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Gilberto Lopes

Publications and source records attributed to Gilberto Lopes.

8 recordsLinked to original sources

Efficacy and safety of oxaliplatin and docetaxel in patients with locally advanced and metastatic non-small-cell lung cancer (NSCLC).

BACKGROUND AND AIMS: Platinum-based doublets are recommended as treatment for advanced or metastatic non-small-cell lung cancer (NSCLC); however, chemotherapy must be tailored to limit side effects. A phase II study was conducted to evaluate the efficacy and safety of oxaliplatin combined with docetaxel for NSCLC. METHODS: Patients with stage IIIB or IV, chemotherapy-naive NSCLC received docetaxel 70 mg/m(2), oxaliplatin 130 mg/m(2), and pegfilgrastim 6 mg every 21 days for up to six cycles. Primary endpoint was overall response rate (ORR), secondary endpoints were progression-free (PFS) and overall survival (OS), and safety. RESULTS: Twenty-nine patients were treated; 93% had stage IV disease and 28% had brain metastases. In 27 evaluable patients with follow-up, there were 10 partial responses for an ORR of 37% (90% confidence interval [CI], 22-55%). Median PFS was 4.6 months (95% CI, 2.6-6.5 months); 12-month PFS was 14.8% (95% CI, 3.4-34.0%). Median OS was 10.9 months (95% CI, 8.9-16.8 months); 12-month OS was 40% (95% CI, 19-61%) and 18-month OS was 16% (95% CI, 1-46%). In 29 treated patients, there were no unusual or unexpected adverse events. The most common grade 3 and 4 toxicities were anemia (14% of patients) and hyperglycemia (10%); there were only two reports of neutropenia; both were grade 1 or 2. CONCLUSION: These phase II findings suggest that the combination of oxaliplatin and docetaxel is active and well tolerated, and should be further investigated as a feasible treatment alternative for patients with advanced or metastatic NSCLC.

Adult↗

Metamizole use among Hispanics in Miami: report of a survey conducted in a primary care setting.

BACKGROUND: Metamizole (dipyrone) is a myelotoxic, nonsteroidal anti-inflammatory agent that has been banned from the US market since 1979. However, dipyrone may be purchased in some areas of the US. We conducted a survey in a primary care setting in Miami, Florida to determine the prevalence of metamizole possession and use among Hispanics living in this area. METHODS: Participants consisted of 137 Hispanic outpatients interviewed consecutively during a primary care visit in the month of February 2005. RESULTS: Metamizole was possessed by 28% of the surveyed population. The most common reasons for using dipyrone were pain (72%) and fever (24%). The vast majority of patients had purchased the medication in Latin America (95%), in most instances without a prescription (95%). Nineteen patients (13%) had used the medication during the previous year. CONCLUSIONS: Metamizole is available to Latino immigrants who reside in the US, despite the FDA ban imposed in 1977.

Anti-Inflammatory Agents, Non-Steroidal↗

Dipyrone-induced granulocytopenia: a case for awareness.

Dipyrone, also known as metamizole, is an analgesic and antipyretic drug that was banned by the United States Food and Drug Administration because of its association with agranulocytosis. However, it is still produced and marketed in several countries in Central and South America as well as in Europe, Asia, and Africa. It can also be found in the United States, where illegal sales have been reported in California gift shops, markets, bakeries, and other retail establishments. Dipyrone is commonly found in the homes of families who are originally from areas where it is still lawfully marketed. We describe a patient who developed granulocytopenia and fever after taking dipyrone and discuss the available literature. Our aim is to raise awareness of this drug, which is commonly used outside the United States, and to call attention to its well-known and potentially lethal side effect.

Adult↗

Primary ectopic breast cancer presenting as a vulvar mass.

