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Mobile RZ, Mendes MC, Machado-Souza C, Queiroz PDM, Bonfim CMS, Torres-Pereira CC, Schussel JL. IL17A and IL17RA gene polymorphisms in Fanconi anemia. Braz Oral Res 2023; 37:e012. [PMID: 36790253 DOI: 10.1590/1807-3107bor-2023.vol37.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 08/18/2022] [Indexed: 02/16/2023] Open
Abstract
Fanconi anemia is a rare autosomal recessive disease. In this disease, cytokine pathways can induce the bone marrow failure that is observed in individuals with Fanconi anemia. Interleukin IL-17 exhibits a protective effect in organisms because it induces neutrophil recruitment and shows a pathological role in several models of autoimmune diseases, periodontal disease, cancer, allograft rejection, and graft versus host disease. Polymorphisms in the IL17A and IL17RA genes were evaluated from DNA in saliva, comparing individuals with or without Fanconi anemia, using models of genotypic transmission (additive, dominant, and recessive). Polymorphisms in the IL17A and IL17RA genes (rs2241044 [C allele], rs879577 [C allele], rs9606615 [T allele], and rs2241043 [C allele]) were risk factors for developing Fanconi anemia. We also performed an analysis of gene markers with clinical variables in the Fanconi group. Polymorphisms in the IL17A gene (rs3819025 [A allele] and rs2275913 [G allele], respectively) were associated with an age of less than 20 years (p = 0.026; RP 0.65) and the female sex (p = 0.043; RP 0.88). The IL17RA gene was also associated with age and the presence of leukoplakia (a potentially malignant oral disorder). An age of less than 20 years was associated with rs917864 (T allele; p = 0.036; RP 0.67). The presence of leukoplakia was associated with rs17606615 (T allele; p = 0.042; RP 0.47). To our knowledge, this is the first study that associates IL17A and IL17RA gene polymorphisms with Fanconi anemia and examines rs2241044 polymorphisms in scientific literature thus far.
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Affiliation(s)
- Rafael Zancan Mobile
- Universidade Federal do Paraná - UFPR, Post Graduate Program in Dentistry, Department of Stomatology, Curitiba, PR, Brazil
| | - Monalisa Castilho Mendes
- Instituto de Pesquisa Pelé Pequeno Príncipe, Faculdades Pequeno Príncipe, Postgraduation Program in Biotechnology Applied in Health of Children and Adolescent, Curitiba, PR, Brazil
| | - Cleber Machado-Souza
- Instituto de Pesquisa Pelé Pequeno Príncipe, Faculdades Pequeno Príncipe, Postgraduation Program in Biotechnology Applied in Health of Children and Adolescent, Curitiba, PR, Brazil
| | - Priscila de Mattos Queiroz
- Universidade Federal do Paraná - UFPR, School of Dentistry, Department of Stomatology, Curitiba, PR, Brazil
| | - Carmem Maria Sales Bonfim
- Universidade Federal do Paraná - UFPR, Complexo Hospital de Clínicas, Bone Marrow Transplantation Program, Curitiba, PR, Brazil
| | | | - Juliana Lucena Schussel
- Universidade Federal do Paraná - UFPR, Post Graduate Program in Dentistry, Department of Stomatology, Curitiba, PR, Brazil
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Nabarrete JM, Pereira AZ, Garófolo A, Seber A, Venancio AM, Grecco CES, Bonfim CMS, Nakamura CH, Fernandes D, Campos DJ, Oliveira FLC, Cousseiro FK, Rossi FFP, Gurmini J, Viani KHC, Guterres LF, Mantovani LFAL, Darrigo LG, Albuquerque MIBPE, Brumatti M, Neves MA, Duran N, Villela NC, Zecchin VG, Fernandes JF. Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: children and adolescents. Einstein (Sao Paulo) 2021; 19:eAE5254. [PMID: 34909973 PMCID: PMC8664291 DOI: 10.31744/einstein_journal/2021ae5254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 12/10/2020] [Indexed: 11/28/2022] Open
Abstract
The Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Children and Adolescents was developed by dietitians, physicians, and pediatric hematologists from 10 Brazilian reference centers in hematopoietic stem cell transplantation. The aim was to emphasize the importance of nutritional status and body composition during treatment, as well as the main characteristics related to patient´s nutritional assessment. This consensus is intended to improve and standardize nutrition therapy during hematopoietic stem cell transplantation. The consensus was approved by the Brazilian Society of Bone Marrow Transplantation.
