DALTON DE ALENCAR FISCHER CHAMONE

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  • article 17 Citação(ões) na Scopus
    Demographic characteristics and prevalence of serologic markers among blood donors who use confidential unit exclusion (CUE) in Sao Paulo, Brazil: implications for modification of CUE polices in Brazil
    (2011) ALMEIDA-NETO, Cesar de; LIU, Jing; WRIGHT, David J.; MENDRONE-JUNIOR, Alfredo; TAKECIAN, Pedro L.; SUN, Yu; FERREIRA, Joao Eduardo; CHAMONE, Dalton de Alencar Fischer; BUSCH, Michael P.; SABINO, Ester Cerdeira
    BACKGROUND: This study evaluated demographic profiles and prevalence of serologic markers among donors who used confidential unit exclusion (CUE) to assess the effectiveness of CUE and guide public policies regarding the use of CUE for enhancing safety versus jeopardizing the blood supply by dropping CUE. STUDY DESIGN AND METHODS: We conducted a cross-sectional analysis of whole blood donations at a large public blood center in Sao Paulo from July 2007 through June 2009, compared demographic data, and confirmed serologic results among donors who used and who have never used CUE (CUE never). RESULTS: There were 265,550 whole blood units collected from 181,418 donors from July 2007 through June 2009. A total of 9658 (3.6%) units were discarded, 2973 (1.1%) because CUE was used at the current donation (CUE now) and 6685 (2.5%) because CUE was used in the past (CUE past). The CUE rate was highest among donors with less than 8 years of education (odds ratio [OR], 2.78; 95% confidence interval [CI], 2.51-3.08). CUE now donations were associated with higher positive infectious disease marker rates than CUE never donations (OR, 1.41; CI, 1.13-1.77), whereas CUE past donations were not (OR, 1.04; CI, 0.75-1.45). CONCLUSION: The CUE process results in a high rate of unit discard. CUE use on an individual donation appears predictive of a high-risk marker-positive donation and, thus, appears to contribute modestly to blood safety. The policy of discarding units from donors who have previously CUE-positive donations does not improve safety and should be discontinued.
  • bookPart
    Fatores de crescimento
    (2013) CHAMONE, Dalton de Alencar; DORLHIAC-LLACER, Pedro Henrique; PEREIRA, Juliana
  • bookPart
    Terapêutica antitrombótica
    (2013) JUNQUEIRA, Patrícia Lima; OKAZAKI, Erica; D'AMICO, Elbio Antonio; CHAMONE, Dalton de Alencar Fischer
  • bookPart
    Diagnóstico laboratorial das alterações da hemostasia
    (2016) ROCHA, Tania Rubia Flores da; D'AMICO, Elbio Antonio; CHAMONE, Dalton de Alencar Fischer
  • conferenceObject
    Extracorporeal shockwave lithotripsy (ESWL) in a patient with congenital fator VII deficiency and von Willebrand disease
    (2013) VILLACA, P. R.; OKAZAKI, E.; ZEINAD-VALIM, A. K.; ROCHA, R. F.; SANDOVAL, E. P. N.; KATO, R. B.; CHEDID-NETO, E. A.; CHAMONE, D. A. F.; D'AMICO, E. A.
  • article 10 Citação(ões) na Scopus
    Azidothymidine is Effective Against Human Multiple Myeloma: A New Use for an Old Drug?
    (2013) PEREIRA, Juliana; LEVY, Debora; RUIZ, Jorge L. M.; BROCARDO, Graciela A.; FERREIRA, Kleber A.; COSTA, Renata O.; QUEIROZ, Rodrigo G.; MARIA, Durvanei A.; HALLACK NETO, Abrahao E.; CHAMONE, Dalton A. F.; BYDLOWSKI, Sergio P.
