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- ItemSomente MetadadadosAplicação da técnica de pcr em tempo real na identificação microbiana e detecção de genes de resistência a antimicrobianos em episódios de bacteremia de pacientes pediátricos com câncer(Universidade Federal de São Paulo (UNIFESP), 2014-04-11) Carlesse, Fabianne Altruda de Moraes Costa [UNIFESP]; Pignatari, Antonio Carlos Campos Pignatari [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: Bloodstream infections (BSI) are major cause of infection-related mortality in patients with cancer. Phenotipic methods are utilized to detect and to identify pathogens in blood stream cultures but with slow time for positivity and final results. Molecular techniques have been utilized for a quick ethiologic diagnosis of blood stream infections allowing the institution of an early adequate therapy improving patients survival rates. Aim: To evaluate if the Real Time PCR method used to identify the main pathogens causing blood stream infections and some important antimicrobial resistance genes causing bloodstream infections could improve the early diagnosis and adequate therapy in oncology pediatric patients. Methods: During March 2010 to March 2012 we conducted a retrospective study at the Oncology Pediatric Institute (IOP-GRAACC-Brazil). The blood stream samples were incubated in the automated Bactec® system and the microbal identification and susceptibility tests were done in the automated Phoenix® system. We included 81 blood positive blood stream samples that were submitted to molecular analysis. Polimicrobial infections were excluded, 69 BSI were analysed in 64 patients. Samples from the blood stream bottles were submitted to molecular tests by Real Time PCR with specific Gram probes, 17 specific gender sequences and antimicrobial resistance genes blaSHV, blaTEM, blaCTX, blaKPC, blaIMP, blaSPM, blaVIM, vanA, vanB e mecA.The adequacy of the antimicrobial therapy was evaluated at the time of the Gram stain result from the positive blood bottle (time 1) and in the available final phenotypic result for the assistant physician (time 2). Results: Gram positive bacteria were identified in 61% of the samples, Gram negative bacteria in 32% and fungi in 7%. There was agreement in 82,6% for the initial Gram stain and 78,2% in the final species identification between the phenotipic and molecular methods. The mecA gene was detected in 81,4% of Staphylococcus spp, and was 91,6% concordant with the phenotypic method. Detection of vanA gene was 100% concordant. For Gram negative bacteria the concordance was 71,4% for Enterobacteriacea and 50% for Pseudomonas aeruginosa. Therapy was inadequate particularly in patients who died (5/6). The molecular tests was concordant in 50% of theses cases. Conclusion: Real Time PCR could be useful in the early identification of pathogens and antimicrobial resistance genes in bloodstream infections of pediatric oncologic patients and could contribute to improve the antimicrobial therapy.
- ItemAcesso aberto (Open Access)Avaliação da eficiência da nutrição parenteral quanto à oferta de energia em pacientes oncológicos pediátricos(Pontifícia Universidade Católica de Campinas, 2007-04-01) Garófolo, Adriana [UNIFESP]; Boin, Susiane Gusi [UNIFESP]; Modesto, Patrícia Claudia [UNIFESP]; Petrilli, Antonio Sergio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: The objective of this study was to evaluate parenteral nutrition efficiency in supplying energy for pediatric oncology patients, indications and main difficulties in the procedure. METHODS: This was an observational descriptive study done from July 2003 to July 2004 at the Pediatric Oncology Institute of the Universidade Federal de São Paulo (UNIFESP). Inclusion criteria: hospitalized cancer patients receiving parenteral. Energy adequateness was analyzed by equations that calculated basal energy expenditure adjusted for initial progression. RESULTS: Forty-one (4%) of the 1016 hospitalized patients received parenteral nutrition: 54% were males and received parenteral nutrition for a median of 10 days (1-51). Fifty-six percent of the episodes did not reach the adjusted basal energy expenditure; 26% remained between 100 and 120% and 18% were above 120%. The mean adjusted basal energy expenditure was 106% with a standard deviation of 38% and a median of 96%. The reasons associated with difficulties to achieve the basal energy expenditure were metabolic intolerance, non-exclusive parenteral nutrition, suspension or interruption of its use, prescription without discussing with nutritionist and use of peripheral route. Parenteral nutrition was mainly indicated in gastrointestinal toxicity. The discarded volume of parenteral nutrition was above 10% in 17 of 35 episodes (49%). Protection from room light (cover) assessed in 19 patients during the days of administration detected an absence of 37 of 315 days (12%). CONCLUSION: Energy supply did not meet the demands of a high percentage of the patients, mainly because of the severity of the clinical scenario, interruptions and non-exclusive use, reducing the amount of time available to administer the nutrition. A multidisciplinary team which would improve the efficiency of the procedures could reduce the losses, guaranteeing a more adequate supply and increasing the benefits of parenteral nutrition.