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Affiliation(s)
- Juliana Moura Nabarrete
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Andrea Z Pereira
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Adriana Garófolo
- Universidade Federal de São PauloInstituto de Oncologia PediátricaSão PauloSPBrazilInstituto de Oncologia Pediátrica, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Adriana Seber
- Universidade Federal de São PauloSão PauloSPBrazilUniversidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Angela Mandelli Venancio
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Carlos Eduardo Setanni Grecco
- Universidade de São PauloFaculdade de Medicina de Ribeirão PretoHospital das ClínicasRibeirão PretoSPBrazilHospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Carmem Maria Sales Bonfim
- Universidade Federal do ParanáHospital de ClínicasCuritibaSPBrazilHospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
| | - Claudia Harumi Nakamura
- Universidade Federal de São PauloInstituto de Oncologia PediátricaSão PauloSPBrazilInstituto de Oncologia Pediátrica, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Daieni Fernandes
- Santa Casa de Misericórdia de Porto AlegrePorto AlegreRSBrazilSanta Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Denise Johnsson Campos
- Universidade Federal do ParanáHospital de ClínicasCuritibaSPBrazilHospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
| | - Fernanda Luisa Ceragioli Oliveira
- Universidade Federal de São PauloEscola Paulista de MedicinaSão PauloSPBrazilEscola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Flávia Krüger Cousseiro
- Santa Casa de Misericórdia de Porto AlegrePorto AlegreRSBrazilSanta Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Flávia Feijó Panico Rossi
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Jocemara Gurmini
- Universidade Federal do ParanáHospital de ClínicasCuritibaSPBrazilHospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
| | - Karina Helena Canton Viani
- Universidade de São PauloFaculdade de MedicinaHospital das ClínicasSão PauloSPBrazilInstituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Luciana Fernandes Guterres
- Santa Casa de Misericórdia de Porto AlegrePorto AlegreRSBrazilSanta Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
| | | | - Luiz Guilherme Darrigo
- Universidade de São PauloFaculdade de Medicina de Ribeirão PretoHospital das ClínicasRibeirão PretoSPBrazilHospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Maria Isabel Brandão Pires e Albuquerque
- Instituto Nacional de Câncer José Alencar Gomes da SilvaRio de JaneiroRJBrazilInstituto Nacional de Câncer José Alencar Gomes da Silva - INCA, Rio de Janeiro, RJ, Brazil.
| | - Melina Brumatti
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Mirella Aparecida Neves
- Universidade Federal do ParanáHospital de ClínicasCuritibaSPBrazilHospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
| | - Natália Duran
- Hospital de Câncer de BarretosBarretosSPBrazilHospital de Câncer de Barretos, Barretos, SP, Brazil.
| | - Neysimelia Costa Villela
- Hospital de Câncer de BarretosBarretosSPBrazilHospital de Câncer de Barretos, Barretos, SP, Brazil.
| | - Victor Gottardello Zecchin
- Universidade Federal de São PauloInstituto de Oncologia PediátricaSão PauloSPBrazilInstituto de Oncologia Pediátrica, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Juliana Folloni Fernandes
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
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Sandri LCS, Pontes L, Bonfim CMS, Kusma SZ. Nursing diagnosis after hematopoietic stem cell transplant due to Fanconi anemia. Rev Bras Enferm 2021; 75:e20190864. [PMID: 34852115 DOI: 10.1590/0034-7167-2019-0864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 08/14/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to identify nursing diagnoses in patients who underwent hematopoietic stem-cell transplants due to Fanconi anemia, according to the NANDA-I taxonomy. METHODS exploratory study using a retrospective analysis of 85 records from patients who underwent hematopoietic stem-cell transplants due to Fanconi anemia, developed in a specialize transplant center in the South of Brazil. The results were analyzed using descriptive statistics. RESULTS 73 different diagnoses were found in 9 out of the 13 domains from the NANDA-I taxonomy. From these, 22 were in 50% or more of the patients investigated, and most of them are related to the domain Safety/Protection. CONCLUSIONS it was possible to identify the nursing diagnosis in the patients who underwent hematopoietic stem cell transplants due to Fanconi anemia, contributing to design a plan for the care of these patients. The same was true for those with other syndromes of chromosomal instability that need to undergo this transplant.
