ABSTRACT
Introduction. SIOPEN INES protocol yielded excellent 5-year survival rates for MYCN-non-amplified metastatic neuroblastoma. Patients deemed ineligible due to lack or delay of MYCN status or late registration were treated, but not included in the study. Our goal was to analyse survival at 10 years among the whole population. Materials and methods. Italian and Spanish metastatic INES patients data are reported. SPSS 20.0 was used for statistical analysis. Results. Among 98 infants, 27 had events and 19 died, while 79 were disease free. Five- and 10-year event-free survival (EFS) were 73 and 70 %, and overall survival (OS) was 81 and 74 %, respectively. MYCN status was significant for EFS, but not for OS in multivariate analysis. Conclusions. The survival rates of patients who complied with all the inclusion criteria for INES trials are higher compared to those that included also not registered patients. Five-year EFS and OS for INES 99.2 were 87.8 and 95.7 %, while our stage 4s population obtained 78 and 87 %. Concerning 99.3, 5-year EFS and OS were 86.7 and 95.6 %, while for stage 4 we registered 61 and 68 %. MYCN amplification had a strong impact on prognosis and therefore we consider it unacceptable that many patients were not studied for MYCN and probably inadequately treated. Ten-year survival rates were shown to decrease: EFS from 73 to 70 % and OS from 81 to 74 %, indicating a risk of late events, particularly in stage 4s. Population-based registries like European ENCCA WP 11-task 11 will possibly clarify these data (AU)
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Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Neuroblastoma/complications , Neuroblastoma/diagnosis , Neoplasm Metastasis/diagnosis , Neoplasm Metastasis/physiopathology , Eligibility Determination/standards , Prognosis , Clinical Protocols , 28599 , Survivorship/physiology , Informed Consent/standardsABSTRACT
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Subject(s)
Humans , Minimally Invasive Surgical Procedures/methods , Hematoma, Subdural, Chronic/surgery , Punctures/methodsABSTRACT
Introducción: El hematoma subdural crónico del adulto (HSDCA) tiene una incidencia bruta global en la población cautiva de nuestra institución (pacientes capitados y planes) de 14,1 casos por 100.000 habitantes/año. No existe un protocolo único de tratamiento. En nuestro hospital, dada la edad avanzada de nuestros pacientes, optamos por una terapia mínimamente invasiva (punción transósea [PTO]) sin anestesia general. El objetivo es realizar un estudio descriptivo de pacientes con HSDCA, analizar la lateralidad y los resultados del tratamiento efectuado. Material y métodos: Se detectaron en forma retrospectiva pacientes con HSDCA internados entre enero de 1998 y mayo de 2009 inclusive. El diagnóstico se basó en neuroimágenes. El tratamiento de elección fue la PTO, realizándose por excepción trepanación o craneotomía. Resultados: Se identificó a 127 pacientes. La edad, el sexo, el desplazamiento de línea media, los días de internación y el número de procedimientos no fueron factores predictivos de letalidad a los 30 días del diagnóstico. Un 80% de los pacientes recibió PTO como único procedimiento. La mediana de internación estos pacientes fue de 4 días. El 55% de los hematomas fueron izquierdos, sin diferencia estadísticamente significativa. Se registraron 6 defunciones en internación (4,7%.). La letalidad acumulada a los seis meses fue del 11,8%. La escala de Markwalder al ingreso no fue predictiva de letalidad estadísticamente significativa. Conclusiones: Los resultados de nuestro estudio sugieren que la PTO es un procedimiento aceptable, de baja letalidad, con escasos días de internación y complicaciones. La letalidad, los mecanismos asociados, la edad, el sexo y el desplazamiento de la línea media no difieren de lo publicado en las diferentes series. Encontramos una mayor frecuencia de hematomas hacia la izquierda, al igual que en las diferentes series, debería realizarse un estudio meta-analítico para determinar con mayor precisión la frecuencia de este predominio (AU)
