Subject(s)
Abnormalities, Multiple , Urogenital Abnormalities , Abnormalities, Multiple/classification , Anus, Imperforate , Face/abnormalities , Fatal Outcome , Female , Humans , Infant, Newborn , Karyotyping , Lumbar Vertebrae/abnormalities , Phenotype , Syndrome , Thoracic Vertebrae/abnormalitiesSubject(s)
Musculoskeletal Diseases/epidemiology , Adolescent , Adult , Aged , Child , Global Health , HumansSubject(s)
Pathology, Oral/trends , Adult , Attitude of Health Personnel , Career Choice , Education, Dental, Graduate , Education, Medical , Employment , Female , Forecasting , Humans , International Cooperation , Internship and Residency , Laboratories, Dental/trends , Male , Pathology, Oral/education , Pathology, Oral/statistics & numerical data , Professional Practice/trends , United StatesSubject(s)
Acid-Base Imbalance/diagnosis , Calcinosis/diagnosis , Dyspnea/etiology , Kidney Failure, Chronic/complications , Uremia/diagnosis , Water-Electrolyte Imbalance/diagnosis , Acid-Base Imbalance/blood , Acid-Base Imbalance/therapy , Adult , Calcinosis/blood , Calcinosis/complications , Dyspnea/blood , Fatal Outcome , Female , Humans , Kidney Failure, Chronic/blood , Kidney Failure, Chronic/therapy , Multiple Organ Failure/blood , Multiple Organ Failure/etiology , Renal Dialysis , Water-Electrolyte Imbalance/blood , Water-Electrolyte Imbalance/therapyABSTRACT
BACKGROUND/AIMS: To determine the alterations in coagulation and fibrinolysis occurring in patients treated with the liver dialysis device. METHODOLOGY: Patients with advanced liver disease treated with the liver dialysis device were studied immediately before and after the liver dialysis device treatment. SETTING: A university hospital intensive care unit. PATIENTS: Thirteen consecutive patients with advanced liver disease being evaluated for or awaiting liver transplantation. INTERVENTION: 4-6 hours of liver dialysis treatment for management of hepatic encephalopathy. OUTCOME MEASURES: A panel of coagulation and anticoagulation factors, as well as fibrinolytic and anti-fibrinolytic factors plus measures of activation of inflammation and soluble adhesion factors. RESULTS: The liver dialysis device used was found to be associated with activation of both coagulation and fibrinolytic pathways, activation of inflammation reactants, and an increase in sL-selectin levels. CONCLUSIONS: Liver dialysis device activates both coagulant and fibrinolytic pathways, activates inflammatory response, but these responses are limited to the vascular compartment by an increase in sL-selectin levels.
Subject(s)
Fibrinolysis , Hemofiltration/methods , Hemostasis , Liver Diseases/therapy , Aged , Biomarkers , Blood Coagulation , Dialysis/instrumentation , Female , Hemofiltration/instrumentation , Humans , Liver Diseases/physiopathology , Male , Middle AgedABSTRACT
BACKGROUND: Ipsilateral salivary gland tumors of different histologic types are rare and make up less than 0.3% of all salivary gland neoplasms. Only nine cases of synchronous benign and malignant ipsilateral parotid gland tumors have been described in the literature. METHODS: Two additional cases of synchronous benign and malignant neoplasms in the parotid gland are reported and discussed with a review of literature. RESULTS: Our first case describes a pleomorphic adenoma and a salivary duct carcinoma, an entity not previously reported in the literature. The second case documents the most common benign and malignant ipsilateral parotid gland neoplasm reported in this case series, a Warthin's tumor and a mucoepidermoid carcinoma. CONCLUSIONS: Synchronous salivary gland tumors exhibiting both benign and malignant components are uncommonly observed, with only nine cases published to date. We describe two additional cases of a synchronous benign and malignant ipsilateral parotid gland tumor.
Subject(s)
Carcinoma/pathology , Neoplasms, Multiple Primary/pathology , Salivary Gland Neoplasms/pathology , Adenolymphoma/pathology , Adenoma, Pleomorphic/pathology , Aged , Carcinoma, Mucoepidermoid/pathology , Female , Humans , Middle Aged , Parotid Neoplasms/pathology , Salivary DuctsABSTRACT
BACKGROUND: We performed a prospective, randomized study in patients with previously untreated advanced (Stage III or IV) laryngeal squamous carcinoma to compare the results of induction chemotherapy followed by definitive radiation therapy with those of conventional laryngectomy and postoperative radiation. METHODS: Three hundred thirty-two patients were randomly assigned to receive either three cycles of chemotherapy (cisplatin and fluorouracil) and radiation therapy or surgery and radiation therapy. The clinical tumor response was assessed after two cycles of chemotherapy, and patients with a response received a third cycle followed by definitive radiation therapy (6600 to 7600 cGy). Patients in whom ther was no tumor response or who had locally recurrent cancers after chemotherapy and radiation therapy underwent salvage laryngectomy. RESULTS: After two cycles of chemotherapy, the clinical tumor response was complete in 31 percent of the patients and partial in 54 percent. After a median follow-up of 33 months, the estimated 2-year survival was 68 percent (95 percent confidence interval, 60 to 76 percent) for both treatment groups (P = 0.9846). Patterns of recurrence differed significantly between the two groups, with more local recurrences (P = 0.0005) and fewer distant metastases (P = 0.016) in the chemotherapy group than in the surgery group. A total of 59 patients in the chemotherapy group (36 percent) required total laryngectomy. The larynx was preserved in 64 percent of the patients overall and 64 percent of the patients who were alive and free of disease. CONCLUSIONS: These preliminary results suggest a new role for chemotherapy in patients with advanced laryngeal cancer and indicate that a treatment strategy involving induction chemotherapy and definitive radiation therapy can be effective in preserving the larynx in a high percentage of patients, without compromising overall survival.