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1.
Transgenic Res ; 20(6): 1253-64, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-21340526

RESUMEN

A mutant allele of the transcription factor gene MYB10 from apple induces anthocyanin production throughout the plant. This gene, including its upstream promoter, gene coding region and terminator sequence, was introduced into apple, strawberry and potato plants to determine whether it could be used as a visible selectable marker for plant transformation as an alternative to chemically selectable markers, such as kanamycin resistance. After transformation, red coloured calli, red shoots and red well-growing plants were scored. Red and green shoots were harvested from apple explants and examined for the presence of the MYB10 gene by PCR analysis. Red shoots of apple explants always contained the MYB10 gene but not all MYB10 containing shoots were red. Strawberry plants transformed with the MYB10 gene showed anthocyanin accumulation in leaves and roots. No visible accumulation of anthocyanin could be observed in potato plants grown in vitro, even the ones carrying the MYB10 gene. However, acid methanol extracts of potato shoots or roots carrying the MYB10 gene contained up to four times higher anthocyanin content than control plants. Therefore anthocyanin production as result of the apple MYB10 gene can be used as a selectable marker for apple, strawberry and potato transformation, replacing kanamycin resistance.


Asunto(s)
Antocianinas/biosíntesis , Regulación de la Expresión Génica de las Plantas , Plantas Modificadas Genéticamente/metabolismo , Transformación Genética , Alelos , Antocianinas/genética , Fragaria/genética , Fragaria/metabolismo , Genes de Plantas , Marcadores Genéticos , Kanamicina/metabolismo , Luz , Malus/genética , Malus/metabolismo , Metanol/metabolismo , Hojas de la Planta/genética , Hojas de la Planta/metabolismo , Raíces de Plantas/genética , Raíces de Plantas/metabolismo , Brotes de la Planta/genética , Brotes de la Planta/metabolismo , Plantas Modificadas Genéticamente/genética , Plásmidos/genética , Plásmidos/metabolismo , Regiones Promotoras Genéticas , Solanum tuberosum/genética , Solanum tuberosum/metabolismo , Técnicas de Cultivo de Tejidos , Transgenes
2.
Bone Marrow Transplant ; 45(2): 219-34, 2010 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19584824

RESUMEN

The European Group for Blood and Marrow Transplantation regularly publishes special reports on the current practice of haematopoietic SCT for haematological diseases, solid tumours and immune disorders in Europe. Major changes have occurred since the first report was published. HSCT today includes grafting with allogeneic and autologous stem cells derived from BM, peripheral blood and cord blood. With reduced-intensity conditioning regimens in allogeneic transplantation, the age limit has increased, permitting the inclusion of older patients. New indications have emerged, such as autoimmune disorders and AL amyloidosis for autologous HSCT and solid tumours, myeloproliferative syndromes and specific subgroups of lymphomas for allogeneic transplants. The introduction of alternative therapies, such as imatinib for CML, has challenged well-established indications. An updated report with revised tables and operating definitions is presented.


Asunto(s)
Enfermedades Hematológicas/terapia , Trasplante de Células Madre Hematopoyéticas , Enfermedades del Sistema Inmune/terapia , Neoplasias/terapia , Adolescente , Adulto , Anciano , Amiloidosis/terapia , Trasplante de Médula Ósea , Niño , Protocolos Clínicos , Europa (Continente) , Enfermedad de Hodgkin/terapia , Humanos , Lactante , Leucemia/terapia , Linfoma no Hodgkin/terapia , Persona de Mediana Edad , Trastornos Mieloproliferativos/terapia , Inmunodeficiencia Combinada Grave/terapia , Acondicionamiento Pretrasplante , Trasplante Autólogo , Trasplante Homólogo
3.
Ann Oncol ; 16(3): 372-82, 2005 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15677622