- ItemSomente MetadadadosB-1 cell: the precursor of a novel mononuclear phagocyte with immuno-regulatory properties(Acad Brasileira De Ciencias, 2009-09-01) Lopes, Jose Daniel [UNIFESP]; Mariano, Mario [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Characterization of the origin, properties, functions and fate of cells is a fundamental task for the understanding of physiological and pathological phenomena. Despite the bulk of knowledge concerning the diverse characteristics of mammalian cells, some of them, such as B-1 cells, are still poorly understood. Here we report the results obtained in our laboratory on these cells in the last 10 years. After showing that B-1 cells could be cultured and amplified in vitro, a series of experiments were performed with these cells. They showed that B1 cells reside mostly in the peritoneal and pleural cavities, migrate to distant inflammatory foci, coalesce to form giant cells and participate in granuloma formation, both in vitro and in vivo. They are also able to present antigens to immunologically responsive cells and are endowed with regulatory properties. Further, we have also shown that these cells facilitate different types of infection as well as tumor growth and spreading. These data are presently reviewed pointing to a pivotal role that these cells may play in innate and acquired immunity.
- ItemSomente MetadadadosO câncer gástrico (cg) é a quinta causa de câncer no Brasil(Universidade Federal de São Paulo (UNIFESP), 2015-12-16) Aguiar Junior, Pedro Nazareth [UNIFESP]; Forones, Nora Manoukian Forones [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Gastric cancer (GC) is the fifth leading cause of cancer in Brazil. Despite the poor prognosis, palliative chemotherapy is the standard treatment for patients with metastatic disease. However, there is still controversy about the best scheme. Objectives: To evaluate the overall survival (OS), response rate (RR) and toxicity in patients with metastatic GC undergoing chemotherapy, to compare the cost-effectiveness of regimens, and assess the prognostic value of tumor expression of HER2 in patients with no specific treatment for this condition. Methods: This is a retrospective observational study, including patients treated in the last four years in UNIFESP oncology sector. Results: 47 patients were included. In the first-line setting: 29 received chemotherapy based on fluoropyrimidine plus platinum (FP) - mean of 59 years (24-88), 34% had ECOG 2 and received an average of 5.7 cycles; 16 were treated with a triple regimen (EOX) - mean of 47 years (27-71), 19% had ECOG 2 and completed 5.4 cycles on average. The remaining two patients were treated with single agent. The median OS of the entire population was 13.8 months. RR was 64% for EOX and 38% for FP (P = 0.25). The median PFS was 9.5 and 5.6 months, respectively (HR 0.85; 95% CI: 0.41 to 1.74). Grade 3 or 4 adverse events were observed in 56% and 28% of patients, respectively (P = 0.64). The cost-effectiveness of treatments was similar (approximately R$ 23,000 for each additional year of survival). However, the ratio reduced by 50% when EOX was administered to patients with ECOG 0 or 1 under 65 years of age. Samples from 35 individuals were available for evaluation of the expression of HER2 and 16% were positive. Favorable histology (intestinal) (HR 0.34, 95%CI: 0.13 to 0.91), achieving second-line treatment (HR 0.25; 95%CI: 0.11 to 0.58) and response to the treatment (HR 0.23; 95%CI: 0.12 to 0.47) were prognostic factors associated with better OS. The expression of HER2 had a trend toward worse prognosis (HR 1.52; 95%CI: 0.50 to 4.66). Conclusion: Patients treated in our hospital showed PFS and OS compatible with the literature. There was no difference between the protocols with two or three drugs. However, the cost-effectiveness of the treatment improved with the regimen-choice based on clinical aspects. Second-line treatment should be considered whenever possible. The presence of tumor expression of HER2
