ABSTRACT
El carcinoma de células renales con translocación (CRT) es un subtipo de carcinoma de células renales (CCR). El presente caso trata de una niña de 11 años con dolor en fosa ilíaca derecha de dos semanas de evolución. Se evidenció tumoración de 2,2 x 1,9 x 2,8 cm en el polo superior del riñón derecho, por ecografía. Luego, fue sometida a nefrectomía radical derecha y a disección ganglionar regional, tras lo cual se diagnosticó CRT subtipo Xp 11.2. Posteriormente, se inició tratamiento de primera línea con pazopanib y quimioterapia concomitante. Esta enfermedad es más frecuente entre los 10 y 15 años. Su pronóstico suele ser mejor comparado al de los adultos. El manejo multidisciplinario asociado a la disponibilidad de medicamentos de primera línea, mejora la sobrevida libre de progresión.
Translocation renal cell carcinoma (t-RCC) is a subtype of renal cell carcinoma (RCC). This case is about an 11-year-old with pain in right iliac fossa for two weeks. Tumor of 2.2 x 1.9 x 2.8 cm was evidenced in the upper pole of the right kidney, by ultrasound. Then, she underwent to a right radical nephrectomy and regional lymph node dissection, after which CRT subtype Xp 11.2 was diagnosed. Subsequently, first-line treatment with pazopanib and concomitant chemotherapy was initiated. This disease is more frequent between 10 and 15 years. Their prognosis is usually better compared to adults. The multidisciplinary management associated with the availability of first-line medications improves progression-free survival.
ABSTRACT
OBJECTIVE: The objectives of the study are to describe sleep habits, fatigue, and sleepiness in Chiclayo's (Peru) bus drivers and explore their relation with traffic accidents. MATERIAL AND METHODS: This is a descriptive cross-sectional study with a non-probability consecutive sampling. The sample size was 126 drivers. Sleepiness was evaluated using the Epworth Sleepiness Scale and sleep hygiene with validated questionnaires. We used a history of traffic accident or a near-traffic accident as an independent variable and applied chi-squared, t, and Mann-Whitney U tests to evaluate initial associations, which were later tested with a multivariate analysis. RESULTS: The mean age was 47.8 ± 9, 7 years, all were male. Twenty-seven (21%) bus drivers drove 10 or more hours per day; twenty-seven (21%) drove 5 or more hours without stopping; and eleven (9%) slept less than 6 h per day. Ninety-three (74%) drivers had fatigue while driving; thirty-one (25%) sleepiness; thirty-six (29%) had an accident or near accident; and (35%) had nodding while driving. Nodding while driving (PR 2.13, IC 1.26-3.59, p < 0.01) and the number of years as a driver (PR 1.03, IC 1.00-1.05, p = 0.02) were associated with an accident or near accident. CONCLUSION: Fatigue, sleepiness, and a history of accident or near accident were frequent. Having had an accident or near accident was significantly associated with nodding while driving and the number of years as a driver in Chiclayo's bus drivers.
Subject(s)
Automobile Driving/psychology , Automobile Driving/statistics & numerical data , Fatigue/epidemiology , Fatigue/psychology , Habits , Sleep , Accidents, Traffic/psychology , Accidents, Traffic/statistics & numerical data , Cross-Sectional Studies , Humans , Male , Middle Aged , Peru/epidemiology , Surveys and QuestionnairesABSTRACT
Introducción: El hipotiroidismo subclínico en adultos mayores es una enfermedad poco estudiada. Objetivos: Determinar la frecuencia de hipotiroidismo subclínico, depresión y deterioro cognitivo y explorar su asociación, en adultos mayores. Diseño: Estudio descriptivo, transversal; muestreo no probabilístico, consecutivo. Escenario: Centro de adultos mayores de EsSalud, Lambayeque, Perú. Métodos: En 2012 y 2014, y en una muestra de 84 pacientes, se cuantificó TSH y T4L mediante técnica ELISA. Se evaluó depresión con el test de Yesavage reducido y el déficit cognitivo con el mini mental test examination. Se determinó frecuencias, porcentajes y análisis inferencial exploratorio mediante el cálculo de razones de prevalencia, con intervalos de confianza al 95 por ciento, usando Epidat v 3.1. Principales medidas de resultados: Hipotiroidismo subclínico, depresión y deterioro cognitivo y su asociación. Resultados: Se estudió 65 mujeres (77 por ciento) y 19 hombres (23 por ciento); en 11 (13,1 por ciento) adultos mayores se halló hipotiroidismo subclínico, en 36 (42,9 por ciento) depresión y en 11 (13,1 por ciento) deterioro cognitivo. No se encontró asociación entre hipotiroidismo subclínico y depresión (RP: 0,85, IC 95 por ciento 0,39 a 1,85; p 0,677) o deterioro cognitivo (RP: 2,48, IC 95 por ciento 0,77 a 7,98; p 0,1349). Conclusiones: Existió una elevada frecuencia de hipotiroidismo subclínico, depresión, y deterioro cognitivo en los adultos mayores estudiados. No se evidenció asociación de hipotiroidismo subclínico con depresión o con deterioro cognitivo...
Introduction: There are few studies on subclinical hypothyroidism in the elderly. Objectives: To determine the frequency of subclinical hypothyroidism, depression and cognitive impairment, and explore their association in elderly patients. Design: Descriptive, cross-sectional study. Scenario: EsSalud seniorsÆ center, Lambayeque, Peru. Methods: In 2012 and 2014 TSH and T4L were determined by ELISA in 84 elderly patients. Depression was assessed through a reduced Yesavage test and cognitive impairment by the mini mental test. Frequencies and percentages were determined and prevalence ratios with 95 per cent confidence intervals were estimated using Epidat v3.1. Main outcome measures: Subclinical hypothyroidism, depression and cognitive impairment and their association. Results: Sixty-five women (77 per cent) and 19 men (23 per cent) were included. Subclinical hypothyroidism was found in 11 older adults (13.1 per cent), depression in 36 (42.9 per cent) and cognitive impairment in 11 (13.1 per cent). No association between subclinical hypothyroidism and depression (PR: 0.85, CI 95 per cent [0.39-1.85], p: 0.677) or subclinical hypothyroidism and cognitive impairment (RP: 2.48, CI 95 per cent [0.77-7.98], p: 0.1349) were found. Conclusions: There was a high frequency of subclinical hypothyroidism, depression, and cognitive impairment in the elderlies studied. There was no association between subclinical hypothyroidism and depression or cognitive impairment...
