Darbo objektas: trys limfinio drenažo technikos, taikytos pacientams po kelio sąnario endoprotezavimo. Darbo problema: augant kelio sąnario endoprotezavimo operacijų skaičiui, dažnai po operacijos atsiranda komplikacijos. Viena labiausiai paplitusių komplikacijų yra kojos patinimas, sukeltas dėl infekcijos, kuri sukelia limfos tekėjimo sutrikimus. Norint pagerinti limfos tekėjimą, sumažinti patinimą, skausmą ir pagerinti judesio amplitudę patartina taikyti limfinio drenažo technikas. Darbo tikslas: palyginti skirtingų limfinio drenažo technikų poveikį pacientams po kelio sąnario endoprotezavimo. Tyrimo uždaviniai: 1. Nustatyti ir palyginti kojos apimčių aukščiau ir žemiau kelio sąnario pokyčius, taikant manualinio limfinio drenažo, presoterapijos ir masažinės technikos „Andulation“ technikas. 2. Nustatyti ir palyginti kelio sąnario lenkimo amplitudės pokyčius, taikant manualinio limfinio drenažo, presoterapijos ir masažinės technikos „Andulation“ technikas. 3. Nustatyti ir palyginti skausmo pokyčius, taikant manualinio limfinio drenažo, presoterapijos ir masažinės technikos „Andulation“ technikas. Tyrimo metodika: tyrime dalyvavo 15 pacientų, iš jų 6 vyrai ir 9 moterys. Moterų amžiaus vidurkis siekė 55,8 metus, o vyrų – 56,5 metus. Pasirinktos trys limfinio drenažo technikos: manualinis limfinis drenažas taikytas 5 pacientams, presoterapija -5 pacientams ir nauja „Andullation“ masažo terapija taikyta 5 pacientams. Gydymas taikytas 4 savaites, prieš ir po technikų taikymo... [toliau žr. visą tekstą] / Object of the research: three lymphatic drainage techniques, used for patients after knee arthroplasty. Problem of research: there are increased numbers of complications after knee arthroplasty operations. One of the most common complications is swelling, caused by infection, which cause disorders of the lymph flow. It is recommended to use lymphatic drainage techniques to improve lymph flow, decrease pain and increase range of motion of the knee. Aim of this research: to compare three lymphatic drainage techniques used on patients after the knee arthroplasty. Goals of the research: 1. Define and compare volumes of the leg, higher and lower knee, after using manual lymphatic drainage, pressotherapy and massage therapy „Andullation“. 2. Measure and compare knee range of motion of bending, after using manual lymphatic drainage, pressotherapy and massage therapy „Andullation“. 3. Identify and compare changes of the pain, after using manual lymphatic drainage, pressotherapy and massage therapy „Andullation“. Methods and organization of the research: There were 15 patients in the research: 6 men and 9 women. The average age of the women was 55.8 years and 56.5 for men. There were three lymphatic drainage techniques used: manual lymphatic drainage on 5 patients, pressotherapy on 5 patients and a new “Andullation” massage therapy, which was performed on 5 patients disregarding their gender and age. There were three parameters used to determine and compare the results: visual... [to full text]

Aims: To describe use of post-operative radiation for endometrial cancer in Ontario. To identify system-related and patient-related factors affecting access to this treatment. Materials and Methods: We performed a retrospective population-based cohort study of patients with surgically resected endometrial cancer in the Canadian province of Ontario between 1992-2003. Patients with evidence of incurable cancer at diagnosis or previous cancer diagnosis were excluded. We used multiple logistic regression to assess patient and system factors affecting radiation use. We controlled for disease-related and treatment-related factors: histology, surgical staging, type of hysterectomy and peritoneal biopsy. We applied a mixed model to account for clustering of data by operating hospital. Results: 9,411 women comprised the study cohort. The median age was 63 years. 26.2% received adjuvant radiation. The proportion of patients receiving radiation varied between cancer centre catchment areas from 18.0% to 34.3% (median 26.3%). In multivariate analysis, older patients were more likely to receive radiation up to the age of 80 (p<.0001). Patients who lived further from regional cancer centres were less likely to receive radiation (p=.0210). Patients who had their surgery during longer prevailing wait times at regional cancer centres were less likely to receive radiation (p=.0441). There was a 2.7-fold variation in the odds of radiation use between cancer centre catchments (p<.0001). Management at a comprehensive gynecologic oncology centre was associated with use of radiation for patients who had surgical staging of lymph nodes. Year of diagnosis and neighborhood income quintile did not significantly affect the use of radiation. Conclusions: There is wide variation in use of radiation for endometrial cancer in Ontario. There is evidence that system factors unrelated to patient’s needs affect use of adjuvant radiation for endometrial cancer in Ontario. Age is a key patient-related factor affecting radiation use. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2009-08-07 22:02:37.308

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 5 uppsatser.