RESUMEN

BACKGROUND: The purpose of this study is to determine the course of fatigue referring to cognitive symptoms (scale 'mental fatigue') as well as the motivation to start any activity (scale 'reduced motivation'), as a function of chemotherapy, in breast cancer patients undergoing adjuvant chemotherapy. PATIENTS AND METHODS: In a prospective cohort study a sample of 157 patients with breast cancer was interviewed at the first, third and fifth cycle of adjuvant chemotherapy as well as 4 and 12 weeks after completion of adjuvant chemotherapy. Patients were treated with standard adjuvant chemotherapy, either a doxorubicin containing schedule or CMF (cyclophosphamide, methotrexate and fluorouracil). The psychological dimensions of fatigue were measured by the Multidimensional Fatigue Inventory. A linear multilevel model was used for analysing the courses. RESULTS: The course of mental fatigue and motivation were not affected by the type of chemotherapy. The course of mental fatigue and motivation varied, but seemed to be stable during the treatment of chemotherapy. After the completion of chemotherapy, a weak improvement was seen. Relatively many patients experienced depressive symptoms during the study. These symptoms were correlated with both dimensions of fatigue. At all measurements mental fatigue was influenced by type of operation where women with a mastectomy were significantly more mentally fatigued than women that had undergone a lumpectomy, but nevertheless they were significantly more motivated to start any activity. Age, marital status, number of treatments and the interval between the operation and the first treatment of chemotherapy also seemed to be important determinants. CONCLUSIONS: An unequivocal pattern of mental fatigue and reduced motivation during as well as after adjuvant chemotherapy was not found. Depressive symptoms were definitely related to these variables. Type of operation had a significant impact on mental fatigue and motivation to start any activity. Health care providers should be aware of the high rate of patients who experience depressive symptoms during and after the treatment of chemotherapy. Further research should include the trajectory preceding adjuvant chemotherapy and a longer study period afterwards. Moreover, the exact influence of the variables 'age', 'marital status', 'number of treatments' and 'the interval between the operation and the first treatment of chemotherapy' on fatigue is unclear and needs further study.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/psicología , Trastornos del Conocimiento/inducido químicamente , Fatiga , Motivación , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Neoplasias de la Mama/cirugía , Ciclofosfamida/administración & dosificación , Depresión , Femenino , Fluorouracilo/administración & dosificación , Humanos , Mastectomía/psicología , Mastectomía Segmentaria/psicología , Metotrexato/administración & dosificación , Persona de Mediana Edad , Estudios Prospectivos , Calidad de Vida
4.
Ann Oncol ; 15(6): 896-905, 2004 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15151946

RESUMEN

BACKGROUND: The purpose of this study was to determine the prevalence of fatigue and the course of fatigue as a function of chemotherapy in breast cancer patients undergoing adjuvant chemotherapy. PATIENTS AND METHODS: In a prospective cohort study, a sample of 157 patients with breast cancer were interviewed, using the Rotterdam Symptom Checklist and the Multidimensional Fatigue Inventory, at the first, third and fifth cycle of adjuvant chemotherapy, as well as 4 and 12 weeks after the last cycle of adjuvant chemotherapy. Patients were treated with either a doxorubicin-containing schedule, or cyclophosphamide, methotrexate and 5-fluorouracil (CMF). RESULTS: The courses of general and physical fatigue are to a large extent similar. After the last cycle of chemotherapy, the CMF group reported a significant increase in fatigue, which was followed by a significant reduction. In the doxorubicin group a significant increase in fatigue was only seen during the first cycles of chemotherapy. The fatigue experienced at the first and the last measurements do not differ significantly. CONCLUSIONS: The prevalence of fatigue increased significantly after the start of chemotherapy. After chemotherapy treatment the prevalence rate seemed to decline. A different impact of chemotherapy on the course of fatigue was found. In the doxorubicin group a direct increase in fatigue was found. In the CMF group a moderate direct increase occurred, followed by a delayed strong increase. An increase in fatigue was associated with a decrease in daily functioning. At all measurement occasions fatigue was affected by type of operation, such that women with a mastectomy were more fatigued than women that underwent a lumpectomy. Receiving radiotherapy also led to an increase in fatigue. With this knowledge breast cancer patients can be better informed about what they can expect. Further research should include interventions addressing how to reduce or cope with fatigue during as well as after receiving adjuvant chemotherapy.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias de la Mama/tratamiento farmacológico , Ciclofosfamida/efectos adversos , Doxorrubicina/efectos adversos , Fatiga/epidemiología , Fluorouracilo/efectos adversos , Metotrexato/efectos adversos , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Neoplasias de la Mama/complicaciones , Quimioterapia Adyuvante/efectos adversos , Ciclofosfamida/administración & dosificación , Progresión de la Enfermedad , Doxorrubicina/administración & dosificación , Fatiga/complicaciones , Femenino , Fluorouracilo/administración & dosificación , Humanos , Metotrexato/administración & dosificación , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Calidad de Vida
5.
Ann Oncol ; 7(7): 677-85, 1996 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-8905025

