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1.
Braz J Otorhinolaryngol ; 90(1): 101365, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38006727

RESUMO

OBJECTIVES: To evaluate the efficacy and tolerance after the electrochemotherapy treatment for local therapy of cutaneous and subcutaneous metastases of head-and-neck tumors and malignant melanoma refractory to standard therapies, mainly in neck metastasis of squamous cell carcinoma. And, to evaluate the relation of this response according to the skin reaction (healing with ulcer or dry crust). METHODS: prospective pase II, observational clinical study of 56 patients with metastases of head-and-neck squamous cell carcinoma (n=13), papillary thyroid carcinoma (n=4), adenoid cystic carcinoma of parotid gland (n=1) or malignant melanoma (n=37, 5 in head). Patients were treated by electrochemotherapy (application of electrical pulses into the tumor) after the administration of a single intravenous dose of bleomycin. Kaplan-Meier curves were performed. The statistical significance was evaluated using log-rank test; p-value of less than 0.05 was considered as significant. RESULTS: Overall clinical response was observed in 47 patients (84%). Local side effects were mild in all the patients. Ten patients (76.9%) with neck metastasis of squamous cell carcinoma had some degree of response, but only in one was complete. Patients even with only partial response had a higher overall survival than patients without response (p= 0.02). Most of the patients with squamous cell carcinoma had diminution of pain and anxiety. Response rate and overall survival was higher in MM patients (86.5%) than in squamous cell cancer patients (76.9%) (p= 0.043). The healing process (dry crust/ulcer) was not associated with the overall survival (p= 0.86). CONCLUSIONS: Electrochemotherapy is associated a higher overall survival and diminution of pain and anxiety. Therefore, it is an option as palliative treatment for patients with neck metastasis of squamous cell carcinoma refractory to other therapies or even as a concomitant treatment with newer immunotherapies. The type of healing of the surgical wound could not be associated with a higher rate of response or survival. LEVEL OF EVIDENCE: III.


Assuntos
Carcinoma de Células Escamosas , Eletroquimioterapia , Neoplasias de Cabeça e Pescoço , Melanoma , Neoplasias Cutâneas , Neoplasias da Glândula Tireoide , Humanos , Antibióticos Antineoplásicos/efeitos adversos , Bleomicina/uso terapêutico , Bleomicina/efeitos adversos , Carcinoma de Células Escamosas/patologia , Eletroquimioterapia/efeitos adversos , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Melanoma/tratamento farmacológico , Melanoma/induzido quimicamente , Dor/induzido quimicamente , Dor/tratamento farmacológico , Cuidados Paliativos , Estudos Prospectivos , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia , Neoplasias da Glândula Tireoide/etiologia , Resultado do Tratamento , Úlcera/induzido quimicamente , Úlcera/tratamento farmacológico
2.
Braz. j. otorhinolaryngol. (Impr.) ; 90(1): 101365, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1534095

RESUMO

Abstract Objectives To evaluate the efficacy and tolerance after the electrochemotherapy treatment for local therapy of cutaneous and subcutaneous metastases of head-and-neck tumors and malignant melanoma refractory to standard therapies, mainly in neck metastasis of squamous cell carcinoma. And, to evaluate the relation of this response according to the skin reaction (healing with ulcer or dry crust). Methods prospective pase II, observational clinical study of 56 patients with metastases of head-and-neck squamous cell carcinoma (n = 13), papillary thyroid carcinoma (n = 4), adenoid cystic carcinoma of parotid gland (n = 1) or malignant melanoma (n = 37, 5 in head). Patients were treated by electrochemotherapy (application of electrical pulses into the tumor) after the administration of a single intravenous dose of bleomycin. Kaplan-Meier curves were performed. The statistical significance was evaluated using log-rank test; p-value of less than 0.05 was considered as significant. Results Overall clinical response was observed in 47 patients (84%). Local side effects were mild in all the patients. Ten patients (76.9%) with neck metastasis of squamous cell carcinoma had some degree of response, but only in one was complete. Patients even with only partial response had a higher overall survival than patients without response (p = 0.02). Most of the patients with squamous cell carcinoma had diminution of pain and anxiety. Response rate and overall survival was higher in MM patients (86.5%) than in squamous cell cancer patients (76.9%) (p = 0.043). The healing process (dry crust/ulcer) was not associated with the overall survival (p = 0.86). Conclusions Electrochemotherapy is associated a higher overall survival and diminution of pain and anxiety. Therefore, it is an option as palliative treatment for patients with neck metastasis of squamous cell carcinoma refractory to other therapies or even as a concomitant treatment with newer immunotherapies. The type of healing of the surgical wound could not be associated with a higher rate of response or survival. Level of evidence III.