- ItemAcesso aberto (Open Access)Características anatomoclínicas dos linfomas caninos na região de Botucatu, São Paulo(Universidade Federal de Minas Gerais, Escola de Veterinária, 1999-06-01) Sequeira, Júlio Lopes; Franco, Marcello Fabiano de [UNIFESP]; Bandarra, Enio Pedone; Figueiredo, L.m.a.; Rocha, Noeme Sousa; Universidade Estadual Paulista (UNESP); Universidade Federal de São Paulo (UNIFESP)This report describes 34 cases of canine lymphoma, all of them referred to the Veterinary Hospital of FMVZ - UNESP in Botucatu - SP, Brazil, comprising, nine German Shepherd dogs, nine mongrels, five Boxers, three Doberman and one of each eigth other breeds. The mean age was 6.2 years, range 1 to 13 years, and 68% of the dogs were males. The stage of the lymphomas was based on the World Health Organization criteria. At the time of diagnosis 32 dogs were at more advanced stages (IIII, IV, and V). Only two dogs were at stage II. The multicentric form was the most common anatomic one. This form was seen in 31 lymphomas. Nevertheless, thymic and alimentary forms were also observed in two and one dogs, respectively.
- ItemAcesso aberto (Open Access)Dermatomiosite juvenil e linfoma de Hodgkin: uma rara associação(Sociedade Brasileira de Reumatologia, 2007-12-01) Cavalcanti, André [UNIFESP]; Terreri, Maria Teresa Ramos Ascensão [UNIFESP]; Sallum, Adriana Maluf Elias; Marie, Suely Kazue Nagahashi; Luisi, Flávio [UNIFESP]; Hilário, Maria Odete Esteves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)Dermatomyositis (DM) in adults is frequently associated with cancer. In contrast, during childhood juvenile dermatomyositis (JDM) is predominantly idiopathic and its association with neoplasia is rare and based only in case reports. Although rare, the presence of neoplasia in JDM patients must always be suspected in face of atypical clinical manifestations and uncommon laboratorial findings. We describe and discuss a case of JDM and Hodgkin disease in an adolescent.
- ItemSomente MetadadadosEstudo histológico da cicatrização da parede abdominal em camundongos com a neoplasia de ehrlich por método imuno-histoquímico(Universidade Federal de São Paulo (UNIFESP), 2014-08-27) Salgado, Flavio Luiz Lima [UNIFESP]; Lopes Filho, Gaspar de Jesus Lopes Filho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To evaluate the histological changes in laparotomy scars of healthy BALB/c mice with an Ehrlich tumor in its various forms of presentation using immunohistochemical techniques. Methods: Studies were conducted on 54 mice divided into 3 groups of 18 animals. One group was the control, the second presented the Ehrlich ascites tumors, and the third group had the subcutaneous form. Seven days after inoculation of the tumor, all 54 mice were submitted to laparotomy. All of the animals in the experiment were operated on again on the seventh day after surgery, with resection of the scar and subsequent euthanasia of the animal. The scars were sent for histological assessment using immunohistochemical techniques to evaluate Cox-2 (cyclooxygenase 2), VEGF (vascular endothelial growth factor) and FGF (fibroblast growth factor); and were analyzed semi-quantitatively on the laparotomy scar and the abdominal wall farthest from the site of the operation. Results: Assessing the weight of the animals, the correct inoculation of the tumor and weight gain in the group with ascites tumors was observed. The histological studies showed that groups with the tumor showed a statistically significant higher presence of Cox-2 compared to the control. In the Cox-2 study of the abdominal wall location, this was the site in which the ascites group showed the most significant difference. The VEGF did not present any significant differences between the 3 groups, regardless of the site studied. The FGF showed a significant increase in animals with the tumor. Conclusion: In mice with different forms of presentation of the Ehrlich tumor, there was a statistically significant predominance of immunoreactivity of Cox-2 and FGF in the surgical scars compared to the group of healthy animals. VEGF showed no significant difference. This finding suggests more inflammation and fibroblast proliferation in animals from the groups with tumors.