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Affiliation(s)
| | - Letícia Pontes
- Universidade Federal do Paraná. Curitiba, Paraná, Brazil
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Ballardin BS, Mobile RZ, Coracin FL, Ribeiro LL, Bonfim CMS, Schussel JL, Carvalho Torres-Pereira C. A case series of medication-related fibrovascular hyperplasia following hematopoietic stem cell transplantation for Fanconi anemia. Pediatr Transplant 2021; 25:e13947. [PMID: 33350561 DOI: 10.1111/petr.13947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/18/2020] [Accepted: 11/24/2020] [Indexed: 11/29/2022]
Abstract
Systemic medications categorized as diphenylhydantoin, calcineurin inhibitor and calcium channel blocker may have effects on the oral cavity by modifying the inflammatory and immune response and causing undesired tissue proliferative reactions. Calcineurin inhibitors are medications commonly used for long periods in patients undergoing allogeneic hematopoietic stem cell transplant (HSCT) and solid organ transplantation. Medication-related fibrovascular hyperplasia (MRFH) is an extra gingival hyperplastic nodular growth associated with medications use. This study reports five cases of pediatric patients (6 to 12-years-old) diagnosed with Fanconi anemia (FA) after HSCT who presented similar oral mucosal lesions associated with the use of cyclosporine, phenobarbital and amlodipine. After excision of the lesions, histopathological analysis described them as pyogenic granuloma (PG). As the aetiology of the lesions manifested by the patients was associated with the use of medications, the final diagnosis was MRFH. Despite the clinical and histopathological similarity between PG and MRFH, it is fundamental to know the aetiological agent for achieving definitive diagnosis and correct management. Considering the etiologic agent (medication) and histopathological findings, it is suggested that the most appropriate term for this manifestation should be "medication-related fibrovascular hyperplasia". The correct nomenclature related to extra gingival hyperplastic lesions identified in patients on medications with potential to induce hyperplastic reactions should be adopted to facilitate scientific communication and improve the treatment.
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Affiliation(s)
- Bárbara Soldatelli Ballardin
- Multiprofessional Residency Program in Oncology and Hematology, Clinic Hospital Complex, Federal University of Parana, Curitiba, Brazil
| | - Rafael Zancan Mobile
- Post-Graduate Program in Dentistry, Department of Stomatology, Federal University of Parana, Curitiba, Brazil
| | | | - Lisandro Lima Ribeiro
- Service of Bone Marrow Transplant, Clinic Hospital Complex, Federal University of Parana, Curitiba, Brazil
| | - Carmem Maria Sales Bonfim
- Service of Bone Marrow Transplant, Clinic Hospital Complex, Federal University of Parana, Curitiba, Brazil
| | - Juliana Lucena Schussel
- Multiprofessional Residency Program in Oncology and Hematology, Clinic Hospital Complex, Federal University of Parana, Curitiba, Brazil.,Post-Graduate Program in Dentistry, Department of Stomatology, Federal University of Parana, Curitiba, Brazil
| | - Cassius Carvalho Torres-Pereira
- Multiprofessional Residency Program in Oncology and Hematology, Clinic Hospital Complex, Federal University of Parana, Curitiba, Brazil.,Post-Graduate Program in Dentistry, Department of Stomatology, Federal University of Parana, Curitiba, Brazil
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Perdoncini NN, Furquim CP, Bonfim CMS, Soares GMS, Torres-Pereira CC. Self-perception of periodontal health status among individuals with Fanconi anemia. Hematol Transfus Cell Ther 2020; 43:453-458. [PMID: 33023865 PMCID: PMC8573027 DOI: 10.1016/j.htct.2020.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/05/2020] [Accepted: 07/20/2020] [Indexed: 12/05/2022] Open
Abstract
