Biomedical subjects

Csilla András

Publications and source records attributed to Csilla András.

10 recordsLinked to original sources

PubMed2006

Malignancies and soluble tumor antigens in rheumatic diseases.

Paraneoplastic symptoms, caused by a malignancy, but not directly related to invasion by the tumor or its metastases are the result of a wide variety of tumor-derived biologic mediators like hormones, peptides, antibodies, cytotoxic lymphocytes, autocrine and paracrine mediators. Recognition of paraneoplastic syndromes is important, as it may lead to an early diagnosis of cancer. There is some evidence that systemic inflammatory diseases, such as rheumatoid arthritis (RA), lupus, scleroderma or dermatomyositis may increase the risk for the development of malignancies, predominantly lymphoproliferative disorders. However, reports are somewhat controversial. Immunosuppressive and cytotoxic drugs used in antirheumatic therapy, such as methotrexate, cyclophosphamide, azathioprine or anti-TNF biologicals may also lead to the development of such tumors. Tumor-associated antigens may be produced by inflammatory cells and their production may be increased in RA and other autoimmune diseases.

Antigens, Neoplasm↗

PubMed2006

[The modern treatment of colorectal cancer. Present and future].

The modern treatment of colorectal cancer. Present and future. Fluorouracyl has been the mainstay of treatment for colorectal cancer for decades. The addition of folinic acid to 5FU, the use of infusional, rather than bolus 5FU, and the combination of new active agents such as irinotecan and oxaliplatin with 5FU/LV have each led to increase in effectivity. Oral formulations of fluoropyrimidines can replace the infusional 5FU therapy with better convenience. The authors review the current progress with the use of novel molecular targeted therapies that are tumor specific with better toxicity profile than chemotherapy. The integration of the new biological response modifier therapeutic possibilities in the chemotherapy protocols may result prolongation in survival, in metastatic patients the presently 2 years survival will approach 3 years. Combining these drugs with chemotherapeutics in the adjuvant setting we hope to raise further the presently achieved 78% of 3 years disease free survival by oxaliplatin plus 5FU therapy. As the variation of agents has been increased, choosing the most effective treatment strategy has become increasingly complex.

Antineoplastic Agents↗

PubMed2005

Prostate cancer underlying acute, definitive dermatomyositis: successful treatment with radical perineal prostatectomy.

The idiopathic inflammatory myopathies are systemic autoimmune diseases characterized by chronic inflammation leading to progressive weakness of the proximal muscles. In 7-66% of cases of adult dermatomyositis different malignant tumours can promote the difficult cascade mechanisms at the cell level, leading to rapid weakness of skeletal muscles [1]. We report on a patient with all characteristic signs of acute, severe dermatomyositis associated with a low-grade, low-stage prostate cancer cured by radical perineal prostatectomy.

Adenocarcinoma↗

PubMed2005

Paraneoplastic rheumatic syndromes.

Paraneoplastic symptoms caused by a malignancy but not directly related to tumour invasion are the result of a wide variety of tumour-derived biologic mediators, such as hormones, peptides, antibodies, cytotoxic lymphocytes, autocrine and paracrine mediators. Recognition of paraneoplastic syndromes is important, as it may lead to an early diagnosis of cancer. On the other hand, the clinical severity of the symptoms can be used as a guide to the extent of response to underlying tumour therapy. The quality of life of the patient is affected, therefore the palliative treatment of paraneoplasia is very important.

Humans↗

PubMed2005

Cancer-associated myositis: clinical features and prognostic signs.

Idiopathic inflammatory myositis is characterized by progressive weakness of the proximal muscles. There is a higher risk of malignancy than in the normal population. The aim of this study was to evaluate the frequency of malignancy among 251 myositis patients. We also compared clinical and immunological characteristics of cancer-associated myositis with primary myositis. There were no malignancies among polymyositis, overlap, or juvenile myositis patients. Twenty-two of ninety dermatomyositis patients also had a malignant disease. Patients with cancer-associated dermatomyositis were significantly older than primary myositis patients and had more severe cutaneous and muscle symptoms. Dysphagia and diaphragmatic involvement were more frequent among cancer-associated patients, while extramuscular features were less frequent. After successful treatment of the malignancy, we were able to manage myositis symptoms. One-year survival rate was significantly better in primary dermatomyositis patients. The subset of cancer-associated myositis differs from primary myositis in many aspects of its clinical and immunological features. Prognosis and life expectancy in cancer-associated myositis patients is determined by the underlying malignant disease. Therefore, age- and sex-specific examinations for detection of an underlying malignancy are important in the management of patients with dermatomyositis.

Adult↗

PubMed2005

[Curative surgical treatment of inoperable pancreatic cancer after neoadjuvant therapy].

In the treatment of pancreatic cancer only curative resection increases the life expectancy. Radical resection is a high risk operation, but it can be performed with low peri-operational mortality in specialist surgical centres. At the time of diagnosis most patients are in stage (TMN of pancreatic cancer UICC 1997) III or IV, thus curative resection cannot be performed. Neo-adjuvant therapy shrinks the tumour in 60-70%, giving new hope for the patients. In this paper authors present two cases of pancreatic cancer resections. Palliative operations were performed in patients with inoperable pancreatic cancer. Later neo-adjuvant chemotherapy was performed--in these cases it meant chemotherapy--and after that a second, this time curative procedure was performed.

Adult↗

PubMed2003

Hypothyroidism and thyroiditis after therapy for Hodgkin's disease.

