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Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium

HECK, Julia E.; BERTHILLER, Julien; VACCARELLA, Salvatore; WINN, Deborah M.; SMITH, Elaine M.; SHAN`GINA, Oxana; SCHWARTZ, Stephen M.; PURDUE, Mark P.; PILARSKA, Agnieszka; ELUF-NETO, Jose; MENEZES, Ana; MCCLEAN, Michael D.; MATOS, Elena; KOIFMAN, Sergio;
Fonte: OXFORD UNIV PRESS Publicador: OXFORD UNIV PRESS
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
125.95%
Background Sexual contact may be the means by which head and neck cancer patients are exposed to human papillomavirus (HPV). Methods We undertook a pooled analysis of four population-based and four hospital-based case-control studies from the International Head and Neck Cancer Epidemiology (INHANCE) consortium, with participants from Argentina, Australia, Brazil, Canada, Cuba, India, Italy, Spain, Poland, Puerto Rico, Russia and the USA. The study included 5642 head and neck cancer cases and 6069 controls. We calculated odds ratios (ORs) of associations between cancer and specific sexual behaviours, including practice of oral sex, number of lifetime sexual partners and oral sex partners, age at sexual debut, a history of same-sex contact and a history of oral-anal contact. Findings were stratified by sex and disease subsite. Results Cancer of the oropharynx was associated with having a history of six or more lifetime sexual partners [OR = 1.25, 95% confidence interval (CI) 1.01, 1.54] and four or more lifetime oral sex partners (OR = 2.25, 95% CI 1.42, 3.58). Cancer of the tonsil was associated with four or more lifetime oral sex partners (OR = 3.36, 95 % CI 1.32, 8.53), and, among men, with ever having oral sex (OR = 1.59, 95% CI 1.09...

Cessation of alcohol drinking, tobacco smoking and the reversal of head and neck cancer risk

MARRON, Manuela; BOFFETTA, Paolo; ZHANG, Zuo-Feng; ZARIDZE, David; WÜNSCH-FILHO, Victor; WINN, Deborah M.; WEI, Qingyi; TALAMINI, Renato; SZESZENIA-DABROWSKA, Neonila; STURGIS, Erich M.; SMITH, Elaine; SCHWARTZ, Stephen M.; RUDNAI, Peter; PURDUE, Mark P.
Fonte: OXFORD UNIV PRESS Publicador: OXFORD UNIV PRESS
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
125.96%
Background Quitting tobacco or alcohol use has been reported to reduce the head and neck cancer risk in previous studies. However, it is unclear how many years must pass following cessation of these habits before the risk is reduced, and whether the risk ultimately declines to the level of never smokers or never drinkers. Methods We pooled individual-level data from case-control studies in the International Head and Neck Cancer Epidemiology Consortium. Data were available from 13 studies on drinking cessation (9167 cases and 12 593 controls), and from 17 studies on smoking cessation (12 040 cases and 16 884 controls). We estimated the effect of quitting smoking and drinking on the risk of head and neck cancer and its subsites, by calculating odds ratios (ORs) using logistic regression models. Results Quitting tobacco smoking for 1-4 years resulted in a head and neck cancer risk reduction [OR 0.70, confidence interval (CI) 0.61-0.81 compared with current smoking], with the risk reduction due to smoking cessation after >= 20 years (OR 0.23, CI 0.18-0.31), reaching the level of never smokers. For alcohol use, a beneficial effect on the risk of head and neck cancer was only observed after >= 20 years of quitting (OR 0.60, CI 0.40-0.89 compared with current drinking)...

Low human papillomavirus prevalence in head and neck cancer: results from two large case-control studies in high-incidence regions

