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Identifying necrolytic migratory erythema in glucagonoma syndrome  胰高血糖素瘤综合征坏死性迁移性红斑的鉴别
Pub Date : 2021-08-12 DOI: 10.15406/jcpcr.2021.12.00465
R. Vasanwala, Joseph R. Malhis, Vivek Malhotra, Ethan Anderson, Kerry J Williams-Wuch
The glucagon secreted by a glucagonoma causes the combination of symptoms known as glucagonoma syndrome. 1 A common presenting feature of glucagonoma syndrome is necrolytic migratory erythema (NME) occurring in about 70 to 80 percent of patients. 2,3 Although this rash is can be found in a handful of other disorders, NME should raise an alarm for glucagonoma syndrome especially if present with systemic symptoms. We present a 51 year old male with a past medical history of type 2 diabetes who presented to oncology after seeing several dermatologists regarding a progressive painful pruritic papular rash along his lower extremities and groin. Previous punch biopsies did not reveal the characteristic findings of necrolytic migratory erythema and the rash was thought to be pustular psoriasis. It was only after over a year as the patient continued to worsen that a malignancy work up was done. Eventually glucagonoma syndrome was confirmed. Necrolytic migratory erythema can disguise itself as several different types of rashes. An unusual or unresponsive psoriasiform rash should prompt an investigation for an alternative diagnosis.
由胰高血糖素分泌的胰高血糖素引起称为胰高血糖素综合征的症状组合。1胰高血糖素瘤综合征的一个共同特征是坏死性迁移性红斑(NME),发生在约70%至80%的患者中。虽然这种皮疹可以在少数其他疾病中发现,但NME应该引起胰高血糖素综合征的警报,特别是当出现全身症状时。我们报告一位51岁男性患者,既往有2型糖尿病病史,因下肢和腹股沟处出现进行性疼痛瘙痒性丘疹而就诊于皮肤科。先前的穿孔活检未发现坏死性迁移性红斑的特征性表现,皮疹被认为是脓疱性牛皮癣。仅仅过了一年多,由于病人病情继续恶化,才进行了恶性肿瘤检查。最终证实胰高血糖素瘤综合征。坏死性迁移性红斑可以伪装成几种不同类型的皮疹。异常或无反应的牛皮癣样皮疹应提示调查替代诊断。
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引用次数: 0
Relationship between innovative and biosimilar trastuzumab used in the treatment of breast cancer: cross-sectional study of financial impact 用于乳腺癌治疗的创新曲妥珠单抗与生物仿制药之间的关系:财务影响的横断面研究
Pub Date : 2021-07-29 DOI: 10.15406/jcpcr.2021.12.00464
Tamara Marques Previ, Andre Fellipe Freitas Rodrigues
The irrational use of drugs today is relevant, so pharmacoeconomics is an analytical tool that links economic factors related to drug use and clinical outcomes. Biological medicines are products derived from genetically modified living cell sources. In this context, the biosimilar drug presents similarity in structure, function, efficacy and safety when compared to the original product. Currently several biosimilars are being developed for the treatment of breast cancer, a fact that directly impacts patient survival. Breast cancer is one of the most common types of cancer, being HER2 positive one of the most aggressive forms of the disease, and its treatment is based on the use of cytotoxic drugs associated with targeted therapy using the monoclonal antibody transtuzumab. There are positive future prospects related to biosimilars with impacts on survival and potential increase of patients with access to innovative treatments. The research aimed to analyze the financial impact of the use of the biosimilar trastuzumab and the increase in the number of patients with access to therapies, through a retrospective documentary cross-sectional study, developed on a representative sample of cost values of the drugs Herceptin and Zedora, for the reference protocol trastuzumab. The results obtained in the descriptive statistics through the analysis of variance were not significant; however, a percentage of savings of 27.89% was obtained for the biosimilar Zedora when compared to Herceptin. Monoclonal antibodies are responsible for 35% of the expenses in oncology. The introduction of biosimilars can contribute to the financial and budgetary sustainability of the health system. Based on the results obtained, it is possible to affirm that for every three patients treated with Herceptin, it is possible to treat four patients using Zedora.
