ABSTRACT
Objetivo. Nuestro objetivo fue analizar el rendimiento de la biopsia selectiva del ganglio centinela valorando la detección gammagráfica tras la administración intratumoral del radiofármaco en pacientes con cáncer de mama que recibieron quimioterapia neoadyuvante. Material y métodos. Sesenta pacientes con diagnóstico de carcinoma infiltrante de mama, estadios T1-T3, que recibieron tratamiento con quimioterapia neoadyuvante fueron sometidas posteriormente a cirugía mamaria y biopsia del ganglio centinela mediante administración intratumoral del radiofármaco. Resultados. Se consiguió la detección gammagráfica de algún ganglio centinela en 55/60 pacientes (91,6%). Cuando se excluyeron los casos con reinyección periareolar del radiofármaco por falta de migración, la detección fue del 70% (42/60). Cuando se comparó la detección o no del ganglio centinela en estas 42 pacientes, no se encontraron diferencias en función de la edad, lateralidad-localización de la lesión, tamaño pre y posquimioterapia, grado histológico del tumor o perfil inmunohistoquímico. Sí existieron diferencias significativas al comparar los grupos según el grado de respuesta patológica del tumor, valorado tanto con el sistema de Miller-Payne (no detección 44,4%-detección 16,7%, p = 0,003) como con el sistema residual cancer burden (72,2%-28,6%, p<0,01). Conclusiones. La detección gammagráfica del ganglio centinela tras administración intratumoral del radiofármaco en pacientes con cáncer de mama que recibieron quimioterapia neoadyuvante estuvo por debajo del valor óptimo, siendo necesaria en ocasiones la reinyección periareolar, lo que podría estar en relación con una alteración de las vías de drenaje linfático. Existió una significativa relación inversa entre detección del ganglio centinela y el grado de respuesta patológica tumoral (AU)
Purpose. Our objective was to analyse the accuracy of the sentinel node biopsy, taking into consideration the scintigraphy detection rate after the intratumoural administration of the radiopharmaceutical in patients with breast cancer who received neoadjuvant chemotherapy. Materials and methods. The study included 60 patients with a diagnosis of invasive breast carcinoma, stage T1-T3, who received treatment with neoadjuvant chemotherapy, and were subsequently subjected to breast surgery and sentinel node biopsy after intra-tumour administration of the radiopharmaceutical. Results. Scintigraphic detection of some sentinel node was achieved in 55/60 patients (91.6%). When those cases that received a second injection of the radiopharmaceutical, performed peri-areolarly due to a lack of tracer migration, were excluded, the detection rate dropped to 70% (42/60). When the detection of sentinel node, or its absence, was compared in those 42 patients, no differences were found with age, laterality-location of the lesion, size pre- and post-neoadjuvant chemotherapy, histological grade, or immunohistochemical profile. There were significant differences when comparing the groups according to the degree of pathological tumour response, both with the Miller-Payne system (non-detection 44.4%-detection 16.7%, p = 0.003) as well as the residual cancer burden (72.2%-28.6%, p<0.01). Conclusions. The scintigraphic detection of the sentinel node after intratumoural administration of the radiopharmaceutical in patients with breast cancer who received neoadjuvant chemotherapy was below the optimal value, and sometimes a further, peri-areolar, injection was necessary, probably in relation to an alteration in the lymphatic drainage pathways. There was a significant inverse relationship between the detection of the sentinel node and level of pathological tumour response (AU)
Subject(s)
Humans , Female , Middle Aged , Sentinel Lymph Node Biopsy , Breast Neoplasms , Breast Neoplasms/drug therapy , Radiopharmaceuticals/administration & dosage , Radiopharmaceuticals/analysis , Carcinoma, Ductal, Breast/drug therapy , Carcinoma, Ductal, Breast , Neoplasm Metastasis/drug therapy , Neoplasm Metastasis , Neoadjuvant Therapy/instrumentation , Neoadjuvant Therapy/methods , Neoadjuvant Therapy , Gated Blood-Pool Imaging/methods , Nuclear Medicine/methods , Nuclear Medicine/trends , Immunohistochemistry/methods , Immunohistochemistry , Retrospective StudiesABSTRACT
