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INTRODUCTION: Retroperitoneal Liposarcomas (RL) are a rare form of malignant tumors, they encompass just 5 % ot these and mainly present in female adults between 50 and 60 years of age. They can be divided into 4 morphological subtypes: 1) well-differentiated, 2) undifferentiated, 3) myxoid, and 4) pleomorphic. CASE PRESENTATION: 41-year-old male who present to the outpatient consult of oncological surgery after being diagnosed via imaging with a giant retroperitoneal liposarcoma. The patient reported unsuccessful weight loss attempts and subsequently noticed an increase in abdominal size as well as the development of ulcers in the lower limbs. He underwent radical resection, which included a right nephrectomy, as the primary treatment. DISCUSSION: Giant retroperitoneal liposarcomas are defined as those 30 cm in diameter or more or 20 kg or more in weight are considered "giants" and are extremely rare. The only treatment involves resection of the tumoration and those adjacent involved organs, and sometimes, uninvolved ones. Due to the high risk of recurrence, adjuvant therapy may be provided as well as imaging follow up. CONCLUSION: RL are a complicated entity to manage. They tend to present high rates of recurrence due to the difficulty of performing a full resection without positive margins. These patients should be thoroughly studied before surgery and appropriate follow-up should be provided.
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INTRODUCTION: Low-dose computed tomography (LDCT) screening reduces lung cancer mortality, but current eligibility criteria underestimate risk in women and racial minorities. We evaluated the impact of screening criteria modifications on LDCT eligibility and lung cancer detection. METHODS: Using data from a Lung Nodule Program, we compared persons eligible for LDCT by the following: U.S. Preventive Services Task Force (USPSTF) 2013 criteria (55-80 y, ≥30 pack-years of smoking, and ≤15 y since cessation); USPSTF2021 criteria (50-80 y, ≥20 pack-years of smoking, and ≤15 y since cessation); quit duration expanded to less than or equal to 25 years (USPSTF2021-QD25); reducing the pack-years of smoking to more than or equal to 10 years (USPSTF2021-PY10); and both (USPSTF2021-QD25-PY10). We compare across groups using the chi-square test or analysis of variance. RESULTS: The 17,421 individuals analyzed were of 56% female sex, 69% white, 28% black; 13% met USPSTF2013 criteria; 17% USPSTF2021; 18% USPSTF2021-QD25; 19% USPSTF2021-PY10; and 21% USPSTF2021-QD25-PY10. Additional eligible individuals by USPSTF2021 (n = 682) and USPSTF2021-QD25-PY10 (n = 1402) were 27% and 29% black, both significantly higher than USPSTF2013 (17%, p < 0.0001). These additional eligible individuals were 55% (USPSTF2021) and 55% (USPSTF2021-QD25-PY10) of female sex, compared with 48% by USPSTF2013 (p < 0.05). Of 1243 persons (7.1%) with lung cancer, 22% were screening eligible by USPSTF13. USPSTF2021-QD25-PY10 increased the total number of persons with lung cancer by 37%. These additional individuals with lung cancer were of 57% female sex (versus 48% with USPSTF2013, p = 0.0476) and 24% black (versus 20% with USPSTF2013, p = 0.3367). CONCLUSIONS: Expansion of LDCT screening eligibility criteria to allow longer quit duration and fewer pack-years of exposure enriches the screening-eligible population for women and black persons.
Subject(s)
Lung Neoplasms , Humans , Female , Male , Lung Neoplasms/diagnosis , Lung Neoplasms/genetics , Lung Neoplasms/epidemiology , Early Detection of Cancer/methods , Smoking/epidemiology , Tomography, X-Ray Computed/methods , Eligibility Determination , Mass Screening/methodsABSTRACT
La proporción de teletratamiento llevada a cabo por psicólogos durante la pandemia por COVID-19 para el TAG, fobia específica, agorafobia, ansiedad social, pánico, TOC y TEPT, así como si la experiencia en teleterapia tiene un efecto significativo en la demanda no han sido estudiadas. Los resultados indican que el TAG con un 69.2%, es el trastorno que más teletratamiento ha recibido y la fobia con un 60.5%, el que menos. El pánico, la ansiedad social, TEPT, TOC y agorafobia tuvieron una demanda media del 67.2%, 66.8%, 64.0%, 63.5% y 62.2%, respectivamente. La experiencia en teleterapia resultó significativa. El teletratamiento para psicólogos con experiencia aumentó una media del 93.9% respecto al 35.7% de aquellos sin experiencia. Un 22.8% de psicólogos no realizó teletramiento de la ansiedad. Estos resultados puede ser útiles para desarrollar programas específicos de prevención e intervención telemática para los trastornos de ansiedad ante futuras pandemias por coronavirus.