RIBEIRO, Karina Braga; LEVI, Jose Eduardo; PAWLITA, Michael; KOIFMAN, Sergio; MATOS, Elena; ELUF-NETO, Jose; WUNSCH-FILHO, Victor; CURADO, Maria Paula; SHANGINA, Oxana; ZARIDZE, David; SZESZENIA-DABROWSKA, Neonila; LISSOWSKA, Jolanta; DAUDT, Alexander; ME
Fonte: OXFORD UNIV PRESS Publicador: OXFORD UNIV PRESS
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
125.87%
Background Recent studies support an important role for human papillomavirus (HPV) in a subgroup of head and neck squamous cell carcinomas (HNSCC). We have evaluated the HPV deoxyribonucleic acid (DNA) prevalence as well as the association between serological response to HPV infection and HNSCC in two distinct populations from Central Europe (CE) and Latin America (LA). Methods Cases (n = 2214) and controls (n = 3319) were recruited from 1998 to 2003, using a similar protocol including questionnaire and blood sample collection. Tumour DNA from 196 fresh tissue biopsies was analysed for multiple HPV types followed by an HPV type-specific polymerase chain reaction (PCR) protocol towards the E7 gene from HPV 16. Using multiplex serology, serum samples were analysed for antibodies to 17 HPV types. Statistical analysis included the estimation of adjusted odds ratios (ORs) and the respective 95% confidence intervals (CIs). Results HPV16 E7 DNA prevalence among cases was 3.1% (6/196), including 4.4% in the oropharynx (3/68), 3.8% in the hypopharynx/larynx (3/78) and 0% among 50 cases of oral cavity carcinomas. Positivity for both HPV16 E6 and E7 antibodies was associated with a very high risk of oropharyngeal cancer (OR = 179, 95% CI 35.8-899) and hypopharyngeal/laryngeal cancer (OR = 14.9...

Vitamin or mineral supplement intake and the risk of head and neck cancer: pooled analysis in the INHANCE consortium

Li, Qian; Chuang, Shu-Chun; Eluf-Neto, Jose; Menezes, Ana; Matos, Elena; Koifman, Sergio; Wuensch-Filho, Victor; Fernandez, Leticia; Daudt, Alexander W.; Curado, Maria Paula; Winn, Deborah M.; Franceschi, Silvia; Herrero, Rolando; Castellsague, Xavier; Mo
Fonte: WILEY-BLACKWELL; HOBOKEN Publicador: WILEY-BLACKWELL; HOBOKEN
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
125.88%
To investigate the potential role of vitamin or mineral supplementation on the risk of head and neck cancer (HNC), we analyzed individual-level pooled data from 12 casecontrol studies (7,002 HNC cases and 8,383 controls) participating in the International Head and Neck Cancer Epidemiology consortium. There were a total of 2,028 oral cavity cancer, 2,465 pharyngeal cancer, 874 unspecified oral/pharynx cancer, 1,329 laryngeal cancer and 306 overlapping HNC cases. Odds ratios (OR) and 95% confidence intervals (CIs) for self reported ever use of any vitamins, multivitamins, vitamin A, vitamin C, vitamin E, and calcium, beta-carotene, iron, selenium and zinc supplements were assessed. We further examined frequency, duration and cumulative exposure of each vitamin or mineral when possible and stratified by smoking and drinking status. All ORs were adjusted for age, sex, race/ethnicity, study center, education level, pack-years of smoking, frequency of alcohol drinking and fruit/vegetable intake. A decreased risk of HNC was observed with ever use of vitamin C (OR = 0.76, 95% CI = 0.590.96) and with ever use of calcium supplement (OR = 0.64, 95% CI = 0.420.97). The inverse association with HNC risk was also observed for 10 or more years of vitamin C use (OR = 0.72...

ORAL MUCOSITIS PREVENTION BY LOW-LEVEL LASER THERAPY IN HEAD-AND-NECK CANCER PATIENTS UNDERGOING CONCURRENT CHEMORADIOTHERAPY: A PHASE III RANDOMIZED STUDY