PURPOSE: Our objective was to analyse the accuracy of the sentinel node biopsy, taking into consideration the scintigraphy detection rate after the intratumoural administration of the radiopharmaceutical in patients with breast cancer who received neoadjuvant chemotherapy. MATERIALS AND METHODS: The study included 60 patients with a diagnosis of invasive breast carcinoma, stage T1-T3, who received treatment with neoadjuvant chemotherapy, and were subsequently subjected to breast surgery and sentinel node biopsy after intra-tumour administration of the radiopharmaceutical. RESULTS: Scintigraphic detection of some sentinel node was achieved in 55/60 patients (91.6%). When those cases that received a second injection of the radiopharmaceutical, performed peri-areolarly due to a lack of tracer migration, were excluded, the detection rate dropped to 70% (42/60). When the detection of sentinel node, or its absence, was compared in those 42 patients, no differences were found with age, laterality-location of the lesion, size pre- and post-neoadjuvant chemotherapy, histological grade, or immunohistochemical profile. There were significant differences when comparing the groups according to the degree of pathological tumour response, both with the Miller-Payne system (non-detection 44.4%-detection 16.7%, p = 0.003) as well as the residual cancer burden (72.2%-28.6%, p<0.01). CONCLUSIONS: The scintigraphic detection of the sentinel node after intratumoural administration of the radiopharmaceutical in patients with breast cancer who received neoadjuvant chemotherapy was below the optimal value, and sometimes a further, peri-areolar, injection was necessary, probably in relation to an alteration in the lymphatic drainage pathways. There was a significant inverse relationship between the detection of the sentinel node and level of pathological tumour response.
Subject(s)
Breast Neoplasms/diagnosis , Breast Neoplasms/drug therapy , Radionuclide Imaging , Radiopharmaceuticals/administration & dosage , Sentinel Lymph Node Biopsy , Technetium Tc 99m Aggregated Albumin/administration & dosage , Adult , Aged , Aged, 80 and over , Chemotherapy, Adjuvant , Female , Humans , Injections, Intralesional , Middle Aged , Neoadjuvant Therapy , Retrospective StudiesABSTRACT
We present the results of lattice QCD calculations of the magnetic moments of the lightest nuclei, the deuteron, the triton, and ^{3}He, along with those of the neutron and proton. These calculations, performed at quark masses corresponding to m_{π}â¼800 MeV, reveal that the structure of these nuclei at unphysically heavy quark masses closely resembles that at the physical quark masses. In particular, we find that the magnetic moment of ^{3}He differs only slightly from that of a free neutron, as is the case in nature, indicating that the shell-model configuration of two spin-paired protons and a valence neutron captures its dominant structure. Similarly a shell-model-like moment is found for the triton, µ_{^{3}H}â¼µ_{p}. The deuteron magnetic moment is found to be equal to the nucleon isoscalar moment within the uncertainties of the calculations. Furthermore, deviations from the Schmidt limits are also found to be similar to those in nature for these nuclei. These findings suggest that at least some nuclei at these unphysical quark masses are describable by a phenomenological nuclear shell model.
ABSTRACT
The low-energy nΣ(-) interactions determine, in part, the role of the strange quark in dense matter, such as that found in astrophysical environments. The scattering phase shifts for this system are obtained from a numerical evaluation of the QCD path integral using the technique of lattice QCD. Our calculations, performed at a pion mass of m(π)~389 MeV in two large lattice volumes and at one lattice spacing, are extrapolated to the physical pion mass using effective field theory. The interactions determined from lattice QCD are consistent with those extracted from hyperon-nucleon experimental data within uncertainties and strengthen model-dependent theoretical arguments that the strange quark is a crucial component of dense nuclear matter.