今天药物的不合理使用是相关的,因此药物经济学是一种分析工具,将与药物使用和临床结果相关的经济因素联系起来。生物药品是从转基因活细胞中提取的产品。在这种情况下,生物仿制药与原产品相比在结构、功能、疗效和安全性方面具有相似性。目前正在开发几种用于治疗乳腺癌的生物仿制药,这一事实直接影响到患者的生存。乳腺癌是最常见的癌症类型之一,是HER2阳性的最具侵袭性的疾病之一,其治疗基于使用细胞毒性药物与使用单克隆抗体transtuzumab的靶向治疗相结合。生物仿制药对患者的生存有积极的影响,并有可能增加患者获得创新治疗的机会。该研究旨在通过回顾性文献横断面研究,分析使用生物仿制药曲妥珠单抗的财务影响和获得治疗的患者数量的增加,该研究开发了赫赛汀和Zedora药物成本值的代表性样本,作为参考方案曲妥珠单抗。描述性统计通过方差分析得到的结果不显著;然而,与赫赛汀相比,生物仿制药Zedora节省了27.89%的费用。单克隆抗体占肿瘤学费用的35%。引进生物仿制药可促进卫生系统的财政和预算可持续性。根据所获得的结果,可以肯定的是,对于每3名接受赫赛汀治疗的患者,有可能治疗4名使用Zedora的患者。
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引用次数: 0
Strategies for the dentist management of cancer patients: narrative literature review  牙科医师治疗癌症病人的策略:叙述性文献回顾
Pub Date : 2021-07-19 DOI: 10.15406/jcpcr.2021.12.00463
H. Antunes, L. D. B. Alves, Ana C S Menezes, A. Costa, F. Heimlich, D. Goldemberg
Aim: To present the dental procedures necessary for the prevention, diagnosis, and treatment of oral toxicities related to cancer treatment. Material and methods: A narrative literature review was carried out regarding the topics of interest. Articles in Portuguese and English, without the restriction of the year of publication and full text available in the databases Pubmed, Scielo, Cochrane, and Google Scholar were investigated. Results: Through this search, 100 articles were selected, consisting of 9 systematic reviews, 3 systematic reviews with meta-analysis, 48 literature reviews, 3 randomized clinical trials, 4 prospective cohorts, 12 retrospective cohorts, 5 cross-sectional studies, 2 case-control studies, 5 case reports, 7 expert consensus panels, 1 letter to the editor and 1 qualitative study, published between 1976 and 2020. Dental procedures were classified according to the therapeutic modality (surgery and radiotherapy for head and neck cancer, chemotherapy, hematopoietic stem cell transplantation, and use of antiresorptive medications) and the time of treatment (prior, during, or after each one). Conclusions: The consulted articles were unanimous regarding the need for dental care for cancer patients in the pre, trans, and post-treatment, highlighting the importance of inserting specialized dental surgeons in the oncology patient care team; thus, this professional should act in the prevention, early diagnosis, and treatment of oral toxicities, to minimize their consequences and improve patients’ quality of life.
目的:介绍预防、诊断和治疗与癌症治疗相关的口腔毒性所必需的牙科程序。材料和方法:对感兴趣的主题进行了叙述文献综述。对葡萄牙语和英语的文章进行了调查,没有出版年份的限制,全文可以在Pubmed、Scielo、Cochrane和Google Scholar数据库中找到。结果:本次检索共纳入100篇文章,包括9篇系统综述、3篇系统综述结合meta分析、48篇文献综述、3篇随机临床试验、4篇前瞻性队列、12篇回顾性队列、5篇横断面研究、2篇病例对照研究、5篇病例报告、7篇专家共识小组、1篇致编辑信和1篇定性研究,均发表于1976年至2020年之间。根据治疗方式(头颈癌的手术和放疗、化疗、造血干细胞移植和抗吸收药物的使用)和治疗时间(每次治疗前、期间或之后)对牙科手术进行分类。结论:咨询的文章一致认为癌症患者在治疗前、治疗中和治疗后需要牙科护理,强调了在肿瘤患者护理团队中加入专业牙科医生的重要性;因此,该专业人员应采取预防、早期诊断和治疗口服毒性的行动,以尽量减少其后果并改善患者的生活质量。
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引用次数: 0
A rare case of metastatic proximal-type epithelioid sarcoma of the ischioanal fossa: case report and literature review 一罕见的转移性坐骨肛管窝近端上皮样肉瘤病例报告及文献复习
Pub Date : 2021-07-01 DOI: 10.15406/JCPCR.2021.12.00462
Harrak Soukaina, Lemsanes Siham, Razine Sawsan, Benchekroun Khadija, Lkhouyaali Siham, Abahsaine Halima, Boutayeb Saber, Errihani Hassan
Epithelioid sarcoma (ES) is a rare high-grade sarcoma subtype that constitutes less than 1% of soft tissue sarcomas (STS).There are two types: distal-type epithelioid sarcoma and proximal-type epithelioid sarcoma, based on anatomic location and the histopathological features. The clinical presentation of ES is varied and can lead to a delay in diagnosis. histopathology examination followed by immunohistochemistry will help to establish the diagnosis. The treatment of choice of Localized ES is a radical excision with microscopically radical margins and perioperative radiotherapy. systemic therapies are used in cases of locally advanced or metastatic ES. We describe a case of reoccurring proximal-type epithelioid sarcoma of the ischioanal fossa. A 56-year-old man operated two years ago for a epithelioid sarcoma of the ischioanal fossa. The patient presented with reoccurring mass at the same location, Magnetic resonance imaging (MRI) of the pelvis showed a mass of the ischioanal fossa. computed tomography (CT) of the chest, abdomen, and pelvis showed multiple pulmonary and liver metastasis. Histopathological features and immunohistochemistry were those of proximal type epithelioid sarcoma. He received intravenous doxorubicin with a partial response after 3 cycles of treatment.