RESUMEN

BACKGROUND: In the Netherlands, 45% of all cancer cases occur in men and women aged 70 years and older. Since the population is ageing and cancer incidence rises with age, the number of new malignancies in the elderly is increasing. It has become apparent that there is a relationship between age at diagnosis and the treatment received. Therefore, age-specific variations in patterns of care for six common forms of cancer in the elderly, are examined. PATIENTS AND METHODS: Patients aged 50 years and older, diagnosed in the period 1988-1992 in Middle and South Limburg with breast, colorectal, lung, ovarian, head and neck cancer and non-Hodgkin lymphoma were included (n = 6911). Data were obtained from the population-based Regional Cancer Registry of the Comprehensive Cancer Centre Limburg. Age-specific differences in diagnostics and treatment were analysed using chi-square analysis (age categories: 50-59, 60-69, 70+). Logistic regression analyses were used to examine the extent to which age increased the chance of not being treated or of receiving less intensive treatment, while controlling for the stage of the disease and the sex of the patient. RESULTS: For all malignancies the stage was unknown in a larger proportion of the patients aged 70 years and older than in the younger patient groups. Compared to their younger counterparts, the diagnosis of elderly breast, colorectal and lung cancer patients was more often based solely on clinical grounds. In the total study population, 16% were not treated. Per age category 50-59 years, 60-69 years and 70+ these percentages were 7%, 12% and 22%, respectively, (P-trend = 0.001). For all malignancies the chance of not receiving treatment increased with increasing age. However, the size and nature of the differences varied with the localisation of the tumour. The proportion of untreated patients was particularly high in the patients with lung cancer and metastatic colorectal and ovarian cancer, and there was an increase with increasing age (P-trend = 0.001). The vast majority of patients with NHL, breast, head and neck and non-metastatic colorectal cancer received treatment, 90%, 94%, 91%, and 99%, respectively. However, elderly patients less often received a combination of treatment modalities. CONCLUSIONS: The diagnostics and choice of treatment for several common types of cancer were dependent on age. This study could not take into account the major problem of co-morbidity which can be a reason to choose for lesser therapy in the elderly. More research is necessary to determine which factors determine the diagnostics and choice of treatment and whether these factors differ between young and elderly patients.


Asunto(s)
Factores de Edad , Manejo de la Enfermedad , Neoplasias/diagnóstico , Neoplasias/terapia , Edad de Inicio , Anciano , Anciano de 80 o más Años , Distribución de Chi-Cuadrado , Terapia Combinada , Intervalos de Confianza , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Neoplasias/patología , Neoplasias/fisiopatología , Países Bajos , Sistema de Registros
6.
Eur J Clin Microbiol Infect Dis ; 14(3): 193-8, 1995 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-7614959

