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Vieira GS, Martinez MC, Cardoso MRA. Cancer mortality in workers at risk of occupational exposure to ionizing radiation in a company in the nuclear sector headquarters in São Paulo. Rev Bras Epidemiol 2024; 27:e240011. [PMID: 38511821 PMCID: PMC10946289 DOI: 10.1590/1980-549720240011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/13/2023] [Accepted: 12/06/2023] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVE To compare cancer mortality among workers exposed to gamma and X radiation and the general population of the city of São Paulo, as well as that of the subgroup monitored with those not monitored for gamma and X radiation in a work unit with ionizing radiation based in the city of São Paulo. METHODS Between 2016 and 2021, a retrospective open cohort study was carried out with workers who were employed from 08/31/1956 to 12/31/2016 based on data collected at the company and in official institutions. Standardized mortality ratios (SMR) were calculated by sex, age and calendar period of cancers grouped according to type, risk factor and organ system in two analyses: in the external analysis, the mortality of the study population was compared with that of the general population of the city of São Paulo; In the internal analysis, the mortality of the monitored subgroup was compared with that of the subgroup not monitored for gamma and X radiation. RESULTS The external mortality analysis showed SMR=0.224 (95%CI 0.208-0.240) and the healthy worker effect, while the internal mortality analysis showed SMR=0.685 (95%CI 0.618-0.758). CONCLUSION This study showed lower cancer mortality among exposed workers when compared to mortality in the general population and the healthy worker effect. Among workers monitored for gamma and X radiation, cancer mortality was lower when compared to those not monitored.
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Beserra VDS, Brito C. [Difficult situations and feelings in palliative oncology care]. CAD SAUDE PUBLICA 2024; 40:e00116823. [PMID: 38359275 PMCID: PMC10876151 DOI: 10.1590/0102-311xpt116823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/28/2023] [Accepted: 09/29/2023] [Indexed: 02/17/2024] Open
Abstract
The act of caring for people in pain, shortness of breath, and imminent death on a daily basis can intensify difficult situations for health professionals. However, difficult situations are rarely discussed in the services and in the professional training process. This study aimed to analyze difficult situations and feelings that emerge from healthcare. This is a phenomenological and qualitative study based on 30 difficult situations of health professionals who work exclusively in palliative oncological care. The interviews were conducted from August to February 2020. The results show that the main difficulties were motivated by identification (when the professional recognizes similarities in the patient they are caring for), a bad death (with suffering), caring for young patients, the death of a mother with a small child, and when there was a divergence between what the professional proposed and the patient's choice. There was a relationship between types of difficult situations and professional category. The professionals expressed both unpleasant feelings (sadness, impotence, anguish, fear) and pleasant feelings (compassion, gratitude). The results show that the concealment of the dying process throughout the societies' development turned it into a taboo, causing distress even in those who work in palliative care. They also show an important subjective dimension of care, usually neglected, which generates suffering, but also resignification. To properly provide care, health professionals must find meaning in the work, made possible by the modification of the their internal mindset via experience, which generates transformation, new meaning, and knowledge from praxis.
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Affiliation(s)
| | - Claudia Brito
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Coppetti LDC, Nietsche EA, Schimith MD, Radovanovic CAT, Lacerda MR, Girardon-Perlini NMO. Men's experience of caring for a family member with cancer: a theory based on data. Rev Lat Am Enfermagem 2024; 32:e4095. [PMID: 38294054 PMCID: PMC10825896 DOI: 10.1590/1518-8345.6679.4095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/28/2023] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVE to understand the meaning attributed by men to the experience of caring for their family member with cancer and to develop a substantive theory that represents the experience of men caring for their family member with cancer. METHOD this is qualitative research guided by the methodological framework of Grounded Theory and the precepts of Symbolic Interactionism. A form with identification and interview data was used. The analysis followed the substantive and theoretical coding stages. RESULTS 12 male caregivers of their family member with cancer participated. The constant comparative analysis of the data allowed the creation of a substantive theory "Experiencing the care of a family member with cancer: men as a caregivers" explaining the experience that has as its central category "The love that drives care", representing the symbolic actions and attitudes of men living in the context of illness due to cancer and care. CONCLUSION the theory allowed us to understand feelings, perceptions, ways of acting and facing the diagnosis, providing care, recognizing difficulties and learning from the situations that arise, making explicit the interactional processes and symbolic elements present and how these influence male caregivers in their actions and attitudes. BACKGROUND (1) For men, caring is a choice (2) Taking care symbolizes a way of expressing love and reciprocation. (3) Love in caring is strengthened by reciprocity, commitment, gratitude and zeal. (4) To provide care, man reorganizes himself and adjusts to the conditions that present themselves (5) Male caregivers need to be heard and included in the actions of health teams.
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Affiliation(s)
| | | | - Maria Denise Schimith
- Universidade Federal de Santa Maria, Departamento de Enfermagem, Santa Maria, RS, Brazil
| | | | - Maria Ribeiro Lacerda
- Universidade Federal do Paraná, Curitiba, PR, Brazil
- Universidade Federal de Bahia, Salvador, BA, Brazil
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de Freitas RA, Menezes TMDO, da Silva GTR, Guerrero-Castañeda RF, Moura HCGB, Oliveira ES, Pessoa LSDC, Costa JS. Implementing nursing diagnoses and care for the spiritual dimension of people with cancer: educational actions. Rev Esc Enferm USP 2023; 57:e20230141. [PMID: 38047744 PMCID: PMC10695168 DOI: 10.1590/1980-220x-reeusp-2023-0141en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/18/2023] [Indexed: 12/05/2023] Open
Abstract
OBJECTIVE To establish the implementation of nursing diagnoses and care for the spiritual dimension of people with cancer. METHOD Action research in a university hospital in the north-east of Brazil. Nine nurses and thirteen nursing technicians from the Onco-hematology and Bone Marrow Transplant Unit of this hospital took part. Data collection took place in four phases and involved the talking map technique, pedagogical workshops and a logbook. The groups' speeches were coded using Maxqda software, subjected to Braun and Clarke's thematic analysis and interpreted in the light of Paulo Freire's constructs. RESULTS Phase 1 sought to apprehend the participants' prior knowledge on the subject; in phase 2, proposals emerged for spiritual care organized in the Nursing Process; in phase 3, the diagnoses and care plan for the spiritual dimension for clinical practice were contemplated; and in phase 4, through the final evaluation, it was possible to see the transformations that occurred in the nursing team's practice with the proposed implementation. CONCLUSION The educational actions provided significant learning for the nursing team and the implementation of diagnoses and nursing care for the spiritual dimension of people with cancer.