- ItemSomente MetadadadosExpression of SIRT1 in Ocular Surface Squamous Neoplasia(Lippincott Williams & Wilkins, 2012-07-01) Alves, Luiz Filipe de A. [UNIFESP]; Fernandes, Bruno F.; Burnier, Julia V.; Mansure, Jose J.; Maloney, Shawn; Odashiro, Alexandre N.; Antecka, Emilia; De Souza, Dominique F.; Burnier, Miguel N.; Henry C Witelson Ocular Pathol Lab; Brazilian AF Cent Hosp; Universidade Federal de São Paulo (UNIFESP); McGill UnivBackground: the class III histone deacetylase SIRT1 is overexpressed in many malignancies and has been implicated in inactivating proteins that are involved in tumor suppression and DNA damage repair. in the current study, we examined the expression of SIRT1 in normal epithelium (NE) compared with ocular surface squamous neoplasia (OSSN) to elucidate a possible role for SIRT1 in the development or progression of this malignancy.Methods: We examined SIRT1 expression by immunohistochemistry in 47 cases of OSSN and 10 specimens of NE. Our sample included 11 benign lesions (papillomas), 25 cases of conjunctival intraepithelial neoplasia, and 11 malignant lesions of squamous cell carcinoma. the extent of staining and intensity was scored and the combined raw data were then converted to the German Immunoreactive Score.Results: Nuclear and cytoplasmic expression of SIRT1 was observed in all cases of OSSN. for the NE specimens, 50% showed negative expression and 30% weak expression, and 20% were considered significantly immunoreactive. the differential expression of SIRT1 between NE and OSSN was statistically significant (P < 0.0001). Additionally, when the staining pattern in cases of conjunctival intraepithelial neoplasia was evaluated, the staining of the more differentiated surface cells was remarkably weaker compared with the cells located closer to the basal membrane.Conclusions: SIRT1 may play an important role in the development and progression of epithelial tumors of the conjunctiva. Further research into the potential of SIRT1 as a novel therapeutic target is warranted.
- ItemSomente MetadadadosExtramedullary plasmacytoma of the third eyelid gland in a dog(Wiley-Blackwell, 2009-03-01) Perlmann, Eduardo; Dagli, Maria L. Z.; Martins, Maria C. [UNIFESP]; Siqueira, Sheila A. C.; Barros, Paulo S. M.; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)A case of extramedullary plasmacytoma of the third eyelid gland in a 7-year-old American Cocker Spaniel is reported. An enlargement of the third eyelid gland, abundant mucopurulent discharge, mild hyperemia and corneal pigmentation in the OD was present. Excisional biopsy of the mass revealed the gland was infiltrated and partially destroyed by a uniform population of neoplastic plasma cells. the neoplastic cells were positive for CD138, Ki-67 and lambda light chain. CD20, CD3, kappa light chain and cytokeratin were negative. Twelve months following surgery, no recurrence was observed. To the authors' knowledge, this is the first extramedullary plasmacytoma of the third eyelid gland reported in dogs.
