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Search Results: 1 - 10 of 359 matches for " Myrna Candelaria "
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Radiosensitizers in cervical cancer. Cisplatin and beyond
Myrna Candelaria, Alicia Garcia-Arias, Lucely Cetina, Alfonso Due?as-Gonzalez
Radiation Oncology , 2006, DOI: 10.1186/1748-717x-1-15
Abstract: Cervical cancer remains one of the greatest killers of women worldwide. According to Globocan 2000, it is estimated that in 2000 the numbers of patients diagnosed with and those who died from this disease were 470,606 and 233,372, respectively [1]. It is remarkable that these rates occur, despite the fact that cervical cancer is a model for early detection due to its long and relatively well-known natural history that offers an excellent opportunity for its detection before lesions become invasive [2].Cervical cancer is currently staged clinically according International Federation of Gynecology and Obstetrics (FIGO) guidelines. In terms of treatment, invasive disease can be divided into three main groups: 1) early stage, which ranges from microinvasive disease IA1, IA2 to macroscopic disease confined to cervix and measuring <4 cm, IB1; 2) locally advanced FIGO stages IB2-IVA, and 3) IVB and recurrent disease [3].The recommended treatment for IA1 patients is either a local procedure such as conization or total hysterectomy, depending on the patient's desire to remain fertile, whereas for IA2 patients the recommendation is for a radical hysterectomy which removes parametrial tissue, upper vagina and pelvic lymph nodes. On average, 8% of cases show positive pelvic lymph nodes. Because many women at this disease stage wish and deserve to preserve fertility, radical trachelectomy is becoming an option for these patients as well as for IB1 patients [4]. In surgically treated early-stage cases, the presence in the surgical specimen of a combination of intermediate-risk factors (vascular and lymphatic permeation, tumor size >2 cm, and deep cervical stroma invasion) or high-risk factors (positive pelvic lymph nodes, parametrial infiltration, and positive surgical margins) dictates the use of adjuvant radiation [5] or chemoradiation, respectively [6].Treatment results for these patients are far from optimal. In this regard, treatment of locally advanced cervical cancer exper
Epigenetics of cervical cancer. An overview and therapeutic perspectives
Alfonso Due?as-González, Marcela Lizano, Myrna Candelaria, Lucely Cetina, Claudia Arce, Eduardo Cervera
Molecular Cancer , 2005, DOI: 10.1186/1476-4598-4-38
Abstract: Cervical cancer remains one of the greatest killers of women worldwide. According to Globocan 2000, it is estimated that in 2000 the numbers of patients diagnosed with and those who died from this disease were 470,606 and 233,372, respectively [1]. It is remarkable that these rates occur despite the fact that cervical cancer is a model for early detection due to its long and relatively well-known natural history, which offers an excellent opportunity for its detection before lesions become invasive [2].Cervical cancer is currently staged clinically according the International Federation of Gynecology and Obststrics (FIGO) guidelines. In terms of treatment, invasive disease can be divided into three main groups: 1) early stage going from microinvasive disease IA1, IA2 to macroscopic disease confined to cervix and measuring <4 cm, IB1; 2) locally advanced FIGO stages IB2-IVA, and 3) IVB and recurrent disease [3].The recommended treatment for IA1 patients is either a local procedure such as conization or total hysterectomy depending on the patient's desire to remain fertile, whereas for IA2 patients the recommended procedure is a radical one including pelvic lymphadenectomy. On average, 8% of cases shows positive pelvic lymph nodes. As many women at this disease stage deserve to preserve fertility, radical trachelectomy is becoming an option for these patients. The same can apply for IB1 patients. In early cases that are surgically treated, the presence in the surgical specimen of a combination of intermediate-risk factors (vascular and lymphatic permeation, tumor size >2 cm, and deep cervical stroma invasion) or high-risk factors (positive pelvic lymph nodes, parametrial infiltration, and positive surgical margins) dictates use of adjuvant radiation or chemoradiation respectively. As a group, the prognosis of early-stage cases is fairly good with 5-year survival exceeding 90% [4,5]Results of treatment for these patients are far from optimal. In this regard, treatment