3.
Homeopathy ; 109(2): 87-96, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31958867

RESUMO

BACKGROUND: Current recommendations for treating obesity in adolescence include a comprehensive approach (nutritional, behavioral, and exercise). Calcarea carbonica ostrearum (CCO) is a homeopathic medicine usually prescribed in obese individuals, but its effects on weight and body fat are not completely known. OBJECTIVE: The aim of this study will be to evaluate the efficacy of homeopathic CCO, in addition to a multidisciplinary intervention (diet, motivational support, and exercise program), on body fat and weight in obese adolescents. METHODS/DESIGN: A randomized, placebo-controlled, double-blind, parallel-group, superiority trial with 3-month study duration will be undertaken. The study will be conducted in a public research hospital in Mexico City, Hospital Juárez de México, in the outpatient services of homeopathy and sports medicine. Eighty non-diabetic adolescents, 12 to 19 years old, who are overweight or obese, will be included. The primary outcome: change in body fat percentage at week 12. The secondary outcomes: change in mean total weight, total body mass index, fat mass index, waist-hip ratio, lean muscle mass, fasting glucose, insulin, insulin resistance, lipid profile, score of Center for Epidemiologic Studies Depression Scale Revised (CESD-R) and score of Screen for Child Anxiety-Related Emotional Disorders (SCARED) at week 12. Efficacy data will be analyzed in the intention-to-treat sample. To determine the difference in the outcomes between groups at baseline and week 12, data will be analyzed using Student's t-test. DISCUSSION: This is the first randomized controlled trial aimed to determine the fat-reducing efficacy in obese adolescents of a homeopathic medicine, CCO, given in addition to a multidisciplinary intervention, compared with placebo plus the same intervention. It is an attempt to support scientific evidence in homeopathy for one of the most common chronic diseases, which causes high mortality due to its complications. CLINICALTRIALS. GOV IDENTIFIER: NCT03945396: https://clinicaltrials.gov/ct2/show/NCT03945396?term=homeopathy+for+obesity+in+Mexican+adolescents&rank=1.


Assuntos
Tecido Adiposo , Homeopatia/métodos , Sobrepeso/terapia , Adolescente , Adulto , Índice de Massa Corporal , Criança , Terapia Combinada , Método Duplo-Cego , Feminino , Humanos , Masculino , México , Inquéritos e Questionários , Relação Cintura-Quadril , Adulto Jovem
4.
Homeopatia Méx ; 85(701): 7-22, mar.-abr. 2016. ilus
Artigo em Espanhol | HomeoIndex - Homeopatia | ID: hom-11642

RESUMO

Antecedentes: la obesidad es un problema de salud pública en México que va en aumento en niños y adolescentes, incrementando el riesgo de enfermedades cardiovasculares y metabólicas a temprana edad. Tradicionalmente, en la práctica clínica homeopática, Calcarea carbonica ostrearum se ha utilizado para la obesidad; sin embargo, no existen estudios de calidad metodológica donde se demuestre sueficacia. El objetivo del estudio fue demostrar la eficacia de Calcarea carbonica ostrearum vs placebo para disminuir la obesidad en adolescentes. Material y métodos: se realizó un ensayo clínico controlado, aleatorizado, doble ciego, de 15 semanas de duración en el Hospital General de México (Ciudad de México) de febrero a agosto de 2010, en el que se incluyó a 25 pacientes adolescentesobesos de entre 14 y 18 años de edad. Se les administró Calcarea carbonica ostrearum 30CH, o placebo, junto con cambios en la dieta y ejercicio. Las variables medidas fueron: peso, índice de masa corporal, perímetro abdominal y porcentaje de grasa corporal. Resultados: se encontraron diferencias estadísticamente significativas entre Calcarea carbonica ostrearum 30CH y placebo en el porcentaje de grasa corporal (Calcarea carbonica ostrearum 2.9±1.1 vs placebo 1.3±1.5; diferencia=1.63, p<0.05). En las demás variables (peso, índice de masa corporal y perímetro abdominal) no se encontraron diferencias estadísticamente significativas entre grupos después de 15 semanas de tratamiento. Conclusión: Calcarea carbonica ostrearum 30CH puede ser efectiva para reducir el porcentaje de grasa corporal en adolescentes obesos. Es necesario que se realicen ensayos clínicos controlados con tamaños de muestra más grandes para corroborar estos resultados. (AU)


