ABSTRACT
Liposarcomas generally originate in the extremities or retroperitoneum, they are very unusual in the head and neck region, and extremely rare in the thorax. The mainstay of treatment for liposarcomas is surgical excision. We report a very unusual case, not reported before to our knowledge, of a well-differentiated liposarcoma arising from the supraclavicular fossa that produces a pathological clavicular fracture. The patient underwent complete resection of the lesion, without damage of the cervical nerves. Eight months after the surgery the patient is free of recurrence. We demonstrate that giant liposarcomas can be resected completely without morbidity.
Subject(s)
Clavicle/injuries , Fractures, Bone/pathology , Head and Neck Neoplasms/pathology , Liposarcoma/pathology , Diagnosis, Differential , Fractures, Bone/complications , Fractures, Bone/surgery , Head and Neck Neoplasms/complications , Head and Neck Neoplasms/surgery , Humans , Liposarcoma/complications , Liposarcoma/surgery , Male , Middle AgedABSTRACT
Some studies suggest that entomopathogenic nematodes (EPN) affect plant-parasitic nematode populations. Here, the effects of live and dead IJ of Heterorhabditis bacteriophora JPM4, H. baujardi LPP7, Steinernema feltiae SN and S. carpocapsae All were evaluated against eggs and J2 of the plant-parasitic nematode Meloidogyne mayaguensis. According to treatment, 100 IJ were applied with 350 eggs, 350 J2 or 175 eggs + 175 J2 to tomato plants. Bioassays were conducted in March to May and repeated in September to November 2005. Both experiments lasted 9 weeks, and the variable evaluated was number of galls per plant. When eggs were used for infections in the first trial, plants exhibited lower gall number compared to control when live and dead H. baujardi IJ and live S. feltiae IJ were added (9.7, 4.5, 7.3 and 85.7 galls, respectively). In the second trial, live S. feltiae and S. carpocapasae IJ influenced gall formation compared to control (14.33, 14.57 and 168.02 galls, respectively). When J2 were used for infections, plants with live H. baujardi IJ presented less galls when compared to control in both trials (38.3 and 355.7 galls in the first trial and 145.2 and 326.2 in the second one, respectively). Infection with a mixture of J2 and eggs resulted in fewer galls than when live S. feltiae IJ were present in both trials, compared to control (38.3 and 44.2 galls vs. 275.3 and 192.2 galls, respectively). We conclude that H. baujardi and S. feltiae apparently may be inhibiting egg hatching and J2 infection.
ABSTRACT
OBJECTIVE: To assess the antiviral efficacy and safety of switching from a protease inhibitor (PI) to nevirapine in patients with long-term HIV-1 RNA suppression on PI-containing regimens, and to assess its influence in the adherence to treatment. METHODS: In an open-label multicentre study, 160 HIV-infected patients with undetectable viral load for at least 6 months on a PI-containing regimen were randomized to either continue with their PI regimen (n=79) or replace PI with nevirapine (n=81). Clinical assessment included plasma HIV-1 RNA, blood chemistry, haematology, lymphocyte counts and adverse events reports. Adherence to treatment and lipodystrophy syndrome were assessed by patient self-reporting. RESULTS: Treatment efficacy was equivalent in the two arms, for patients with viral loads either above or below 100 000 HIV-1 RNA copies/mL. The increase in CD4 cell count was significant in both arms (P<0.00001) but the average CD4 cell count at 48 weeks was slightly higher in the nevirapine arm (596 vs. 569; P=0.1588). The number of patients with severe hypertriglyceridaemia (>400 mg/dL) after 48 weeks of treatment decreased in the nevirapine arm (from 11 to six), but increased in the PI arm (from four to 11) and led to treatment discontinuation in two patients. Lipodystrophy changes increased in 15% of patients in the PI arm but decreased in 4% of patients in the nevirapine arm. Finally, although adherence was similar in the two arms, patients reported that it required significantly less effort to stay on treatment in the nevirapine arm. Conclusions The results indicate that switching from PI to nevirapine is as effective as continuing with PI for maintaining viral control, even in patients with baseline viral load above 100,000 copies/mL. In addition, reductions in hypertriglyceridaemia and lipodystrophy and in the effort required to stay on treatment were observed.
Subject(s)
Anti-HIV Agents/therapeutic use , HIV Infections/drug therapy , HIV-1/isolation & purification , Nevirapine/therapeutic use , Reverse Transcriptase Inhibitors/therapeutic use , Adult , Anti-HIV Agents/adverse effects , Antiretroviral Therapy, Highly Active , CD4 Lymphocyte Count , Female , Follow-Up Studies , HIV Infections/virology , HIV Protease Inhibitors/adverse effects , HIV Protease Inhibitors/therapeutic use , HIV-Associated Lipodystrophy Syndrome/chemically induced , Humans , Male , Nevirapine/adverse effects , Patient Compliance , RNA, Viral/analysis , Reverse Transcriptase Inhibitors/adverse effects , Treatment Outcome , Viral LoadABSTRACT
A 75-year-old patient presented with a superior vena cava syndrome (SVCS) lasting 3 years. A prostatic carcinoma was found and a supraclavicular lymph node biopsy specimen disclosed metastasis of the prostatic carcinoma. Antiandrogen and luteinizing hormone-releasing hormone analogue therapy produced a marked improvement. Prostatic carcinoma, although a very rare cause, must be considered in the diagnosis of cases of SVCS with a protracted course, since it is a treatable disease.