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Boguszewski CL. Safety of long-term use of daily and long-acting growth hormone in growth hormone-deficient adults on cancer risk. Best Pract Res Clin Endocrinol Metab 2023; 37:101817. [PMID: 37643936 DOI: 10.1016/j.beem.2023.101817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Daily injections of recombinant human growth hormone (rhGH) have been used in clinical practice for almost four decades as a replacement therapy in adult patients with GH deficiency (GHD). Long-term adherence to daily injections of rhGH is a clinical concern that may result in reduced therapeutic efficacy, and long-acting GH (LAGH) formulations have been developed in an attempt of overcoming this problem. Long-term safety issues of rhGH are the other side of the coin that has been carefully monitored over the years, particularly related to the proliferative actions of GH that could increase the risk of tumor recurrence or induce the development of new benign and malignant tumors. In this review, we present what is currently known about the cancer risk in GHD adults treated with daily rhGH injections and we discuss the major concerns and responses needed from future surveillance studies regarding the safety of LAGH preparations.
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Affiliation(s)
- Cesar Luiz Boguszewski
- Department of Internal Medicine, Endocrine Division (SEMPR), University Hospital, Federal University of Parana, Curitiba, Brazil.
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Bernardez B, Mangues-Bafalluy I, Callejo VM, Ávila JJF, Rodríguez JAM, Aradilla MAP, Bautista MJM. Risk stratification model for the pharmaceutical care of oncology patients with solid or hematologic neoplasms. Farm Hosp 2023:S1130-6343(23)00106-X. [PMID: 37884399 DOI: 10.1016/j.farma.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE We aimed to develop of a risk stratification model for the pharmaceutical care of patients with solid or hematologic neoplasms who required antineoplastic agents or supportive treatments. METHOD The risk stratification model was collaboratively developed by oncology pharmacists from the Spanish Society of Hospital Pharmacy (SEFH). It underwent refinement through 3 workshops and a pilot study. Variables were defined, grouped into 4 dimensions, and assigned relative weights. The pilot study collected and analyzed data from participating centers to determine priority levels and evaluate variable contributions. The study followed the Kaiser Permanente pyramid model, categorizing patients into 3 priority levels: Priority 1 (intensive PC, 90th percentile), Priority 2 (60th-90th percentiles), and Priority 3 (60th percentile). Cut-off points were determined based on this stratification. Participating centers recorded variables in an Excel sheet, calculating mean weight scores for each priority level and the total risk score. RESULTS The participants agreed to complete a questionnaire that comprised 22 variables grouped into 4 dimensions: demographic (maximum score=11); social and health variables and cognitive and functional status (maximum=19); clinical and health services utilization (maximum=25); and treatment-related (maximum=41). From the results of applying the model to the 199 patients enrolled, the cut-off points for categorization were 28 or more points for priority 1, 16-27 points for priority 2, and less than 16 for priority 3; more than 80% of the total score was based on the dimensions of "clinical and health services utilization" and "treatment-related." Interventions based on the pharmaceutical care model were recommended for patients with solid or hematological neoplasms, according to their prioritization level. CONCLUSION This stratification model enables the identification of cancer patients requiring a higher level of pharmaceutical care and facilitates the adjustment of care capacity. Validation of the model in a representative population is necessary to establish its effectiveness.
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Affiliation(s)
- Beatriz Bernardez
- Departamento de Medicina, Universidad de Santiago de Compostela, Santiago, Spain; Unidad de Farmacia Oncológica, Servicio de Farmacia, Hospital Clínico, Universitario de Santiago de Compostela, Santiago, Spain; Grupo de Farmacología, Instituto de Investigación Santiago de Compostela (IDIS), Santiago, Spain.
| | - Irene Mangues-Bafalluy
- Servicio de Farmacia, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Grupo de Farmacoepidemiología y Farmacodinamia, Institut de Recerca Biomèdica, IRBLleida, Lleida, Spain
| | - Virginia Martínez Callejo
- Unidad de Farmacia Oncológica, Servicio de Farmacia, Hospital Universitario Marqués de Valdecilla, Santander, Spain
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de Oliveira AP, Castro MDS, de Lima DVM. Glycemic variability and mortality in oncologic intensive care units. Rev Bras Enferm 2023; 76:e20220812. [PMID: 37820156 PMCID: PMC10561948 DOI: 10.1590/0034-7167-2022-0812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/29/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the association between glycemic variability and mortality in patients admitted to oncologic intensive care units. METHODS A retrospective cohort study was conducted using a convenience sample of 30 medical records of patients over 18 years of age of both sexes. Glycemic variability was measured using the standard deviation and general amplitude. Statistical analysis was performed using the receiver operating characteristic (ROC) curve and the area under the curve (AUC). The significance level (α) was set at 5% with a confidence interval (CI) of 95%. RESULTS The study included 14 male patients (46.67%) with a mean age of 60±15 years. A total of 1503 blood glucose samples were collected. The AUC analysis for the standard deviation did not show a statistically significant result (p=.966; 95% CI=[0.283, 0.726]). In contrast, the general amplitude had a statistically significant association with mortality (p=.049; 95% CI=[0.514, 0.916]). CONCLUSIONS This study found that glycemic variability measured by the general amplitude was significantly associated with patient mortality in oncologic intensive care units. These findings suggest that monitoring glycemic variability may be an important factor in the management of critically ill patients in oncologic intensive care units.
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Silva LDS, Sousa AFD, de Carvalho DHF, Kalinke LP. Non-pharmacological therapies for cancer patients in Portugal and Brazil: an experience report. Rev Esc Enferm USP 2023; 57:e20230091. [PMID: 37738314 PMCID: PMC10516480 DOI: 10.1590/1980-220x-reeusp-2023-0091en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 07/25/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVE To describe the experience of nurses from a center in Portugal and two in Brazil regarding the use of non-pharmacological therapies in cancer patients. METHOD This is a professional experience report. RESULTS In the Portuguese institution, a group of nurses has been performing massage therapy, reflexology, postural teaching, thermotherapy, relaxation, guided imagery, Reiki, music therapy, aromatherapy, among others, for 17 years, with significant results in pain and vital signs with satisfactory perceptions. In Brazil, the clinical application is incipient, clinical studies with auriculotherapy, relaxation with guided imagery and floral therapy are taking place, with significant results for physical symptoms, anxiety, and quality of life improvement. CONCLUSION In both countries, nurses have made efforts to implement non-pharmacological therapies. While in the Portuguese reality they have been formally institutionalized in care, in Brazil the therapies take place with voluntary work and through intervention research. This report can encourage the translation of autonomous practice to clinical studies for proposing evidence of therapies in Integrative Oncology.