    Azidothymidine (AZT) is an antiretroviral drug that affects cell proliferation, apoptosis, and the NF-kappa B pathway. As multiple myeloma (MM) presents with constitutive activation of NF-kappa B, we analyzed the effect of AZT on human MM cell lines. We evaluated the cytotoxic effect of AZT in human MM cell lines sensitive (8226/S) or resistant to doxorubicin (8226/DX5) and human T cell lymphoblast-like cells, uterine sarcoma cells, and HUVEC using MTT assay. Cytotoxicity was also evaluated in vivo in nude mice xenografted with 8226/S tumor. The effect of AZT on the expression of genes involved in cell proliferation, apoptosis, angiogenesis, and the NF-kappa B pathway was analyzed in the xenografts using real-time polymerase chain reaction. AZT was effective against both 8226/S and 8226/DX5 cells in a dose and time-dependent manner (p = 0.02) in vitro and promoted cell cycle arrest in S phase in these cells. The tumor volume was lower in mice treated with AZT compared to untreated mice (p = 0.0003). AZT down-regulated the pro-proliferative genes encoding AKT1, MYC, STAT1, MAPK8, MAPK9, CCL-3, Bcl-3, and cyclin D2; pro-angiogenenic genes encoding VEGF and IL8; and genes involved in cell adhesion (ICAM1 and FN1) and the NF-kappa B pathway. AZT up-regulated the expression of tumor suppressor gene FOXP1 and the pro-apoptotic genes encoding BID, Bcl-10, and caspase-8. Thus, we demonstrated the cytotoxic effect of AZT in human MM cell lines for the first time. Our data may provide the rationale for future clinical trials of AZT for treating MM.
  • article 24 Citação(ões) na Scopus
    Pretherapeutic Expression of the hOCT1 Gene Predicts a Complete Molecular Response to Imatinib Mesylate in Chronic-Phase Chronic Myeloid Leukemia
    (2012) NARDINELLI, Luciana; SANABANI, Sabri Saeed; DIDONE, Alline; FERREIRA, Patricia de Barros; SERPA, Mariana; NOVAES, Mafalda Megumi Yoshinaga; MARCHIANI, Mariana; RUIZ, Antonio Lancha; LIMA, Ismael Severino; CHAMONE, Dalton de Alencar Fischer; BENDIT, Israel
    In this retrospective study we evaluated the pretherapeutic mRNA expression of the hOCT1 (human organic cation transporter 1) gene in patients with chronic-phase (CP) chronic myeloid leukemia (CML) who varied in terms of their response to imatinib (IM). hOCT1 mRNA was quantified by real-time PCR. Patients were classified as expressing either high (n = 44) or low hOCT1 mRNA (n = 44). The complete cytogenetic response rates observed at 6, 12 and 18 months were 47.7, 84.1 and 91%, respectively, in patients with high hOCT1 mRNA and 47.5, 81.8 and 86.3%, respectively, in patients with low hOCT1 transcripts. The major molecular response rates were not significantly different between patients with high and low hOCT1 mRNA after 6 months of therapy (22.7 vs. 9.1%; p = 0.07), but they were significantly different after 12 months (54.5 vs. 31.8%; p = 0.026) and 18 months (77.2 vs. 56.8%; p = 0.034). Complete molecular responses were observed in 5 patients with low and 17 patients with high hOCT1 mRNA (p = 0.003). The 5-year event-free and overall survival analyses revealed no significant differences between the groups. These data imply that knowledge of the pretherapeutic level of hOCT1 could be a useful marker to predict IM therapy outcome in treatment-naive CP CML patients.
  • article 7 Citação(ões) na Scopus
    Evaluation of Long-Term Outcomes, Cytogenetic and Molecular Responses with Imatinib Mesylate in Early and Late Chronic-Phase Chronic Myeloid Leukemia: A Report from a Single Institute
    (2012) BENDIT, Israel; SANABANI, Sabri Saeed; CONCHON, Monika; SERPA, Mariana; NOVAES, Mafalda Megumi Yoshinaga; NARDINELLI, Luciana; PEREIRA, Thales Dalessandro Meneguin; TUCUNDUVA, Luciana; FERREIRA, Patricia de Barros; DORLHIAC-LLACER, Pedro Enrique; CHAMONE, Dalton de Alencar Fischer
    Here we compare the management and survival outcomes of chronic myeloid leukemia (CML) patients who had early or late imatinib mesylate (IM) therapy. The cytogenetic and molecular responses of 189 CML patients were analyzed. Of this group, 121 patients were classified as the early chronic phase (ECP) group and started IM within 12 months of diagnosis. The other 68 patients were classified as the late chronic phase (LCP) group who had been treated with interferon (IFN)-alpha-2 and crossed over to IM more than 12 months after diagnosis. The overall rates of complete cytogenetic response (CCyR) and major molecular response (MMR) at last follow-up were 83.6 and 78.1% in the ECP and LCP groups, respectively. The CCyR rates were 89.3 (for ECP patients) versus 73.5% (for LCP patients; p < 0.0001). At last follow-up, 82.4% ECP and 64.2% LCP patients had achieved an MMR (p < 0.0001). No significant differences were noted between the two groups with regard to survival outcomes. Our experience reveals that IM is an effective rescue therapy in most CML LCP patients who are intolerant or in whom IFN-alpha therapy fails. Such therapeutic options should be considered in LCP patients, particularly in countries where IM may not be available.