- ItemSomente MetadadadosPrognostic markers of low-grade squamous intraepithelial lesions: the role of topoisomerase II alpha and active caspase-3(I R O G Canada, Inc, 2008-01-01) Coelho, Raquel Autran [UNIFESP]; Focchi, Gustavo Rubino de Azevedo [UNIFESP]; Nogueira-de-Souza, Naiara Corrêa [UNIFESP]; Sartori, Marair Gracio Ferreira [UNIFESP]; Silva, Ismael Dale Cotrim Guerreiro da [UNIFESP]; Ribalta, Julisa Chamorro Lascasas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: To study the relationship between topoisomerase II alpha, active caspase-3 expressions and HPV DNA in uterine cervices with low-grade squamous intraepithelial lesions (LSIL). Methods: Forty women with LSIL and 32 without cervical neoplasia diagnosed through cytologic and histopathologic examination were evaluated regarding topoisomerase II alpha and active caspase-3 expressions and HPV DNA detection using PCR (GP5/GP6) in cervicovaginal smears. Results: The mean percentage of cells immunomarked by topoisomerase in the group with LSIL was 11.62% while in the control it was 4.13% (p < 0.0001). In the presence of HPV DNA, topoisomerase expression was higher in the group With productive viral infection than in nonneoplastic tissue (p = 0.004). Caspase-3 expression was observed in 17 patients with LSIL (42.5%) and in five without cervical neoplasia (15.63%). Conclusion: The use of topoisomerase II alpha and active caspase-3 in cervical biopsies may help to define the prognosis of HPV cervical infection.
- ItemSomente MetadadadosQuality of Life of Post-MastectomyWomen Living in a Semi-Arid Region of Brazil(Mdpi Ag, 2017) Araujo Neto, Emidio A.; Alves, Beatriz C. A.; Gehrke, Flavia de S.; Azzalis, Ligia A. [UNIFESP]; Junqueira, Virginia C. B. [UNIFESP]; Sousa, Luiz Vinicius de A.; Adami, Fernando; Fonseca, Fernando L. A. [UNIFESP]Health is the major reference regarding quality of life
- ItemSomente MetadadadosSupplementation with Selenium Can Influence Nausea, Fatigue, Physical, Renal, and Liver Function of Children and Adolescents with Cancer(Mary Ann Liebert, Inc, 2015-01-01) Santos Vieira, Maria Luiza dos; Affonso Fonseca, Fernando Luiz [UNIFESP]; Costa, Larissa Grossi; Beltrame, Registila Libania; Sousa Chaves, Carolina Machado de; Cartum, Jairo; Alves, Sarah Isabel P. M. do N. [UNIFESP]; Azzalis, Ligia Ajaime [UNIFESP]; Campos Junqueira, Virginia Berlanga [UNIFESP]; Pereira, Edimar Cristiano [UNIFESP]; Rocha, Katya Cristina; Fac Med ABC; Universidade Federal de São Paulo (UNIFESP)The drugs used in chemotherapy treatments have little specificity, attack tumor cells, and also injure proliferative tissues. Knowledge of the functions of micronutrients has greatly increased, especially of Selenium (Se) that presents immunomodulatory and antitumor functions. the present study evaluated the health-related quality of life of patients undergoing chemotherapy for the treatment of leukemias and lymphomas (LL) and solid tumors (ST) while receiving Selenium (Se) supplementation. This is a randomized, double-blind, crossover study that evaluated the quality of life (EORTC-QLQ-C30 questionnaire), renal and liver functions of patients supplemented with Se. There was no statistically significant alteration in LL patients. However, the fatigue and nausea scores after 30 days did decrease in this group as well as in the ST group. After 1 year supplementation with Selenium, a more noticeable decrease in the scores concerning fatigue and nausea could be observed in the ST group, when compared with the beginning of the study. the LL patients also presented a decrease in the fatigue scores and physical functions. the kidney function as well as liver function has improved after Selenium supplementation when compared with the placebo intake in LL and ST patients, more remarkably in the LL group. Supplementation with Selenium promotes the reduction of chemotherapy side effects in cancer patients, especially by improving the conditions of patients with fatigue, nausea, and impaired physical function. Renal and liver functions have also improved.