DSpace Community: Coleção voltada para a inserção de documentos da área de Oncologia Clínica

The primum non nocere principle

Wed, 01 Jan 2020 00:00:00 GMT

Title: The primum non nocere principle Authors: Guaraldi, Simone; Maluf Filho, Fauze Description: p. 565-568.

Evidence of recurrent selection of mutations commonly found in SARS-CoV-2 variants of concern in viruses infecting immunocompromised patients

Sat, 01 Jan 2022 00:00:00 GMT

Title: Evidence of recurrent selection of mutations commonly found in SARS-CoV-2 variants of concern in viruses infecting immunocompromised patients Authors: Goes, Livia Ramos; Siqueira, Juliana Domett; Garrido, Marianne Monteiro; Alves, Brunna Luiza Misael; Cicala, Claudia; Arthos, James; Viola, Joao Paulo de Biaso; Soares, Marcelo Alves Abstract: Chronically immunosuppressed patients infected with SARS-CoV-2 often experience prolonged virus shedding, and may pave the way to the emergence of mutations that render viral variants of concern (VOC) able to escape immune responses induced by natural infection or by vaccination. We report herein a SARS-CoV-2+ cancer patient from the beginning of the COVID-19 pandemic whose virus quasispecies across multiple timepoints carried several immune escape mutations found in more contemporary VOC, such as alpha, delta and omicron, that appeared to be selected for during infection. We hypothesize that immunosuppressed patients may represent the source of VOC seen throughout the COVID-19 pandemics. Description: p. 1-5.: il. color.

Is there a window of opportunity to optimize trastuzumab cardiac monitoring?

Sat, 01 Jan 2022 00:00:00 GMT

Title: Is there a window of opportunity to optimize trastuzumab cardiac monitoring? Authors: Paula, Bruno Henrique Rala de; Costa, Maria Eduarda Teixeira Ferro; Sousa, Carlos Augusto Moreira de; Bines, José Abstract: Background: It remains unclear whether the current arbitrary screening recommendations of trastuzumab-related cardiotoxicity provides an adequate balance between preventing heart damage and curtailing a curative treatment. Aim: To determine the incidence rate and consequences of trastuzumab-induced cardiotoxicity as adjuvant treatment in a real-world scenario. Methods: We present a retrospective analysis of cardiac function measured by echocardiogram at baseline and every 3 mo during trastuzumab treatment. Cardiotoxicity was defined as a drop in left ventricular ejection fraction (LVEF) ≥ 10% from baseline and/or any drop < 50%. Results: Between January 2011 and December 2014, 407 patients were selected. Most (93.6%) were treated with an anthracycline followed by a taxane-based regimen and trastuzumab for 12 mo. Forty patients (9.8%) had cardiotoxicity. None of them were symptomatic, and 28 (72.5%) completely recovered LVEF. Cardiotoxicity happened early as shown by LVEF measured on echocardiogram 2 to 4 as compared to 5 to 7 (odds ratio = 2.47, 95% confidence interval: 1.09, 5.63, P = 0.024). There were 54 deaths (13.3%) during the 70-mo follow-up period; 1 (0.2%) was attributed to late cardiotoxicity (4 years after treatment). The absence of symptomatic cardiotoxicity during trastuzumab treatment and moreover the early occurrence on the treatment period may translate into a strategy to evaluate less frequently. Conclusion: We observed a 10% rate of asymptomatic cardiotoxicity, which mirrors the results from the large adjuvant trials. Despite being transient, an LVEF drop led to frequent treatment delays and interruptions. It remains unclear whether LVEF decline is predictive of late cardiotoxicity, and treatment efficacy is compromised. Description: p. 403-410.: il. p&b,

Pacientes oncológicos sob cuidados paliativos: ocorrências relacionadas à punção venosa e hipodermóclise

Sat, 01 Jan 2022 00:00:00 GMT

Title: Pacientes oncológicos sob cuidados paliativos: ocorrências relacionadas à punção venosa e hipodermóclise Authors: Bolela, Fabiana; Lima, Roberta de; Souza, Ana Carolina; Moreira, Michele Rocha; Lago, Ana Julia de Oliveira; Simino, Giovana Paula Rezende; Araújo, Jakeline Silva de Abstract: Objetivo: identificar as ocorrências relacionadas à punção venosa periférica e à hipodermóclise entre pacientes internados em um hospital geral e em um hospital exclusivo de assistência a pacientes em cuidados paliativos oncológicos. Método: estudo observacional, descritivo e multicêntrico. A amostra do tipo consecutiva e não probabilística foi constituída por 160 pacientes oncológicos internados sob cuidados paliativos. A variável desfecho correspondeu às ocorrências e complicações relacionadas a cada tipo de punção. Utilizou-se um questionário contendo as variáveis sociodemográficas e clínicas e um roteiro estruturado para acompanhamento e avaliação diária da punção. Foram utilizadas estatísticas descritivas para a análise dos dados. Resultados: as ocorrências relacionadas à punção venosa no hospital geral foram sujidade de sangue na inserção do cateter (17,4 %) e prazo de uso expirado (15,8%), enquanto no serviço específico para atendimento a pacientes sob cuidados paliativos foram prazo de uso expirado (32%) seguido de infiltração (18,9%). Quanto à hipodermóclise, foram duas punções subcutâneas com sinais flogísticos (1,0%) no hospital geral e um hematoma no local de inserção do cateter (0,5%). No serviço específico para atendimento a pacientes sob cuidados paliativos foram três punções subcutâneas com sinais flogísticos (5,7%). Conclusão: as ocorrências relacionadas à punção venosa periférica foram superiores às relacionadas à hipodermóclise. Description: p. 1-10.: tab. p&b.