During the follow-up of thyroid function of 151 patients with Hodgkin's disease in complete remission for at least 1 year, 26 cases of subclinical, 12 cases of manifest clinical hypothyroidism and 2 cases of hyperthyroidism (Graves-Basedow disease) were confirmed. Thyroid dysfunction was more frequent in patients who had undergone mantle or neck radiotherapy. Hypothyroidism was most often revealed from the 6th year on following radiotherapy. Thyroid autoantibody positivity was found to be more frequent in patients with thyroid dysfunction, and conversely, thyroid dysfunction was more frequent among the 28 patients with autoantibody positivity. Ultrasound examination and fine needle aspiration cytology of the thyroid confirmed thyroiditis in 96% of the patients with antibody positivity. No relationship was found between thyroiditis and the form of treatment for Hodgkin's disease. We have found that both neck irradiation and thyroiditis may play a role in the increased number of thyroid dysfunction in patients treated for Hodgkin's disease. Thyroiditis is not caused by neck radiotherapy but may be the result of immune regulation disorders in Hodgkin's disease. For substitution or isohormone therapy, levothyroxine is suggested for use. We suggest that examination of the thyroid should be performed at least once a year during the follow-up of Hodgkin's disease patients.

Adolescent↗

PubMed2002

[Second malignancies in patients treated for Hodgkin's disease].

THE AIM OF THE STUDY: to analyse the incidence of second malignant neoplasms (SMN) in patients treated for Hodgkin s disease. PATIENTS AND METHODS: Since 1(st) January 1967, 534 patients have received primary treatment for Hodgkin s disease and 470 cases have proved to be adequate for data analysis as regards to the development of SMN. RESULTS: SMN developed in 34 cases (7.2%), solid neoplasms were diagnosed in 26 cases (5.5%), lung neoplasms had the greatest incidence (11/26), hematologic malignancies were detected in 8 cases (1.7%), and non-Hodgkin s lymphoma was found in 5/8 cases. The mean age of patients with solid neoplasms was 38.1 years (18-59 years) at the diagnosis of Hodgkin s disease and the length of time until the diagnosis of SMN was 13.5 years (1-33 years). The mean age of patients with hematologic malignancies was 45 years (17-64 years), the latency period was 3.2 years (9 months-12 years). The therapies employed prior to the development of solid neoplasms involve: irradiation in 6 cases, chemotherapy in 8 and combined therapy in 12 cases. Out of the 20 cases of chemotherapy, CV/O/PP and its variants were used in 17 cases. Prior to the development of hematologic malignancies, 5 patients had received chemotherapy, 3 combined therapy and 7 patients CV/O/PP and its variants. CONCLUSIONS: The incidence of SMN, especially as regards to hematologic malignancies, was found lower in our patients as compared to literary data. This can be explained by the less intensive therapeutic techniques employed earlier as well as by shorter survival periods. As a result of better therapeutic management, the chances of long term survivals have increased and we should make every effort to avoid late complications such as SMN when planning therapeutic strategies.

Adolescent↗

PubMed2002

[Myositis associated with tumors].

AIMS OF THE STUDY: In the 214 polymyositis / dermatomyositis patients in our department we studied the association of polymyositis / dermatomyositis with malignant tumors, the clinical specificities and therapeutic response changes in these cases. METHODS: Retrospective analysis of the data available since 1985 of the patients treated at the DEOEC 3(rd) Department of Internal Medicine. RESULTS: From 60 patients with dermatomyositis 9 were diagnosed with neoplasia. In 5 patients simultaneously with the dermatomyositis diagnosis, in the other 4 patients 2-2-3-7 years after the onset of dermatomyositis. In the 154 patients with polymyositis we did not observe development of tumors. CONCLUSIONS: Neoplasm was observed in 15% of patients with dermatomyositis. The patients presented with serious skin involvement which did not respond well to the dermatomyositis treatment. The patients in whom tumors developed simultaneously with the dermatomyositis required more aggressive treatment. After the therapy of the tumor (surgery, radiotherapy), the skin and muscle symptoms responded better to the immunosuppressive therapy.

Aged↗

PubMed2002

[Treatment of malignant liver tumors with radio-frequency ablation (RFA)].

INTRODUCTION: A lot of different methods exist for the treatment of liver primary and secondary tumours. Nowadays surgery is the method of choice. If operation is not possible and other conditions are available, local tumour ablation is applicable. One of these methods is the radio-frequency (RF) thermal ablation. AIMS: This method is effective on the base of literature, albeit the indications are not uniform. Authors by the own experience wanted to get dates to define the indication and to study the effectivity of this method in the therapy of liver tumour. PATIENTS/METHODS: Between the 1 January 2000 and 31 January 2002, 86 tumors of 40 patients were treated with RF thermal tumour ablation. This method was applied first in Hungary by our workgroup. RF ablation was performed with generator Cosman CC-1, Radionics, Burlington and cooled-tip single or cluster electrodes. RESULTS: Complete response was achieved in 56 percent. Results of primary tumour necrosis was better when the diameter of the tumour was 3.5-4 cm or less or the treatment was achieved by cluster electrode. 20 patients became tumour free (5 have breast cancer). Tumour spread came into existence in the spite of therapy in ten patients, 8 patients died. The average observation time was one year. In conclusion, the results of this study show that RF ablation with a cooled-tip electrode needle is a safe and effective technique for local treatment of hepatic lesions 4 cm or less in diameter and if the number of lesion less than 4-5. CONCLUSIONS: Authors suggest to use widely the RF technique with other methods in the treatment of hepatic tumours.

Adult↗