Tamoxifen-associated vasculitis in a breast cancer patient
Myrna Candelaria, Rafael Hurtado-Monroy, Pablo Vargas-Viveros, Silvia Carrillo-Mu?noz, Alfonso Duenas-Gonzalez
World Journal of Surgical Oncology , 2007, DOI: 10.1186/1477-7819-5-9
Abstract: Herein we report the case of a 53-year old patient, who developed cholestasis and vasculitis during the treatment with tamoxifen. This toxicity was reversable after the removal of the drug. Thereafter she continued adjuvant treatment for breast carcinoma with anastrazole. Since tamoxifen has been widely indicated for patients with breast carcinoma, we did a literature review, looking for other cases with this type of toxicity.This case is the third with vasculitis informed in the literature, but the first one that additionally developed cholestasis and arthritis. Although it is rare, we discuss the indication of this drug in the actual era, where aromatase inhibitors offer a better security profile.Breast cancer is the most common cause of cancer death in women worldwide. Rates vary about fivefold around the world, but they are increasing even in regions that until recently had low rates of disease [1] Endocrine treatment is indicated in hormone-sensitive patients. Tamoxifen is an oral antiestrogen, first used in metastatic breast cancer in the early 1970s. Large clinical trials were initiated in the late 1970s and early 1980s to test the drug's role as adjuvant therapy in early stage breast cancer. Observations of marked decreases in the development of contralateral breast cancer among tamoxifen recipients suggested potential for the drug in chemoprevention of breast cancer. The most recent analysis of the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) which included information on 37,000 women in 55 trials of adjuvant tamoxifen, published in 2005, confirms the value of this oral antiestrogen. Among women with ER-positive disease, the reduction in the recurrence rate and in the breast cancer death rate are highly significant either after 1–2-year or 5-year use of tamoxifen, but are greater in the latter. This indirect evidence that 1–2 years is less effective than 5 years of tamoxifen in ER-positive disease is highly significant for recurrence, and for
Linfomas plasmoblásticos del tracto gastrointestinal en pacientes con sida Plasmablastic lymphoma of the gastrointestinal tract in AIDS patients
Alejandro Avilés-Salas,Roberto Herrera-Goepfert,Diana Aguilar-León,Myrna Candelaria-Hernández
Medicina (Buenos Aires) , 2011,
Abstract: Los pacientes con infección por el virus de inmunodeficiencia humana (HIV) tienen 200 veces más riesgo de desarrollar un linfoma no Hodgkin (LNH) con respecto a la población general. El linfoma plasmoblástico (LP) representa menos del 3% de todos los LNH asociados con el HIV. El objetivo de este estudio es informar las características clínico-patológicas de 5 pacientes con enfermedad HIV/sida y LP del tracto gastrointestinal. Se revisaron de forma retrospectiva los casos de LP del tracto gastrointestinal diagnosticados en el Instituto Nacional de Cancerología de la Ciudad de México en el periodo comprendido entre los a os 2000 al 2009. Se analizaron las características clínico-patológicas y se realizaron cortes de bloques de tejidos embebidos en parafina para reacciones de inmunohistoquímica. La presencia del virus de Epstein Barr (VEB) se examinó por reacción en cadena de la polimerasa (PCR) in situ. De los cinco pacientes, cuatro fueron hombres y una mujer, con una mediana de edad de 29 a os. Tres tumores se localizaron en la región anorrectal, uno en colon ascendente y el restante en el estómago. Histológicamente, todos los tumores se caracterizaron por una proliferación difusa de células grandes de aspecto plasmoblástico. Las células neoplásicas fueron CD 138/MUM-1 positivas y CD 20 / PAX-5 negativas. En cuatro pacientes se detectó el genoma del VEB en las células neoplásicas mediante PCR in situ. La mediana de seguimiento fue 18 meses; tres pacientes estaban vivos con enfermedad y dos sobreviven sin evidencias de la neoplasia. El diagnóstico precoz de LP como una entidad clínico-patológica es importante para establecer el tratamiento correcto y mejorar el pronóstico de estos pacientes. The risk of developing non-Hodgkin lymphoma (NHL) is 200 times higher in HIV-positive patients than otherwise healthy persons. Plasmablastic lymphoma (PL) represents < 3% of all NHL associated with HIV infection. The aim of this study was to review the clinical-pathologic features of PL of the gastrointestinal tract in 5 patients with HIV/aids disease. We performed a retrospective study of PL of the gastrointestinal tract diagnosed at the National Institute of Cancer at Mexico City, from 2000 to 2009. Clinical and pathological information was obtained and immunohistochemical studies were performed in paraffin-embedded tissue sections. The presence of Epstein-Barr Virus (EBV) was examined by in situ polymerase chain reaction (PCR). Four male and 1 female were included with a median of age of 29 years. Three tumors involved the ano-rectal area, one tumor the ascendant