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Affiliation(s)
- Leonel dos Santos Silva
- Universidade Federal do Paraná, Programa de Pós-graduação em Enfermagem, Curitiba, PR, Brazil
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Guan Y. Diagnostic Value of Three-Dimensional Speckle Tracking Imaging Strain Parameters for Detection of Cancer Chemotherapy-Related Cardiac Dysfunction: A Meta-Analysis. Arq Bras Cardiol 2023; 120:e20220370. [PMID: 37531470 PMCID: PMC10464855 DOI: 10.36660/abc.20220370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 03/22/2023] [Accepted: 05/10/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Chemotherapeutic agents (e.g., anthracyclines, trastuzumab) commonly used for treating malignant tumors have been demonstrated to have cardiotoxic effects, which is associated with poor prognosis. Three-dimensional echocardiography has been used to predict cancer chemotherapy-induced cardiac dysfunction. OBJECTIVES Evaluation of the diagnostic performance of strain parameters, global area strain (GAS), longitudinal strain (GLS), circumferential strain (GCS), and radial strain (GRS) by meta-analysis. METHODS Relevant studies were searched from the Embase, PubMed, and Web of Science databases. Statistical analysis was performed using Stata 12. The summary receiver operating characteristic curve, sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and corresponding 95% confidence interval for the four strain parameters were pooled. P<0.05 was considered statistically significant. RESULTS Nine studies involving 650 participants were included. GAS and GLS showed significant diagnostic advantages over GCS and GRS. For GAS, the sensitivity was 0.85 (0.70, 0.93) and specificity was 0.82(0.78, 0.86) with PLR of 4.76 (3.55, 6.39) and NLR of 0.18 (0.09, 0.39) and an area under the curve (AUC) of 0.85 (0.82, 0.88). For GLS, the sensitivity was 0.81 (0.74, 0.86) and specificity was 0.81(0.68, 0.90) with PLR of 4.35(2.42, 7.80) and NLR of 0.23 (0.17, 0.33) and an AUC of 0.85 (0.82, 0.88). The GCS showed a sensitivity of 0.63 and a specificity of 0.79 with an AUC of 0.77. The GRS showed a sensitivity of 0.74 and a specificity of 0.66 with an AUC of 0.73. CONCLUSION 3D-STI strain parameters GAS and GLS showed good performance in detecting early cardiac dysfunction in patients with tumors receiving chemotherapy.
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Affiliation(s)
- Yingying Guan
- Taizhou Central HospitalTaizhou University HospitalTaizhouChinaTaizhou Central Hospital (Taizhou University Hospital), Taizhou – China
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Rocha MCDS, de Azevedo VD, dos Santos MDFL, Soares RDDA, Santos VEP, de Azevedo IC. Elements for assistance to patients with hematological malignancies to propose care lines: a scoping review. Rev Bras Enferm 2023; 76:e20220152. [PMID: 36753254 PMCID: PMC9901355 DOI: 10.1590/0034-7167-2022-0152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 10/02/2022] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVES to identify the elements for assistance to patients with hematological malignancies to propose a care line. METHODS this is a scoping review, anchored in the JBI theoretical framework, with searches carried out in April 2021, in eight electronic databases and 10 repositories of theses and dissertations. RESULTS the final sample consisted of 93 studies, and the main forms of assistance provided that can support a care line for this public were imaging tests, immunophenotyping, chemotherapy regimens, radiotherapy, infection management, assessment of nutritional status, maintenance of oral function, symptom management and screening for second malignancies. CONCLUSIONS the elaboration of a care line for onco-hematologic patients is necessary, considering the complexity surrounding the diagnosis and treatment of hematologic malignancies, in addition to the difficulties that are imposed in relation to access and continuity of care in the network.
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PARADA AA, VENCO FE, VARCA-NETO MR, EL IBRAHIM R, POLETTI PB, BRITO HP, SARE HDF, MALAFAIA O. WHICH LESIONS ARE AT HIGHER RISK OF DEVELOPING COLORECTAL CARCINOMAS: SUPERFICIALLY ELEVATED SERRATED LESIONS OR DEPRESSED LESIONS? Arq Bras Cir Dig 2023; 35:e1716. [PMID: 36629693 PMCID: PMC9831628 DOI: 10.1590/0102-672020220002e1716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/09/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND There are lesions that are still being missed in colonoscopy. Many of those could be superficially elevated serrated lesions or depressed ones. AIMS The aim of this study was to compare the histopathological characteristics of these lesions and their risks for submucosal carcinoma. METHODS This is a retrospective, cross-sectional, and observational study comparing 217 superficially elevated serrated lesions larger than 5 mm resected by colonoscopies (G1) with 558 depressed lesions (G2). RESULTS In G1, 217 lesions were found in 12,653 (1.7%) colonoscopies; in G2, 558 lesions were found in 36,174 (1.5%) colonoscopies. In G1, 63.4% were women and in G2, there was no gender predominance. The average size of G1 was 16.2 mm and G2 was 9.2 mm (p<0.001). G1 predominated on the proximal colon and G2 on the distal and rectum (p<0.001). In G1, there were 214 (98.6%) low-grade intramucosal neoplasia and 3 (1.4%) high-grade intramucosal neoplasia. Excluding 126 hyperplastic polyps and considering 91 sessile serrated adenomas in G1, we observed 88 (96.7%) low-grade intramucosal neoplasia and 3 (3.3%) high-grade intramucosal neoplasia; in G2, we observed 417 (74.7%) low-grade intramucosal neoplasia, 113 (20.3%) high-grade intramucosal neoplasia, and 28 (5.0%) submucosal adenocarcinomas (p<0.001). CONCLUSION Depressed lesions significantly had more high-grade intramucosal neoplasia and more invasive carcinomas in the submucosal layer than superficially elevated serrated lesions and more than superficially elevated sessile serrated adenomas.