de Lima, Aline Gouvea; Villar, Rosangela Correa; de Castro, Gilberto, Jr.; Antequera, Reynaldo; Gil, Erlon; Rosalmeda, Mauro Cabral; Honda Federico, Miriam Hatsue; Longo Snitcovsky, Igor Moises
Fonte: ELSEVIER SCIENCE INC; NEW YORK Publicador: ELSEVIER SCIENCE INC; NEW YORK
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
125.87%
Purpose: Oral mucositis is a major complication of concurrent chemoradiotherapy (CRT) in head-and-neck cancer patients. Low-level laser (LLL) therapy is a promising preventive therapy. We aimed to evaluate the efficacy of LLL therapy to decrease severe oral mucositis and its effect on RT interruptions. Methods and Materials: In the present randomized, double-blind, Phase III study, patients received either gallium-aluminum-arsenide LLL therapy 2.5 J/cm(2) or placebo laser, before each radiation fraction. Eligible patients had to have been diagnosed with squamous cell carcinoma or undifferentiated carcinoma of the oral cavity, pharynx, larynx, or metastases to the neck with an unknown primary site. They were treated with adjuvant or definitive CRT, consisting of conventional RT 60-70 Gy (range, 1.8-2.0 Gy/d, 5 times/wk) and concurrent cisplatin. The primary endpoints were the oral mucositis severity in Weeks 2, 4, and 6 and the number of RT interruptions because of mucositis. The secondary endpoints included patient-reported pain scores. To detect a decrease in the incidence of Grade 3 or 4 oral mucositis from 80% to 50%, we planned to enroll 74 patients. Results: A total of 75 patients were included, and 37 patients received preventive LLL therapy. The mean delivered radiation dose was greater in the patients treated with LLL (69.4 vs. 67.9 Gy...

Diet and the risk of head and neck cancer: a pooled analysis in the INHANCE consortium

Chuang, Shu-Chun; Jenab, Mazda; Heck, Julia E.; Bosetti, Cristina; Talamini, Renato; Matsuo, Keitaro; Castellsague, Xavier; Franceschi, Silvia; Herrero, Rolando; Winn, Deborah M.; La Vecchia, Carlo; Morgenstern, Hal; Zhang, Zuo-Feng; Levi, Fabio; Dal Maso
Fonte: SPRINGER; DORDRECHT Publicador: SPRINGER; DORDRECHT
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
125.9%
We investigated the association between diet and head and neck cancer (HNC) risk using data from the International Head and Neck Cancer Epidemiology (INHANCE) consortium. The INHANCE pooled data included 22 case-control studies with 14,520 cases and 22,737 controls. Center-specific quartiles among the controls were used for food groups, and frequencies per week were used for single food items. A dietary pattern score combining high fruit and vegetable intake and low red meat intake was created. Odds ratios (OR) and 95% confidence intervals (CI) for the dietary items on the risk of HNC were estimated with a two-stage random-effects logistic regression model. An inverse association was observed for higher-frequency intake of fruit (4th vs. 1st quartile OR = 0.52, 95% CI = 0.43-0.62, p (trend) < 0.01) and vegetables (OR = 0.66, 95% CI = 0.49-0.90, p (trend) = 0.01). Intake of red meat (OR = 1.40, 95% CI = 1.13-1.74, p (trend) = 0.13) and processed meat (OR = 1.37, 95% CI = 1.14-1.65, p (trend) < 0.01) was positively associated with HNC risk. Higher dietary pattern scores, reflecting high fruit/vegetable and low red meat intake, were associated with reduced HNC risk (per score increment OR = 0.90, 95% CI = 0.84-0.97).; International Agency for Research on Cancer; International Agency for Research on Cancer; US National Institutes of Health (NIH)...

Planejamento e relação estrutura-atividade de inibidores da MARK3 em câncer de cabeça e pescoço; Design and structure-activity relationship of inhibitors of MARK3 in head and neck cancer

Volpini, Josiana Garcia de Araujo
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 29/09/2010 Português
Relevância na Pesquisa
125.88%
O Projeto Genoma Humano do Câncer (PGHC), financiado pela FAPESP e pelo Instituto Ludwig de Pesquisa sobre o câncer, buscou identificar os genes expressos nos tipos mais comuns de câncer no Brasil. Tal projeto conseguiu identificar aproximadamente um milhão de sequências de genes de tumores frequentes no Brasil. A contribuição brasileira foi maior para tumores de cabeça e pescoço, mama e cólon. Uma das iniciativas mais recentes e estimuladas pelo PGHC é o projeto Genoma Clínico, o qual visa desenvolver novas formas de diagnóstico e tratamento do câncer através do estudo de genes expressos. A partir da análise molecular de tecidos saudáveis e neoplásicos em diferentes estágios, é possível identificar marcadores de prognóstico, permitindo escolhas de terapias mais adequadas e eficientes. A proteína MARK3 foi identificada como um desses marcadores, em neoplasias de tecidos de cabeça e pescoço, sendo o objetivo deste estudo a aplicação de técnicas de bioinformática e modelagem molecular no planejamento baseado em estrutura de candidatos a fármacos antineoplásicos que bloqueiem a atividade da proteína MARK3. Após screening virtual em bases de dados de compostos (1.000.000 aproximadamente) com propriedades drug-like...