Introduction Fanconi anemia (FA) is a rare genetic disease characterized by congenital malformations and bone marrow failure. One of the most common oral diseases in individuals with FA is periodontitis and adequate self-perception of periodontal status could contribute to its prevention and early detection. Aim To compare oral health self-perception, measured by a questionnaire, with the clinical oral condition of patients with FA. Methods and Results Fifty-six patients with FA, over 11 years of age, answered a questionnaire about dental history and self-reported oral health. Decayed, missing, and filled teeth (DMFT), Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI) were measured. The median age of participants was 21 years (min 11, max 44), 31 (55%) were females and 25 (45%) males. Thirty-five (62.5%) participants rated their oral condition as satisfactory and 7 (12.5%) participants reported tooth mobility, 10 (17.9%) exposed roots and 21 (37.5%) gingival bleeding. Clinical examination detected average DMFT = 5.23, VPI = 31.36% and GBI = 33.77%. The gingival bleeding report was more frequent among individuals with higher GBI (p = 0.014). The DMFT was higher in those who had already undergone dental treatments (p = 0.031). There was an association between participants who presented dental caries and who rated their oral health as poor (p = 0.03). The question “Do your gums bleed easily?” had good accuracy in the evaluation of periodontal disease (p = 0.68). Conclusion Oral health self-perception of individuals with FA about gingival inflammation was associated with their gingival bleeding index.
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Rodrigues JAP, Lacerda MR, Gomes IM, Paes MR, Ribeiro RP, Bonfim CMS. PERFIL CLÍNICO DE CRIANÇAS SUBMETIDAS A TRANSPLANTE DE CÉLULAS-TRONCO HEMATOPOIÉTICAS. Cogitare Enferm 2019. [DOI: 10.5380/ce.v24i0.55967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: identificar o perfil clínico de crianças em pós-transplante de células-tronco hematopoiéticas.Método: pesquisa quantitativa, transversal, retrospectiva, em serviço transplantador do Sul/Brasil, com dados de prontuários de crianças com 12 anos incompletos, submetidas a transplante. Para análise utilizaram-se medidas de tendência central, dispersão, frequências e testes do qui-quadrado e Fisher para associar variáveis.Resultados: a média de idade foi de 6,2 anos, predomínio do sexo masculino 92 (66,7%), diagnóstico Anemia de Fanconi 42 (30,4%) e transplante alogênico não aparentado 71 (51,4%). A alta hospitalar aconteceu em até 30 dias pós-transplante para 85 (61,6%) e 48 (34,8%) foram reinternadas. As perdas do cateter acometeram 11 crianças (8%) e as principais intercorrências clínicas ambulatoriais foram dor, tosse, coriza e febre. Infecção viral esteve relacionada ao transplante não aparentado e doença do enxerto contra hospedeiro.Conclusão: o perfil identificado corrobora o planejamento de cuidados a esta população, contribuindo com a prática de enfermagem.
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Nuernberg MAA, Rodrigues SC, Perdoncini NN, Funke VAM, Bonfim CMS, Nabhan SK, Torres-Pereira CC. Periodontal status of candidates for allogeneic hematopoietic stem cell transplantation. Spec Care Dentist 2017; 37:187-193. [DOI: 10.1111/scd.12229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | | | | | - Samir Kanaan Nabhan
- Avenida Prefeito Lothário Meissner; 632, Jardim Botânico Curitiba Paraná Brazil, 80210-170
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Nuernberg MAA, Nabhan SK, Bonfim CMS, Funke VAM, Torres-Pereira CC. Access to oral care before hematopoietic stem cell transplantation: understand to improve. Support Care Cancer 2016; 24:3307-13. [DOI: 10.1007/s00520-016-3142-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 02/22/2016] [Indexed: 10/22/2022]
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Marinho DH, Neto JZ, Bonfim CMS, Funke VAM, Ribeiro LL. Unrelated hematopoietic stem cell transplantation in the pediatric population: single institution experience. Rev Bras Hematol Hemoter 2015; 37:236-41. [PMID: 26190426 PMCID: PMC4519707 DOI: 10.1016/j.bjhh.2015.