ABSTRACT
Bladder cancer (BC) is the tenth most common cause of cancer worldwide and is the thirteenth leading cause of cancer mortality. The non-muscle invasive (NMI) variant represents 75% of cases and has a mortality rate of less than 1%; however, it has a high recurrence rate. The gold standard of management is transurethral resection in the case of new lesions. However, this is associated with significant morbidity and costs, so the reduction of these procedures would contribute to reducing complications, morbidity, and the burden to the health system associated with therapy. In this clinical scenario, strategies such as active surveillance have emerged that propose to manage low-risk BC with follow-up; however, due to the low evidence available, this is a strategy that is underutilized by clinicians. On the other hand, in the era of biomarkers, it is increasingly known how to use them as a tool in BC. Therefore, the aim of this review is to provide to clinical practitioners the evidence available to date on AS and the potential role of biomarkers in this therapeutic strategy in patients with low-grade/risk NMIBC. This is the first review linking use of biomarkers and active surveillance, including 29 articles.
Subject(s)
Biomarkers, Tumor , Non-Muscle Invasive Bladder Neoplasms , Humans , Non-Muscle Invasive Bladder Neoplasms/diagnosis , Watchful Waiting/methodsABSTRACT
AIM: To describe the clinical and epidemiological characteristics of children with pediatric glaucoma (PG) treated in an ophthalmologic national reference center. MATERIALS AND METHODS: A retrospective study of patients diagnosed with PG in a national ophthalmologic reference center was made, between 2005 and 2015. Clinical findings, type of treatment, and the follow-up were evaluated. RESULTS: A total of 89 patients (145 eyes) were included. The median age of diagnosis was 2.0 years. The most frequent type of glaucoma was primary PG with 67.4% of affected patients, primary congenital glaucoma (PCG) being more frequent (69 eyes) than juvenile open-angle glaucoma (JOAG 36 eyes). Secondary PG accounted for 32.6% of the cases (40 eyes). At least one surgical procedure was needed in 56.6% of all studied eyes, and 10.7% of eyes had more than two surgical procedures. Even more, eyes with PCG had surgery in 88.4% of cases. On the contrary, eyes with JOAG did not require surgery. In the last assessment, the distribution of cases according visual acuity did not show differences. However, it is important to note that patients with secondary PG maintained a good vision only in 17.9% of cases. CONCLUSION: Pediatric glaucoma is a heterogeneous group of diseases, and due to its low incidence, descriptive reports of large cohorts are not available. This study has a well-detailed report of PG characteristics in a national reference center. The frequency of JOAG in the present study was significantly higher than that reported in other studies. Also, clinical characteristics of all glaucoma described have some differences from data published. CLINICAL SIGNIFICANCE: There are few studies that describe characteristics of PG. This study is an important tool to analyze the characteristics of PG in an effort to better know the disease. HOW TO CITE THIS ARTICLE: Saavedra C, Rios HA, Belalcazar S, et al. Characteristics of Pediatric Glaucoma in a Latin American Reference Center. J Curr Glaucoma Pract 2020;14(1):10-15.
ABSTRACT
Objetivos: Conocer características demográficas, de formación profesional, y características de la práctica profesional de Terapeutas Ocupacionales que apoyan los procesos de integración educativa al Sistema Educativo Regular, en las regiones Quinta y Metropolitana, durante el año 2005.Metodología: Estudio no experimental, transversal y descriptivo, muestra no probabilística, constituida por 41 Terapeutas Ocupacionales. Se construye el instrumento Cuestionario para Terapeutas Ocupacionales en Educación Regular, aplicado durante el 12 de diciembre de 2005 y 06 de enero de 2006. Análisis y tratamiento de datos según estadística descriptiva; muestra se subdivide en Terapeutas Ocupacionales que trabajan en Proyectos de Integración Escolar (PIE) y estrategias complementarias (SIN PIE).Resultados y conclusiones: Existen Terapeutas Ocupacionales apoyando procesos de integración educativa, con diferencias en la práctica profesional entre ambas estrategias. Se desempeñan en Quinta Región y Metropolitana, egresan de Universidad de Chile y Universidad de Playa Ancha de Ciencias de la Educación, se perfeccionan en distintas áreas, la mayoría no realiza publicaciones. Diferencias en condiciones laborales y población intervenida; similitudes en nivel educativo de los estudiantes que reciben el apoyo y marcos teóricos utilizados. Ambos grupos evalúan distintos ámbitos del desempeño ocupacional, preferentemente con instrumentos no estandarizados; incluyen actividades en el contexto de desempeño escolar físico y social, modalidad de trabajo individual y grupal, y otras funciones; trabajan mayormente en equipo multiprofesional. Terapeutas Ocupacionales de ambas estrategias apoyan integración y realizan acciones inclusivas.
Goals: To determjne demographic characteristics, professional training and professional practice characteristics of Occupational Therapists that support scholar integration processes to the Regular Education System in the Fifth and Metropolitan Regions, throughout 2005.Methodology: Non-experimental, cross sectional and descriptive study, non-probabilistic sample, composed by 41 Occupational Therapists. The Questionaire for Occupational Therapists in Regular Education was developed, which was applied during December 12, 2005, and January 6, 2006. Analysis and data processing were carried out according to descriptive statistics; sample is subdivided in Occupational Therapists who work in Scholar Integration Projects (SIP) and complementary strategies (without SIP).Results and conclusions: There are Occupational Therapists supporting educational integration processes, with differences in the professional practice between both strategies. They work in the Fifth and Metropolitan regions, graduated from Universidad de Chile and Universidad de Playa Ancha de Ciencias de la Educacion, they perform further training in different areas, most of them do not make publications. Differences in laboral condition and in the intervening population are present; similarities in the educational level of the students and in the theorical frameworks used. Both groups evaluate different field of the occupational performance, especially non-standardized instruments; they include activities in the physical and social context of scholar performance, individual and group work modality, and other functions; they work mainly in multiprofessional teams. Occupational Therapists of both strategies support the integration and make inclusive actions.