RESUMO
BACKGROUND: Gastrointestinal stromal tumours (GISTs) located in the jejunum or ileum (JI-GIST) are considered worse prognosis compared to those of gastric (G-GIST) location. It has been suggested that this dogma should be revised. The aim of this study was to describe the characteristics of jejunoileal GISTs and its prognosis and to compare them with G-GISTs in the era of imatinib. METHODS: We retrospectively reviewed the clinical histories of all the patients diagnosed with GISTs between January 2000 and November 2016: Clinical and pathological data, as recurrence, metastatic state, disease-free survival (DFS) as well as overall survival (OS) rates of patients were reviewed. RESULTS: JI-GIST patients comprise 29 cases (37.7%). Compared to G-GIST, JI-GIST patients had undergone emergency surgery more frequently (37.9% vs. 10.4%, p = 0.007). According to the NIH-Fletcher classification, the low or very-low risk group represents 17.2% of JI-GISTs as opposed to 37.6% of G-GISTs (p < 0.005). When the AFIP-Miettinen system was used the low or very-low group represented 17.2% of JI-GISTs vs. 58.4% in the G-GISTs group (p < 0.001). Both local recurrence (24.1% vs. 12.5%, p < 0.05) and metastatic rate (34.5% vs. 22.9%, p < 0.05) were higher in the JI-GIST group than in G-GIST. 5- and 10-year DFS and 10-year OS rate were lower for JI-GIST (54.5% and 39.6% vs. 77.2% and 60.8%, and 57.9% vs. 65%, respectively, p < 0.05). CONCLUSIONS: The observed differences between both groups in DFS and OS rates at long term could be attributed to the effect of imatinib.
Assuntos
Antineoplásicos/uso terapêutico , Tumores do Estroma Gastrointestinal/tratamento farmacológico , Tumores do Estroma Gastrointestinal/mortalidade , Neoplasias do Íleo/tratamento farmacológico , Neoplasias do Íleo/mortalidade , Mesilato de Imatinib/uso terapêutico , Neoplasias do Jejuno/tratamento farmacológico , Neoplasias do Jejuno/mortalidade , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/mortalidade , Idoso , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
INTRODUCTION: The number of patients who have a cardiac implantable electronic device (CIEDs) that undergo a course of radiotherapy is increasing due to the ageing population. The majority of clinical studies only evaluate any CIED malfunction at the end of a course of irradiation or in a case of there being symptoms of possible malfunction. As a result, little data has been collected on CIED status acquired during an active course of irradiation. MATERIAL AND METHODS: We aimed to evaluate the correct functioning of a CIED during a course of radiotherapy. So, a retrospective analysis was made of all patients having CIEDS in a single institution during their course of radiotherapy. All CIEDs were systematically checked before and during the course of radiotherapy according to the risk of device failure and patient dependence. RESULTS: Data was analysed from 56 patients (43 men, 13 women) with a mean age of 78.2 years, of whom 87.5% of the patients carried a pacemaker (PM), the 39% of the patients were PM dependent, and the remaining patients carried an implantable cardioverter-defibrillator (ICD). An observable dose of irradiation was evident in only 10 cases. 69.1% of the CIEDs were checked daily and the remainder were checked weekly. During the radiotherapy course, 82% of the patients did not complain of any cardiological event. The CIED of five patients experienced an increase in the threshold and, in another case, a sudden reduction in the duration of the battery was reported. Another patient with a CIED experienced a cardiac insufficiency episode triggered by a ventricular tachycardia. CONCLUSION: In conclusions, although adverse clinical events from exposure of a CIED to irradiation are rare, they can appear in any group of risk. No dose-dependency was observed on the malfunction of the CIED.
Assuntos
Desfibriladores Implantáveis , Análise de Falha de Equipamento , Neoplasias/radioterapia , Marca-Passo Artificial , Radioterapia Conformacional/métodos , Idoso , Idoso de 80 Anos ou mais , Desfibriladores Implantáveis/estatística & dados numéricos , Feminino , Seguimentos , Cardiopatias/terapia , Humanos , Masculino , Marca-Passo Artificial/estatística & dados numéricos , Dosagem Radioterapêutica , Radioterapia Conformacional/efeitos adversos , Radioterapia de Intensidade Modulada , Estudos RetrospectivosRESUMO
BACKGROUND: The aim of the study is to clarify if a classification based on the time of occurrence of associated malignancies in GIST patients can help in the understanding of the clinical controversies observed in these patients. METHODS: We retrospectively reviewed all the patients diagnosed with GIST tumors between January 1999 and October 2016. They were divided into GIST patients associated with other tumors (A-GIST) and those not associated (NA-GIST). A-GIST patients were also divided into four types according to the proposed classification. RESULTS: Of 104 GIST patients, 32 (30.7%) (A-GIST group) had at least one additional primary malignancy. The most frequent location of the associated malignancy was the GI tract (26%). Compared to NA-GIST, A-GIST were more often asymptomatic with a lower risk of recurrence. The main cause of death in NAGIST was GIST itself, being associated tumors the main cause of death in A-GIST group. No differences were found in DFS and OS between A-GIST and NA-GIST. CONCLUSIONS: The use of the proposed classification classifies GIST patients with associated malignancies in different subtypes that differ substantially in terms of incidence, type of neoplasms associated, cause of the association and prognosis.