Hemangioendotelioma epitelioide y fusiforme de ganglio linfático: Caso clínico Spindle and epithelioid hemangio-endothelioma of the lymph node: Report of one case
Alejandro Avilés-Salas,José Cruz Torres-Lucatero,Ximena Fernandez-Soto,Myrna Candelaria-Hernández
Revista médica de Chile , 2013,
Abstract: Background: Primary vascular tumors of lymph nodes are extremely rare with the exception of AlDS-related Kaposi's sarcoma. The diagnosis of epithelioid hemangio-endothelioma (EH) is difficult to make without ancillary studies, since it is devoid of morphological features indicating its vascular nature and it may be overlooked when it appears as a primary tumor of lymph nodes. Spindle and epithelioid hemangio-endothelioma (SEH) is considered to be a variant of EH, which has been reported to occur exclusively in lymph nodes and the spleen. We report a 70-year-old male with chronic lymphocytic leukemia (CLL) and left cervical lymphadenopathy. An excisional biopsy was performed, and microscopically the lymph node showed effacement of nodal architecture by a tumor composed of spindle cells disposed in intersecting fascicles, and characterized by abundant eosinophilic cytoplasm, elongated nuclei and conspicuous nucleoli. A second population of cells had an epithelioid appearance with intracyto-plasmic vacuoles containing red blood cells. lmmunohistochemically, the tumor cells were positive for CD31 and CD34. The final diagnosis was SEH of the lymph node.
Pre-exenterative chemotherapy, a novel therapeutic approach for patients with persistent or recurrent cervical cancer
Carlos Lopez-Graniel, Rigoberto Dolores, Lucely Cetina, Aaron Gonzalez, David Cantu, Jose Chanona, Jesus Uribe, Myrna Candelaria, Rocio Brom, Jaime de la Garza, Alfonso Duenas-Gonzalez
BMC Cancer , 2005, DOI: 10.1186/1471-2407-5-118
Abstract: Patients with recurrent or persistent disease and no evidence of systemic disease, considered not be candidates for pelvic exenteration because of the extent of pelvic tumor, received 3-courses of platinum-based chemotherapy. Response was evaluated by CT scan and bimanual pelvic examination; however the decision to perform exenteration relied on the physical findings. Toxicity to chemotherapy was evaluated with standard criteria. Survival was analyzed with the Kaplan-Meier method.Seventeen patients were studied. The median number of chemotherapy courses was 4. There were 9 patients who responded to chemotherapy, evaluated by bimanual examination and underwent pelvic exenteration. Four of them had pathological complete response. Eight patients did not respond and were not subjected to surgery. One patient died due to exenteration complications. At a median follow-up of 11 months, the median survival for the whole group was 11 months, 3 months in the non-operated and 32 months in those subjected to exenteration.Pre-exenterative chemotherapy is an alternative for cervical cancer patients that are no candidates for exenteration because of the extent of the pelvic disease. Its place in the management of recurrent disease needs to be investigated in randomized studies, however, its value for offering long-term survival in some of these patients with no other option than palliative care must be stressed.Cervical cancer continues to be an important health burden with a yearly incidence of almost half a million new cases in the world and a mortality rate of about 50% [1]. Currently, locally advanced disease is treated with concurrent cisplatin-based chemoradiation [2]. However, approximately in 25% of all patients treated for cervical carcinoma, the tumor will progress or recur locally [3,4], being the most common site of recurrence the pelvis. Thus, local relapse continues to be a significant problem for these patients, as tumor persistence or local recurrence in an irradia
HER2 expression in cervical cancer as a potential therapeutic target
