ABSTRACT
Las células madre (CM) internacionalmente se dividen en embrionarias o fetales y somáticas, en dependencia de su origen. Las CM embrionarias son células pluripotenciales que generan todo tipo de células del organismo y no se emplean por problemas éticos y de lesgilaciones vigentes que prohíben su uso, además de la oposición de la iglesia. Las células somáticas, por el contrario, son las que se usan y ellas son multipotenciales, pero teóricamente solo generan un tipo de tejido específico
Stem cells (CM) are internationally divided into embryonic or fetal and somatic, depending on their origin. The embryonic CMs are pluripotent cells that generate all types of cells of the organism and are not used for ethical problems and current infractions that prohibit their use, in addition to the opposition of the church. Somatic cells, on the other hand, are the ones that are used and they are multipotential, but theoretically they only generate a specific type of tissue
Subject(s)
Cardiovascular Diseases , TherapeuticsABSTRACT
Mujer de 21 años, procedente de Camisea, Cusco, con dos semanas de debilidad muscular progresiva que llego inclusive a la falla ventilatoria, elevación extrema de crantina sérica total, patrón miopático en la electromiografía y con presencia de necrosis masiva sin infiltrado inflamatorio en la biopsia muscular. La pciente mejoró clínica y por los estudios de laboratorio con el tratamiento inmunosupresor.
A 21 year-old woman, from Camisea, Cusco, with two weeks of progressive muscle weakness that came even to ventilatory failure, extreme elevation of total serum creatine phosphokinase (CPK) a myopathic pattern in electromyography and presence of massive necrosis without inflammatory infiltrate in the muscle biopsy. The patient improved the clinical and laboratory parameters with immunosuppressive treatment.
Subject(s)
Humans , Female , Young Adult , Muscular Diseases , Myositis , Necrosis , PolymyositisABSTRACT
The aim of this study was to assess the treatment patterns and safety of sunitinib, sorafenib and bevacizumab in real-world clinical settings in US, Europe and Asia. Medical records were abstracted at 18 community oncology clinics in the US and at 21 tertiary oncology centers in US, Europe and Asia for 883 patients ≥ 18 years who had histologically/cytologically confirmed diagnosis of advanced RCC and received sunitinib (n=631), sorafenib (n=207) or bevacizumab (n=45) as first-line treatment. No prior treatment was permitted. Data were collected on all adverse events (AEs) and treatment modifications, including discontinuation, interruption and dose reduction. Treatment duration was estimated using Kaplan-Meier analysis. Demographics were similar across treatment groups and regions. Median treatment duration ranged from 6.1 to 10.7 months, 5.1 to 8.5 months and 7.5 to 9.8 months for sunitinib, sorafenib and bevacizumab patients, respectively. Grade 3/4 AEs were experienced by 26.0, 28.0 and 15.6% of sunitinib, sorafenib and bevacizumab patients, respectively. Treatment discontinuations occurred in 62.4 (Asia) to 63.1% (US) sunitinib, 68.8 (Asia) to 90.0% (Europe) sorafenib, and 66.7 (Asia) to 81.8% (US) bevacizumab patients. Globally, treatment modifications due to AEs occurred in 55.1, 54.2 and 50.0% sunitinib, sorafenib and bevacizumab patients, respectively. This study in a large, global cohort of advanced RCC patients found that angiogenesis inhibitors are associated with high rates of AEs and treatment modifications. Findings suggest an unmet need for more tolerable agents for RCC treatment.
Subject(s)
Antibodies, Monoclonal, Humanized/administration & dosage , Carcinoma, Renal Cell/drug therapy , Indoles/administration & dosage , Niacinamide/analogs & derivatives , Phenylurea Compounds/administration & dosage , Pyrroles/administration & dosage , Adult , Aged , Aged, 80 and over , Angiogenesis Inhibitors/administration & dosage , Angiogenesis Inhibitors/adverse effects , Antibodies, Monoclonal, Humanized/adverse effects , Asia , Bevacizumab , Carcinoma, Renal Cell/epidemiology , Carcinoma, Renal Cell/pathology , Drug-Related Side Effects and Adverse Reactions/pathology , Europe , Female , Humans , Indoles/adverse effects , Kaplan-Meier Estimate , Male , Middle Aged , Niacinamide/administration & dosage , Niacinamide/adverse effects , Phenylurea Compounds/adverse effects , Pyrroles/adverse effects , Sorafenib , Sunitinib , Treatment Outcome , United StatesABSTRACT
BACKGROUND: Third-generation aromatase inhibitors (letrozole, anastrozole) have shown superior efficacy in early and advanced breast cancer compared with tamoxifen. For HR+, HER2+ MBC, combination of an AI with an anti-HER2 agent (lapatinib or trastuzumab) has shown clinical benefit. METHODS: Six databases were searched until January 2009 for randomized controlled clinical trials, assessing the safety and efficacy of first-line treatments for postmenopausal women with HR+ and HER2 (ErbB2) positive MBC, who have not received prior therapy for advanced or metastatic disease. Relevant interventions were lapatinib, aromatase inhibitors, tamoxifen, and trastuzumab. Outcomes included overall survival (OS), progression-free-survival (PFS), time-to-progression (TTP), and objective response rate (ORR). RESULTS: Eighteen studies (62 papers) were included. Lapatinib + letrozole was significantly superior to letrozole alone based on a direct head-to-head study in terms of PFS/TTP and ORR. Using a network meta-analysis, compared with lapatinib + letrozole, tamoxifen (HR = 0.45 (95% CI: 0.32, 0.65) and anastrozole (HR = 0.53 (0.36, 0.80)) scored significantly worse in terms of PFS/TTP and ORR (tamoxifen: OR = 0.25 (0.12, 0.53), anastrozole: OR = 0.27 (0.12, 0.58). The combination also seemed significantly superior to exemestane in terms of PFS/TTP (HR = 0.52 (0.34, 0.79)). Lapatinib + letrozole also seemed better, although not significantly, in terms of OS versus tamoxifen: HR = 0.74 (0.49, 1.12), anastrozole: HR = 0.71 (0.45, 1.14) and exemestane: HR = 0.65 (0.39, 1.11). When compared with trastuzumab + anastrozole, lapatinib + letrozole seemed to be better in terms of OS (HR = 0.85 (0.47, 1.54)), PFS/TTP (HR = 0.89 (0.54, 1.47)) and ORR (OR = 0.92 (0.24, 3.48)), although, none of these results were significant. DISCUSSION: Lapatinib + letrozole was significantly superior to letrozole in terms of PFS/TTP and ORR based on a direct head-to-head study. Indirect comparisons appeared to favor lapatinib + letrozole versus other first-line treatments used in this patient population in terms of three main outcomes: OS, PFS/TTP and ORR. Indirect comparison results are based on a network analysis for which the basic assumptions of homogeneity, similarity and consistency were not fulfilled. Therefore, despite the fact that these are the best available data, the results need to be interpreted with caution.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Carcinoma/drug therapy , Nitriles/administration & dosage , Quinazolines/administration & dosage , Receptor, ErbB-2/metabolism , Receptors, Cytoplasmic and Nuclear/metabolism , Triazoles/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Breast Neoplasms/metabolism , Breast Neoplasms/pathology , Carcinoma/metabolism , Carcinoma/pathology , Disease Progression , Female , Humans , Lapatinib , Letrozole , Neoadjuvant Therapy , Neoplasm Metastasis , Nitriles/adverse effects , Quinazolines/adverse effects , Receptor, ErbB-2/genetics , Receptors, Cytoplasmic and Nuclear/genetics , Triazoles/adverse effectsABSTRACT
A review of the literature on the inferior retained canines is carried out, their frequency, diagnosis and treatment options. Two clinical cases are shown, the first with an inferior lateral incisive transposition that blocked the eruption of the canines; the second case presented bilateral retention of the inferior canines.
Subject(s)
Cuspid/pathology , Tooth, Impacted/therapy , Child , Dentition, Mixed , Female , Follow-Up Studies , Humans , Incisor/pathology , Malocclusion, Angle Class I/therapy , Mandible , Radiography , Tooth Eruption, Ectopic/diagnostic imaging , Tooth Eruption, Ectopic/therapy , Tooth Movement Techniques/instrumentation , Tooth, Impacted/diagnostic imagingABSTRACT
La condromalacia patelar está asociada a inestabilidad rotuliana. La inclinación troclear femoral lateral se ha vinculado a inestabilidad patelar, pero no se conoce su asociación con la condromalacia patelar. Se incluyeron 39 pacientes, ambos sexos, edades de 13-74 años, a quienes se realizó resonancia magnética y artroscopia de la rodilla. La sensibilidad y especificidad de la resonancia magnética para la condromalacia patelar fue 84 por ciento y 71,4 por ciento. El grado leve de condromalacia patelar afectó más a hombres y pacientes más jóvenes, mientras que los grados moderado y severo afectaron más al sexo femenino y pacientes de más edad. No hubo diferencias significativas entre los valores de inclinación troclear femoral lateral de los pacientes con y sin condromalacia patelar. Sin embargo, en la condromalacia patelar severa la inclinación troclear femoral lateral fue menor, particularmente en comparación a los casos moderados (17,6º vs. 21,8º, P=0,06). La inclinación troclear femoral lateral y la inestabilidad patelar podrían estar asociadas a condromalacia patelar severa, pudiendo condicionar progresión de la enfermedad
The patellar chondromalacia is associated to rotulian instability. The lateral femoral troclear inclination is linked to patellar inestabily; however, there are not studies about linking it to patellar chondromalacia. 39 patients of both genders were included; age range between 13-74 years, who underwent magnetic resonance and arthroscopy of the knee. The sensitivity and specificity of the magnetic resonance for patellar chondromalacia were 84 percent and 71.4 percent. Mild cases were more frequents in men and younger subjects. Moderate and severe grades were more frequents in the femenine gender and affect older patients. There were not significant differences between the values of lateral femoral troclear inclination of the patients with and without chondromalacia patellar. However, the lateral femoral troclear inclination was lower in the severe patellar chondromalacia, particularly in comparison to moderate cases (17.6º vs. 21.8º, P=0.06). The lateral femoral troclear inclination and patellar instability could be associated to severe patellar chondromalacia; They may be according the progression of the disease