Diss. (sammanfattning) Uppsala : Uppsala universitet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2008. / Härtill 5 uppsatser.

Thesis (M.Sc.)--University of Alberta, 2009. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Master of Science, Oncology. Title from pdf file main screen (viewed on October 24, 2009). Includes bibliographical references.

Η αντιμετώπιση του καρκίνου του προστάτη (αλλά και των υπόλοιπων νεοπλασματικών νοσημάτων) δεν περιλαμβάνει απλώς την ανεύρεση νέων χημειοθεραπευτικών φαρμάκων. Αφορά και την κατοχύρωση ορισμένων δεικτών που μπορούν να μας δώσουν περισσότερες πληροφορίες για την ύπαρξη της νόσου, αλλά και του σταδίου εξέλιξης που βρίσκεται έτσι ώστε να παίρνονται οι πλέον σωστές αποφάσεις για την διαχείριση του ασθενούς. Η βιβλιογραφική αναφορά που ακολουθεί θα ασχοληθεί εκτενώς με αυτά τα ζητήματα (δηλ. τους δείκτες νόσου/σταδίου νόσου του καρκίνου του προστάτη) και ιδιαίτερα με μια υποομάδα αυτών: των μοριακών δεικτών της σταδιοποίησης της λεμφαδενικής νόσου στον καρκίνο του προστάτη. Αφορά μια πολλά υποσχόμενη μερίδα μοριακών δεικτών στην αντιμετώπιση της συγκεκριμένης νόσου που ενδέχεται να επηρεάσει και την προσέγγιση άλλων συμπαγών όγκων. / Use of new molecular markers for staging of lymph node disease in the prostate cancer.

Orientadora: Rosemeri de Oliveira Vasconcelos / Banca: Valéria Marçal Felix de Lima / Banca: Antonio Carlos Alessi / Resumo: A Leishmaniose Visceral (LV) é uma zoonose de interesse em saúde pública e o cão é o principal reservatório doméstico de Leishmania chagasi. Este protozoário modula a resposta imune do hospedeiro. A citocina MIF favorece a permanência do macrófago no sítio da injúria e protege-o da apoptose. O objetivo deste estudo foi avaliar a presença de MIF nos linfonodos de cães com LV, comparando estes achados com a densidade de macrófagos parasitados nos linfonodos e com o estadiamento clínico dos cães. Neste estudo utilizou-se 33 cães oriundos de Araçatuba, município endêmico para a LV. Os cães foram distribuídos nos grupos assintomático (A), oligossintomático (O) e sintomático (S). As alterações morfológicas dos linfonodos poplíteo, subescapular, ilíaco e mesentérico foram avaliadas quanto ao perfil celular, determinado por escores. A carga parasitária e a imunodetecção de MIF foi feita pela técnica de imuno-histoquímica. Nos cães dos grupos com sinais clínicos (O e S), as reações inflamatória granulomatosa e plasmocitária foram predominantes. No grupo S, a atrofia linfóide predominou e associou-se ao maior número de granulomas e a maior carga parasitária. A densidade de parasitos nos linfonodos periféricos diferiu significativamente do grupo S para os demais grupos (P<0,05). A densidade de macrófagos imunomarcados com MIF foi maior no grupo S e apresentou uma correlação significativa com a carga parasitária no linfonodo poplíteo (P<0,05). Conclui-se que macrófagos são uma das células mais envolvidas na resposta ao parasito. O protozoário utiliza MIF para manter o macrófago no sítio de infecção, favorecendo a sua sobrevivência no hospedeiro / Abstract: Visceral leishmaniasis (VL) is a zoonotic disease critical for the public health and the dog is the main Leishmania chagasi„s domestic reservoir. This protozoan modulates the immune response of the host. The MIF cytokine facilitates the permanence of the macrophage in the site of injury and protects it from apoptosis. The aim of this study was to evaluate the MIF presence in the lymph nodes of dogs with VL, comparing these findings with the parasite density in the lymph nodes and with the clinical outcome of the dogs. Third three dogs from Araçatuba, an endemic city for VL, were used in this study. Dogs were distributed in the asymptomatic (A), oligosymptomatic (O) and symptomatic (S) groups. The cellular profile of the morphologic changes of the popliteal, subscapular, iliac and mesenteric lymph nodes were evaluated and scored. Immunohistochemistry did the parasite load and the MIF immunodetection technique. Granulomatous and plasmocitary inflammatory reaction predominated in the groups with clinical signs (O and S). In the S group, lymphoid atrophy predominated and was associated with high number of granulomas and high parasite load. Comparing the groups, the density of the parasites in the peripheral lymph nodes was significantly different for the S group (P<0.05). The density of the immunolabeling MIF macrophages was higher in the S group and had a significant positive correlation with the parasite load in the popliteal lymph node (P<0.05). In conclusion, the macrophages are the most involved cells, and the protozoan uses the MIF to keep the macrophage in the infection site, helping its survival in the host / Mestre

