RESUMEN
BACKGROUND: Optimal post-treatment surveillance for patients with Hodgkin lymphoma in first complete remission (CR) is unknown. Guidelines are based on consensus rather than high-quality evidence. It is unknown if routine screening leads to earlier relapse detection or translates into better outcomes. PATIENTS AND METHODS: We identified 258 patients with relapse after CR and determined whether the recurrence was detected as a result of patient-detected symptoms (PT group) or through exams or tests ordered by the physician in the absence of symptoms (MD group). RESULTS: Of 258 recurrences, 182 (71%) were in the PT group. The median time to diagnosis of recurrence was similar in both groups (PT group = 1.65 years; MD group = 1.95 years; P = 0.69). Neither the postrelapse progression-free (PFS, P = 0.26) nor overall survival (OS, P = 0.40) differed significantly between the groups. CONCLUSION: Patients are much more likely to detect recurrence than their physicians employing routine follow-up testing. There is no difference in PFS or OS between patients whose recurrence is self-diagnosed versus those whose recurrence is diagnosed by physician through routine screening. We found no benefit for detection of HL recurrence in asymptomatic patients and thus cannot support the routine use of costly, anxiety-provoking or potentially harmful tests in the absence of symptoms.
Asunto(s)
Detección Precoz del Cáncer , Enfermedad de Hodgkin/diagnóstico , Recurrencia Local de Neoplasia/diagnóstico , Rol del Médico , Autoexamen , Adulto , Supervivencia sin Enfermedad , Femenino , Enfermedad de Hodgkin/mortalidad , Humanos , Masculino , Inducción de RemisiónRESUMEN
A patient with schizoaffective disorder and anticholinergic refractory neuroleptic-induced parkinsonism manifested a marked increase of parkinsonian symptoms and dystonia after ECT. This is the first report in the literature of such an unusual reaction of parkinsonian and dystonic symptoms to ECT.
Asunto(s)
Terapia Electroconvulsiva/efectos adversos , Trastornos Psicóticos/complicaciones , Trastornos Psicóticos/terapia , Adulto , Antipsicóticos/efectos adversos , Distonía/inducido químicamente , Distonía/complicaciones , Flufenazina/efectos adversos , Humanos , Masculino , Enfermedad de Parkinson Secundaria/inducido químicamente , Enfermedad de Parkinson Secundaria/complicacionesRESUMEN
Dura can greatly facilitate the closure of abdominal wall defects. However, a main disadvantage of its use are the adhesions which develop between omentum, bowel and dura and may lead to bowel obstructions. In this study various groups of rats had either the anterior wall replaced by untreated dura or by dura covered with fibrin glue prior to implantation. Adhesions were found in 75% of sham operated rats, 100% after untreated dura implantation and 50% after the implantation of fibrin glue treated dura.