ABSTRACT
Algunas de las recomendaciones basadas en la evidencia científica disponible establecen que, aunque se han hecho muchos estudios sobre la eficacia de la manipulación, existen escasas descripciones sobre la manipulación cervical para disfunción en FRS, y sus consideraciones clínicas de aplicación. El objetivo de nuestro estudio es aportar las generalidades básicas para la adecuada aplicación de este procedimiento terapéutico (AU)
Some of the recommendations based on the available scientific evidence establish that although there are many trials about the effectiveness of manipulation, there are few descriptions about cervical manipulation for dysfunctions in FRS, and their clinical considerations of being applied. The objective of our trial is to provide the basic generalities for the appropriate application of this therapeutic procedure (AU)
Subject(s)
Humans , Male , Female , Neck Pain/diagnosis , Neck Pain/therapy , Manipulation, Orthopedic/instrumentation , Manipulation, Orthopedic/methods , Manipulation, Orthopedic , Manipulation, Spinal/instrumentation , Manipulation, Spinal/methods , Manipulation, Spinal , Neck Pain/epidemiology , Neck Pain/rehabilitation , Neck Pain , Cervical Vertebrae/pathology , Cervical Vertebrae , Vertical Dimension , Pain Measurement/methods , Pain Measurement/trendsABSTRACT
We present evidence for the existence of a bound H dibaryon, an I=0, J=0, s=-2 state with valence quark structure uuddss, at a pion mass of m(π)â¼389 MeV. Using the results of lattice QCD calculations performed on four ensembles of anisotropic clover gauge-field configurations, with spatial extents of Lâ¼2.0, 2.5, 3.0, and 3.9 fm at a spatial lattice spacing of b(s)â¼0.123 fm, we find an H dibaryon bound by B(∞)(H)=16.6±2.1±4.6 MeV at a pion mass of m(π)â¼389 MeV.
Subject(s)
Amyloidosis/diagnostic imaging , Lung Diseases/diagnostic imaging , Aged , Humans , Male , RadiographyABSTRACT
Localized fibrous tumors of the pleura are rare tumors that represent less than 5% of the pleural tumors, although they have also been described in extrathoracic locations such as the abdomen, head and neck or central nervous system. A total of 80% begin in the visceral pleura and are not related with environmental risk factors. They generally occur in patients over 50 with a mild predominance in the woman. Up to 50% of the patients are asymptomatic, so that it appears as an incidental finding on the chest X-ray. These are slow growing tumors. They are seen on the X-ray as well-defined rounded lesions dependent on the pleura and 50% are pediculated. It is important to know its radiological characteristics for its diagnosis of suspicion and correct treatment since surgical resection is generally curative. Local recurrence after the surgery is very common if it is not completely excised.
Subject(s)
Solitary Fibrous Tumor, Pleural/diagnostic imaging , Adult , Female , Humans , Male , Middle Aged , RadiographyABSTRACT
Los tumores fibrosos localizados de la pleura son tumores raros que representan menos del 5% de los tumores pleurales, aunque también han sido descritos en localizaciones extratorácicas como el abdomen, cabeza y cuello o sistema nervioso central.El 80% se originan en la pleura visceral y no están relacionados con factores de riesgo ambientales. Generalmente ocurren en pacientes mayores de 50 años con un leve predominio en el sexo femenino.Hasta el 50% de los pacientes son asintomáticos, por lo que aparece como un hallazgo incidental en la radiografía de tórax. Estos tumores son de lento crecimiento y se presentan radiológicamente como lesiones redondeadas bien delimitadas dependientes de la pleura y en el 50% pediculados. Es importante conocer sus características radiológicas para su diagnóstico de sospecha y su correcto tratamiento, ya que la extirpación quirúrgica suele ser curativa.Es más habitual la recurrencia local tras la cirugía si no se extirpa por completo