Ectopic breast tissue is found along the primitive embryonic milk lines, which extend from the axilla to the groin. Rarely, its occurrence has been described in the vulva. We report a patient who developed primary adenocarcinoma of ectopic breast tissue in such a location and present a review of the pertinent medical literature. The predominant pathology is that of invasive ductal carcinoma; however, other tumor types have also been reported in accessory breast tissue. Its treatment usually entails surgical resection with lymph node dissection. Adjuvant therapy should be guided by the same principles as in orthotopic breast carcinoma.

Adenocarcinoma↗

Pemetrexed-associated urticarial vasculitis.

Pemetrexed (Alimta, Eli Lilly and Company, Indianapolis, IN) is a structurally novel anti-folate agent. The United States Food and Drug Administration has approved pemetrexed for the treatment of patients with malignant pleural mesothelioma and previously treated patients with locally advanced or metastatic non-small cell lung cancer. In the phase III trials that led to its approval, rash was reported in 17 and 22% of patients receiving pemetrexed alone or in combination with cisplatin. However, little has been published about the characteristics of this rash or about its mechanism. In an attempt to contribute to the growing body of knowledge about this new agent, we describe a case in which a patient developed a rash secondary to urticarial vasculitis associated with pemetrexed.

Aged↗

Docetaxel in the management of advanced pancreatic cancer.

The poor outcome of pancreatic cancer with conventional treatment options emphasizes the need for continued research. The benefits of gemcitabine in improving quality of life and survival have been established in patients with advanced pancreatic cancer. Randomized clinical trials studying the addition of a second drug to gemcitabine, either a classic cytotoxic (5-fluorouracil, cisplatin, irinotecan, pemetrexed, oxaliplatin, or exatecan) or targeted agents (ie, the farnesyl transferase inhibitor R115777 or the metalloproteinase inhibitor marimastat) have not resulted in improvement in survival compared with gemcitabine alone. Although limited activity of docetaxel in patients with pancreatic adenocarcinoma has been reported in single-agent studies, attractive efficacy results have been documented with docetaxel in combination with other chemotherapeutic agents for the management of advanced pancreatic cancer. Phase I and II trials of docetaxel in combination with gemcitabine, irinotecan, 5-fluorouracil, or thalidomide, as well as trials of docetaxel and radiotherapy, suggest that docetaxel combinations in pancreatic cancer should be further studied in randomized trials.

Antineoplastic Agents, Phytogenic↗

Large vessel involvement in ANCA-associated vasculitides: report of a case and review of the literature.

Vasculitides are currently classified according to the size of the vessels involved and characteristic clinical and histopathologic findings. Antineutrophil cytoplasmic antibodies (ANCA) and other serologic tests have been used to further characterize small vessel vasculitides. Large vessel involvement in ANCA-associated small vessel vasculitides has been overlooked in the medical literature. Here, we report a case of fatal aortitis and aortic dissection in a patient with microscopic polyangiitis and review reported cases of large vessel involvement in ANCA-associated vasculitides since 1990. We have attempted to characterize this subgroup of patients. Large vessel disease in ANCA-associated vasculitis may present as stenosing large vessel arteritis, aneurysmal disease, aortic dissection, aortic rupture, aortic regurgitation, and death. Prominent perivascular inflammation may present as mediastinal, cervical or abdominal soft tissue masses. ANCA-associated large vessel disease should be considered in the differential diagnosis of these disorders. The epidemiologic, clinical and pathologic characteristics of these patients differ from those of the well-defined large vessel vasculitides such as giant cell (temporal) arteritis or Takayasu's arteritis. We suggest that large vessel involvement is part of the spectrum of ANCA-associated vasculitis rather than an overlap with other large vessel vasculitides. It occurs in both myeloperoxidase- and proteinase 3-positive patients with either Wegener's granulomatosis or microscopic polyangiitis, but has not been reported in Churg-Strauss syndrome. Large vessel vasculitis can precede small vessel vasculitis or occur in the absence of small vessel involvement. We hope this report will contribute to the ongoing development of classification systems for the vasculitic syndromes.

Aortic Dissection↗