Tabagismo, consumo de álcool e câncer de cabeça e pescoço nas regiões Sudeste, Sul e Centro-Oeste do Brasil; Smoking, alcohol consumption and head and neck cancer in Southeast, South and Midwest of Brazil

Sakaguti, Suely Aparecida Kfouri
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 30/04/2013 Português
Relevância na Pesquisa
125.97%
Introdução. Considerando-se a incidência e os reflexos na qualidade de vida, os tumores de cabeça e pescoço constituem-se em relevante problema de saúde pública. A medida de efeito dos principais fatores de risco, tabaco e álcool, no risco de acometimento de cânceres de cabeça e pescoço tem sido pouco relatada no Brasil. Objetivo. Verificar as variações de risco decorrentes do tabagismo e do consumo de bebidas alcoólicas no câncer de cabeça e pescoço nas regiões Sudeste, Sul e Centrooeste do Brasil. Sujeitos e Métodos. Estudo caso-controle de base hospitalar conduzido entre setembro de 1998 e maio de 2003, com base em 1.594 casos diagnosticados com carcinoma espinocelular de cabeça e pescoço, confirmados histologicamente, em hospitais das cidades de São Paulo e Rio de Janeiro (Sudeste), Porto Alegre e Pelotas (Sul), Goiânia (Centro-oeste), e 1.292 controles. Os pacientes foram entrevistados por meio de questionários com informações sobre características e hábitos, bem como dados clínicos e laboratoriais para o diagnóstico de câncer de cabeça e pescoço. A OR (odds ratio) e IC 95 por cento (intervalo com 95 por cento de confiança) para câncer de cabeça e pescoço associados ao tabaco e álcool foram estimados por regressão logística não condicional. O modelo foi ajustado por idade...

Função do sistema estomatognático em indivíduos dentados após tratamento de câncer de cabeça e pescoço comparados com indivíduos saudáveis; Function of the stomatognathic system in dentate after treatment of head and neck cancer compared with healthy subjects

Dante, André Mario Maia
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 03/10/2013 Português
Relevância na Pesquisa
125.94%
O câncer é considerado uma doença genética, extremamente complexa, que resulta de alterações concomitantes em genes geralmente relacionados à proliferação, diferenciação e morte celular. Os tumores de cabeça e pescoço englobam ampla variedade de neoplasias malignas que tem origem na mucosa do segmento aerodigestório superior, sendo responsável por cerca de 5% de todos os novos tumores diagnosticados. A Odontologia desempenha hoje um papel importante nas diferentes fases terapêuticas contra o câncer, seja na fase que antecede a cirurgia, em que uma avaliação prévia poderá reduzir de forma efetiva complicações oriundas de processos infecciosos ou inflamatórios crônicos, de origem bucal, que podem exacerbar após o tratamento cirúrgico, seja na prevenção das sequelas bucais que ocorrem durante e após o tratamento por radioterapia, como a osteorradionecrose dos tecidos da região irradiada. Esse estudo teve como objetivo avaliar, bilateralmente, por meio da eletromiografia (EMG), o padrão de comportamento (morfológico e funcional) da atividade dos músculos masseter e temporal nas condições clínicas de Repouso, Protrusão, Lateralidades direita e esquerda, Máxima Intercuspidação Habitual (MIH) e Mastigação com Parafilme M®. Avaliou também a espessura muscular por meio da ultrassonografia no Repouso e na Máxima Intercuspidação Habitual (MIH) e a força de mordida molar máxima direita e esquerda de dez indivíduos dentados totais...