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 02/09/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Hematopoietic stem cell transplantation has been successfully used to treat the pediatric population with malignant and non-malignant hematological diseases. This paper reports the results up to 180 days after the procedure of all unrelated hematopoietic stem cell transplantations in pediatric patients that were performed in one institution. METHODS A retrospective review was performed of all under 18-year-old patients who received unrelated transplantations between 1995 and 2009. Data were analyzed using the log-rank test, Cox stepwise model, Kaplan-Meier method, Fine and Gray model and Fisher's exact test. RESULTS This study included 118 patients (46.8%) who received bone marrow and 134 (53.2%) who received umbilical cord blood transplants. Engraftment occurred in 89.47% of the patients that received bone marrow and 65.83% of those that received umbilical cord blood (p-value<0.001). Both neutrophil and platelet engraftments were faster in the bone marrow group. Acute graft-versus-host disease occurred in 48.6% of the patients without statistically significant differences between the two groups (p-value=0.653). Chronic graft-versus-host disease occurred in 9.2% of the patients with a higher incidence in the bone marrow group (p-value=0.007). Relapse occurred in 24% of the 96 patients with malignant disease with 2-year cumulative incidences of 45% in the bone marrow group and 25% in the umbilical cord blood group (p-value=0.117). Five-year overall survival was 47%, with an average survival time of 1207 days, and no significant differences between the groups (p-value=0.4666). CONCLUSION Despite delayed engraftment in the umbilical cord blood group, graft-versus-host disease, relapse and survival were similar in both groups.
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Ono SE, de Carvalho Neto A, Gasparetto EL, Coelho LODM, Escuissato DL, Bonfim CMS, Ribeiro LL. X-linked adrenoleukodystrophy: correlation between Loes score and diffusion tensor imaging parameters. Radiol Bras 2015; 47:342-9. [PMID: 25741116 PMCID: PMC4341377 DOI: 10.1590/0100-3984.2013.1886] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Accepted: 04/29/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The present study was aimed at evaluating the correlation between diffusion tensor imaging parameters and Loes score as well as whether those parameters could indicate early structural alterations. MATERIALS AND METHODS Diffusion tensor imaging measurements were obtained in 30 studies of 14 patients with X-linked adrenoleukodystrophy and were correlated with Loes scores. A control group including 28 male patients was created to establish agematched diffusion tensor imaging measurements. Inter- and intraobserver statistical analyses were undertaken. RESULTS Diffusion tensor imaging measurements presented strong Pearson correlation coefficients (r) of -0.86, 0.89, 0.89 and 0.84 for fractional anisotropy and mean, radial and axial diffusivities (p < 0.01). Analysis of changes in diffusion tensor measurements at early stage of the disease indicates that mean and radial diffusivities might be useful to predict the disease progression. CONCLUSION Measurements of diffusion tensor parameters can be used as an adjunct to the Loes score, aiding in the monitoring of the disease and alerting for possible Loes score progression in the range of interest for therapeutic decisions.
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Affiliation(s)
- Sergio Eiji Ono
- Master, MD, Radiologist at Clínica DAPI - Diagnóstico Avançado por Imagem, Curitiba, PR, Brazil
| | - Arnolfo de Carvalho Neto
- PhDs, Associate Professors, Universidade Federal do Paraná (UFPR), Radiologists at Clínica DAPI - Diagnóstico Avançado por Imagem, Curitiba, PR, Brazil
| | - Emerson Leandro Gasparetto
- PhD, Research Productivity Scholar - Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Course of Post-graduation in Medicine (Radiology), Department of Radiology, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Luiz Otávio de Mattos Coelho
- Titular Member of Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), MD, Radiologist at Clínica DAPI - Diagnóstico Avançado por Imagem, Curitiba, PR, Brazil
| | - Dante Luiz Escuissato
- PhDs, Associate Professors, Universidade Federal do Paraná (UFPR), Radiologists at Clínica DAPI - Diagnóstico Avançado por Imagem, Curitiba, PR, Brazil
| | - Carmem Maria Sales Bonfim
- MD, Hematologist, Coordinator for the Pediatric Bone Marrow Transplant Program at Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR), Curitiba, PR, Brazil