RESUMEN

Thirty-one isolates of Stomatococcus mucilaginosus were cultured from the blood (n = 6), throat (n = 23) and sputum (n = 2) of 18 hospitalized patients, 13 of whom were neutropaneic and five of whom were non-neutropaneic. Antibiotic susceptibility testing, performed by means of a broth microdilution method, showed that the minimal inhibitory concentrations (MICs) of ciprofloxacin were > or = 4 mg/l for the isolates collected from neutropaenic patients. All these patients received ciprofloxacin as part of their prophylactic regimen. In contrast, the MICs for four of five isolates collected from non-neutropaenic patients, none of whom were receiving ciprofloxacin, were < or = 2 mg/l. In addition, 14 of the 31 isolates were cultured from seven neutropaenic patients, admitted to the same ward over a 12-week period. To evaluate possible cross-acquisition of strains between patients, cluster analysis of all 31 isolates was performed using phenotypic characteristics, MIC values and acid production from carbohydrates (API 50 CH). Overall, 22 isolate clusters were distinguished. In five of 18 patients, two or more isolates were cultured which belonged to different clusters. In only one patient, identical isolates were cultured from blood and from the throat. All six isolates of cluster 7 were cultured within the aforementioned 12-week period from three neutropaenic patients. These data support the possibility of cross-acquisition of strains between patients although its frequency seems to be low.


Asunto(s)
Ciprofloxacina/uso terapéutico , Infección Hospitalaria/microbiología , Infecciones por Bacterias Grampositivas/microbiología , Micrococcus/aislamiento & purificación , Neutropenia/microbiología , Antibacterianos/farmacología , Análisis por Conglomerados , Recuento de Colonia Microbiana , Infección Hospitalaria/tratamiento farmacológico , Farmacorresistencia Microbiana , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Humanos , Pruebas de Sensibilidad Microbiana , Micrococcus/efectos de los fármacos , Neutropenia/tratamiento farmacológico , Sensibilidad y Especificidad
8.
Ann Oncol ; 4(4): 295-301, 1993 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-8518219

RESUMEN

BACKGROUND: The Comprehensive Cancer Center trial 82-01 is a prospective randomized study to investigate the value of the addition of high-dose medroxyprogesterone acetate (MPA) to chemotherapy in patients with node-positive operable breast cancer. MPA may be of advantage in this setting because of its activity in estrogen receptor ER-positive as well as ER-negative tumors and since it may protect against chemotherapy-induced myelosuppression and thus enable maintenance of the appropriate chemotherapeutic scheduling. PATIENTS AND METHODS: Four hundred eight evaluable patients with node-positive (N+) operable breast cancer (T1-3, N1) were entered in a multicenter randomized trial. Two hundred nine patients were randomized in the MPA- arm and 199 in the MPA+ arm. CAF chemotherapy was given as a short i.v. bolus infusion: cyclophosphamide 500 mg/m2 i.v. day 1, doxorubicin 40 mg/m2 i.v. day 1, and 5-fluorouracil 500 mg/m2 i.v. day 1, q 4 wks x 6. MPA was given intramuscularly (i.m.) 500 mg q d x 28 days, followed by 500 mg i.m. twice weekly during 5 months. RESULTS: The main side effects of MPA were weight gain with a mean of 5.5 kg as opposed to 1.8 kg in the control group (p = 0.01) and vaginal bleeding in 30/199 in the MPA+ group and 0 in the MPA- group. MPA ameliorated vomiting grade III, IV (45% vs. 28%, p < 0.001), nausea grade III, IV (50% vs. 34%, p < 0.001) and leucocyte nadir grade III, IV (20% vs. 11%, p = 0.003). Disease-free survival (DFS) after 5 years was 59% in the MPA+ and 49% in the MPA- group (p = 0.12). Patients > or = 60 years benefitted most from MPA treatment, in particular if freedom from distant metastases was taken as the endpoint (p = 0.02). Overall survival (OS) was not significantly different between the two treatment groups (p = 0.18), but within subgroups analysed there was an advantage for MPA+ in patients > or = 55 years (p = 0.002) and in pT1 patients (p = 0.045). CONCLUSIONS: High-dose MPA ameliorates CAF side effects and reduces the risk of metastatic disease, especially in elderly breast cancer patients.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/patología , Quimioterapia Adyuvante , Ciclofosfamida/administración & dosificación , Doxorrubicina/administración & dosificación , Femenino , Fluorouracilo/administración & dosificación , Estudios de Seguimiento , Humanos , Metástasis Linfática , Acetato de Medroxiprogesterona/administración & dosificación , Persona de Mediana Edad , Estudios Prospectivos , Tasa de Supervivencia
9.
J Clin Epidemiol ; 44(3): 273-83, 1991.
Artículo en Inglés | MEDLINE | ID: mdl-1999687