Saúde oral, capacidade mastigatória e estado nutricional de indivíduos pós-tratamento de câncer de cabeça e pescoço; Oral health, capacity masticatory and nutritional status of individuals after treatment of head and neck cancer

Gonçalves, Jeanne Kelly
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 01/04/2015 Português
Relevância na Pesquisa
125.93%
Câncer de cabeça e pescoço é um termo amplo comumente utilizado para definir neoplasias da cavidade oral, faringe e laringe. O tratamento com cirurgia, quimioterapia e radioterapia está associado a vários efeitos colaterais, dentre eles prejuízos na condição oral, capacidade mastigatória e quadros de desnutrição. O presente estudo teve como objetivo verificar a influência da condição de saúde oral sobre a capacidade mastigatória e o estado nutricional em indivíduos que realizaram tratamento para câncer de cabeça e pescoço. A condição oral foi avaliada de acordo com a classificação do índice CPOD, CPI e avaliação de uso e necessidade de prótese; a capacidade mastigatória com o uso da Escala Funcional Intraoral de Glasgow; e o estado nutricional por meio do R24h e antropometria (ASG-PPP, IMC, CB, PCT e CMB). Foram incluídos no estudo dados de 23 indivíduos (18 homens e 5 mulheres) após tratamento do câncer de cabeça e pescoço com idade média de 57 anos. De acordo com a avaliação da condição oral, o CPOD médio foi 24,3, 43,4% da amostra era edêntulo, 91,3% necessitavam de prótese e apenas 56,5% utilizavam prótese. Indivíduos idosos apresentaram maior índice de utilização de prótese. O estado de saúde oral foi correlacionado com a capacidade mastigatória...

Shorter CAG repeat length in the AR gene is associated with poor outcome in head and neck cancer

Rosa, Fabiola Encinas; Mattos dos Santos, Rodrigo; Poli-Frederico, Regina Celia; Canevari, Renata de Azevedo; Nishimoto, Ines Nobuko; Magrin, Jose; Rainho, Claudia Aparecida; Kowalski, Luiz Paulo; Rogatto, Silvia Regina
Fonte: Elsevier B.V. Publicador: Elsevier B.V.
Tipo: Artigo de Revista Científica Formato: 732-739
Português
Relevância na Pesquisa
125.89%
Objective: Alterations in the size of the [CAG](n) repeats of the AR gene have been described in several types tumors. The purpose of this study was to evaluate if there is an association between the AR [CAG](n) repeat alleles and the relative risk for head and neck cancer and to analyse microsatellite instability (MSI) and loss of heterozygosity (LOH) in these tumors.Design: Matched samples of blood and head and neck tumors were evaluated using two methodologies, silver-stained gels to perform the analyses of MSI and LOH, and automated analysis to confirm these results and for genotyping of the AR [CAG](n), repeat length. Sixty-nine individuals without cancer were used as a control group for both procedures. The Log-rank test was used to compare overall survival and disease-free survival curves. The Cox proportional hazards regression models were performed to determine the [CAG], repeats as an independent prognostic factor.Results: Patients with alleles <= 20 in the male group showed a correlation with lower disease-free survival (P = 0.0325) and with recurrence or metastasis (RR 2.52, CI 95%). in the female group, the allele 2 (longer allele) showed a significant lower mean of [CAG](n), repeat when compared to the control group. Microsatellite instability was detected in nine cases in both procedures. In six out of these nine cases...

Genetic variability of vascular endothelial growth factor and prognosis of head and neck cancer in a Brazilian population

Ruiz,M.T.; Biselli,P.M.; Maniglia,J.V.; Pavarino-Bertelli,E.C.; Goloni-Bertollo,E.M.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2010 Português
Relevância na Pesquisa
125.93%
Vascular endothelial growth factor (VEGF) is one of the most potent endothelial cell mitogens and plays a critical role in angiogenesis. Polymorphisms in this gene have been evaluated in patients with several types of cancer. The objectives of this study were to determine if there was an association of the -1154G/A polymorphism of the VEGF gene with head and neck cancer and the interaction of this polymorphism with lifestyle and demographic factors. Additionally, the distribution of the VEGF genotype was investigated with respect to the clinicopathological features of head and neck cancer patients. The study included 100 patients with histopathological diagnosis of head and neck squamous cell carcinoma. Patients with treated tumors were excluded. A total of 176 individuals 40 years or older were included in the control group and individuals with a family history of neoplasias were excluded. Analysis was performed after extraction of genomic DNA using the real-time PCR technique. No statistically significant differences between allelic and genotype frequencies of -1154G/A VEGF polymorphism were identified between healthy individuals and patients. The real-time PCR analyses showed a G allele frequency of 0.72 and 0.74 for patients and the control group...

