RESUMO
A case of a 53-year-old man with constrictive pericarditis due to the ingestion of a toothpick is presented. Computed tomography was unable to show the toothpick, and the diagnosis was made during the operation. Ingested toothpicks have often been reported as a cause of gastrointestinal injuries but in this rare case a toothpick actually migrated into the pericardium.
Assuntos
Candidíase/etiologia , Corpos Estranhos/complicações , Pericardite/etiologia , Pericardite/microbiologia , Pericárdio , Drenagem/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pericárdico/etiologia , Derrame Pericárdico/terapia , Técnicas de Janela Pericárdica , PericardiectomiaRESUMO
In order to study the usefulness of treatment with vinblastine (VLB) in the prevention of cancer metastasis in squamous cell lung cancer, 50 patients with locoregional disease were randomized to receive either locoregional RT alone (group A) or a weekly intravenous bolus injection of VLB (6 mg/m2) concurrently with and after locoregional radiotherapy (RT) (55 Gy in 6 weeks) until the appearance of metastases (group B). Neither the incidence of death with metastases, metastasis-free survival (MFS) nor overall survival (S) were significantly affected by treatment with the drug. However, due to the limited number of patients in each group, the power of the statistical test was such to allow only the detection of differences in MFS and S to or more than 80 per cent at the P = 0.05 level. Local tumor response was significantly superior in group B (P less than 0.05). Acute toxicity (dysphagia, myelosuppression) during RT was significantly worse in group B. During long-term therapy with VLB, mild polyneuropathy developed in the majority of patients in group B. Furthermore, seven patients discontinued treatment with VLB during maintenance due to compliance (4) and excessive neurotoxicity (3). This treatment schedule with VLB is not recommended for patients with locoregional squamous cell lung cancer as significant toxicity is present during and after RT and significant increase in MFS and S is lacking. Because of an apparent increase in local response, the combination of VLB and RT merits further investigation in those tumors where local tumor control is crucial.
Assuntos
Carcinoma de Células Escamosas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Metástase Neoplásica/prevenção & controle , Vimblastina/uso terapêutico , Idoso , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/secundário , Terapia Combinada , Feminino , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/radioterapia , Masculino , Pessoa de Meia-Idade , Distribuição AleatóriaRESUMO
A 52 years old woman with mitral valve prolapse and a history of 3 cardiac syncopes occurring during antiarrhythmic therapy underwent mitral valve replacement. Antiarrhythmic drugs had to be continued postoperatively but no major ventricular arrhythmias occurred after surgery.
Assuntos
Arritmias Cardíacas/etiologia , Prolapso da Valva Mitral/complicações , Antiarrítmicos/uso terapêutico , Arritmias Cardíacas/tratamento farmacológico , Eletrocardiografia , Feminino , Próteses Valvulares Cardíacas , Ventrículos do Coração , Humanos , Pessoa de Meia-Idade , Prolapso da Valva Mitral/diagnóstico , Prolapso da Valva Mitral/cirurgiaRESUMO
Indomethacin given to adults with glomerulonephritis usually reduces their urinary excretion of protein and fibrinogen/fibrin-related (F.R.) antigen. Nevertheless, non-responders exist. Platelet aggregation is significantly more strongly inhibited by indomethacin in good responders than in nonresponders. This supports the hypothesis that the reduction of urinary excretion of F.R. antigen during indomethacin administration is related, at least in part, to inhibition of intrarenal platelet aggregation and of the subsequent fibrin deposition.