Introduction: Chronic subdural hematoma in adults (CSDH) has a global crude incidence of 14.1/100,000 per year in our institution captive population. There is no single treatment protocol. In our hospital we choose a minimal invasive technique (trans-marrow puncture) without general anaesthesia due to the age of the population. A descriptive study of patients with CSDH and treatment results, including a laterality analysis, is presented. Material and methods: We retrospectively searched patients with (CSDH) between January 1998 and May 2009. The diagnosis was made by neuroimaging techniques in all patients. The preferred treatment was trans-marrow puncture; exceptionally some patients were treated by burr holes or craniotomy. Results: We found 127 patients. Age, gender, midline displacement, hospitalisation days, and number of procedures, were not a predictive factor of mortality in the first month. A slight majority (55%) of CSDH were on the left side, with no statistically significant difference. There were 6 (4.7%) deaths during hospitalisation. In our series cumulative mortality at six months was 11.8%. Markwalder scale at admission was not a predictive factor of statistically significant mortality. An 80% of the patients received trans-marrow puncture as single procedure was performed on 80% of the patients. Conclusions: The results of our study suggest that trans-marrow puncture is an acceptable procedure, with low mortality, and less hospitalisation days and complications. Mortality, associated mechanisms, age, gender, midline displacement are no different than in others previous publications. We found a higher frequency of hematomas to the left, as in other series. Metaanalysis studied need to be performed to determine more accurately the frequency of this dominance (AU)
Subject(s)
Humans , Hematoma, Subdural, Chronic/surgery , Craniotomy , Minimally Invasive Surgical Procedures/methods , Punctures/methods , Hematoma, Subdural, Chronic/mortality , /statistics & numerical dataABSTRACT
Objetivo: Determinar si la administración de un preparado lácteo enriquecido con un suplemento de fibra soluble (Naturfibra)®[inulina y maltodextrina resistente a la digestión (Fibersol 2®)], afecta a la sintomatología en el estreñimiento crónico primario idiopático. Ámbito: Sujetos de ambos sexos con estreñimiento según los criterios de Roma II. Sujetos: Se trata de un ensayo clínico doble ciego aleatorizado de intervención dietética realizado en 32 individuos con estreñimiento de ambos sexos (hombres 4; mujeres 28) y con una edad media de 47 ± 15 años. Los 32 individuos que formaban la muestra, se dividieron al azar en dos grupos homogéneos. Intervenciones: A cada grupo se le asignó un tipo de leche (A o B), una de ellas era leche semidesnatada enriquecida con fibra (A) y la otra leche semidesnatada (B). Los sujetos tomaron medio litro de leche diario durante 20 días, lo que supone que aquellos que tomaron la leche enriquecida ingirieron 20 gramos de fibra al día. Resultados: Los individuos que presentaban esfuerzo deposicional (p < 0,001), sensación de evacuación incompleta (p < 0,001), sensación de obstrucción en la evacuación (p < 0,001) y número de días entre deposiciones, disminuyeron significativamente tras la ingesta de leche con fibra. Conclusiones: La ingesta de un preparado lácteo con un suplemento de fibra que contiene 20 gramos de fibra soluble (inulina y maltodextrina resistente a la digestión), mejora la situación de estreñimiento crónico primario idiopático en base a los criterios de Roma II (AU)
Background: fibre is effective in some types of constipation. Our objective was to determine if the administration of an enriched dairy preparation with a supplement of soluble fibre (Naturfibra)® [inulin and digestion resistant maltodextrin (Fibersol 2®)], improves primary chronic constipation. Methods: Prospective, randomized, double blind clinical trial randomized with dietary intervention in 32 subjects with constipation according to the Rome II criteria. Thirty two subjects (men 4; women 28) with an average age of 47 ± 15 years were randomly divided in two homogeneous groups. A type of milk (A or B) was assigned to each group. Group A received fibre enriched semi-skimmed milk; Group B received semi skimmed milk. The subjects drank half a litre of milk per day during 20 days, meaning that those who drank the enriched milk ingested 20 grams of fibre a day. Result: The subjects that presented straining at defecation (p < 0,001), sensation of incomplete evacuation (p < 0,001), sensation of obstruction in the evacuation (p < 0,001) and days between bowel movements, diminished significantly after the intake of milk supplemented with fibre. Conclusion: The intake of a dairy preparation with a supplement of fibre containing 20 grams of soluble fibre (inulin and digestion resistant maltodextrin), improves the situation of idiopathic primary chronic constipation based on the Rome II criteria (AU)
Subject(s)
Humans , Male , Female , Constipation/diet therapy , Dietary Fiber/administration & dosage , Inulin/administration & dosage , Probiotics/administration & dosage , Polymers/therapeutic use , Milk , Nutrition SurveysABSTRACT
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