ABSTRACT
The need for an access to the venous system, in order to infuse chemotherapeutic treatments or parenteral nutrition, has increased the number of central venous access systems (CVAS) implanted in the past years. Between February 1985 and December 1990, 87 devices were implanted in 76 patients (from 11 months to 15 years of age), with a median function time of 349 days (range: 7 to 1887 days). The overall incidence of complications was 0.10 per 10 days of catheterization, with complication rates for infection and thrombosis of 0.02 and 0.03, respectively. Nineteen systems were removed because of complications and 11 because of completion of the treatment. Of the cases, 97.7% included a follow-up period. The present study confirms the advantages of these devices, with a long working life and a low complication rate, being a good alternative for chronically ill children requiring long-term and/or cyclic intravenous therapy.
Subject(s)
Catheterization, Central Venous/methods , Infusions, Intravenous/instrumentation , Injections, Intravenous/instrumentation , Parenteral Nutrition/methods , Adolescent , Catheterization, Central Venous/instrumentation , Catheters, Indwelling , Chemotherapy, Adjuvant/methods , Child , Child, Preschool , Female , Humans , Infant , Infusion Pumps, Implantable , Infusions, Intravenous/methods , Injections, Intravenous/methods , Male , Neoplasms/therapy , Parenteral Nutrition/instrumentation , Treatment OutcomeSubject(s)
Hyperlipoproteinemia Type II/therapy , Arteriosclerosis/etiology , Cholesterol/blood , Cholesterol/metabolism , Humans , Hyperlipoproteinemia Type II/etiology , Hyperlipoproteinemia Type II/surgery , Lipid Metabolism , Lipoproteins/metabolism , Liver Transplantation , Portacaval Shunt, Surgical , Receptors, Cell Surface/metabolism , Receptors, LipoproteinABSTRACT
A review of the current state of carcinoid tumors is presented, with special attention to the diagnostic, pronostic and new therapeutic aspects. In spite of being a well known entity the diagnosis is difficult being confirmed only by pathologic findings. The current medical therapy and surgical options are described. New surgical alternatives--organ cluster transplantation--seems to be the definitive solution in metastatic disease.
Subject(s)
Carcinoid Tumor/therapy , Carcinoid Tumor/diagnosis , Carcinoid Tumor/metabolism , Carcinoid Tumor/pathology , Humans , Malignant Carcinoid Syndrome/therapy , PrognosisABSTRACT
In the last decade, the development of the liver grafting in childs, has pointed out the efficacy of this modality as the treatment of several inborns errors of metabolism. Due to the technical limitations of the orthotopic liver transplantation, new modalities have been sought. Among them, liver cells transplantation represent the most attractive. Different studies have confirmed the efficacy of liver cell grafting in the treatment of several experimental models of hepatophathy: acute liver failure experimental cirrhosis and models of enzyme deficiency. These results have established the bases for the future clinical application of this technique in childs. As well as other forms of isolated cell transplantation; liver cell grafting could provide a good model for cryopreservation, immunological manipulation and genetic engineering.
