[Presentation, staging, and outcome of patients with hepatocellular carcinoma at a center in Veracruz, Mexico]. / Presentación, clasificación y evolución de los pacientes con carcinoma hepatocelular en un centro de Veracruz, México.

BACKGROUND: Hepatocellular carcinoma (HCC) staging provides a basis for calculating disease prognosis and therapeutic guidance. Liver resection and transplantation are curative options, and ablation therapies are applied to patients that are not candidates for curative treatment. Survival after liver resection or ablation therapies varies. AIMS: To describe the presentation, staging, management, and outcome in patients with HCC in our center. PATIENTS AND METHODS: Forty-two patients had a 7-year prospective follow-up. Survival was calculated with the Kaplan-Meier analysis and the log-rank test was used for its comparison between the staging systems (Okuda, BCLC, and CLIP) and types of treatment (liver resection, radiofrequency ablation, and no surgical treatment). RESULTS: The mean age of the patients was 68.9 ± 9.5 years; 57% were women. A total of 54% of the patients presented with cirrhosis and 31% were infected with hepatitis C virus (HCV). The mean tumor size was 6.48 ± 2.52cm. The CLIP 0, Okuda I, and BCLC A stages had better survival rates than the other stages (P<0.05). Survival with resection was superior (median of 32 months and survival at 1, 3, and 5 years of 83, 39, and 19.7%, respectively) to that of both radiofrequency ablation (median of 25 months and survival at 1 and 3 years of 90 and 17.2%, respectively) and no surgical treatment (1 year < 5%) (P<0.05). CONCLUSION: The patients at our center were diagnosed at late stages of HCC, as is the case in other Mexican populations. Outcome in relation to CLIP and BCLC was similar to the prognoses reported in the literature. The best results were observed in the patients with early stage disease and those that underwent HCC resection surgery.

Supernumerary teeth removal and orthodontic tooth repositioning: a case report.

A case is presented of a 12-year-old, black male, who had a full permanent dentition except for retaining the two maxillary primary central incisors. A radiographic examination revealed the presence of two supernumerary teeth interfering with the eruption of the permanent central incisors. Space was orthodontically created for the permanent central incisors, the primary central incisors and supernumerary teeth were removed, and the permanent central incisors were orthodontically brought into proper alignment.

Thrombocytopathy due to a defect of the platelet membrane complex.

A new type of primary thrombocytopathy is described. Three main alterations were found: (1) a defect of the aggregation reaction with ADP, epinephrine and collagen and a normal response to ristocetin and arachidonic acid; (2) a moderate deficiency of platelet procoagulant activity, and (3) a combined hypertrophy of the two membrane systems of the platelet--the open canalicular and the dense tubular. The latter defect is shown as an abnormal membrane complex situated on one of the platelet poles. This thrombocytopathy is discussed as a new variety of primary platelet disorder.