  • conferenceObject
    Maintenance with rituximab is not associated with severe or uncommon infections in patients with follicular lymphoma: results from the phase IIIB MAXIMA study
    (2012) WITZENS-HARIG, M.; ROCCO, A. Di; HAZEL, G. van; CHAMONE, D.; RUFFERT, K.; ROWE, J.; ARCAINI, L.; PODDUBNAYA, I.; HO, A.; IVANOVA, V.; VRANOWSKY, A.; OERTEL, S.; THURLEY, D.; FOA, R.
    Clinical trial data support the efficacy of rituximab maintenance therapy, following rituximab-based chemoimmunotherapy, in patients with follicular lymphoma (FL). With safety as its primary objective, this phase IIIB study (clinicaltrials.gov identifier: NCT00430352) was the first large prospective evaluation of rituximab maintenance in clinical practice. Patients (n = 534) with first-line or relapsed FL who responded to ≥8 cycles of rituximab-based induction therapy (anthracycline 62%, alkylator 21%, purine analog 8%, rituximab monotherapy 5%, other 4%) received twelve 2-monthly rituximab infusions for 2 years. Overall, 422 infections occurred in 193 (36.1%) patients, most commonly nasopharyngitis (7.1%), bronchitis (4.7%), sinusitis (4.3%), upper respiratory tract infection (3.9%), and influenza (3.7%); and were grade 3/4/5 in 21 (3.9%), 2 (0.4%) and 1 (0.2%) patient(s), respectively. Fifty-one hematologic adverse events occurred in 35 (6.6%) patients, most commonly neutropenia (n = 18; 3.4%; grade 3 or 4 in 13 patients; 2.4%). Grade 3 or 4 hypogammaglobulinemia occurred in 5 (0.9%) patients. Rates and types of infections were similar in patients with or without prolonged neutropenia or hypogammaglobulinemia. Rituximab maintenance every 2 months for 2 years is not associated with uncommon or severe infections in clinical practice in FL. Prolonged neutropenia and hypogammaglobulinamia are rare, manageable events.
  • conferenceObject
    Thrombelastography as screening test for the diagnosis of Scott syndrome
    (2012) VILLACA, P.; ROCHA, T.; OKAZAKI, E.; VALIM, A.; OLIVEIRA, V.; CHAMON, D.; DAMICO, E.
    Background: Scott syndrome (SS) is a rare bleeding disorder, characterized by impaired platelet procoagulant activity (PCA). The laboratory tests for its diagnosis are available in specialized laboratories, and sometimes only for research purposes. Case Report: A 35 year-old male patient was referred to our centre for diagnosis of hemostasis disorder. He had a history of bruises and hematomas since childhood. Blood transfusion was required after postectomy and crural hernioplasty. His family history for bleeding was negative. Laboratory investigation showed normal measurement of all coagulation factors, including VWF antigen/activity, normal evaluation of fibrinolytic system (alpha2-antiplasmin, plasminogen, and euglobulin lysis time), as well as plateletaggregometry (ADP, ADR, arachidonic acid, collagen, and ristocetin). Thrombelastography (TEG) was hypocoagulant (prolonged R and K; reduced angle MA, G, TG, MRTG, and TMRTG), which led us to consider abnormality of PCA. Then a series of TEGs was performed, mixing total blood (patient and control) with platelet-poor plasma (PPP) and platelet-rich plasma (PRP) of the patient and control. When PRP (control) was added to patient’s total blood, TEG was normalized, suggesting PCA dysfunction, and the hypothesis of SS was made. A PCA test was performed using washed platelet and activated prothrombinic complex, resulting in reduced PCA. After that, we performed the phosphatidylserin expression by flow cytometry, using annexin V and a thrombin generation assay (TGA) with control PRP, confirming the diagnosis of SS. Conclusion: SS is a rare disease, and usually confirmatory tests are not part of the routine, even in specialized laboratories. TEG using mixtures of total blood and PRP of patient and control can be a simple and less expensive alternative method for screening impaired PCA in patients with bleeding disorders. In this case, such an approach helped in elucidating the diagnosis when sophisticated tests such as annexin V and thrombin generation were not promptly available.