RESUMO
The study evaluates the clinical and pathological findings of 16 patients with locally advanced penile carcinoma (PC) submitted to emasculation, and discusses questions related to the usefulness of bilateral orchiectomy. Between 1999 and 2010, 172 patients with PC were treated. Sixteen (9%) underwent emasculation. Data were retrieved from the institution's database including age, ethnicity, date of surgery, residential setting, level of schooling, time to diagnosis, type of reconstruction, complications, tumor stage and grade, vascular and perineural invasion along with invasion of corpus cavernosum, corpus spongiosum, testicles, scrotum and urethra. A total of 16 patients (average: 63.1 years) with locally advanced PC were included. All were illiterate or semiliterate rural dwellers and 87% were white. The time to diagnosis was 8-12 months. The mean follow-up time was 31.9 months (1-119). By the time of the last follow-up, only seven patients (43.75%) were alive. Tumors were pT4 (n = 6), pT3 (n = 8), pT2 (n = 2), Grade I (n = 5) and Grade II (n = 11). The histopathological examination revealed invasion of the urethra (n = 13), scrotum (n = 5) and testicles (n = 1). The surgical margin was positive in one patient. Six patients (37.5%) had vascular invasion and 11 (68.7%) had perineural invasion. Currently, only one of the former is alive. The finding of focal microscopic testicular infiltration in only one of 32 testicles, even in the presence of clinically apparent scrotal invasion, suggests that emasculation without bilateral orchiectomy is a safe treatment option for patients with locally advanced PC.
Assuntos
Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma de Células Escamosas/cirurgia , Orquiectomia/métodos , Neoplasias Penianas/cirurgia , Testículo/cirurgia , Carcinoma de Células Escamosas/patologia , Seguimentos , Estimativa de Kaplan-Meier , Tratamentos com Preservação do Órgão/métodos , Prognóstico , Neoplasias Penianas/patologia , Fatores de Tempo , Resultado do TratamentoRESUMO
With the dawn of the new century, dentistry has seen a new face in the fields of diagnosis, treatment and prevention. Twenty one children were asked to brush their teeth for five days. The brushes were put in Robertson's Cooked Meat broth and cultured. Growth of Streptococcus Mutans were seen. These brushes were then placed in disinfectants such as 0.2% chlorhexidine gluconate (Gp I), 1% sodium hypochlorite(Gp II) and water (Gp III) for 24 hrs and then cultured. Disappearance of growth of microorganisms was seen in Gp I and Gp II and remnants of growth seen in Gp III. It can be concluded that the use of disinfectant is a must for every individual at regular intervals.
Assuntos
Criança , Pré-Escolar , Clorexidina/análogos & derivados , Contagem de Colônia Microbiana , Descontaminação/métodos , Dispositivos para o Cuidado Bucal Domiciliar/microbiologia , Desinfetantes de Equipamento Odontológico/farmacologia , Humanos , Hipoclorito de Sódio/farmacologia , Escovação Dentária/instrumentaçãoRESUMO
Neuropathic pain is seen in a third of cancer patients and is not always responsive to traditional analgesics. We describe practical guidelines for the use antidepressants and anticonvulsants as adjuvant analgesics in such situations. Newer adjuvant analgesics, interventional procedures and options for the management of pain emergencies, are also briefly outlined.