RESUMEN
RESUMEN El Cáncer de Ovario Epitelial es la novena causa de cáncer en la mujer y la neoplasia ginecológica más letal en países desarrollados. La mayoría de las pacientes son diagnosticadas en etapa avanzada de la enfermedad debido a la ausencia de síntomas específicos. La cirugía y la quimioterapia cumplen un rol fundamental en el tratamiento de esta enfermedad. En pacientes con enfermedad avanzada (estadios III - IV) al momento del diagnóstico, la extirpación de todo tumor macroscópico (citorreducción óptima) ha demostrado ser el factor pronóstico más importante, demostrando un beneficio tanto en tiempo libre de enfermedad como en sobrevida global. Nuestro objetivo es describir, desde una perspectiva multidisciplinaria, los aspectos técnicos más relevantes de la citorreducción del abdomen superior para aquellas pacientes con neoplasias de origen ginecológico.
ABSTRACT Epithelial Ovarian cancer is the ninth most frequent cancer in women and the most lethal gynecologic malignancy in developed countries. The majority of patients are diagnosed in advanced stage of the disease due to the lack of specific symptoms. Surgery and systemic treatment play a key role in the treatment of this disease. For those patients with advanced stage at the time of diagnosis (III - IV), removal of all macroscopic disease (optimal cytoreduction) has been shown as the most important prognostic factor, demonstrating improvement not only in progression free survival but also in overall survival. Our aim is to describe, in a multidisciplinary fashion, the most relevant aspect about oncological debulking procedures in the upper abdominal cavity for women with gynecological malignancies.
Asunto(s)
Humanos , Femenino , Neoplasias Ováricas/cirugía , Neoplasias Glandulares y Epiteliales/cirugía , Procedimientos Quirúrgicos de Citorreducción/métodos , Neoplasias Ováricas/terapia , Procedimientos Quirúrgicos Ginecológicos , Cavidad Abdominal/cirugíaRESUMEN
RESUMEN Las displasias esqueléticas son un grupo heterogéneo de condiciones que afectan primariamente la formación y crecimiento de huesos y cartílagos, se caracterizan por un acortamiento generalizado de huesos largos. Son patologías de baja prevalencia, que se pueden diagnosticar con precisión mediante ultrasonografía del primer y segundo trimestre. La importancia de esta patología radica en que posee una letalidad cercana al 50%. La displasia esqueletica letal más frecuente es la displasia tanatofórica, la cual se caracteriza por macrocefalia con base de cráneo estrecha, tórax estrecho, cuerpos vertebrales planos, micromelia generalizada, ausencia de fracturas, ventriculomegalia, polihidroamnios y mineralización ósea normal. Debido a que la presentación de la displasia tanatoforica se debe a una mutación autosómica dominante de novo no germinal, el riesgo de recurrencia no es mayor que el de la población general. Dado su elevada letalidad no pasa a generaciones futuras.
SUMMARY Skeletal dysplasias are a heterogeneous group of conditions that primarily affect the formation and growth of bones and cartilage, characterized by a generalized shortening of long bones. These are pathologies of low prevalence, which can be accurately diagnosed by first and second trimester ultrasonography. The importance of this pathology lies in that it has a lethality close to 50%. The most common lethal skeletal dysplasia is tanophilic dysplasia, which is characterized by macrocephaly with a narrow cranial base, narrow chest, flat vertebral bodies, generalized micromelia, absence of fractures, ventriculomegaly, polyhydroamnios and normal bone mineralization. Because the presentation of the tanophoretic dysplasia is due to an autosomal dominant mutation of novo non-germinal, the risk of recurrence is not greater than that of the general population. Given its high lethality does not happen to future generations.
Asunto(s)
Humanos , Masculino , Recién Nacido , Anomalías Congénitas , Displasia Tanatofórica/diagnóstico por imagen , Recien Nacido Prematuro , Ultrasonografía , Anomalías MusculoesqueléticasRESUMEN
El tratamiento médico del embarazo ectópico (EE) no complicado es una alternativa para el manejo de esta patología. Existen distintos criterios para su uso y las tasas de éxito publicadas son variadas. Realizamos una revisión de 34 casos de pacientes con diagnóstico de EE no complicado en el Hospital Regional de Talca, reportándose una tasa de éxito con dosis única de metotrexato de 65%. Un 20,5% de las pacientes requirieron una dosis adicional de metotrexato. La tasa total de éxito con tratamiento médico alcanzó un 73.5%. El manejo médico es una alternativa efectiva a la cirugía en pacientes bien seleccionadas. Se debe evaluar de manera local los criterios de inclusión para el tratamiento médico del EE no complicado.
Medical treatment of non complicated ectopic pregnancy is an alternative for the management of this pathology. There are different criteria for it's use, and published success rates are heterogeneous. We reviewed 34 cases of patients with diagnosis of no complicated ectopic pregnancy in Hospital Regional de Talca, and we reported a success rate of 65% with a single dose of methotrexate. 20,5% of patients needed an additional dose of medication. The global success rate of medical treatment was 73,5%. No surgical management is an effective alternative for well-selected patients. The criteria for medical treatment of no complicated EE must be evaluated locally.
Asunto(s)
Humanos , Femenino , Embarazo , Adulto , Embarazo Ectópico/tratamiento farmacológico , Abortivos no Esteroideos/uso terapéutico , Metotrexato/administración & dosificación , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Despite the improvements in medical treatment over recent decades, hemophilia patients experience deterioration in their quality of life. This study provides a demographic and clinical characterization of hemophilia patients and how this affects their quality of life. This is based on a descriptive cross-sectional study on quality of life of 20patients with hemophilia from the Province of Curicó, Maule Region. The following antecedents were obtained from each patient: age, weight, height, severity of hemophilia, presence of hepatitis B virus, hepatitis C virus, human immunodeficiency virus and Chagas disease. To measure the quality of life the Short Form-36 survey was applied to each one of the patients. The average age was 35+/-16 years old and body mass index was 25+/-4 kg/m2. Regarding the severity level of the disease, in 55 percent of the patient it was found mild. More over, 25 percent of patients had hepatitis C. The most co-morbidity was for articular lesions. Quality of life is affected mainly by lack of sport and also due to the severity level of disease. The current challenge is to provide comprehensive care, both for patients and their families, where the main goal aims at restoring the sense of wellbeing, their right to be perceived as a person with capacity to develop.