Alma Chavez-Blanco, Victor Perez-Sanchez, Aurora Gonzalez-Fierro, Teresa Vela-Chavez, Myrna Candelaria, Lucely Cetina, Silvia Vidal, Alfonso Due?as-Gonzalez
BMC Cancer , 2004, DOI: 10.1186/1471-2407-4-59
Abstract: We analyzed a series of cervical cancer cell lines, the primary tumors of 35 cases of cervical cancer patients and four recurrent cases, with the Hercep Test in order to establish whether this tumor type overexpress HER2 at level of 2+/3+ as trastuzumab is currently approved for breast cancer having such level of expression.The results indicate that only 1 out of 35 primary tumors cases overexpress the receptor at this level, however, two out of four recurrent tumors that tested negative at diagnosis shifted to Hercep Test 2+ and 3+ respectively.The low frequency of expression in primary cases suggests that trastuzumab could have a limited value for the primary management of cervical cancer patients, however, the finding of "conversion" to Hercep Test 2+ and 3+ of recurrent tumors indicates the need to further evaluate the expression of HER2 in the metastatic and recurrent cases.Cervical carcinoma is a leading cause of death in women of reproductive age worldwide, particularly in developing countries. While curable in early stages, the treatment results of locally advanced disease are unsatisfactory. The current standard of treatment -cisplatin-based chemoradiation- fails to cure at least 15% to 45% of bulky IB to IIIB patients, and in addition, multimodality treatment incorporating chemotherapy, surgery and radiation at its best is unlikely to substantially increase the cure rate. Because of this, the logical step to follow is the testing of molecular targeted therapies trying to improve the prognosis of cervical cancer patients [1].Human papillomavirus infection is recognized as the stronger etiological factor for the development of this tumor; however, overexpression of the epidermal growth factor receptor family members is also common and seems to play an important oncogenic role [2]. HER2 (also known as c-erbB-2) is a transmembrane receptor protein with tyrosine kinase activity that belongs to this family and it is overexpressed in a number of solid tumors. Its
Hydralazine target: From blood vessels to the epigenome
Claudia Arce, Blanca Segura-Pacheco, Enrique Perez-Cardenas, Lucia Taja-Chayeb, Myrna Candelaria, Alfonso Due?nas-Gonzalez
Journal of Translational Medicine , 2006, DOI: 10.1186/1479-5876-4-10
Abstract: Hydralazine, a potent arterial vasodilator that reduces peripheral resistance directly by relaxing the smooth muscle cell layer in arterial vessels, has long been used for management of hypertensive disorders and heart failure [1,2]; nonetheless, its current use is limited nearly to hypertensive disorders during pregnancy [3,4]. Despite numerous studies with the drug, its mechanism of action has remained unknown but it is suggested that hydralazine may function by either modulating the effect of purine-like compounds released from sympathetic nerve endings, and/or by producing an altered Ca2+ balance in vascular smooth muscle cells [5-7]. The majority of its effects are confined to the cardiovascular system. Decrease in blood pressure after hydralazine administration is associated with a selective decrease in vascular resistance in coronary, cerebral, and renal circulation, with a lesser effect in skin and muscle. Hydralazine lowers peripheral vascular resistance equally in supine and upright positions; it also lowers pulmonary vascular resistance and increases cardiac output causing mild pulmonary hypertension. [1,2].Hydralazine is well absorbed through the gastrointestinal tract, but systemic bioavailability is low. Because the acetylated compound is inactive, the dose necessary to produce a systemic effect is higher in fast acetylators. N-acetylation of hydralazine occurs in bowel and/or liver. Hydralazine's half-life is 1 h and systemic clearance of the drug is approximately 50 mL/kg/min. Hydralazine rapidly combines with circulating α keto-acid to form hydrazones, and the major metabolite recovered from the plasma is hydralazine piruvic acid hydrazone. This metabolite possesses a longer half-life than hydralazine but does not appear to be very active. Systemic metabolism is dependent on hydroxylation followed by conjugation with glucoronic acid in liver, which is not dependent on acetylation rate; therefore, half-life does not differ to a great degree between s
The prince and the pauper. A tale of anticancer targeted agents
Alfonso Due?as-González, Patricia García-López, Luis Herrera, Jose Medina-Franco, Aurora González-Fierro, Myrna Candelaria