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Affiliation(s)
- Artur Adolfo PARADA
- Faculdade Evangélica Mackenzie do Paraná, Postgraduate Program in Principles of Surgery – Curitiba (PR), Brazil;
| | - Filadelfio Euclydes VENCO
- Nove de Julho Hospital, Center for Endoscopic Diagnosis and Therapeutics of São Paulo – São Paulo (SP), Brazil;
| | - Miguel Reynaldo VARCA-NETO
- Nove de Julho Hospital, Center for Endoscopic Diagnosis and Therapeutics of São Paulo – São Paulo (SP), Brazil;
| | - Roberto EL IBRAHIM
- Nove de Julho Hospital, Center for Endoscopic Diagnosis and Therapeutics of São Paulo – São Paulo (SP), Brazil;
| | - Paula Bechara POLETTI
- Nove de Julho Hospital, Center for Endoscopic Diagnosis and Therapeutics of São Paulo – São Paulo (SP), Brazil;
| | - Helcio Pedrosa BRITO
- Nove de Julho Hospital, Center for Endoscopic Diagnosis and Therapeutics of São Paulo – São Paulo (SP), Brazil;
| | - Heloisa de Fátima SARE
- Faculdade Evangélica Mackenzie do Paraná, Postgraduate Program in Principles of Surgery – Curitiba (PR), Brazil;
| | - Osvaldo MALAFAIA
- Faculdade Evangélica Mackenzie do Paraná, Postgraduate Program in Principles of Surgery – Curitiba (PR), Brazil; ,Evangélico Mackenzie University Hospital – Curitiba (PR), Brazil
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Dutra VGP, da Silva JHCM, Jomar RT, Silveira HCS, Muzi CD, Guimarães RM. Burden of occupational cancer in Brazil and federative units, 1990-2019. Rev Bras Epidemiol 2023; 26:e230001. [PMID: 36629613 PMCID: PMC9838239 DOI: 10.1590/1980-549720230001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 10/03/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To analyze the spatiotemporal distribution of the burden of occupational cancer in Brazil and federative units between 1990 and 2019. METHODS Data were extracted from the Global Burden of Disease (GBD) study. Deaths from cancer whose attributable risk factor was occupational carcinogens were considered. Spatial analysis was performed with the first and last years of the series (1990 and 2019). Age-adjusted mortality rates were used to estimate the global Moran's Index (Moran's I), and the local indicator of spatial association (LISA) to identify clusters in the country with the respective statistical significance. The occupational cancer mortality rate, adjusted for age, was analyzed based on its trend for Brazil and federative units, in the period between 1990 and 2019. RESULTS Between 1990 and 2019, occupational cancer mortality rate showed a decreasing trend (R2=0.62; p<0.001) as well as the burden of disease indicator - DALY (R2=0.84; p<0.001). However, mortality is increasing in most states, suggesting that a minority of federative units induce the country's global trend. There is also the development of a spatial pattern of autocorrelation, indicating clusters of states with low mortality and DALY rates in the Northeast and high values in the South of the country. CONCLUSION The overall decreasing trend in the trend of occupational cancer masks the heterogeneity across states. This scenario may be associated with the diversity of economic activities, and suggests a decentralized and equitable plan for occupational cancer surveillance.
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Affiliation(s)
| | | | - Rafael Tavares Jomar
- Instituto Nacional de Câncer, Hospital Cancer Registry – Rio de Janeiro (RJ), Brazil
| | | | - Camila Drumond Muzi
- Instituto Nacional de Câncer, Assistance Division — Rio de Janeiro (RJ), Brazil
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Oliveira I, Lopes R, Cruz I, Bragança B, Azevedo J, Andrade A. Tuberous Sclerosis: Unusual Findings in the Setting of a Rare Disease. Arq Bras Cardiol 2023; 120:e20220147. [PMID: 36790305 PMCID: PMC10389102 DOI: 10.36660/abc.20220147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 06/13/2022] [Accepted: 09/01/2022] [Indexed: 02/16/2023] Open
Affiliation(s)
- Ines Oliveira
- Centro Hospitalar Tâmega e SousaEPEPenafielPortugalCentro Hospitalar Tâmega e Sousa,1 EPE, Penafiel – Portugal
| | - Rafaela Lopes
- Centro Hospitalar Tâmega e SousaEPEPenafielPortugalCentro Hospitalar Tâmega e Sousa,1 EPE, Penafiel – Portugal
| | - Isabel Cruz
- Centro Hospitalar Tâmega e SousaEPEPenafielPortugalCentro Hospitalar Tâmega e Sousa,1 EPE, Penafiel – Portugal
| | - Bruno Bragança
- Centro Hospitalar Tâmega e SousaEPEPenafielPortugalCentro Hospitalar Tâmega e Sousa,1 EPE, Penafiel – Portugal
| | - João Azevedo
- Centro Hospitalar Tâmega e SousaEPEPenafielPortugalCentro Hospitalar Tâmega e Sousa,1 EPE, Penafiel – Portugal
| | - Aurora Andrade
- Centro Hospitalar Tâmega e SousaEPEPenafielPortugalCentro Hospitalar Tâmega e Sousa,1 EPE, Penafiel – Portugal
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Ankad BS, Behera B, Lallas A, Akay BN, Bhat YJ, Chauhan P, Enechukwu NA, Geller S, Jha AK, Kaliyadan F, Kayitenkore K, Kelati A, Vinay K, Stein J, Traoré I, Usatine RP, Errichetti E. International Dermoscopy Society (IDS) Criteria for Skin Tumors: Validation for Skin of Color Through a Delphi Expert Consensus by the "Imaging in Skin of Color" IDS Task Force. Dermatol Pract Concept 2023; 13:dpc.1301a67. [PMID: 36892378 PMCID: PMC9946051 DOI: 10.5826/dpc.1301a67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION A structured set of eight basic dermoscopic parameters (lines, clods, dots, circles, pseudopods, structureless, else, and vessels) including a total of 77 variables with corresponding descriptive and metaphoric vocabulary has been released for evaluation of skin tumors by the International Dermoscopy Society (IDS). OBJECTIVES To validate the aforementioned criteria for the use in darker phototypes (phototypes IV-VI) via an expert consensus. METHODS The two-round "Delphi method" was adopted, with an iterative process including two rounds of email questionnaires. Potential panelists were asked to take part in the procedure via email on the basis of their expertise in the dermoscopy of skin tumors in dark phototypes. RESULTS A total of 17 participants were involved. All the original variables of the eight basic parameters reached agreement during the first round, except for "pink small clods" ("milky red globules") and "structureless pink zone" ("milky red areas"). Moreover, during the first round, panelists proposed a change of three existing items and the introduction of four new items, i.e., "black, small clods" ("black globules"), "follicular plugs", "erosions/ulcerations", and "white color around vessels" ("perivascular white halo"). All such proposals achieved agreement, thus being included in the final list, for a total of 79 items. There was consistency between the descriptive and metaphoric approaches in terms of scoring. CONCLUSIONS Albeit most of the original items were considered applicable even for skin of color, there are some points of differences that physicians need to know. No significant preference was found between descriptive and metaphoric terminology among panelists.
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Affiliation(s)
- Balachandra S Ankad
- Department of Dermatology, Venereology and Leprosy, SN Medical College, Bagalkot, Karnataka, India
| | - Biswanath Behera
- Department of Dermatology and Venereology, AIIMS, Bhubaneswar, India
| | - Aimilios Lallas
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Bengu Nisa Akay
- Department of Dermatology, School of Medicine, Ankara University, Ankara, Turkey
| | - Yasmeen J Bhat
- Department of Dermatology, Venereology and Leprology, Government Medical College, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Payal Chauhan
- Department of Dermatology, All India Institute of Medical Sciences (AIIMS), Bilaspur, Himachal Pradesh, India
| | - Nkechi Anne Enechukwu
- Nnamdi Azikiwe University/Nnamdi Azikiwe Teaching Hospital Nnewi, Anambra State, Nigeria
| | - Shamir Geller
- Division of Dermatology, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abhijeet Kumar Jha
- Department of Dermatology & STD, Patna Medical College & Hospital, Patna, India
| | - Feroze Kaliyadan
- Department of Dermatology, Sree Narayana Institute of Medical Sciences, Ernakulum, India
| | | | - Awatef Kelati
- Dermatology Department, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jennifer Stein
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA
| | | | - Richard P Usatine
- Department of Dermatology and Cutaneous Surgery, Department of Family and Community Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Enzo Errichetti
- Institute of Dermatology, "Santa Maria della Misericordia" University Hospital, Udine, Italy
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Masculinidades y salud de los hombres en la Región de las Américas. Rev Panam Salud Publica 2022; 46:e151. [PMID: 36177302 DOI: 10.26633/RPSP.2022.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/11/2023] [Indexed: 11/28/2022] Open
Abstract
[This corrects the article DOI: 10.26633/RPSP.2022.93.].
