ABSTRACT
The National Atomic Energy Commission of Argentina (CNEA) constructed a novel thermal neutron source for use in boron neutron capture therapy (BNCT) applications at the RA-3 research reactor facility located in Buenos Aires. The aim of the present study was to perform a dosimetric characterization of the facility and undertake radiobiological studies of BNCT in an experimental model of oral cancer in the hamster cheek pouch. The free-field thermal flux was 7.1 x 10(9) n cm(-2)s(-1) and the fast neutron flux was 2.5 x 10(6) n cm(-2)s(-1), indicating a very well-thermalized neutron field with negligible fast neutron dose. For radiobiological studies it was necessary to shield the body of the hamster from the neutron flux while exposing the everted cheek pouch bearing the tumors. To that end we developed a lithium (enriched to 95% in (6)Li) carbonate enclosure. Groups of tumor-bearing hamsters were submitted to BPA-BNCT, GB-10-BNCT, (GB-10+BPA)-BNCT or beam only treatments. Normal (non-cancerized) hamsters were treated similarly to evaluate normal tissue radiotoxicity. The total physical dose delivered to tumor with the BNCT treatments ranged from 6 to 8.5 Gy. Tumor control at 30 days ranged from 73% to 85%, with no normal tissue radiotoxicity. Significant but reversible mucositis in precancerous tissue surrounding tumors was associated to BPA-BNCT. The therapeutic success of different BNCT protocols in treating experimental oral cancer at this novel facility was unequivocally demonstrated.
Subject(s)
Boron Neutron Capture Therapy/instrumentation , Mouth Neoplasms/radiotherapy , Nuclear Reactors , 9,10-Dimethyl-1,2-benzanthracene/toxicity , Animals , Argentina , Boron Neutron Capture Therapy/adverse effects , Boron Neutron Capture Therapy/methods , Carcinogens/toxicity , Cricetinae , Mesocricetus , Mouth Neoplasms/chemically induced , Radiometry/methodsABSTRACT
La Ley 41/2002 ha supuesto una actualización jurídica y ética en el tema de información al paciente. El consentimiento informado es un imperativo ético que refleja el derecho del paciente a decidir sobre su propia salud y que es exigible en la lex artis. El consentimiento informado es un proceso de comunicación y no la obtención de una firma en un documento. Se realiza una breve reseña histórica sobre la relación médico-paciente, sobre la evolución del concepto de autonomía hasta la actualidad y sobre los elementos necesarios para el consentimiento informado. (AU)
Subject(s)
Bioethics , Patient-Centered Care/classification , Patient-Centered Care/statistics & numerical data , Patient Participation/statistics & numerical data , Informed Consent/statistics & numerical data , Informed Consent/legislation & jurisprudence , Societies, Medical/standards , Societies, Medical/organization & administration , Societies, Medical , Human Rights/legislation & jurisprudence , Human Rights/standards , Bioethics , Informed Consent/historyABSTRACT
Primary systemic amyloidosis or AL-amyloidosis is an uncommon disease characterized by the accumulation in vital organs of a fibrillar protein consisting of monoclonal light chains. It is a plasma-cell dyscrasia related to multiple myeloma where clonal plasma cells in the bone marrow produce immunoglobulins that are amyloidogenic. A monoclonal component is present in the serum or urine of 90% of patients. The presentation of most patients with AL amyloidosis is usually related to congestive heart failure, nephrotic syndrome o peripheral neuropathy, but there are unusual features suggesting giant cell arteritis (GCA) and polymyalgia rheumatic (PMR). Although in the majority of AL cases the plasma cells clone is small, the assumption is that the outcome of the disease is uniformly fatal (median survival 12-15 months) and treatment is analogous to those used in malignant proliferative disease. We describe a patient with AL amyloidosis who presented with manifestations of GCA and PMR, and we review the main characteristics of primary amyloidosis.
Subject(s)
Amyloidosis/diagnosis , Giant Cell Arteritis/etiology , Polymyalgia Rheumatica/etiology , Aged , Fatal Outcome , Humans , MaleABSTRACT
OBJECTIVE: To report an uncommon association of prostate and lung cancer. METHODS: The characteristics of both tumors, their association with tumors in other sites and the time of presentation are analyzed. RESULTS: Both tumors were in the advanced stages. Metastatic carcinoma of the prostate was discarded due to the form of presentation. CONCLUSIONS: Although the association of prostate and lung cancer is uncommon, the possibility of synchronous tumors should be considered in patients with urinary and pulmonary symptoms suggestive of neoplasm. It is important to determine if the lesion is a metastasis, since the prognosis depends on the second tumor.