Localized fibrous tumors of the pleura are rare tumors that represent less than 5% of the pleural tumors, although they have also been described in extrathoracic locations such as the abdomen, head and neck or central nervous system.A total of 80% begin in the visceral pleura and are not related with environmental risk factors. They generally occur in patients over 50 with a mild predominance in the woman.Up to 50% of the patients are asymptomatic, so that it appears as an incidental finding on the chest X-ray. These are slow growing tumors.They are seen on the X-ray as well-defined rounded lesions dependent on the pleura and 50% are pediculated. It is important to know its radiological characteristics for its diagnosis of suspicion and correct treatment since surgical resection is generally curative.Local recurrence after the surgery is very common if it is not completely excised
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Neoplasms, Fibrous TissueABSTRACT
INTRODUCTION: High-frequency oscillatory ventilation is a safe and effective means of delivering mechanical ventilatory support. OBJECTIVE: To evaluate the safety and effectiveness of high-frequency oscillatory ventilation in pediatric patients with acute respiratory failure. PATIENTS AND METHOD: From August 2003 to July 2005, we performed a prospective observational study of 11 children older than 1 month who underwent high-frequency oscillatory ventilation. Pediatric risk of mortality scores (PRISM), Murray lung-injury scores and air leak scores were recorded at baseline before ventilation. The following variables were studied: ventilatory settings (FiO2 and mean airway pressure), gasometric (PaO2, SaO2, PaCO2, pHa, PaO2/FiO2 ratio) and hemodynamic parameters (Partm, PVC), and the oxygenation index. RESULTS: The overall survival rate was 82 %. Significant increases were found in PaO2 (p < 0.05), SaO2 (p < 0.05) and the PaO2/FiO2 ratio (p < 0.05), while mean airway pressure (p < 0.001), oxygenation index (p < 0.001), and FiO2 (p < 0.001) significantly decreased over time. CONCLUSIONS: High-frequency oscillatory ventilation significantly improved oxygenation in children with acute hypoxemic respiratory failure.
Subject(s)
High-Frequency Ventilation , Respiratory Insufficiency/therapy , Acute Disease , Child , Child, Preschool , Humans , Infant , Prospective Studies , Survival Analysis , Treatment OutcomeABSTRACT
Introducción La ventilación de alta frecuencia oscilatoria es una terapéutica válida, que utiliza una estrategia protectora pulmonar. Objetivo Evaluar la utilidad de esta técnica en niños con insuficiencia respiratoria aguda. Pacientes y método Entre agosto de 2003 y julio de 2005 realizamos un estudio prospectivo y observacional de 11 niños mayores de un mes tratados con ventilación de alta frecuencia oscilatoria. Se hizo una valoración de la gravedad, con la escala Pediatric Risk of Mortality (PRISM); del daño pulmonar, con la de Murray, y de la gravedad del barotrauma, con la de escape aéreo. Se estudiaron las siguientes variables: del respirador (fracción inspiratoria de oxígeno [FiO2], presión media en la vía aérea), gasométricas (presión parcial arterial de oxígeno [PaO2], saturación arterial de oxígeno [SaO2], presión parcial arterial de dióxido de carbono [PaCO2], pH arterial [pHa], relación PaO2/FiO2), índice de oxigenación, y hemodinámicas (presión arterial media [PAM], presión venosa central [PVC]). Resultados La supervivencia global fue del 82 %. Nosotros hemos encontrado modificaciones consistentes en un incremento de la PaO2 (p < 0,05), SaO2 (p < 0,05), y relación PaO2/ FiO2 (p < 0,05); así como un descenso de la presión media en la vía aérea (p < 0,001), del índice de oxigenación (p < 0,001) y de la FiO2 (p < 0,001). Conclusiones La ventilación de alta frecuencia oscilatoria ha mejorado la oxigenación en niños con fallo respiratorio agudo hipoxémico