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Duarte LE, Delgado F, Di Leo NC, Bertone CL, Franci Alvarez M, Montico S, Oliva A. [Mortality from cancer, arsenic, and nitrates in drinking water and cropland in ArgentinaMortalidade por câncer, arsênio e nitratos na água para consumo humano e em áreas semeadas na Argentina]. Rev Panam Salud Publica 2022; 46:e129. [PMID: 36060206 PMCID: PMC9426947 DOI: 10.26633/rpsp.2022.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/23/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Cancer mortality in the central region of Argentina is among the highest in the country. Two possible environmental factors could explain this situation: agricultural activity and drinking water quality. The objective of the study is to evaluate the interaction between these variables. Methods This is a retrospective ecological study. Total cropland over 10-year periods as well as the percentage of the population exposed to high levels of arsenic and nitrates in drinking water were analyzed and compared to total mortality rates (TMR) and organ-specific mortality rates (SMR); the Spearman's rank correlation coefficient was then calculated. Results Positive and significant correlations were found between the first two 10-year periods of total cropland and the first 10-year period of TMR, as well as correlations with lung, pancreatic, and colon cancers in men and colon cancer in women. Elevated arsenic levels are associated with TMR in both sexes across all 10-year periods but are specifically associated with lung cancer in men. No significant correlation was found with nitrates. Conclusions The association between total cropland and TMR/SMR is stronger with proximity over time, with greater impact from the oldest crops. The association between TMR and consumption of water containing arsenic, as well as the association with lung SMR in men and colon SMR in women, show that exposure over time is essential to understanding regional epidemiological conditions. The synergy between these variables should be explored.
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Affiliation(s)
- Leandro Emanuel Duarte
- Programa Medio Ambiente y Salud (PROMAS) Centro de Estudios interdisciplinarios Universidad Nacional de Rosario Argentina Programa Medio Ambiente y Salud (PROMAS), Centro de Estudios interdisciplinarios, Universidad Nacional de Rosario, Argentina
| | - Florencia Delgado
- Programa Medio Ambiente y Salud (PROMAS) Centro de Estudios interdisciplinarios Universidad Nacional de Rosario Argentina Programa Medio Ambiente y Salud (PROMAS), Centro de Estudios interdisciplinarios, Universidad Nacional de Rosario, Argentina
| | - Néstor Cristian Di Leo
- Centro de Estudios Territoriales (CET) Facultad de Ciencias Agrarias, Universidad Nacional de Rosario Argentina Centro de Estudios Territoriales (CET), Facultad de Ciencias Agrarias, Universidad Nacional de Rosario, Argentina
| | - Carola Leticia Bertone
- Centro de Investigación e Innovación Tecnológica Universidad Nacional de La Rioja Argentina Centro de Investigación e Innovación Tecnológica, Universidad Nacional de La Rioja, Argentina
| | - María Franci Alvarez
- Instituto Académico Pedagógico de Ciencias Sociales Universidad Nacional de Villa María Argentina Instituto Académico Pedagógico de Ciencias Sociales, Universidad Nacional de Villa María, Argentina
| | - Sergio Montico
- Centro de Estudios Territoriales (CET) Facultad de Ciencias Agrarias, Universidad Nacional de Rosario Argentina Centro de Estudios Territoriales (CET), Facultad de Ciencias Agrarias, Universidad Nacional de Rosario, Argentina
| | - Alejandro Oliva
- Programa Medio Ambiente y Salud (PROMAS) Centro de Estudios interdisciplinarios Universidad Nacional de Rosario Argentina Programa Medio Ambiente y Salud (PROMAS), Centro de Estudios interdisciplinarios, Universidad Nacional de Rosario, Argentina
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Santos VDON, Coelho SDEO, Vieira AA. Sacrococcygeal teratoma: evaluation of its approach, treatment and follow-up in two reference children cancer centers in Brazil / Rio de Janeiro. Rev Col Bras Cir 2022; 49:e20223341. [PMID: 36074393 PMCID: PMC10578848 DOI: 10.1590/0100-6991e-20223341-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/06/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION sacrococcygeal teratoma (TSC) is the most common tumor of the neonatal period. Alphafetoprotein is an important tumor marker and is used in the follow-up period as a marker of malignancy. The complete surgical resection of the tumor associated with coccygectomy is the standard treatment and chemotherapy in different stages are necessary. Follow-up consists of serial exam: tumor markers, imaging searching to possible metastasis sites, in addition to a complete physical examination. METHODOLOGY a descriptive, retrospective, study was carried out by analyzing a chart of 25 patients of two different reference children cancer center; with TSC in the State of Rio de Janeiro from 2004 to 2019. The clinical and epidemiological data collected were described and a comparison was made between these two centers studied. RESULTS the sociodemographic characteristics found were similar to those described in the medical literature. Data related to treatment and follow-up, such as the use of chemotherapy, use of specific imaging tests, digital rectal examination, and outpatient follow-up, differed between the two centers studied. There was a 25% loss of follow-up. CONCLUSION the characteristic of being a non-cancer center can interfere with the full application of the current protocol for the treatment of sacrococcygeal teratoma. The knowledge of the data of the studied cases can allow the optimization of the approach of the patients with this pathology and generate discussions about the integral application of the specific therapeutic protocol in the medical centers that are qualified for such treatment.
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Affiliation(s)
| | | | - Alan Araujo Vieira
- - Universidade Federal Fluminense, Saúde Materno-Infantil - Rio de Janeiro - RJ - Brasil
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18
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Mariño MAG. Sentinel Lymph Node Biopsy in Endometrial Cancer - A Systematic Review and Quality Assessment of Meta-Analyses. Rev Bras Ginecol Obstet 2022; 44:785-789. [PMID: 35724685 PMCID: PMC9948145 DOI: 10.1055/s-0042-1749067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/17/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To assess the quality of recent meta-analyses reviewing the diagnostic utility of sentinel node biopsy in endometrial cancer. METHODS With the MeSH terms endometrial neoplasms and sentinel lymph node biopsy, PubMed and Embase databases were searched on October 21, 2020, and again on November 10, 2021, with meta-analysis and publication date filters set to since 2015. The articles included were classified with the A Measurement Tool to Assess Systematic Reviews (AMSTAR 2) assessment tool. RESULTS The database searches found 17, 7 of which, after the screening, were selected for full review by the author, finally extracting six meta-analyzes for quality analysis. The rating with the AMSTAR 2 assessment tool found that overall confidence in their results was critically low. CONCLUSION This study found that the quality of recent meta-analyses on the utility of the staging of endometrial cancer with sentinel node biopsy, evaluated by the AMSTAR 2 assessment tool, is classified as critically low, and, therefore, these meta-analyses are not reliable in the summary of their studies.