| | - Lisandro Lima Ribeiro
- MD, Hematologist, Fanconi Anemia Clinica at Service of Bone Marrow Transplant, Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR), Curitiba, PR, Brazil
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Furquim CP, Pivovar A, Cavalcanti LG, Araújo RF, Sales Bonfim CM, Torres-Pereira CC. Mouth self-examination as a screening tool for oral cancer in a high-risk group of patients with Fanconi anemia. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:440-6. [DOI: 10.1016/j.oooo.2014.06.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 06/23/2014] [Accepted: 06/25/2014] [Indexed: 11/25/2022]
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Dos Santos DR, Sales Bonfim CM, De Azevedo Mazza V, Loewen Wall M, Alves das Mercês NN. PROCESSO DE BRINCAR DA CRIANÇA HOSPITALIZADA GUIADO PELO MODELO LÚDICO. Cogitare Enferm 2014. [DOI: 10.5380/ce.v19i3.36669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
O brincar é fundamental para o desenvolvimento saudável da criança e durante a hospitalização pode configurar-se como estratégia de cuidado, desde que sua aplicação seja sistematizada e fundamentada. O objetivo do estudo é relatar o processo de brincar guiado pelo Modelo Lúdico. Os participantes foram três crianças do sexo masculino, hospitalizadas em um serviço de transplante de medula óssea, entre setembro e outubro de 2012. A coleta dos dados se deu por meio de instrumentos adaptados do Modelo Lúdico e se desenvolveu em três etapas: conhecendo a criança, cuidando e brincando e acompanhando a evolução do compor tamento lúdico. As crianças foram participativas, demonstrando autonomia, prazer e manutenção do papel ocupacional. O Modelo Lúdico foi considerado importante ferramenta para nortear o cuidado integral e humanizado nesse contexto.
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Campos DJ, Biagini GLK, Funke VAM, Bonfim CMS, Boguszewski CL, Borba VZC. Vitamin D deficiency in children and adolescents submitted to hematopoietic stem cell transplantation. Rev Bras Hematol Hemoter 2014; 36:126-31. [PMID: 24790538 PMCID: PMC4005511 DOI: 10.5581/1516-8484.20140029] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 10/25/2013] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Sub-optimal levels of vitamin D have been found to be highly prevalent in all age groups, with epidemiologic studies demonstrating a link between vitamin D deficiency and disease susceptibility, such as infection and cancer, and mortality rates. In adult transplant patients, it has been suggested that the immunomodulatory properties of vitamin D may have an important role in the prevention and treatment of graft-versus-host disease. OBJECTIVE The objective of this study was to assess serum 25-hydroxyvitamin D levels of children and adolescents submitted to allogeneic hematopoietic stem cell transplantation. METHODS Serum 25-hydroxyvitamin D levels of 66 patients, aged 4-20 years, were assessed at three stages: before hospitalization for hematopoietic stem cell transplantation and at 30 and 180 days after hematopoietic stem cell transplantation. The control group consisted of 25 healthy children. RESULTS At the pre-hematopoietic stem cell transplantation stage, patients had lower levels of 25-hydroxyvitamin D compared to controls (25.7 ± 12.3 ng/mL vs. 31.9 ± 9.9 ng/mL; p-value = 0.01), and a higher prevalence of 25-hydroxyvitamin D deficiency (32% vs. 8%; p-value = 0.01). Prevalence increased significantly after hematopoietic stem cell transplantation (p-value = 0.01) with half of the patients having vitamin D deficiency at 180 days after transplantation. At this stage, mean serum 25-hydroxyvitamin D levels were 20.9 ± 10.9 ng/mL, a significant decline in relation to baseline (p-value = 0.01). No correlation was found between 25-hydroxyvitamin D levels and vitamin D intake, graft-versus-host disease, corticoid use or survival rates. CONCLUSION Low levels of 25-hydroxyvitamin D were detected even before hematopoietic stem cell transplantation and were significantly lower at 180 days after hematopoietic stem cell transplantation, thus recommending vitamin D supplementation for children and adolescents submitted to hematopoietic stem cell transplantation.
