Objetivo: Neste artigo cientifico apresenta-se um estudo do tipo revisão de literatura que teve como objetivo principal compreender quais as principais técnicas fisioterapêuticas utilizadas para o tratamento da Síndrome de Down (SD) e os principais resultados obtidos nestas pesquisas. Métodos: Estudo exploratório do tipo revisão de literatura, sendo aplicados os descritores “Síndrome de Down” e “Fisioterapia” em português e inglês nas seguintes bases de dados: CAPES, Scielo, Medline e LILACS, na linha de tempo dos últimos 10 anos. Resultados: Nas respectivas bases de dados foi computado 70 pesquisas com estes descritores nos últimos 10 anos, porém, após os critérios de inclusão e exclusão foram constatados que apenas 10 artigos apresentaram dados qualitativos ou quantitativos sobre a prática da fisioterapia nos tratamentos das disfunções musculares ou motoras em portadores de (SD). Os autores pesquisados demonstraram uma tendência de pesquisa voltada para lactentes, sendo que dos 10 artigos 9 eram voltadas para as crianças e apenas 1 pesquisa para adolescentes e adultos, demonstrando uma carência para o segmento da terceira idade. Considerações Finais: Os resultados das pesquisas destes 10 artigos apontam que tratamentos fisioterapêuticos que aplicam protocolos multissensoriais demonstram bons resultados na reabilitação motora, entretanto, os fisioterapeutas ainda utilizam técnicas consideradas mais tradicionais como Bobath e Kabat.
Background Trastuzumab is indicated for the treatment of patients overexpressing HER2 in metastatic breast cancer and HER-positive early breast cancer. Purpose This study aimed to evaluate the use of trastuzumab in an adjuvant setting, in the Hospital Garcia de Orta. Materials and methods This evaluation, carried out in September 2011, included all early-stage breast cancer patients who started trastuzumab in 2008 or 2009. Data source: medical records and patients' prescriptions from the cytostatic unit in the pharmacy department. Each patient was evaluated on six factors of poor prognosis (age < 50 years; invasion of lymph nodes; absence of oestrogen and progesterone receptors; tumour size > 2 cm; disease staging ≥ GIII and overexpression of the HER2 receptor). Results This study included 32 women with an average age of 49.5±11.4 years (33-75 years). Twenty-five women were clinically well (78.1%), 2 (6.3%) had metastases and 5 (15.6%) died. All patients had at least one factor of poor prognosis (over-expression of HER2). Only 1 patient had 1 poor prognosis factor, 6 had two factors of poor prognosis, 12 patients had 3, 9 patients presented 4 and 4 patients had 5 factors for poor prognosis. Statistically significant differences were found between the patients who were clinically well and those who developed metastatic disease or died, for the number of poor prognosis factor present at the time of trastuzumab prescription (p<0.05). Of all the poor prognosis factors, disease staging was the one that showed statistically significant differences between the 2 groups of patients (p<0.001). Conclusions The literature refers to disease staging as the most accurate estimate of prognosis in breast cancer. Based in our study, disease staging was also the factor of prognosis that best predicted the result of trastuzumab therapy.
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Background Patients with recurrent malignant gliomas, such as glioblastoma multiform and anaplastic astrocytoma, have a poor prognosis. Repeat surgery may not be feasible, because of tumour infiltration, and additional irradiation has limited control on further tumour growth and would potentiate neurological toxicity. Treatment options are limited. The association of an angiogenesis inhibitor with a classical cytotoxic -bevacizumab plus irinotecan – is one of the options used by the neuro-oncologists. Purpose Evaluate the effectiveness of combination bevacizumab and irinotecan in recurrent malignant gliomas. Materials and methods Retrospective analyse of patients with gliomas treated with bevacizumab/irinotecan. Data source: medical records and patients prescription from the cytostatic unit in pharmacy department. The following variables were analysed: sex, age at diagnosis, diagnosis, previous treatment received, number of cycles and dose. Disease progression was evaluated by MRI. Results This study included 16 patients (7 females, 9 males) with a mean age at diagnosis of 45,75±9,75 years (range 29-60). The principal diagnosis was glioblastoma multiform (68,7%). Bevacizumab/Irinotecan was used in second-line treatment in 9 patients (56,2%) and in third-line setting in 7 patients (43,8%). Fifteen patients did radiation therapy with concurrent Temozolomide (TMZ) before Bevacizumab/Irinotecan, and all patients had undergone prior surgical resection. The mean number of cycles of bevacizumab/Irinotecan was 7,9±5,5 (1-16). Disease progression, was observed in 12 patients (75%) and 4 are still in treatment. Considering the patients who already stopped treatment, the calculated time to disease progression, based on the duration of bevacizumab/irinotecan treatment, was 22,4 weeks. (Time to disease progression described in the literature: 23,0 weeks). Conclusions Preliminary results with Bevacizuman/Irinotecan in the treatment of patients with high grade gliomas are similar the results observed in the literature and encouraging in poor prognosis disease in malignant glioma.
Elaborado por Maurício Amormino Júnior-CRB6/2422 O conteúdo dos artigos e seus dados em sua forma, correção e confiabilidade são de responsabilidade exclusiva dos autores. 2019 Permitido o download da obra e o compartilhamento desde que sejam atribuídos créditos aos autores, mas sem a possibilidade de alterá-la de nenhuma forma ou utilizá-la para fins comerciais.
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