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Affiliation(s)
- Mario Arturo González Mariño
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
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19
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Campos JADB, da Silva WR, Spexoto MCB, Serrano SV, Marôco J. Clinical, dietary and demographic characteristics interfering on quality of life of cancer patients. Einstein (Sao Paulo) 2018; 16:eAO4368. [PMID: 30517364 PMCID: PMC6276908 DOI: 10.31744/einstein_journal/2018ao4368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 05/21/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To estimate the dietary intake of cancer patients and its relation with clinical and demographic characteristics, and to assess the contribution of dietary intake, appetite/symptoms and clinical and demographic characteristics to their quality of life. METHODS The consumption of energy and macronutrients of patients was estimated. The relation between dietary intake and clinical and demographic characteristics was evaluated by analysis of variance. The intake of energy and macronutrient of the patients was compared to the nutritional recommendations using 95% confidence interval. The Cancer Appetite and Symptom Questionnaire (CASQ) and the European Organization for Research and Treatment of Cancer (EORTC QLQ C-30) were used to assess appetite/symptoms and quality of life, respectively. The psychometric properties of the instruments were estimated. A structural equation model was prepared. RESULTS In this study, 772 cancer patients (63.1% women) participated. There was a significant relation between dietary intake and work activity, economic class, specialty field of cancer, type of treatment and nutritional status. Patients' energy and macronutrients intake was below recommended values. Both CASQ and EORTC QLQ C-30 were refined to fit the data. In the structural model, impaired appetite, more symptoms, presence of metastasis, being female and of higher economic classes were characteristics that significantly contributed to interfering in patients' quality of life. CONCLUSION The dietary intake of oncology patients did not reach the recommended values. Different characteristics impacted on quality of life of patients and should be considered in clinical and epidemiological protocols.
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Affiliation(s)
| | | | | | | | - João Marôco
- Instituto Universitário de Ciências Psicológicas, Sociais e da Vida, Lisboa, Portugal
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Paiva CE, Paiva BSR, de Paula Pântano N, Preto DD, de Oliveira CZ, Yennurajalingam S, Hui D, Bruera E. Development and validation of a prognostic nomogram for ambulatory patients with advanced cancer. Cancer Med 2018; 7:3003-3010. [PMID: 29856126 PMCID: PMC6051167 DOI: 10.1002/cam4.1582] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 05/01/2018] [Accepted: 05/04/2018] [Indexed: 12/25/2022] Open
Abstract
Predicting survival of advanced cancer patients (ACPs) is a difficult task. We aimed at developing and testing a new prognostic tool in ACPs when they were first referred to palliative care (PC). A total of 497 patients were analyzed in this study (development sample, n = 221; validation sample, n = 276). From 35 initial putative prognostic variables, 14 of them were selected for multivariable Cox regression analyses; the most accurate final model was identified by backward variable elimination. Parameters were built into a nomogram to estimate the probability of patient survival at 30, 90, and 180 days. Calibration and discrimination properties of the Barretos Prognostic Nomogram (BPN) were evaluated in the validation phase of the study. The BPN was composed of 5 parameters: sex, presence of distant metastasis, Karnofsky Performance Status (KPS), white blood cell (WBC) count, and serum albumin concentration. The C-index was 0.71. The values of the area under the curve (AUC) of the receiver operating characteristic (ROC) curve were 0.84, 0.74, and 0.74 at 30, 90, and 180 days, respectively. There were good calibration results according to the Hosmer-Lemeshow test. The median survival times were 313, 129, and 37 days for the BPN scores <25th percentile (<125), 25th to 75th percentile (125-175), and >75th percentile (>175), respectively (P < .001). The BPN is a new prognostic tool with adequate calibration and discrimination properties. It is now available to assist oncologists and palliative care physicians in estimating the survival of adult patients with advanced solid tumors.
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Affiliation(s)
- Carlos Eduardo Paiva
- Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, SP, Brazil.,Palliative Care and Quality of Life Research Group, Post-Graduate Program, Barretos Cancer Hospital, Barretos, SP, Brazil.,Researcher Support Center, Learning and Research Institute, Barretos Cancer Hospital, Barretos, SP, Brazil
| | - Bianca Sakamoto Ribeiro Paiva
- Palliative Care and Quality of Life Research Group, Post-Graduate Program, Barretos Cancer Hospital, Barretos, SP, Brazil.,Researcher Support Center, Learning and Research Institute, Barretos Cancer Hospital, Barretos, SP, Brazil
| | - Naitielle de Paula Pântano
- Researcher Support Center, Learning and Research Institute, Barretos Cancer Hospital, Barretos, SP, Brazil
| | | | - Cleyton Zanardo de Oliveira
- Palliative Care and Quality of Life Research Group, Post-Graduate Program, Barretos Cancer Hospital, Barretos, SP, Brazil.,Researcher Support Center, Learning and Research Institute, Barretos Cancer Hospital, Barretos, SP, Brazil.,Education and Research, BP - A Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil
| | - Sriram Yennurajalingam
- Department of Palliative Care and Rehabilitation Medicine, M.D. Anderson Cancer Center, The University of Texas, Houston, TX, USA
| | - David Hui
- Department of Palliative Care and Rehabilitation Medicine, M.D. Anderson Cancer Center, The University of Texas, Houston, TX, USA
| | - Eduardo Bruera
- Department of Palliative Care and Rehabilitation Medicine, M.D. Anderson Cancer Center, The University of Texas, Houston, TX, USA
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Silva NDP, Reis RDS, Cunha RG, Oliveira JF, de Lima CFDS, Pombo-de-Oliveira MS, Santos MO, de Camargo B. Birth weight and risk of childhood solid tumors in Brazil: a record linkage between population-based data sets. Rev Panam Salud Publica 2017. [PMID: 28444001 PMCID: PMC6660849 DOI: 10.26633/rpsp.2017.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE To analyze the relationship between the development of childhood solid tumors and 1) birth weight and 2) fetal growth, using two Brazilian population-based data sets. METHODS A case-cohort study was performed using two population-based data sets, and linkage between the Live Birth Information System (Sistema de Informação sobre Nascidos Vivos, SINASC) and 14 population-based cancer registries (PBCRs) was established. Four controls per case were chosen randomly from the SINASC data set. Tumors were classified as central nervous system (CNS), non-CNS embryonal, and other tumors ("miscellaneous"). Adjustments were made for potential confounders (maternal age, mode of delivery, maternal education, birth order, gestational age, sex, and geographic region). Odds ratios (ORs) with 95% confidence intervals (CIs) were computed using unconditional logistic regression analysis. RESULTS In a trend analysis, for every 500 g of additional birth weight, the crude OR was 1.12 (CI: 1.00-1.24) and the adjusted OR was 1.02 (CI: 0.90-1.16) for all tumors. For every 1 000 g of additional birth weight, the crude OR was 1.25 (CI: 1.00-1.55) and the adjusted OR was 1.04 (CI: 0.82-1.34) for all tumors. Among children diagnosed after reaching the age of 3 years, in the miscellaneous tumor category, the OR was significantly increased for every additional 500 g and 1 000 g of birth weight. CONCLUSIONS The study data suggested that increased birth weight was associated with childhood solid tumor development, especially among children more than 3 years old with "miscellaneous" tumors.