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Affiliation(s)
- Denise Johnsson Campos
- Universidade Federal do Paraná, Curitiba, PR, Brazil, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
| | - Gleyne Lopes Kujew Biagini
- Universidade Federal do Paraná, Curitiba, PR, Brazil, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
| | - Vaneuza Araujo Moreira Funke
- Universidade Federal do Paraná, Curitiba, PR, Brazil, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
| | - Carmem Maria Sales Bonfim
- Universidade Federal do Paraná, Curitiba, PR, Brazil, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
| | - César Luiz Boguszewski
- Universidade Federal do Paraná, Curitiba, PR, Brazil, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
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Campos DJ, Boguszewski CL, Funke VAM, Bonfim CMS, Kulak CAM, Pasquini R, Borba VZC. Bone mineral density, vitamin D, and nutritional status of children submitted to hematopoietic stem cell transplantation. Nutrition 2013; 30:654-9. [PMID: 24613437 DOI: 10.1016/j.nut.2013.10.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 10/15/2013] [Accepted: 10/28/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the effect of allogeneic hematopoietic stem cell transplantation (HSCT) on bone mineral density (BMD), serum vitamin D levels, and nutritional status of 50 patients between ages 4 and 20 y. METHODS We conducted pre-HSCT and 6-mo post-HSCT evaluations. We measured BMD at the lumbar spine (LS) and total body (TB) by dual energy x-ray absorptiometry (DXA); body composition by bioimpedance analysis, and dietary intakes of calcium and vitamin D using the 24-h recall and semiquantitative food frequency questionnaire methods. RESULTS We observed a significant reduction in BMD 6 mo post-HSCT. Nearly half (48%) of patients had reductions at the LS (average -9.6% ± 6.0%), and patients who developed graft-versus-host disease (GVHD) had the greatest reductions (-5.6% versus 1.2%, P < 0.01). We also found reductions in serum levels of 25-hydroxyvitamin D (25-OHD), from 25.6 ± 10.9 ng/dL to 20.4 ± 11.4 ng/dL (P < 0.05), and in body weight. Corticosteroid treatment duration, severity of chronic GVHD, serum 25-OHD levels, and family history of osteoporosis were all risk factors associated with variations in BMD at the LS. CONCLUSION HSCT in children and adolescents negatively effects their BMD, nutritional status, and vitamin D levels. We suggest that early routine assessment be done to permit prevention and treatment.
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Affiliation(s)
- Denise Johnsson Campos
- Bone Marrow Transplantation Unit, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil; Endocrine Division (SEMPR), Department of Internal Medicine, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
| | - César Luiz Boguszewski
- Endocrine Division (SEMPR), Department of Internal Medicine, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Carmem Maria Sales Bonfim
- Bone Marrow Transplantation Unit, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Carolina Aguiar Moreira Kulak
- Endocrine Division (SEMPR), Department of Internal Medicine, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Ricardo Pasquini
- Bone Marrow Transplantation Unit, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Victória Zeghbi Cochenski Borba
- Endocrine Division (SEMPR), Department of Internal Medicine, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
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Morando J, Fortier SC, Pasquini R, Zanis Neto J, Bonfim CMS. Early lymphocyte recovery as a predictor of outcome, including relapse, after hematopoietic stem cell transplantation. Rev Bras Hematol Hemoter 2013; 34:430-5. [PMID: 23323067 PMCID: PMC3545430 DOI: 10.5581/1516-8484.20120108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 06/29/2012] [Indexed: 12/03/2022] Open
Abstract
Background Despite advances in the treatment of acute leukemia, many patients need to undergo
hematopoietic stem cell transplantation. Recent studies show that early lymphocyte
recovery may be a predictor of relapse and survival in these patients. Objective To analyze the influence of lymphocyte recovery on Days +30 and +100
post-transplant on the occurrence of relapse and survival. Methods A descriptive, retrospective study was performed of 137 under 21-year-old
patients who we resubmitted to hematopoietic stem cell transplantation for acute
leukemia between 1995 and 2008. A lymphocyte count < 0.3 x 109/L
on Day +30 post-transplant was considered to be inadequate lymphocyte recovery and
counts ≥ 0.3 x 109/L were considered adequate. Lymphocyte
recovery was also analyzed on Day +100 with < 0.75 x 109/Land
≤ 0.75 x 109/L being considered inadequate and adequate
lymphocyte recovery, respectively. Results There was no significant difference in the occurrence of relapse between patients
with inadequate and adequate lymphocyte recovery on Day +30 post-transplant.