Objetivos: Avaliar a eficácia da injeção intraoperatória para identificação do linfonodo sentinela (LS) em câncer de mama com o uso do Dextran 500-99m-Tecnécio (Tc) e azul patente. Analisar se as doses do radiofármaco, o IMC (índice de massa corporal) e o volume da mama influenciam no tempo para migração ao LS. Metodologia: Estudo prospectivo, realizado entre abril de 2008 e junho de 2009, que incluiu 74 biópsias de LS em pacientes com câncer de mama em estádios T1N0 e T2N0. Injetou-se, após indução anestésica, de 0,5 a 1,5 mCi de Dextran 500-99m-Tc filtrado 0,22 μm na região subareolar num volume de 5 ml e 2 ml de azul patente. Resultados: Identificou-se o LS em 100% dos casos. Um LS (1,35%) estava marcado apenas com o azul patente. A taxa de identificação com o “probe” foi de 98% (73/74 casos). A dose média de radiofármaco aplicada foi 0,97 mCi + 0,22. O tempo médio para marcação do LS foi de 10,7 minutos (+ 5,7min). Identificamos em média 1,66 LS com o radioisótopo. A dose aplicada não apresentou relação com o tempo para captação (p=0,73). Quanto maior o volume da mama e IMC, maior o tempo para captação na região axilar (Pearson Correlation r=0,393 p<0,01; r=0,469 p<0,01 - respectivamente). Conclusão: A injeção intraoperatória do radiofármaco é eficaz para identificação do LS em câncer de mama. O tempo para marcação do LS é maior em pacientes com IMC elevado e mamas volumosas. Doses maiores de radiofármaco não diminuem o tempo de migração. / Objectives: To determine the identification of sentinel lymph node (SLN) in breast cancer after intraoperative injection of Dextran 500‐99mTechnetium (Tc) and blue dye. To analyze if the doses of the radioisotope, body mass index (BMI) and breast volume influence the migration time of the SLN. Methodology: Prospective study between april 2008 and june 2009, which included 74 biopsies of SLN in patients with breast cancer in stages T1N0 and T2N0. Intraoperative injection after induction of general anesthesia, 0.5 to 1.5 mCi of dextran 500‐99m‐Tc filtered 0.22 μm in the subareolar region in a volume of 5 ml and 2 ml of blue dye. Results: We identified the SLN in 100% of cases. In one case (1.35%) the SLN was marked only with the blue dye. The SLN identification rate with the probe was 98% (73/74 cases). The mean dose of radioisotope injected was 0.97 + 0.22 mCi. The average time to mark the SLN was 10.7 minutes (+ 5.7 min). We identified an average 1.66 SLN with the radioisotope. The dose had no effect on the time to capture (p = 0.73). The larger breast volume and BMI, the greater the capture time in the axillary region (Pearson Correlation r=0.393 p <0.01, r=0.469 p <0.01 - respectively). Conclusion: Intraoperative injection of the radioisotope is effective for the identification the SLN in breast cancer. Time to mark the SLN is higher in patients with high BMI and large breasts. Higher doses of radioisotope do not decrease the migration time.