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Rosa RFM, D'Ecclesiis WFB, Dibbi RP, Rosa RCM, Trevisan P, Graziadio C, Paskulin GA, Zen PRG. 45,X/46,XY mosaicism: report on 14 patients from a Brazilian hospital. A retrospective study. SAO PAULO MED J 2014; 132:332-8. [PMID: 25351753 PMCID: PMC10496778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 08/15/2013] [Accepted: 10/22/2013] [Indexed: 04/07/2023] Open
Abstract
CONTEXT AND OBJECTIVE 45,X/46,XY mosaicism, or mixed gonadal dysgenesis, is considered to be a rare disorder of sex development. The aim of our study was to investigate the clinical and cytogenetic characteristics of patients with this mosaicism. DESIGN AND SETTING A retrospective study in a referral hospital in southern Brazil. METHODS Our sample consisted of patients diagnosed at the clinical genetics service of a referral hospital in southern Brazil, from 1975 to 2012. Clinical and cytogenetic data were collected from the medical records. RESULTS Fourteen patients were included in the sample, with ages at the first evaluation ranging from 2 days to 38 years. Nine of them had female sex of rearing and five, male. Regarding the external genitalia, most were ambiguous (n = 10). One patient presented male phenotype and was treated for a history of azoospermia, while three patients presented female phenotype, of whom two had findings of Turner syndrome and one presented secondary amenorrhea alone. Some findings of Turner syndrome were observed even among patients with ambiguous genitalia. None presented gonadal malignancy. One patient underwent surgical correction for genital ambiguity and subsequent exchange of sex of rearing. Regarding cytogenetics, we did not observe any direct correlation between percentages of cell lines and phenotype. CONCLUSIONS 45,X/46,XY mosaicism can present with a wide variety of phenotypes resulting from the involvement of different aspects of the individual. All these observations have important implications for early recognition of these patients and their appropriate management.
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Affiliation(s)
- Rafael Fabiano Machado Rosa
- PhD. Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Willy Francisco Bartel D'Ecclesiis
- MD. Physician, Residency Program in Obstetrics and Gynecology, Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Raquel Papandreus Dibbi
- MD. Postgraduate Student, Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Gynecologist and Obstetrician, Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Rosana Cardoso Manique Rosa
- MD. Postgraduate Student, Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Pediatrician, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil
| | - Patrícia Trevisan
- MD. Postgraduate Student, Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Pharmacist, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Carla Graziadio
- MD. Postgraduate Student, Postgraduate Program in Pathology and Professor of Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Giorgio Adriano Paskulin
- PhD. Professor of Clinical Genetics and of the Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Paulo Ricardo Gazzola Zen
- PhD. Professor of Clinical Genetics and of the Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
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Rosa RFM, D'Ecclesiis WFB, Dibbi RP, Rosa RCM, Trevisan P, Graziadio C, Paskulin GA, Zen PRG. 45,X/46,XY mosaicism: report on 14 patients from a Brazilian hospital. A retrospective study. SAO PAULO MED J 2014; 132:332-338. [PMID: 25351753 PMCID: PMC10496778 DOI: 10.1590/1516-3180-2014-1326729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 08/15/2013] [Accepted: 10/22/2013] [Indexed: 02/01/2024] Open
Abstract
CONTEXT AND OBJECTIVE 45,X/46,XY mosaicism, or mixed gonadal dysgenesis, is considered to be a rare disorder of sex development. The aim of our study was to investigate the clinical and cytogenetic characteristics of patients with this mosaicism. DESIGN AND SETTING A retrospective study in a referral hospital in southern Brazil. METHODS Our sample consisted of patients diagnosed at the clinical genetics service of a referral hospital in southern Brazil, from 1975 to 2012. Clinical and cytogenetic data were collected from the medical records. RESULTS Fourteen patients were included in the sample, with ages at the first evaluation ranging from 2 days to 38 years. Nine of them had female sex of rearing and five, male. Regarding the external genitalia, most were ambiguous (n = 10). One patient presented male phenotype and was treated for a history of azoospermia, while three patients presented female phenotype, of whom two had findings of Turner syndrome and one presented secondary amenorrhea alone. Some findings of Turner syndrome were observed even among patients with ambiguous genitalia. None presented gonadal malignancy. One patient underwent surgical correction for genital ambiguity and subsequent exchange of sex of rearing. Regarding cytogenetics, we did not observe any direct correlation between percentages of cell lines and phenotype. CONCLUSIONS 45,X/46,XY mosaicism can present with a wide variety of phenotypes resulting from the involvement of different aspects of the individual. All these observations have important implications for early recognition of these patients and their appropriate management.
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Affiliation(s)
- Rafael Fabiano Machado Rosa
- PhD. Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Willy Francisco Bartel D'Ecclesiis
- MD. Physician, Residency Program in Obstetrics and Gynecology, Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Raquel Papandreus Dibbi
- MD. Postgraduate Student, Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Gynecologist and Obstetrician, Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Rosana Cardoso Manique Rosa
- MD. Postgraduate Student, Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Pediatrician, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil
| | - Patrícia Trevisan
- MD. Postgraduate Student, Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Pharmacist, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Carla Graziadio
- MD. Postgraduate Student, Postgraduate Program in Pathology and Professor of Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Giorgio Adriano Paskulin
- PhD. Professor of Clinical Genetics and of the Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Paulo Ricardo Gazzola Zen
- PhD. Professor of Clinical Genetics and of the Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), and Clinical Geneticist, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil
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Casarim ALM, Tincani AJ, Negro AD, Aguiar CG, Fanni RV, Martins AS. Carotid body tumor: retrospective analysis on 22 patients. SAO PAULO MED J 2014; 132:133-9. [PMID: 24760216 PMCID: PMC10852084 DOI: 10.1590/1516-3180.2014.1323452] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 06/27/2013] [Accepted: 07/16/2013] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE Carotid body tumors, or chemodectomas, are the most common head and neck paragangliomas, accounting for 80% of the cases. They may present minor symptoms; however, they deserve special attention in order to achieve accurate diagnosis and adequate treatment. The objectives of this study were to show the approach towards chemodectomas and evaluate the complications of the patients treated surgically without previous embolization. DESIGN AND SETTING Retrospective study on chemodectomas followed up at the Head and Neck Surgery Service, Department of Surgery, Unicamp. METHODS Twenty-two patients were evaluated between 1983 and 2009. The diagnosis was based on clinical findings and imaging methods. The epidemiological characteristics, lesion characteristics, diagnostic methods, treatment and complications were analyzed. RESULTS The paragangliomas were classified as Shamblin I (9%), II (68.1%) and III (22.7%). Angiography, magnetic resonance imaging and computed tomography confirmed the diagnosis in 20 patients (90.9%). Five (22.7%) had significant bleeding during the surgery, while four (18.1%) had minor bleeding. Four patients (18.1%) developed neurological sequelae. Seven (31.8%) needed ligatures of the external carotid artery. Three patients (13.6%) underwent carotid bulb resection. The postoperative follow-up ranged from 3 months to 14 years without recurrences or mortality. CONCLUSIONS In our experience and in accordance with the literature, significant bleeding and neurological sequelae may occur in chemodectoma cases, particularly in Shamblin III patients. The complications from treatment without previous embolization were similar to data in the literature data, from cases in which this procedure was applied prior to surgery.