Introduction High-frequency oscillatory ventilation is a safe and effective means of delivering mechanical ventilatory support. Objective To evaluate the safety and effectiveness of high-frequency oscillatory ventilation in pediatric patients with acute respiratory failure. Patients and method From August 2003 to July 2005, we performed a prospective observational study of 11 children older than 1 month who underwent high-frequency oscillatory ventilation. Pediatric risk of mortality scores (PRISM), Murray lung-injury scores and air leak scores were recorded at baseline before ventilation. The following variables were studied: ventilatory settings (FiO2 and mean airway pressure), gasometric (PaO2, SaO2, PaCO2, pHa, PaO2/FiO2 ratio) and hemodynamic parameters (Partm, PVC), and the oxygenation index. Results The overall survival rate was 82 %. Significant increases were found in PaO2 (p < 0.05), SaO2 (p < 0.05) and the PaO2/FiO2 ratio (p < 0.05), while mean airway pressure (p < 0.001), oxygenation index (p < 0.001), and FiO2 (p < 0.001) significantly decreased over time. Conclusions High-frequency oscillatory ventilation significantly improved oxygenation in children with acute hypoxemic respiratory failure
Subject(s)
Infant, Newborn , Infant , Child , Child, Preschool , Humans , High-Frequency Ventilation , Respiratory Insufficiency/therapy , Acute Disease , Prospective Studies , Survival Analysis , Treatment OutcomeABSTRACT
The nonmesonic weak decay of polarized Lambda hypernuclei is studied for the first time by taking into account, with a Monte Carlo intranuclear cascade code, the nucleon final state interactions. A one-meson-exchange model is employed to describe the Lambda-->N-->nN processes in a finite nucleus framework. The relationship between the intrinsic Lambda asymmetry parameter a(Lambda) and the asymmetry a(M)(Lambda) accessible in experiments is discussed. A strong dependence of a(M)(Lambda) on nucleon final state interactions and detection threshold is obtained. Our results for a(M)(Lambda) are consistent with (11)(Lambda)B--> and (12)(Lambda)C--> data but disagree with observations in (5)(Lambda)H-->e.
ABSTRACT
La adenosina es el fármaco de elección en el tratamiento de las taquiarritmias supraventriculares del niño. Presentamos un caso de bloqueo aurículo-ventricular mantenido, que precisó maniobras de reanimación cardiopulmonar, tras la administración de adenosina intravenosa en un niño con taquicardia supraventricular. Ocasionalmente, la adenosina puede presentar efectos secundarios muy graves. Por este motivo, su administración debe realizarse en una unidad con capacidad para tratar de forma inmediata esos posibles efectos indeseables (AU)
Subject(s)
Infant , Male , Humans , Adenosine/adverse effects , Tachycardia, Supraventricular/drug therapy , Heart Block/chemically inducedABSTRACT
By combining a one-meson-exchange model for the LambdaN-->nN transition in finite nuclei with an intranuclear cascade code, we have obtained nucleon-nucleon (angular and energy) coincidence distributions from the nonmesonic weak decay of (5)(Lambda)He and (12)(Lambda)C hypernuclei. Although, due to the elimination of interferences, two-nucleon coincidences are expected to give a cleaner extraction (with respect to single nucleon observables) of the ratio Gamma(n)/Gamma(p) identical with Gamma(Lambdan-->nn)/Gamma(Lambdap-->np), we show that the effect of the final state interactions is still important even when applying favorable energy and angular cuts. The agreement of our results for the ratio N(nn)/N(np) between the number of nn and np emitted pairs with preliminary KEK coincidence data allows us to conclude that Gamma(n)/Gamma(p) for (5)(Lambda)He should be small and close to the value of 0.46 predicted by our meson-exchange model.
ABSTRACT
No disponible
Subject(s)
Adult , Aged , Male , Female , Humans , Rupture, Spontaneous , Time Factors , Thrombophlebitis , Syndrome , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Ultrasonography, Doppler , Muscular Diseases , Popliteal Cyst , Pyridines , Pyrroles , Anticholesteremic Agents , Creatine Kinase , Diagnosis, Differential , Magnetic Resonance Imaging , Lovastatin , Heptanoic Acids , Clinical Enzyme TestsABSTRACT
Aportamos un caso de perforación vesical extraperitoneal espontánea, debida a la presencia de un carcinoma vesical de naturaleza urotelial (AU)
Subject(s)
Aged , Male , Humans , Rupture, Spontaneous , Peritoneum , Carcinoma , Urinary Bladder NeoplasmsABSTRACT
No disponible