Background: obesity is a health problem in Mexico. The prevalence of juvenile and child obesity is raising and is strongly related to cardiovascular and metabolic risk factors. Traditionally, in daily homeopathic practice, Calcarea carbonica ostrearum is prescribed for obesity. Nevertheless there is a lack of well-designed studies to prove its efficacy. The objetive of this study was to investigate the efficacy of Calcarea carbonica ostrearum 30CH vs placebo for reducing obesity in adolescents. Methods/design: a randomized, double-blind, placebo-controlled two-arm trial with a 15 weeks follow-up study was conducted in the Hospital General de Mexico in Mexico City. Twenty-five adolescents between 14 and 18 years were included. The outcomes were: weight, body mass index, abdominal circumference and percentage of body fat. Results: percentage of body fat was the only outcome with statistically significant difference between Calcarea carbonica ostrearum 30CH and placebo (Calcarea carbonica ostrearum 2.9±1.1 vs placebo 1.3±1.5, difference=1.63, p<0.05). Neither weight, nor body mass index, nor abdominal circumference were different from placebo after 15 weeks of treatment. Conclusion: Calcarea carbonica ostrearum 30CH could be effective for reducing the percentage of body fat in obese adolescents. Further studies with larger sample sizes are needed to confirm these results. (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Calcarea Carbonica/uso terapêutico , Obesidade Infantil , Homeopatia , México
5.
Rev Lat Am Enfermagem ; 12 Spec No: 420-6, 2004.
Artigo em Espanhol | MEDLINE | ID: mdl-15303197

RESUMO

This psychometric study aims to evaluate the attitudes of nurses working in a hospital network towards alcoholic patients. Research participants were 71 nurses from Public Hospitals in La Paz, Bolivia. Data were collected through the Seaman Mannello scale (Nurses' Attitudes Towards Alcohol and Alcoholism), which consists of five subscales. According to the research results, nurses agree that alcoholic patients' life in unpleasant, so that they are not their preferred patients. They believe these patients deserve nursing care like everybody else but disclose indifference towards feeling comfortable about this care, although they affirm their willingness to help the patient. Nurses perceive alcoholics as sensitive persons and think that alcohol consumption turns normal persons fragile and silly, which is risky since they conceptualize alcoholics as serious and unrecoverable patients. These data illustrate that the nurses' attitudes reflect their personal and professional context and probably their nursing education about this subject.


Assuntos
Alcoolismo , Atitude do Pessoal de Saúde , Enfermeiras e Enfermeiros , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos e Questionários
6.
Rev. latinoam. enferm ; 12(n.esp): 420-426, mar.-abr. 2004. graf
Artigo em Espanhol | LILACS, BDENF - Enfermagem | ID: lil-361170

RESUMO

Se trata de un estudio psicometrico para evaluar actitudes de enfermeras de un complejo hospitalario con relación al paciente alcohólico. Participaron 71 enfermeras de Hospitales públicos de la Paz, Bolivia. Se utilizó para recolectar datos la escala SEAMAN MANNLLO (Nurses' Atittudes Toward Alcohol and Alcohol), compuesta por cinco subescalas. Los resultados indicaron que las enfermeras concuerdan que la vida del alcohólico es desagradable, no siendo el paciente de su preferencia, creen que merecen atención de enfermería como otros pero indican indiferencia cuanto a sentirse cómodas en esa atención, aunque afirmaron disposición para ayudarlo. Se percibe a los alcohólicos como personas sensibles, tienen la opinión que consumir bebidas alcohólicas convierten las personas normales en débiles y tontas, lo que es arriesgado porque conceptualizan al alcohólico como paciente grave e irrecuperable. Tales datos señalaron las actitudes de las enfermeras reflejan entorno personal, profesional y probablemente la formación de enfermería sobre ese tema


Assuntos
Humanos , Masculino , Feminino , Alcoolismo , Enfermeiras e Enfermeiros , Enfermeiros , Relações Enfermeiro-Paciente , Equipe de Enfermagem
9.
Rev. cienc ; : 61-5, 1997. graf
Artigo em Espanhol | LILACS | ID: lil-243012

RESUMO

Analiza que el embarazo ectópico (EE) o extrauterino es una patología cuya incidencia en la actualidad se ha aumentado considerablemente a nivel mundial, su diagnóstico sigue siendo un desafío aún con las pruebas especializadas y complejas que existen. En el presente trabajo hacemos una comparación retrospectiva del manejo del EE en dos hospitales diferentes del país, viendo cómo el diagnóstico precoz y tratamiento oportuno dan como resultado una morbimortalidad de cero para los períodos estudiados.


Assuntos
Feminino , Gravidez Ectópica/etiologia , Gravidez Ectópica/mortalidade , Gravidez Ectópica/terapia , Hospitais , Equador , Pacientes
10.
Rev. cienc ; : 90-1, 1997.
Artigo em Espanhol | LILACS | ID: lil-243021

RESUMO

Expone que el embarazo cervical es uno de los tipos de gestación ectópica cuya presentación es extremadamente rara y pone en peligro la vida de la paciente. Informamos el caso de una mujer ingresada en el Servicio de Obstetricia del Hospital "Carlos Andrade Marín", que clínica y ultrasonográficamente fue diagnosticada de embarazo ectópico cervical; tratado quirúrgicamente con evolución satisfactoria. Además, en el presente artículo descubrimos los aspectos más sobresalientes que conocemos sobre este procedimiento.


Assuntos
Feminino , Adulto , Departamentos Hospitalares , Hospitais , Histerectomia , Obstetrícia , Gravidez Ectópica , Equador , Pacientes
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