However, the transplant-related mortality was significantly higher in patients
with inadequate recovery on Day +30. Patients with inadequate lymphocyte recovery
on Day +30 had worse overall survival and relapse-free survival than patients with
adequate recovery. There was no significant difference in the occurrence of
infections and acute or chronic graft-versus-host disease. Patients with
inadequate lymphocyte recovery on Day +100 had worse overall survival and
relapse-free survival and a higher cumulative incidence of relapse. Conclusion The evaluation of lymphocyte recovery on Day +30 is not a good predictor of
relapse after transplant however patients with inadequate lymphocyte recovery had
worse overall survival and relapse-free survival. Inadequate lymphocyte recovery
on Day +100 is correlated with higher cumulative relapse as well as lower overall
survival and relapse-free survival.
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de Araujo MR, Rubira-Bullen IRF, Santos CF, Dionísio TJ, Bonfim CMS, De Marco L, Gillio-Tos A, Merletti F. High prevalence of oral human papillomavirus infection in Fanconi's anemia patients. Oral Dis 2011; 17:572-6. [PMID: 21332606 DOI: 10.1111/j.1601-0825.2011.01803.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Fanconi's anemia (FA) is a rare recessive genetic disorder characterized by bone marrow failure, developmental and congenital abnormalities, which frequently evolves to aplastic anemia and neoplasias, primarily acute leukemia and head-neck carcinomas. Risk of malignancies increases after hematopoietic stem cell transplantation (HSCT), and the role of human papillomavirus (HPV) in FA carcinogenesis have been proposed. OBJECTIVE To investigate prevalence of oral HPV in FA patients without oral malignant lesions. MATERIALS AND METHODS After oral examination, 76 subjects without detectable oral malignant lesions were included and classified in four groups: 20 FA submitted to HSCT (I), 22 FA not submitted to HSCT (II), 18 severe aplastic anemia (SAA) submitted to HSCT (III) and 16 healthy subjects (IV). Liquid-based cytology sampling, HPV screening by polymerase chain reaction and genotyping by reverse hybridization were performed. RESULTS The HPV detection rates were: group I 35%, group II 27.3%, group III 38% and group IV 6.25%. Prevalence of high risk HPV types, mainly HPV16, was detected. Compared with control group, suggestions for increased likelihood of being HPV infected in SAA (OR = 9.55, 95% CI: 1.01-125.41) and FA patients submitted to HSCT (OR = 8.08, 0.83-72.29) emerged. CONCLUSION Patients without oral malignant lesions submitted to HSCT, have high prevalence of oral HPV. HPV screening and close follow up should be considered in these patients.
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Affiliation(s)
- M R de Araujo
- Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil.
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Morando J, Mauad MA, Fortier SC, Piazera FZ, Souza MPD, Oliveira C, Machado C, Matos E, Azevedo WM, Ribeiro LL, Nunes EC, Bitencourt MA, Setúbal DC, Funke VM, Oliveira MMD, Medeiros LA, Nabhan SK, Loth G, Sola CBS, Koliski A, Pasquini R, Zanis Neto J, Colturato VAR, Bonfim CMS. Transplante de células-tronco hematopoéticas em crianças e adolescentes com leucemia aguda: experiência de duas instituições Brasileiras. Rev Bras Hematol Hemoter 2010. [DOI: 10.1590/s1516-84842010000500006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Morando J, Mauad MA, Fortier SC, Piazera FZ, Souza MPD, Oliveira C, Machado C, Matos E, Azevedo WM, Ribeiro LL, Nunes EC, Bitencourt MA, Setúbal DC, Funke VM, Oliveira MMD, Medeiros LA, Nabhan SK, Loth G, Sola CBS, Koliski A, Pasquini R, Zanis Neto J, Colturato VAR, Bonfim CMS. Transplante de células-tronco hematopoéticas em crianças e adolescentes com leucemia aguda: experiência de duas instituições brasileiras. Rev Bras Hematol Hemoter 2010. [DOI: 10.1590/s1516-84842010005000093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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