RESUMO
Pretreatment with [131I] metaiodobenzylguanidine (MIBG) followed by surgical resection in advanced neuroblastoma (stage 3 and 4) has been studied in relation to resectability, morbidity and mortality, survival rate after two years, control of distant metastasis and serum levels of LDH as prognostic factors. Twenty-one patients with advanced neuroblastoma were primarily treated with MIBG radiotherapy, followed by surgical resection. Sixteen patients had stage 4 disease. Between 2 and 6 courses of MIBG treatment were given per patient. In 17 patients gross complete resection was achieved. Two patients developed complications directly related to the operation, one died as a result of this. The overall mortality was 38%. MIBG therapy resulted in partial response in 13 patients and in stable disease in 8 patients. Two years survival in the group with partial response was 86% and in the group with stable disease 28%. Because of the resulting excellent general condition of the patients the interval between pretreatment with MIBG and surgery could be very short. Follow-up till December 1994 showed that 13 children were alive for 3 to 47 months. Seven had no evidence of disease. Preoperative MIBG de novo treatment in advanced neuroblastoma is equal to induction chemotherapy, but less toxic.
Assuntos
Neoplasias das Glândulas Suprarrenais/radioterapia , Antineoplásicos/uso terapêutico , Radioisótopos do Iodo/uso terapêutico , Iodobenzenos/uso terapêutico , Neuroblastoma/radioterapia , Neoplasias do Sistema Nervoso Periférico/radioterapia , 3-Iodobenzilguanidina , Adolescente , Neoplasias das Glândulas Suprarrenais/mortalidade , Neoplasias das Glândulas Suprarrenais/patologia , Neoplasias das Glândulas Suprarrenais/cirurgia , Criança , Pré-Escolar , Terapia Combinada , Feminino , Seguimentos , Humanos , Lactente , Masculino , Estadiamento de Neoplasias , Neuroblastoma/mortalidade , Neuroblastoma/patologia , Neuroblastoma/cirurgia , Neoplasias do Sistema Nervoso Periférico/mortalidade , Neoplasias do Sistema Nervoso Periférico/patologia , Neoplasias do Sistema Nervoso Periférico/cirurgia , Radioterapia Adjuvante , Taxa de Sobrevida , Sistema Nervoso Simpático/patologia , Sistema Nervoso Simpático/efeitos da radiação , Sistema Nervoso Simpático/cirurgiaRESUMO
From 1988 to 1992 160 children with clinically or pathologically proven Burkitt's lymphoma were seen and treated in Queen Elizabeth Central Hospital in Blantyre, Malawi. We present the epidemiologic features, the results of staging using ultrasonography, fine needle aspiration biopsy, and the different treatment regimens used. Lack of resources made it extremely difficult to provide the necessary high level of care for these children or to carry out a proper study in the management of this fascinating disease.
Assuntos
Linfoma de Burkitt/terapia , Linfoma de Burkitt/patologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Fatores de TempoRESUMO
The incidence of malignancies in industrialised countries is 100 per million but this figure drops to 40 per million in Malawi. There may be under-reporting due to inadquate medical facilities; lack of parental awareness and the role that the traditional healer plays
Assuntos
Lactente , NeoplasiasRESUMO
This paper reviews the cases of childhood malignancy seen between January 1985 and March 1989 and compares the results with those of Molyneux
Assuntos
Lactente , NeoplasiasRESUMO
Cricothyroidotomies instead of tracheostomies were performed in 61 adult patients over a period of two years. The indications were as for tracheostomy. The majority of the patients had severe trauma, respiratory problems and sepsis. The procedure was to be found easy and fast. There were no severe complications during or directly after the operation. Of the 23 surviving patients 7 were lost for follow up, 16 patients were reexamined 6 months after decannulation. No serious complications had developed, although 2 patients had minor granulation tissue formation at the stoma site and 1 had a minimal anterior narrowing of the subglottic region without granulation tissue. None of these patients needed treatment.
Assuntos
Cartilagens Laríngeas/cirurgia , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Respiração Artificial , Sucção , Fatores de Tempo , TraqueotomiaRESUMO
Between 1978 and 1982 14 patients were treated for bile-duct cysts. The predominant clinical signs were obstructive jaundice and hepatomegaly in the younger patients, while pain was the most common symptom in the older patients. Ultrasonography was a valuable diagnostic technic but percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopancreatography (ERCP) were associated with septic complications; as an alternative, routine preoperative cholangiography is recommended to visualize the type of bile-duct cyst. Excision of the bile-duct cyst was considered the treatment of choice. Excision was performed in 11, and internal drainage in three patients. Cholangitis developed in four children after excision of the cyst. In our series the prognosis was good following surgical treatment, even in younger patients.