Subject(s)
Adenocarcinoma/diagnosis , Lung Neoplasms/diagnosis , Neoplasms, Multiple Primary/diagnosis , Pleural Effusion, Malignant/etiology , Prostatic Neoplasms/diagnosis , Aged , Humans , MaleABSTRACT
La amiloidosis primaria o amiloidosis AL es una discrasia de células plasmáticas difícil de diferenciar del mieloma múltiple, que se caracteriza por el depósito de una proteína fibrilar de cadenas ligeras monoclonales en tejidos y órganos. Es una enfermedad poco frecuente, en la que un clon de células plasmáticas en la médula ósea produce inmunoglobulinas amiloidogénicas. En el 90 por ciento de los casos se detecta por inmunoelectroforesis inmunoglobulinas monoclonales en sangre u orina. Habitualmente se manifiesta como insuficiencia cardiaca, síndrome nefrótico o neuropatía periférica, pero excepcionalmente pueden existir síntomas sugestivos de arteritis de células gigantes (ACG) o polimialgia reumática (PMR). Aunque el número de clones de células plasmáticas en la médula ósea suele ser pequeño, la actitud terapeútica es la de una enfermedad proliferativa maligna, siendo la supervivencia media de 12 a 15 meses.Presentamos un paciente cuya primera manifestación de amiloidosis primaria fueron síntomas de ACG y PMR, y revisamos las principales características de esta enfermedad. (AU)
Subject(s)
Aged , Male , Humans , Giant Cell Arteritis , Fatal Outcome , Polymyalgia Rheumatica , AmyloidosisABSTRACT
OBJECTIVE: To describe a case of a solitary pulmonary nodule in a patient that had been treated for carcinoma of the renal pelvis. METHODS: A solitary pulmonary nodule was detected on the chest film of a patient that had been treated for carcinoma of the renal pelvis. The characteristics of the nodule are described and its diagnosis, with special reference to metastasis and primary pulmonary carcinoma, is discussed. RESULTS: The anatomopathological study demonstrated a chondroid hamartoma. CONCLUSIONS: A metastatic or a primary tumor is suspected when a solitary pulmonary nodule is detected in a patient that has been previously treated for urothelial carcinoma. However, other types of lesions with a more favourable outcome cannot be discarded, such as chondroid hamartoma as in the case described herein.
Subject(s)
Kidney Neoplasms/pathology , Lung Neoplasms/secondary , Solitary Pulmonary Nodule/secondary , Humans , Kidney Neoplasms/therapy , Kidney Pelvis , Male , Middle Aged , Solitary Pulmonary Nodule/therapyABSTRACT
No disponible
Subject(s)
Adult , Male , Humans , Tuberculosis, Pulmonary , Neutropenia , Antitubercular AgentsABSTRACT
Infrahepatic interruption of the inferior cava vein, is a rare congenital anomaly, usually associated with congenital heart and abdominal diseases. The systemic venous flow is accommodated by the dilated azygos. This dilated azygos arch accounts for the right paratracheal or mediastinal mass, and may be misinterpreted as a neoplasm. We report a case with this congenital vascular anomaly, associated with another of tracheobronchial tree.
Subject(s)
Azygos Vein/pathology , Lung Diseases/diagnosis , Vena Cava, Inferior/abnormalities , Diagnosis, Differential , Dilatation, Pathologic , Humans , Lung Diseases/diagnostic imaging , Male , Middle Aged , Radiography, Thoracic , Tomography, X-Ray ComputedABSTRACT
We report a 58-year-old woman with classical rheumatoid arthritis (RA) who developed a membranous glomerulonephritis (MGN). She had never been treated with gold or D-penicillamine; other connective tissue diseases as well as hepatitis B were excluded. We suggest that the responsible cause of MGN is RA.
Subject(s)
Antirheumatic Agents , Arthritis, Rheumatoid/complications , Glomerulonephritis, Membranous/etiology , Gold , Penicillamine , Arthritis, Rheumatoid/diagnosis , Female , Glomerulonephritis, Membranous/diagnosis , Humans , Immunoglobulin G/immunology , Middle AgedABSTRACT
A leg bone pain syndrome of unclear etiology has been recently described in renal transplant patients receiving cyclosporine A. Herein we report a 54-year-old woman treated with cyclosporine A (CsA), corticosteroids and azathioprine who developed two months after renal transplantation severe symmetric pain with periarticular soft tissue swelling in the knees and metatarsophalangeal joints. Scintigraphy showed periarticular radionuclide activity. Clinical onset was associated with both the high dosage and with the plasma levels of CsA. Symptoms improved when the dosage of CsA was reduced and the plasma levels declined to less than 150 ng/ml.
