ABSTRACT
Despite decades of research, prognosis for SCLC patients remains poor, and treatment options limited. SCLC is an immunogenic tumor with high somatic mutation rates due to tobacco exposure resulting in potential neo-antigens, the presence of suppressed immune responses, and occurrence of paraneoplastic disorders. The use of T cell immune-checkpoint inhibitors (anti-PD1: nivolumab, pembrolizumab; anti-PD-L1: atezolizumab, durvalumab; anti-CTLA-4: ipilimumab, tremelimumab) have shown promising antitumor activity with the potential to prolong survival in SCLC patients. In fact, atezolizumab when combined with chemotherapy has achieved the milestone of being the first drug to improve survival in patients with newly diagnosed extensive-stage SCLC. Other immunotherapeutic approaches evaluated in clinical trials for SCLC include the use of cytokines, cancer vaccines, antiganglioside therapies, TLR9 inhibition, anti-Notch signaling, and anti-CD47. This review discusses the rationale and clinical evidence of immunotherapy in SCLC, the conflictive clinical results of novel immunotherapeutic agents and combinatorial therapies under evaluation in SCLC patients.
Subject(s)
Immunotherapy/methods , Lung Neoplasms/therapy , Small Cell Lung Carcinoma/therapy , Animals , Humans , Lung Neoplasms/immunology , Small Cell Lung Carcinoma/immunologyABSTRACT
No disponible
Subject(s)
Humans , Hypothesis-Testing , Nervous System Diseases/complications , Nervous System Diseases/diagnosis , Language Disorders/complications , Language Disorders/epidemiology , Psychometrics/methods , Peer Review/methods , Diagnostic and Statistical Manual of Mental Disorders , Child Development/physiology , Psychometrics/instrumentationABSTRACT
A 39 year old female presented with a multifocal lesions in the skull, at the frontal right and parietal left. We performed bilateral craniectomies guided with navigation, and the bone defects were repaired with titanium mesh. The pathological examination reported intraosseous cavernous hemangioma in both lesions. Follow up of six months without any complication or recurrence and good cosmetic outcome.
Subject(s)
Frontal Bone/pathology , Hemangioma, Cavernous/pathology , Parietal Bone/pathology , Adult , Female , Frontal Bone/surgery , Hemangioma, Cavernous/surgery , Humans , Parietal Bone/surgery , Treatment OutcomeABSTRACT
Presentamos el caso clínico de una paciente de 39 años de edad quien presenta dos tumoraciones en cráneo a nivel frontal derecho y parietal izquierdo, que fueron resecadas en bloque mediante craniectomías guiadas por navegación. El defecto óseo fue reconstruido con mallas de titanio. El reporte histopatológico fue de hemangioma óseo en ambas lesiones. El seguimiento a 6 meses posterior a la cirugía sin evidencia de recurrencia y con un resultado cosmético satisfactorio (AU)
A 39 year old female presented with a multifocallesions in the skull, at the frontal right and parietal left. We performed bilateral craniectomies guided with navigation, and the bone defects were repaired with titanium mesh. The pathological examination reported intraosseous cavernous hemangioma in both lesions. Follow up of six months without any complication or recurrence and good cosmetic outcome (AU)
Subject(s)
Humans , Female , Adult , Hemangioma, Cavernous/surgery , Skull Neoplasms/surgery , Bone Neoplasms/surgery , Tomography, X-Ray ComputedABSTRACT
Se han revisado las recomendaciones referentes al síndrome coronario agudo (SCA) sin elevación del segmento ST. Estas recomendaciones están diseñadas para ayudar a los médicos de las unidades de cuidados intensivos cuando hacen las primeras evaluaciones de estos pacientes. Fundamentalmente son para ayudar al diagnóstico precoz, la estratificación de riesgo y el tratamiento inicial. La necesidad para un tratamiento individualizado es en este momento uno de los objetivos primarios en el abordaje del SCA, con o sin elevación del segmento ST, y ésta es la razón por la que creemos que las recomendaciones deben ser de una naturaleza predominantemente práctica dado que afectan la toma de decisiones en la práctica diaria de la medicina (AU)
These recommendations are designed to be of assistance to doctors in ICUs when making first evaluations of these patients. They are mainly intended to assist with early diagnosis, risk stratification and initial treatment. The need for individualised treatment is at present one of the main objectives in the management of Acute Coronary Syndrome (ACS), with or without ST elevation, and this is why we believe the recommendations should be of a predominantly practical nature, given that they affect decision making in the day to day practice of medicine (AU)
Subject(s)
Humans , Male , Female , Aged , Acute Coronary Syndrome/diagnosis , Acute Coronary Syndrome/therapy , Cardiovascular Agents/therapeutic use , Early Diagnosis , Electroencephalography , Critical Care , Combined Modality Therapy , Myocardial Revascularization , Angioplasty, Balloon, Coronary , Severity of Illness Index , TriageABSTRACT
These recommendations are designed to be of assistance to doctors in ICUs when making first evaluations of these patients. They are mainly intended to assist with early diagnosis, risk stratification and initial treatment. The need for individualised treatment is at present one of the main objectives in the management of Acute Coronary Syndrome (ACS), with or without ST elevation, and this is why we believe the recommendations should be of a predominantly practical nature, given that they affect decision making in the day to day practice of medicine.
