whereas the absence of such toxicity indicates that the dosages of drugs are not pharmacologically adequate. Monitoring of neutropenia in patients who receive chemotherapy may contribute to improved drug efficacy and favourable survival

Modificações no periodonto de ratos diabéticos após a movimentação ortodôntica Periodontal ligament changes after induced dental movement in diabetic rats

OBJETIVOS: o objetivo deste trabalho foi avaliar as modificações do ligamento periodontal de incisivos de ratos diabéticos submetidos a forças ortodônticas. MÉTODOS: vinte ratos machos Wistar (Rattus norvegicus) com 105 dias de idade foram empregados. Os ratos foram divididos em quatro grupos: C - animais normoglicêmicos não submetidos à movimentação dentária; CAO - animais normoglicêmicos submetidos à movimentação dentária; D - animais diabéticos não submetidos à movimentação dentária; DAO - animais diabéticos submetidos à movimentação dentária. Os animais permaneceram com o dispositivo de movimentação dentária por 5 dias. Foram avaliados o número de vasos sangüíneos e a espessura do ligamento periodontal nos terços cervical, médio e apical dos cortes histológicos. RESULTADOS E CONCLUSÕES: no lado de tensão, a movimentação dentária nos animais do grupo CAO resultou em um ligamento periodontal mais espesso (17,64% no terço apical, 39,28% no terço médio e 51,35% na região cervical), quando comparado ao grupo C (p < 0,05 para os terços médio e cervical). No grupo DAO, o aumento da espessura do ligamento periodontal foi 50,55% (terço apical), 48,14% (terço médio) e 50% (terço cervical) maior que nos animais do grupo D (p < 0,05). O número de vasos sanguíneos encontrados no ligamento periodontal não apresentou diferenças estatisticamente significantes quando todos os grupos foram comparados (p > 0,05). Ainda no lado de tensão, foram observadas lacunas de reabsorção nos animais dos grupos CAO, D e DAO. O lado de pressão não foi examinado nesta fase do estudo.<br>AIM: The aim of this study was to evaluate the periodontal ligament changes after induced dental movement of the upper incisor in diabetic rats. METHODS: Twenty Wistar rats (Rattus norvegicus) with 105 days of age were used. The rats were divided in four groups: C - normoglicemic animals not submitted to dental movement; CAO - normoglicemic animals submitted to dental movement; D - diabetic animals not submitted the dental movement; DAO - diabetic animals submitted to dental movement. The animals had remained with dental movement devices during 5 days. The number of sanguine vessels and the thickness of the periodontal ligament were evaluated at cervical, medium and apical histological cut regions. RESULTS AND CONCLUSION: At tension side, the dental movement in the animals of group CAO resulted in a thicker periodontal ligament (17.64% apical, 39.28% medium, 51.35% cervical) when compared to C group (p < 0.05 for medium and cervical area). Group DAO exhibited an increase of periodontal ligament thickness of 50.55% (apical), 48.14% (average) and 50% (cervical) when compared to group D (p < 0.05). The periodontal ligament sanguine vessels number did not differed significantly for all groups (p < 0.05). At tension side, bone reabsorption lacunae were observed in CAO, D and DAO groups. The pressure side was not examined in this study phase