Assuntos
Neoplasias Gastrointestinais/epidemiologia , Tumores do Estroma Gastrointestinal/epidemiologia , Neoplasias Primárias Múltiplas/epidemiologia , Feminino , Seguimentos , Neoplasias Gastrointestinais/complicações , Tumores do Estroma Gastrointestinal/complicações , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/complicações , Prognóstico , Estudos Retrospectivos , Espanha/epidemiologia , Taxa de SobrevidaRESUMO
Cutaneous neoplasia is common in non-human primates. We describe the gross and microscopic features of multicentric cutaneous keratoacanthomas in a free-living marmoset (Callithrix sp.). Immunohistochemistry for human papillomavirus and herpes simplex virus type I and simplex virus type II was negative. Keratoacanthomas should be included in the differential diagnosis for cutaneous masses in non-human primates.
Assuntos
Callithrix , Ceratoacantoma/patologia , Doenças dos Macacos/patologia , Animais , Diagnóstico Diferencial , Feminino , Imuno-Histoquímica , Ceratoacantoma/diagnóstico , Doenças dos Macacos/diagnósticoAssuntos
Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Cabelo/patologia , Neoplasias Cutâneas/patologia , Neoplasias de Cabeça e Pescoço/patologia , Pilomatrixoma/patologia , Biópsia , Diagnóstico Diferencial , Doenças do Cabelo/cirurgia , Neoplasias Cutâneas/cirurgia , Neoplasias de Cabeça e Pescoço/cirurgia , Pilomatrixoma/cirurgiaRESUMO
Las patologías torácicas son poco frecuentes. Dentro de éstas se encuentran los quistes broncopulmonares, que por lo general son de carácter benigno. Se presentan dos casos de diagnóstico antenatal, de evolución benigna y resolución espontánea.
Assuntos
Feminino , Gravidez , Humanos , Pulmão/anormalidades , Cisto Broncogênico , Diagnóstico Diferencial , Cisto Broncogênico/complicações , Remissão Espontânea , Ultrassonografia Pré-NatalRESUMO
El diagnóstico de megavejiga en el embarazo es infrecuente más aun si se trata de un feto femenino. Este hecho nos permite delimitar bastante las alternativas diagnósticas, dentro de un espectro bastante heterogénico. El síndrome Megavejiga-Microcolon Hipoperistalsis Intestinal(MMIHS) es una patología de muy mal pronóstico que asocia megavejiga y alteraciones intestinales severas. Es por esto que es importante tenerla presente, para poder dar a los padres una información fidedigna y certera en cuanto al pronóstico. Presentamos 2 casos de nuestro servicio en el período 1998-2003. Se comentan los aspectos diagnósticos, terapéuticos y la evolución.
Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Anormalidades Múltiplas , Colo/anormalidades , Ultrassonografia Pré-Natal , Bexiga Urinária/anormalidades , Segundo Trimestre da GravidezRESUMO
Se realizó un estudio experimental, con el objeto de determinar la asociación del diagnóstico clínico de las pulpopatías con los hallazgos histopatológicos que se producen en el órgano dentinopulpar. Esta investigación analizó, bajo determinados criterios clínicos e histopatológicos, 51 piezas dentarias humanas, incluyendo dientes sanos y dientes con diferentes grados de compromiso del órgano pulpar. Las piezas dentarias fueron fijadas y descalcificadas, para posteriormente ser procesadas, obteniéndose diferentes cortes histológicos, los que fueron teñidos y observados al microscopio óptico. Como resultados, se obtuvo un alto porcentaje de asociación (84.4 por ciento) entre los hallazgos histopatológicos y los criterios clínicos utilizados para el diagnóstico. Fue interesante observar el compromiso parcial, en estados pulpares diagnosticados clínicamente como irreversibles y la falta evidente de relación entre la sintomatología dolorosa y la extensión del compromiso pulpar. Además, alrededor de un 21.6 por ciento de las muestras presentaron trastornos regresivos que corresponden a una respuesta del tejido conjuntivo vascular de la pulpa frente a un estímulo de larga data
Assuntos
Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Doenças da Polpa Dentária , Calcificações da Polpa Dentária/diagnóstico , Chile , Diagnóstico Clínico , Técnica de Descalcificação , Polpa Dentária , Doenças da Polpa Dentária , Necrose da Polpa Dentária , Dentina , Epidemiologia Descritiva , Técnicas Histológicas , Microscopia , Pulpite , Interpretação Estatística de DadosRESUMO
Background: Indoor pollution can be an important risk factor for human health, considering that people spend more than 60 percent of their time in their houses. Aim: To investigate indoor pollution in a zone of extreme poverty in Metropolitan Santiago. Material and methods: During 24h, carbon monoxide (CO), sulfur dioxide (SO2), respirable particulate matter (PM10), polycyclic aromatic hydrocarbons absorbed in PM5, temperature and humidity, were measured in the interior of 24 houses in La Pintana, Santiago. Results: The higher pollutant concentrations were observed during hours when heating was used, in houses that used coal (mean PM10 250 µg/m3, CO 42 ppm, SO2 192 ppb) or firewood (mean PM10 489 µg/m3, CO 57 ppm, SO2 295 ppb). In all houses, polycyclic aromatic hydrocarbons were detected and they came from the interior of the house and not from external filtered air. Coal, firewood and cigarette smoke were important sources of carcinogenic and kerosene and gas were sources of non carcinogenic polycyclic aromatic hydrocarbons. Conclusions: In the houses studied, the population was exposed to an accumulation of highly toxic pollutants, caused by a lack of ventilation. A high relative humidity also contributed to the growth of biological pollutants