Prevention of oral mucositis in head and neck cancer patients : a systematic review.

Bowen, Joanne
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2012 Português
Relevância na Pesquisa
125.88%
Oral mucositis is a common and costly consequence of cancer treatment that currently lacks adequate intervention options. Patients treated for head and neck malignancies are at particularly high risk of severe mucositis, which significantly impedes delivery of therapy and consequently results in poorer outcomes in this population. As such, the quantitative objective of this review was to identify the effectiveness of agents and devices for oral mucositis prevention in newly diagnosed adult head & neck cancer patients being treated with radiotherapy with or without chemotherapy. The methodological framework developed by the Joanna Briggs Institute was followed to conduct the review. The quantitative component of the review considered any randomised controlled trials. In the absence of RCTs other research designs, such as non-randomised controlled trials and before and after studies, were considered for inclusion in a narrative summary to enable the identification of current best evidence. Databases were searched for published and non-published studies. A total of 202 studies were retrieved for review, with 81 studies excluded after reading the full article for clearly not meeting the inclusion criteria of the review. Two reviewers independently assessed 123 studies for methodological quality...

Amifostin in subkutaner Anwendung bei Patienten mit Kopf-Hals-Tumoren; Subcutaneous application of amifostine on patients with head and neck cancer

Wilder, Daniel
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
Português
Relevância na Pesquisa
125.88%
Hintergrund: Amifostin (Ethyol®), ein phosphorylierter Aminothioalkohol mit der chemischen Bezeichnung S-2[3-aminopropylamino]-ethyl-thiophosphorsäure, ist eine Substanz mit einem breiten zytoprotektiven Spektrum für die radio- und chemotherapeutisch induzierten Nebenwirkungen. Die Substanz fungiert dabei im Sinne einer Prodrug. Daraus wird, in Abhängigkeit von der alkalischen Phosphatase, der dephosphorylierte aktive Metaboliten WR-1065 gebildet. Dieser ist für die protektiven Wirkungen hauptsächlich verantwortlich. Weitere Oxidationen führen zu den entsprechenden symmetrischen (WR-33278) und gemischten Disulfiden. Die Zulassung der Substanz ist bisher lediglich auf eine intravenöse Applikation beschränkt. Hier zeigten sich bei radiotherapeutisch behandelten Patienten mit Kopf-Hals-Tumoren eine signifikante Reduktion einer Xerostomie und eine wesentlich höhere Lebensqualität der betroffenen Patienten. Präklinische Daten weisen auf eine signifikante Bioverfügbarkeit dieser Substanz auch bei einer subkutanen Applikation hin. In der vorliegenden Arbeit sollten erstmals umfangreiche Daten zur Pharmakokinetik von Amifostin und seiner Metaboliten, dem klinischem Outcome und Verträglichkeit für die subkutane Anwendung, im direkten Vergleich mit einer intravenösen Kontrollgruppe...

PATIENT RELATED DIAGNOSTIC DELAY, SYMPTOM APPRAISAL AND LAY CONSULTATION IN HEAD AND NECK CANCER

Queenan, JOHN
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
Português
Relevância na Pesquisa
125.94%
The objectives of this thesis were to; 1) identify established risk factors and gaps in the current peer reviewed literature relating to factors associated with patient related diagnostic delay in head and neck cancer, 2) describe and document patients’ personal responses to symptoms of head and neck cancer, the characteristics of the patients’ lay-consultants and the responses that the patients received from their lay-consultants and 3) assess the association between patient/network-related diagnostic delay and a) whether the patient felt any urgency to investigate their symptoms, b) whether the patient told someone in their social network about their symptoms (lay-consultancy) and c) lay-consultant influence. The first manuscript is a scoping review that demonstrates that there is a lack of studies that address; the personal symptom experiences of patients, the psycho-social processes of help-seeking and the independent effects of suspected risk factors for head and neck cancer. The results of the first manuscript also provided me with guidance on what the important confounders of our primary relationship of interest were most likely to be. The second manuscript suggests that patient related delay may be influenced by the patients’ mistaken belief that their symptoms were non-urgent with or without the influence of their lay-consultant. The third manuscript provides evidence that the primary barrier to seeking help from an HCP is whether or not those individuals experiencing symptoms think they are urgent enough to warrant further investigation. The study found no evidence to support the assertion that increased risk of delay is associated with decreased lay-consultancy. The results of this thesis indicate that most of the patient related delay occurs during the individuals’ symptom appraisal process with or without input from their social network. I think that individuals at risk of late stage presentation of head and neck cancer should be provided with targeted information encouraging them to seek help from a health care provider if the key signs or symptoms of head and neck cancer have not resolved within three weeks.; Thesis (Ph.D...