Subject(s)
Acute Coronary Syndrome/diagnosis , Acute Coronary Syndrome/drug therapy , Acute Coronary Syndrome/surgery , Acute Coronary Syndrome/therapy , Aged , Angioplasty, Balloon, Coronary , Cardiovascular Agents/therapeutic use , Combined Modality Therapy , Critical Care/standards , Diagnostic Imaging , Early Diagnosis , Electroencephalography , Emergency Medical Services/standards , Female , Humans , Male , Myocardial Revascularization , Risk Assessment , Severity of Illness Index , TriageABSTRACT
No disponible
Subject(s)
Humans , Psychological Theory , Mental Processes , Autistic Disorder/psychology , Asperger Syndrome/psychology , Child DevelopmentABSTRACT
No disponible
Subject(s)
Humans , Language Disorders , Research/trends , Articulation DisordersABSTRACT
AIMS: To analyze whether repetition of nonwords (NWR) is a good method to differentiate between Spanish-speaking children with specific language impairment (SLI), children with normal language development (NL), and children with articulation disorder (AD), and to study whether phonological and syllabical characteristics, which are present in nonwords used in this task, are compatible with a SLI explanation on the basis of the temporal auditory limitation. PATIENTS AND METHODS: Eighteen 5- and 6-year-old children with NL, 19 with SLI, and 19 with AD, performed verbal tasks (principally, lexical and verbal memory tasks), and two NWR tasks: one is formed by four nonwords series with frequent syllables, in accordance with the analysis of syllable frequency in Spanish, and the other task is formed by nonwords with infrequent syllables. RESULTS: Like in English, NWR is the best method to differentiate children with SLI and children with NL; yet children with a minor impairment, like AD, show deficits in this task. Therefore, this disorder could be considered as an 'intermediate zone' between NL and SLI. Then it seems that AD is not an unmixed impairment of production only, since in its origin there are difficulties linked with the formation of the phonological representations of the words. CONCLUSIONS: With regard to syllable frequency, results do not support the explanation on the basis of temporal auditory limitation in Spanish. Results are discussed in relation to other explanations: general limitation of processing, with special incidence of the phonological working memory, and connectionist perspectives.