Molecular Cancer , 2008, DOI: 10.1186/1476-4598-7-82
Abstract: At present, cancer remains a significant health problem worldwide. According to International Agency for Research on Cancer-World Health Organization (IARC-WHO) estimates, cancer rates are set to increase at an alarming rate, from 10 million new cases globally in 2000 to 15 million in 2020 [1]. Cancer statistics from the U.S. show a total of 1,368,030 new cancer cases and 563,700 deaths expected; paradoxically, there has been a decrease or stabilization in mortality rates from cancer, particularly in major cancers such as lung, colorectal, prostate, and breast. A recent estimate of trends in 5- and 10-year relative survival of cancer patients in the U.S. in 1998–2003 from the 1973–2003 Surveillance, Epidemiology, and End Results Program data base indicated significant improvements in 5- and 10-year relative survival for 14 of 24 assessed common forms of cancer, such as prostate, breast, and colorectal cancer. Improvements in long-term survival were strongest for prostate cancer, non-Hodgkin lymphoma, and kidney cancer. In general, these improvements are likely the result of progress in early detection, treatment, or both, depending on tumor type [2].With regard to cancer treatment with drugs, we are currently in the interphase of two treatment eras. So-called pregenomic therapy names the traditional cancer drugs, mainly cytotoxic drug types. This tagging stems from the fact that in general terms, pregenomic cancer drugs were empirically developed based mainly on their capacity to inhibit cancer growth in experimental systems regardless of their nature and potential mechanism of action. Contrariwise, post-genomic era-type drugs refer to rationally based designed drugs in which the startpoint comprises, first, target identification, second, demonstrating that candidate drugs inhibit this target, and third, proving that cancer growth is affected as a consequence of target inhibition.Whereas the scientific basis for development of these drug classes is strong, our curre
Brachytherapy versus radical hysterectomy after external beam chemoradiation: a non-randomized matched comparison in IB2-IIB cervical cancer patients
Lucely Cetina, Alicia Garcia-Arias, Myrna Candelaria, David Cantú, Lesbia Rivera, Jaime Coronel, Blanca Bazan-Perkins, Vladimir Flores, Aaron Gonzalez, Alfonso Due?as-González
World Journal of Surgical Oncology , 2009, DOI: 10.1186/1477-7819-7-19
Abstract: In this non-randomized comparison EBRT-CT protocol was the same in both groups of 40 patients. In the standard treated patients, EBRT-CT was followed by one or two intracavitary Cesium (low-dose rate) applications within 2 weeks of finishing external radiation to reach a point A dose of at least 85 Gy. In the surgically treated patients, radical hysterectomy with bilateral pelvic lymph node dissection and para-aortic lymph node sampling were performed within 7 weeks after EBRT-CT. Response, toxicity and survival were evaluated.A total of 80 patients were analyzed. The patients receiving EBRT-CT and surgery were matched with the standard treated cases. There were no differences in the clinicopathological characteristics between groups or in the delivery of EBRT-CT. The pattern of acute and late toxicity differed. Standard treated patients had more chronic proctitis while the surgically treated had acute complications of surgery and hydronephrosis. At a maximum follow-up of 60 months, median follow-up 26 (2–31) and 22 (3–27) months for the surgery and standard therapy respectively, eight patients per group have recurred and died. The progression free and overall survival are the same in both groups.The results of this study suggest that radical hysterectomy can be used after EBRT-CT without compromising survival in FIGO stage IB2-IIB cervical cancer patients in settings were brachytherapy is not available. A randomized study is needed to uncover the value of surgery after EBRT-CT.Cervical cancer ranks seventh in the list of most frequent cancers worldwide. However, this tumor is second only after breast cancer as the most common gynecological neoplasm [1]. Currently, chemoradiation is accepted as the standard of care for patients with locally advanced cervical cancer. An updated meta-analysis that includes 4,921 patients shows that chemoradiation improves overall survival and progression-free survival, whether or not platinum is used, with absolute benefits of 10 and
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