The distribution of teletreatment carried out by psychologists during the COVID-19 pandemic for GAD, specific phobia, agoraphobia, social anxiety, panic, OCD and PTSD, and whether experience in teletherapy has an significant effect on demand have not been studied. The results indicate that GAD with 69.2% has been the disorder that has received the most teletherapy and phobia with 60.5%, the least. Panic, social anxiety, PTSD, OCD, and agoraphobia had a demand of 67.2%, 66.8%, 64.0%, 63.5%, and 62.2%, respectively. The experience in teletherapy was significant. Tele-treatment for experienced psychologists increased an average of 93.9% compared to 35.7% for those without experience. 22.8% of psychologists did not carry out anxiety teletherapy. These results may be useful to develop specific prevention and telematic intervention programs for anxiety disorders in the face of future coronavirus pandemics
Subject(s)
Humans , Health Sciences , Teletherapy , Phobic Disorders , Phobia, Social , Psychology , Evaluation of Results of Therapeutic Interventions , Crisis Intervention , Therapy, Computer-Assisted , Distance Counseling , Disease PreventionABSTRACT
Objetivo: analisar 54 transfusöes intravasculares intra-uterinas (TIVs), ressaltando complicaçöes do procedimento e morbimortalidade perinatal. Material e Métodos: fetos submetidos a TIVs na Clínica Materno-Fetal e Maternidade Carmela Dutra (Florianópolis, SC), entre janeiro de 1992 e agosto de 1997, foram incluídos no estudo. As características das gestantes, dados relativos ao procedimento e ao recém-nascido foram tabulados para análise e apresentados de forma descrita, utilizando-se percentagem, média, desvio padräo, mediana, variaçäo e risco relativo (RR) com intervalo de confiança de 95 por cento (IC) conforme apropriado. Resultados: foram realizadas 50 TIVs e quatro ex-sangüíneo transfusöes em 21 fetos. Houve quatro óbitos (20 por cento), três dos quais (75 por cento) ocorridos em fetos hidrópicos. A idade gestacional média quando da primeira transfusäo foi de 29,1 semanas. A concentraçäo média de hemoglobina foi de 5,69 mg/dl. A taxa de mortalidade decorrente do procedimento foi de 7,4 por cento. A idade gestacional média ao nascimento foi 33,9 semanas e o peso médio foi 2.437 gramas. Sessenta e cinco por cento dos recém-nascidos receberam ex-sangüíneo transfusao complementar. Conclusäo: a taxa de mortalidade por procedimento (7,4 por cento) foi semelhante à relatada na literatura mundial. A taxa de mortalidade perinatal (20 por cento) foi mais elevada do que a relatada na literatura estrangeira, mas inferior à relatada em estudo conduzido no Brasil, no qual a prevalência de fetos hidrópicos foi semelhante.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adult , Blood Transfusion, Intrauterine , Erythroblastosis, Fetal/therapy , Blood Transfusion, Intrauterine/adverse effects , Confidence Intervals , Epidemiology, Descriptive , Infant MortalityABSTRACT
Se analizan los resultados de 250 anestesias balanceadas con nalbufina y halotano o enflorano en niños, con estado físico (ASA) I a IV, en operaciones con duración entre 12 minutos y 5.15 horas. Las edades fluctuaron entre 2 meses y 17 años. Se monitorizó frecuencia cardiaca, tensión arterial y temperatura. Se observó disminución en el consumo del anestésico halogenado, estabilidad cardiovascular trans y postanestésica, rápida recuperación, analgesia postoperatoria y no depresión respiratoria. El promedio de la valoración de Aldrete, al llegar a sala de recuperación, fue de 8 puntos. La dosis total de nalbufina varió entre 100 a 300 mcg/kg. de peso. Se consideró que las dosis más adecuadas de nalbufina, fueron las mayores de 100 mcg/kg. de peso. 19% de los niños, presentaron en la valoración de Aldrete, 7 puntos o menos, al salir de quirófano y esto estuvo relacionado con dosis de 250 mcg/kg. En pacientes desnutridos, no es conveniente emplear dosis mayores de 150 mcg/kg de peso, ya que presentarán sedación postanestésica profunda. En la mayoría de los casos (84%), la estancia en sala de recuperación fue menor de una hora y la analgesia postoperatoria satisfactoria