Subject(s)
Articulation Disorders/etiology , Language Development Disorders/complications , Child , Child, Preschool , Female , Humans , Male , Psycholinguistics , SpainABSTRACT
Objetivos. Saber si la repetición de pseudopalabras (RPP)es una tarea que diferencia bien a los niños hispanohablantes contrastorno específico de lenguaje (TEL) respecto a los que muestranun desarrollo normal del lenguaje (DN) y trastorno de articulación(TA), y comprobar si las características fonológicas y silábicas delespañol, presentes en las pseudopalabras utilizadas en esta tarea,son compatibles con una explicación del TEL basada en la limitaciónauditiva temporal. Pacientes y métodos. 18 niños con DN, 19con TEL y 19 con TA, todos de 5 y 6 años, han realizado tareas verbales(sobre todo léxicas y de memoria verbal) y dos tareas deRPP: una con sílabas frecuentes y otra con sílabas no frecuentes.Resultados. Como en inglés, la RPP es la tarea que diferencia mejora los niños con TEL respecto a los niños con DN; pero inclusolos niños con un trastorno menor, como el TA, muestran déficit enesta tarea; puede considerarse este trastorno como una zona intermediaentre le DN y el TEL. Parece, pues, que el TA no es sóloun trastorno puro de producción, sino que en su origen hay dificultadesrelacionadas con la formación de las representaciones fonológicasde las palabras. Conclusiones. En cuanto a la frecuenciade las sílabas, los resultados no apoyan la explicación basada en lalimitación auditiva temporal en español. Se discuten otras explicaciones:limitación general de procesamiento, con especial incidenciade la memoria fonológica de trabajo, y perspectivas conexionistas
Aims. To analyze whether repetition of nonwords (NWR) is a good method to differentiate between Spanishspeakingchildren with specific language impairment (SLI), children with normal language development (NL), and childrenwith articulation disorder (AD), and to study whether phonological and syllabical characteristics, which are present innonwords used in this task, are compatible with a SLI explanation on the basis of the temporal auditory limitation. Patientsand methods. Eighteen 5- and 6-year-old children with NL, 19 with SLI, and 19 with AD, performed verbal tasks (principally,lexical and verbal memory tasks), and two NWR tasks: one is formed by four nonwords series with frequent syllables, inaccordance with the analysis of syllable frequency in Spanish, and the other task is formed by nonwords with infrequentsyllables. Results. Like in English, NWR is the best method to differentiate children with SLI and children with NL; yet childrenwith a minor impairment, like AD, show deficits in this task. Therefore, this disorder could be considered as an intermediatezone between NL and SLI. Then it seems that AD is not an unmixed impairment of production only, since in its origin there aredifficulties linked with the formation of the phonological representations of the words. Conclusions. With regard to syllablefrequency, results do not support the explanation on the basis of temporal auditory limitation in Spanish. Results are discussedin relation to other explanations: general limitation of processing, with special incidence of the phonological workingmemory, and connectionist perspectives
Subject(s)
Child , Humans , Child Language , Articulation Disorders , Language Development Disorders , Verbal Behavior , Spain , Case-Control Studies , Task Performance and Analysis , VocabularyABSTRACT
No disponible
No disponible
Subject(s)
Male , Female , Child , Humans , Personal Construct Theory , Communication , Language Development , Child Development/physiologyABSTRACT
We report the naming performance of a fluent aphasic, DP, who shows a striking dissociation between semantic and phonological (nonword) errors: he produced numerous semantic errors but virtually no phonological errors. DP's pattern of performance is the reverse of that reported for patient DM (Caramazza, Papagno, & Ruml, 2000), who only made phonological errors in a naming task. These patterns of performance are inconsistent with the proposal by Dell, Schwartz, Martin, Saffran, and Gagnon (1997) that the naming deficit in fluent aphasia is the result of global damage to all levels of the lexical access system and support instead the hypothesis that brain damage can selectively disrupt distinct subcomponents of the lexical processing system.
Subject(s)
Aphasia, Wernicke/physiopathology , Semantics , Verbal Behavior/physiology , Aphasia, Wernicke/diagnosis , Humans , Male , Middle Aged , Neuropsychological Tests , Phonetics , Severity of Illness IndexABSTRACT
Several polyfunctionalized cyclobutane derivatives have been synthesized using commercial (-)-alpha-pinene and (-)-verbenone as chiral precursors. Thus, oxidative cleavage of these compounds by using ruthenium trichloride afforded quantitatively (-)-cis-pinonic and (-)-cis-pinononic acids, respectively, without epimerization. These products were converted into several types of aldehydes, which are the key intermediates in the synthesis of cyclobutane dehydro amino acids via Wittig-Horner condensations with suitable phosphonates. These reactions are highly stereoselective, affording exclusively (Z) isomers, stereochemistry being assessed by NMR experiments. The obtained dehydro amino acids are polyfunctionalized molecules useful for the synthesis of other alpha-amino acids, with additional chiral centers, whose configuration must be induced by the chirality of the terpene employed as a precursor.
Subject(s)
Amino Acids/chemical synthesis , Cyclobutanes/chemistry , Monoterpenes , Terpenes , Amino Acids/chemistry , Bicyclic Monoterpenes , Cyclobutanes/chemical synthesis , Indicators and Reagents , StereoisomerismABSTRACT
We report a case of a 22 year-old drug addict man with overt heart failure and cardiomegaly. The patient had no prior history of tuberculosis and not clinical features to suggest this diagnosis. Tuberculosis myocarditis was found at the necropsy. It is important to point out the frequency of this pathology, the uncommon clinical presentation of this case; as well as the lack of immunologic response to the tuberculous bacillus.