Toward Developing Pharmacokinetic Response Criteria to Chemoradiation in Head and Neck Cancer Patients Using Dynamic Contrast-Enhanced MRI

Onxley, Jennifer Dixon
Fonte: Universidade Duke Publicador: Universidade Duke
Tipo: Tese de Doutorado
Publicado em //2012 Português
Relevância na Pesquisa
125.9%

Purpose: The purpose of this study was to assess the feasibility of using dynamic contrast-enhanced MRI to monitor early treatment-induced changes in pharmacokinetic (PK) parameters in head and neck cancer patients. The intrinsic variability of three parameters (Ktrans, ve, and iAUC60) without treatment intervention was measured and compared to the treatment-induced variability.

Materials and Methods: Twenty patients were imaged while undergoing chemoradiation therapy (CRT) for head and neck malignancies. The imaging protocol included two baseline scans one week apart (B1, B2), and a third scan after 1-2 weeks of chemoradiation (ETX - early treatment). The images were acquired on a 1.5T scanner in the coronal plane with a temporal resolution of 10 sec. A population-averaged arterial input function was calculated from plasma concentration curves in both the left and the right carotids of each patient at each time point (B1, B2, ETX). The statistical significance of using a left/right AIF or a time-point-specific AIF was evaluated using Bland-Altman plots. To further ensure the correct calculation of PK parameters, the accuracy of the flip angles produced by the MR scanner was measured in phantoms and a volunteer. PK analysis was performed in iCAD (Nashua...

Specific alterations in the serum amino acid profile of patients with lung cancer and head and neck cancer

Cobo Dols,M.; Domínguez López,M.; Ramírez Plaza,C.; Pérez Miranda,E.; Gil Calle,S.; Villar Chamorro,E.; Alés Díaz,I.; Montesa Pino,A.; Alcaide García,J.; Gutiérrez Calderón,V.
Fonte: Oncología (Barcelona) Publicador: Oncología (Barcelona)
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/09/2006 Português
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125.92%
PURPOSE: Metabolism of the immediate principles is altered in cancer patients, resulting in an altered serum concentration of amino acids. The aim of this study was to find specific serum amino acid profiles in patients with cancer of the lung or head and neck. MATERIAL AND METHODS: We analyzed the baseline serum levels of 27 amino acids in 51 patients with cancer of the lung or head and neck with no metabolic alterations or other concomitant disorders and compared the results with a control group. RESULTS: Compared with the control group, patients with head cancer had significant differences in cysteine, aspartic acid, 3-methyl histidine, alanine, glycine, lysine, methionine, proline, serine, taurine, tyrosine, and threonine; and patients with lung cancer in cysteine, aspartic acid, 3-methyl histidine, histidine, citrulline, ornithine, alanine, glycine, lysine, methionine, proline, serine, taurine, tyrosine, and threonine. CONCLUSIONS: Variation in serum levels of certain amino acids in head and neck cancer and lung cancer is probably caused by interaction of the neoplasm with the protein metabolism. Each type of tumor has a certain specificity in the serum amino acid profile that may be useful in the diagnosis of these tumors.