上皮样肉瘤(ES)是一种罕见的高级别肉瘤亚型,占软组织肉瘤(STS)的不到1%。根据解剖位置和组织病理学特征,可分为远端型上皮样肉瘤和近端型上皮样肉瘤。ES的临床表现多种多样,可能导致诊断延误。组织病理学检查和免疫组织化学检查将有助于确定诊断。局部ES的治疗选择是显微边缘根治性切除和围手术期放疗。全身性治疗用于局部晚期或转移性ES。我们描述了一个复发的近端上皮样肉瘤的坐骨窝。一名56岁男子两年前因坐骨肛管窝上皮样肉瘤手术。患者在同一位置出现复发性肿块,骨盆磁共振成像(MRI)显示坐骨肛管窝肿块。胸部、腹部及骨盆的电脑断层扫描显示多发性肺及肝脏转移。组织病理特征及免疫组化与近端型上皮样肉瘤一致。他接受静脉注射阿霉素,治疗3个周期后部分缓解。
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引用次数: 0
Biliary mucinous cystic neoplasm with invasive carcinoma and recurrent cholangitis due to hepatolithiasis 胆道黏液性囊性肿瘤合并浸润性癌及肝内胆管炎复发
Pub Date : 2021-06-15 DOI: 10.15406/jcpcr.2021.12.00460
F. Kulalı
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引用次数: 0
Three-in-one: case of multiple primary malignancies concurrently in a 70 year-old female 三合一:70岁女性多发性原发恶性肿瘤合并病例
Pub Date : 2021-05-12 DOI: 10.15406/JCPCR.2021.12.00458
Joseph R. Malhis, Chintav Shah, S. O’Brien, R. Vasanwala, S. Jaggernauth
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引用次数: 0
Curious case of acute encephalopathy in a 64-yearold male 一例64岁男性急性脑病的奇怪病例
Pub Date : 2021-05-11 DOI: 10.15406/JCPCR.2021.12.00457
Joseph R. Malhis, S. O’Brien, Alex Belote, B. Brander
A 64-year-old male presents with acute encephalopathy and upon further evaluation, he was found to have lymphadenopathy in the neck and parotid region. Subsequent lumbar puncture (LP) revealed the presence of blast cells in the CSF concerning for leukemic meningitis. A lymph node biopsy was consistent with CD5 positive DLBCL. He was started on chemotherapy with Hyper-CVAD and intrathecal methotrexate, improving his clinical condition but he was lost to follow up. Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL). Diagnosis is based on symptoms and excisional lymph node biopsy with immunotyping. It is extremely important to have a lymph node biopsy if suspicious for lymphoma because of its aggressive nature. Indicators for such include CD5 positivity and extranodal involvement. The risk factors for CNS involvement in DLBCL include high International Prognostic Index (IPI) score, bone marrow involvement, and extranodal involvement such as bone, lung and testis. The purpose of the report is to emphasize the importance of ruling out lymphoma when diffuse lymphadenopathy is present in the setting of encephalopathy; the potential of aggressive behavior of this disease including involvement of the CNS; and discussing the overall social determinants of health for this patient resulting in delayed diagnosis and lack of an optimal treatment plan to be carried out.
