RESUMO
Does radical mastectomy for cancer remain needed? Breast conserving treatment may be achieved by surgery, primary chemotherapy followed by radiotherapy and surgery. This article attempts at defining (according to clinical and pathological parameters of the tumor and patient's characteristics), when conservative treatment is not allowed and radical mastectomy must be performed. Mastectomy must be performed first when there are multiple tumors or a tumor too large with respect to the breast volume or diffuse microcalcifications on mammograms. Sometimes the stage of pregnancy, a personal history of collagen vascular disease or prior radiotherapy or the willing of the patient lead to perform radical mastectomy. Secondary mastectomy is necessary in case of failure of conservative treatment or recurrence after breast conserving treatment.
Assuntos
Neoplasias da Mama/cirurgia , Mastectomia Simples , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/cirurgia , Feminino , Humanos , Recidiva Local de Neoplasia/cirurgia , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/cirurgiaRESUMO
Chronic malignant pleural effusion may be treated by instillating products in the pleural space to induce pleurodesis. We used intrapleural doxycycline at doses greater than 2000 mg in 16 malignant pleural effusion (14 patients). Patient survival ranged from 1 day to 19.5 months. Mean drainage duration was 7.5 days (range, 5-10 days). Pain (moderate n=7; severe n=2) was the most frequent side-effect with hypotension (moderate n=3; severe n=1). Five cases were not evaluable at one month because of death during the month following treatment (n=3) or during treatment (n=2). At one month follow-up, success was defined as no pleural effusion (n=5), partial response as minimal effusion (n=4) and we considered that treatment had failed if pleural drainage was necessary (n=2). Five patients died within one month and 5 had more than 3 months survival (4 without recurrence).
Assuntos
Antibacterianos/administração & dosagem , Doxiciclina/administração & dosagem , Derrame Pleural Maligno/terapia , Pleurodese , Adulto , Idoso , Antibacterianos/efeitos adversos , Doxiciclina/efeitos adversos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Derrame Pleural Maligno/etiologia , Recidiva , Escleroterapia , Análise de Sobrevida , Resultado do TratamentoRESUMO
A major drawback of In-111-labeled monoclonal antibodies (MoAb) is the presence of intense liver, renal, and bone marrow nonspecific activity. This makes the display of the images hardly optimal and their visual interpretation difficult. In this study, the "intrinsic color scale" (which consists of selecting the limits of the color scale as the highest and the lowest pixel value of the image) was compared to a new, simple algorithm for the determination of the limits of the color scale. This algorithm was based on the count density in the iliac crest areas. OC-125 or anti-CEA In-111 MoAb F(ab')2 fragments were used in 32 patients with suspected recurrence of ovarian (19 patients) or colorectal cancer (13 patients). Final diagnosis was assessed by surgery (21 patients), biopsy (five patients), or followup (six patients). A 10-minute abdomino-pelvic anterior view was recorded two days after injection. These views are displayed using the two methods and interpreted by two observers. Using their responses in each quadrant of the pelvis, the authors calculated two ROC curves. The comparison of the ROC curves showed better performances for the new method. For example, for the same specificity (73%), the sensitivity of the new method was significantly better (78% versus 68%). This result confirmed the importance of a good methodology for displaying immunoscintigraphic images.
Assuntos
Anticorpos Monoclonais , Neoplasias Colorretais/diagnóstico por imagem , Radioisótopos de Índio , Recidiva Local de Neoplasia/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Algoritmos , Feminino , Humanos , Pessoa de Meia-Idade , Curva ROC , CintilografiaAssuntos
Neoplasias do Ânus/cirurgia , Adenocarcinoma/patologia , Idoso , Neoplasias do Ânus/diagnóstico , Neoplasias do Ânus/patologia , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/patologia , Diagnóstico Diferencial , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Metástase Neoplásica , Papiloma/patologiaRESUMO
Se describen distintos tipos de anastomosis digestivas (en total 70) realizadas con el instrumento EEA, destacando las dificultades encontradas en su utilizacion.Los resultados obtenidos evidencian una disminucion de morbimortalidad si se la compara con las anastomosis convencionales El estudio anatomopatologico en piezas de autopsia, muestra una franca disminucion de la reaccion inflamatoria a nivel de la sutura. Se recomienda el uso de este procedimiento
Assuntos
Humanos , Grampeadores Cirúrgicos , Sistema Digestório/cirurgiaRESUMO
Se describen distintos tipos de anastomosis digestivas (en total 70) realizadas con el instrumento EEA, destacando las dificultades encontradas en su utilizacion.Los resultados obtenidos evidencian una disminucion de morbimortalidad si se la compara con las anastomosis convencionales El estudio anatomopatologico en piezas de autopsia, muestra una franca disminucion de la reaccion inflamatoria a nivel de la sutura. Se recomienda el uso de este procedimiento