Influence of an immuno-enhanced formula in postsurgical ambulatory patients with head and neck cancer

Izaola,O.; de Luis,D. A.; Cuellar,L.; Terroba,M.C.; Ventosa,M.; Martin,T.; Aller,R.
Fonte: Nutrición Hospitalaria Publicador: Nutrición Hospitalaria
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/10/2010 Português
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Background: Patients with head and neck cancer undergoing surgery have a high incidence of ambulatory postoperative complications. Objective: The aim of our study was to investigate the influence of an oral immunoenhanced supplement (arginine and glutamine) on nutritional and biochemical parameters in postsurgical ambulatory patients with head and neck tumor. Design: A population of 39 ambulatory postsurgical patients with oral and laryngeal cancer was enrolled. At Hospital discharge postsurgical head and neck cancer patients were asked to consume two units per day of a specially designed enhanced supplement for a twelve week period. Results: The mean age was 60.2+/-13.1 years (9 female/30 males). Duration of supplementation was 90.8+20 days. A significant increase of albumin (3.1±0.6 g/dl vs 4.12+0.7g /dl;p<0.05), prealbumin (21.4±6.3 mg/dl vs 22.4+5.9 mg/dl;p<0.05) and transferrin (198.8±45.2 mg/dl vs 253.8+60.7 mg/dl; p<0.05) levels were observed. No differences were detected in weight and other anthropometric parameters. Ten patients (41.3%) received radiotherapy along the enhanced supplementation period and only 5 (20% of patients with radiotherapy) developed a clinical oral mucositis. Conclusions: At dose used...

Immunoenhanced enteral nutrition formulas in head and neck cancer surgery: a systematic review

Casas Rodera,P.; de Luis,D. A.; Gómez Candela,C.; Culebras,J. M.
Fonte: Nutrición Hospitalaria Publicador: Nutrición Hospitalaria
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/06/2012 Português
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Introduction: Significant malnutrition exists in a high percentage of patients with head and neck cancer. Malnutrition is associated with defects in immune function that may impair the host response to malignancy. Malnutrition and immunosupression make patients highly susceptible to postoperative infections and complications. Objectives: Some studies of patients receiving immuno-nutrition in the perioperative period in head and neck cancer have shown beneficial effects on clinical outcome and inmune status. The authors carried out a systematic review of randomised control trials to determine whether perioperative immunonutrition has a role in the treatment of head and neck cancer. Methods: 14 trials of polymeric nutritional supplementation with immunonutrition were identified. Two studies compared two types of immunonutrition. Results: A reduction in the length of postoperative hospital stay was seen in some trials, but the reason for this reduction is not clear. Some studides showed statistical differences with less complications in arginine-enhanced group and also showed a significant decrease of fistula complications in patients treated with a high arginine dose enhanced formula, if compared with a medium dose of arginine. Conclussion: Those planning future studies face challenges. A suitable powered clinical trial is required before firm recommendations can be made on the use of immunonutrition in head and neck cancer patients posto-peratively.

Clinical effects of a w3 enhanced powdered nutritional formula in postsurgical ambulatory head and neck cancer patients

Luis,D. A. de; Izaola,O.; Cuellar,L.; Terroba,M. C.; Ventosa,M.; Martin,T.; Aller,R.
Fonte: Nutrición Hospitalaria Publicador: Nutrición Hospitalaria
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/10/2013 Português
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Background: Patients with head and neck cancer undergoing surgery have a high risk of nutritional complications. Objective: The aim of our study was to investigate the influence of an oral w3 enriched immunoenhanced powdered formula in nutritional and biochemical parameters in postsurgical ambulatory patients with head and neck tumor. Design: A population of 33 ambulatory postsurgical patients with oral and laryngeal cancer was enrolled. At Hospital discharge postsurgical head and neck cancer patients were asked to consume two units per day of a w3 enriched immunoenhanced powdered formula for a twelve week period. Results: The mean age was 61.3 ± 9.1 years (6 female/27 males). Duration of supplementation was 95.9 ± 21.1 days. A significant increase of albumin and transferrin levels was observed, in total group and in patients undergoing radiotherapy and without it. No differences were detected in weight and other anthropometric parameters in total group and in patients with radiotherapy during the protocol. Nevertheless, patients without radiotherapy showed a significant improvement of BMI; weight, fat free mass and fat mass. Conclusions: At dose used, an omega 3 enriched powdered formula improved seric protein levels in ambulatory postoperative head and neck cancer patients. Improvement of weight...