RESUMEN

In order to gain insight into the causality of the relation between beta-carotene and cancer, we performed a randomized placebo-controlled trial in which the effect of beta-carotene on the regression and progression rates of cervical dysplasia were examined. The experimental group (n = 137) received a supplemental dose of 10 mg of beta-carotene daily for 3 months. The control group (n = 141) received placebo capsules. As the outcome parameter, two definitions of regression and progression were used, which were based on the degree of dysplasia before and after the medication period. The number of patients who showed progression was too small to allow conclusions. No effect of beta-carotene on the regression percentages was observed: OR = 0.68 (95% CI: 0.28-1.60) using the broad definition; and OR = 1.22 (95% CI: 0.43-3.41) with the strict definition. A secondary analysis, in which the effect of the total intake of beta-carotene (diet + medication) on the regression percentages of cervical dysplasia was studied, did not show a positive effect either. The paper discusses to what extent issues in the study design may have masked a potential effect and how our results affect the evidence for a causal relation between beta-carotene and cancer.


Asunto(s)
Carotenoides/uso terapéutico , Displasia del Cuello del Útero/tratamiento farmacológico , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Cooperación del Paciente , Pronóstico , Proyectos de Investigación , Encuestas y Cuestionarios , beta Caroteno
10.
Radiology ; 173(1): 137-41, 1989 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-2780999

RESUMEN

A study of anorectal function during fluoroscopically monitored defecation was conducted in 32 asymptomatic subjects. Two observers independently measured various parameters on defecograms and reviewed video recordings during the subjects' squeezing, rest, and straining. There was a wide range of measurements for the anorectal angle, the position of the anorectal junction, perineal motility, and anal canal width. Interobserver variation of these measurements was large. In 17 subjects, both observers agreed that rectal emptying was incomplete. In 10 patients, there was agreement on the presence of rectal wall changes such as intussusception, rectocele, and mucosal prolapse. Defecographic measurements should be interpreted with caution and should not be used as the only criteria for treatment. Anatomic changes of the anorectal region during straining at defecation do not necessarily cause symptoms but may be a precursor of clinical disorders. Defecography is useful in the detection of these abnormalities.


Asunto(s)
Canal Anal/diagnóstico por imagen , Defecación , Recto/diagnóstico por imagen , Adulto , Anciano , Canal Anal/fisiología , Sulfato de Bario , Enema , Femenino , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Recto/fisiología , Grabación en Video
11.
Bone Marrow Transplant ; 4(1): 119-21, 1989 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-2466510

RESUMEN

Two patients who underwent autologous bone marrow transplantation for recurrent non-Hodgkin's lymphoma relapsed at 46 and 28 days after the transplant. Both patients had an HLA-identical sibling and were treated with high-dose chemotherapy and allogeneic marrow transplantation. One patient is now 24 months after the allogeneic transplant without evidence of disease. The second patient died on day 7 with interstitial pneumonia. We conclude that high-dose therapy and allogeneic bone marrow transplantation after failure of autologous transplantation for non-Hodgkin's lymphoma is feasible and should be considered in young patients with HLA-identical siblings.


Asunto(s)
Trasplante de Médula Ósea , Linfoma de Burkitt/cirugía , Linfoma no Hodgkin/cirugía , Adolescente , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Bleomicina/administración & dosificación , Linfoma de Burkitt/tratamiento farmacológico , Cisplatino/administración & dosificación , Terapia Combinada , Ciclofosfamida/administración & dosificación , Citarabina/administración & dosificación , Dexametasona/administración & dosificación , Doxorrubicina/administración & dosificación , Humanos , Leucovorina/administración & dosificación , Linfoma no Hodgkin/tratamiento farmacológico , Masculino , Metotrexato/administración & dosificación , Prednisona/administración & dosificación , Reoperación , Trasplante Autólogo , Trasplante Homólogo , Vincristina/administración & dosificación
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