64岁男性,急性脑病,经进一步评估,发现颈部和腮腺区有淋巴结病。随后的腰椎穿刺(LP)显示脑脊液中存在与白血病性脑膜炎有关的母细胞。淋巴结活检符合CD5阳性DLBCL。他开始接受Hyper-CVAD和鞘内甲氨蝶呤化疗,临床状况有所改善,但未能随访。弥漫性大b细胞淋巴瘤(DLBCL)是最常见的非霍奇金淋巴瘤(NHL)类型。诊断是基于症状和切除淋巴结活检与免疫分型。由于其侵袭性,如果怀疑淋巴瘤,进行淋巴结活检是非常重要的。其指标包括CD5阳性和结外受累。DLBCL中中枢神经系统受累的危险因素包括高国际预后指数(IPI)评分、骨髓受累和结外受累,如骨、肺和睾丸。该报告的目的是强调在脑病的背景下,当弥漫性淋巴结病变存在时,排除淋巴瘤的重要性;这种疾病的潜在攻击行为,包括累及中枢神经系统;并讨论该患者健康的整体社会决定因素,导致延误诊断和缺乏最佳治疗计划。
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引用次数: 0
Unilateral breast carcinoma with three different histological types-case report 三种不同组织学类型的单侧乳腺癌1例报告
Pub Date : 2021-04-23 DOI: 10.15406/JCPCR.2021.12.00454
Aditi Agrawal, Rajshri Kelkar, Tuhina Mishra
Breast cancer is the commonest malignancy in the world Unilateral serous or serosanguinous nipple discharge is always a cause for concern. 10% of the cases are due to malignant causes. However, we report a rare case of a 52 year old woman with serosanguinous nipple discharge who was later diagnosed with unilateral breast carcinoma with three different histological types which were not detected by mammogram and a MRI Breast was needed to diagnose it. It is a rarity and not reported till date.
乳腺癌是世界上最常见的恶性肿瘤,单侧浆液性或浆液性乳头溢液一直引起人们的关注。10%的病例是由于恶性原因。然而,我们报告一个罕见的病例,52岁的女性患有浆液性乳头溢液,后来被诊断为单侧乳腺癌,有三种不同的组织学类型,乳房x光检查未发现,需要乳房MRI诊断。这是罕见的,直到今天才有报道。
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引用次数: 0
Physiotherapeutic performance in mastectomy after breast cancer: a literature review 物理治疗在乳腺癌乳房切除术后的表现:文献综述
Pub Date : 2021-04-21 DOI: 10.15406/JCPCR.2021.12.00453
Adrianne Moura Carvalho, G. Salerno
Cancer is characterized by disorganized and chaotic cell growth that results from genetic changes inherited or acquired by the action of certain environmental, chemical, radioactive, viral and hormonal agents named carcinogens, which thereby initiate the process of tumorigenesis.1 Breast cancer is the second most common form of cancer in the world and the leading cause of death by cancer among females. It mainly affects women aged between 40 and 60 years.1,2 The main risk factors are genetics and external, such as environment, living habits, eating habits, age, menarche, exposure to estrogen, radiation, obesity, sedentarism and environmental toxins.1,2
癌症的特点是细胞生长紊乱和混乱,这种细胞生长是由某些被称为致癌物的环境、化学、放射性、病毒和激素因素遗传或获得的基因变化引起的,从而启动了肿瘤发生的过程乳腺癌是世界上第二常见的癌症,也是女性癌症死亡的主要原因。它主要影响40至60岁的女性。1,2主要的危险因素有遗传和外部因素,如环境、生活习惯、饮食习惯、年龄、月经初潮、雌激素暴露、辐射、肥胖、久坐和环境毒素等
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引用次数: 0
A study on disease dynamics of covid-19 in different states of India: A data driven analysis of the available evidence 关于印度不同邦covid-19疾病动态的研究:对现有证据的数据驱动分析
Pub Date : 2021-03-23 DOI: 10.15406/JCPCR.2021.12.00451
J. Prasad, Pradyuman Verma, N. Tyagi
Severe Acute Respiratory Syndrome Corona virus 2 (SARS– CoV–2) is named as Corona-virus that causes Corona virus disease 2019 (COVID-19). Corona virus disease is transmitted from people to people through respiratory droplets and contact routes.1 Droplet transmission occurs through close contacts with someone who has COVID-19 symptoms. Hence, Corona virus disease transmission occurs by direct contact with infected people or by contacts with surfaces in the immediate environment or objects, used by infected persons. Thus, people may acquire Corona virus disease through air or after touching contaminated objects even after hours.2 Airborne transmission of the disease could be possible in specific circumstances and settings. WHO declared outbreak of COVID-19 disease a Public Health Emergency of International Concern on 30 January 2020.3
冠状病毒2 (SARS - CoV-2)被命名为导致2019冠状病毒病(COVID-19)的冠状病毒。冠状病毒病通过呼吸道飞沫和接触途径在人与人之间传播飞沫传播是通过与有COVID-19症状的人密切接触发生的。因此,冠状病毒病的传播是通过与感染者的直接接触或与感染者使用的直接环境或物体的表面接触而发生的。因此,即使在几个小时后,人们也可能通过空气或接触被污染的物体而感染冠状病毒病在特定情况和环境中,疾病可能通过空气传播。世卫组织于2020年1月30日宣布2019冠状病毒病疫情为国际关注的突发公共卫生事件
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引用次数: 0
期刊
Journal of Cancer Prevention & Current Research
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