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Affiliation(s)
- André Luís Maion Casarim
- MD. Attending Physician, Head and Neck Surgery Service, Department of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil
| | - Alfio José Tincani
- MD, PhD. Associate Professor, Head and Neck Surgery Service, Department of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil
| | - André Del Negro
- MD, PhD. Associate Professor, Head and Neck Surgery Service, Department of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil
| | - Camila Guimarães Aguiar
- MD. Attending Physician, Head and Neck Surgery Service, Department of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil
| | - Renato Ventura Fanni
- MD. Attending Physician, Head and Neck Surgery Service, Department of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil
| | - Antonio Santos Martins
- MD, PhD. Associate Professor, Head and Neck Surgery Service, Department of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil
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Garófolo A. Enteral nutrition during bone marrow transplantation in patients with pediatric cancer: a prospective cohort study. SAO PAULO MED J 2012; 130:159-66. [PMID: 22790548 PMCID: PMC10876195 DOI: 10.1590/s1516-31802012000300005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 03/29/2011] [Accepted: 09/29/2011] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE Cancer patients undergoing bone marrow transplantation (BMT) often require nutritional therapy due to treatment toxicities. The aim here was to evaluate the use of tube feeding and its applicability, indications, contraindications and complications in these patients. DESIGN AND SETTING Prospective observational study conducted at a public university in São Paulo between January 2002 and August 2007. METHODS The patients were followed up daily in the BMT unit by a research dietitian. Tube feeding was indicated when oral supplementation proved to be insufficient, when the patient had severe malnutrition or there was an impediment to use of oral feeding. It was contraindicated in the presence of gastrointestinal toxicity of grade 3 and 4 or other conditions that implied a risk or hindered its use or placement. Complications of tube feeding were divided into minor and major, according to whether they had life-threatening implications. RESULTS Forty-two (47.2%) patients had indications for tube feeding: the main reasons were transplantation inadequate food and supplement intake, insufficient intake with malnutrition or weight loss, severe malnutrition or need for oral fasting. Thirty-one (73.8%) received tube feeding: 11 autologous and 20 allogenic patients (P = 0.04). The main contraindications were severe gastrointestinal toxicities and sinusitis. Minor complications from tube feeding were more prevalent in patients with allogenic BMT, but no major complications were observed. CONCLUSION Enteral nutrition is a feasible procedure in patients undergoing BMT and should be encouraged. The main difficulty in BMT patients, in relation to tube feeding, is gastrointestinal toxicities.
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Affiliation(s)
- Adriana Garófolo
- Nutritional Services, Grupo de Apoio ao Adolescente e à Criança com Câncer, Universidade Federal de São Paulo, São Paulo, Brazil.
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Battaglini C, Bottaro M, Dennehy C, Rae L, Shields E, Kirk D, Hackney AC, Hackney A. The effects of an individualized exercise intervention on body composition in breast cancer patients undergoing treatment. SAO PAULO MED J 2007; 125:22-8. [PMID: 17505681 PMCID: PMC11014705 DOI: 10.1590/s1516-31802007000100005] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2006] [Revised: 12/02/2005] [Accepted: 11/29/2006] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Changes in metabolism have been reported in the majority of patients undergoing cancer treatment, and these are usually characterized by progressive change in body composition. The effects of aerobic exercise programs to combat the cancer and cancer treatment-related side effects, which include the negative changes in body composition, have been extensively reported in the literature. However, few resistance exercise intervention studies have hypothesized that breast cancer patients might benefit from this type of exercise. The purpose of this study was to determine whether exercise protocols that emphasize resistance training would change body composition and strength in breast cancer patients undergoing treatment. DESIGN AND SETTING Randomized controlled trial, at the Campus Recreation Center and Rocky Mountain Cancer Rehabilitation Institute of the University of Northern Colorado, and the North Colorado Medical Center. METHODS Twenty inactive breast cancer patients were randomly assigned to a 21-week exercise group (n = 10) or a control group (n = 10). The exercise group trained at low to moderate intensity for 60 minutes on two days/week. The primary outcome measurements included body composition (skinfold method) and muscle strength (one repetition maximum). RESULTS Significant differences in lean body mass, body fat and strength (p = 0.004, p = 0.004, p = 0.025, respectively) were observed between the groups at the end of the study. CONCLUSION The results suggest that exercise emphasizing resistance training promotes positive changes in body composition and strength in breast cancer patients undergoing treatment.
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Affiliation(s)
- Claudio Battaglini
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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de Nigris F, Cerutti J, Morelli C, Califano D, Chiariotti L, Viglietto G, Santelli G, Fusco A. Isolation of a SIR-like gene, SIR-T8, that is overexpressed in thyroid carcinoma cell lines and tissues. Br J Cancer 2002; 86:917-23. [PMID: 11953824 PMCID: PMC2364158 DOI: 10.1038/sj.bjc.6600156] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2001] [Accepted: 12/14/2001] [Indexed: 11/19/2022] Open
Abstract
We used subtractive library screening to identify the changes that occur in gene expression during thyroid cell neoplastic transformation. Complementary DNA from normal thyroid cells (HTC 2) was subtracted from a complementary DNA library constructed from a human thyroid papillary carcinoma cell line. The library was screened for genes upregulated in human thyroid papillary carcinoma cell line cells, and several cDNA clones were isolated. One of these clones has a sirtuin core and high homology with the human silent information regulator protein family. This clone, designated "SIR-T8", was overexpressed in human thyroid carcinoma cell lines and tissues, but not in adenomas. The human SIR-T8 protein has a molecular weight of 39 kDa and is primarily located in the cytoplasm under the nuclear membrane. The SIR-T8 gene is located on chromosome 17q25-1.
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Affiliation(s)
- F de Nigris
- Servizio di Oncologia Sperimentale "E", Istituto per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, 80131 Naples, Italy
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