RESUMEN
BACKGROUND: The frontal bone is an anatomical structure of the skull separated by the metopic suture in the childhood. The scientific literature indicates that metopic suture consolidates with closure in the early stages of life. Metopism is the term used to describe a metopic suture that persists up to the adulthood. Persistent metopic suture is associated potentially with the agenesis of the frontal sinus. AIM: To investigate the prevalence of absent frontal sinuses in dry skulls with metopism. MATERIALS AND METHODS: The present study was performed after the approval of the local Committee of Ethics in Research. The sample consisted of dry skulls (n=245), aging between 17 and 50 years old, of the Forensic Medical Institute of Goiânia, Brazil. The skulls underwent anthropological exam in the search for metopism. Radiographic exam was performed in the skulls with metopism to verify the presence or absence of the frontal sinus. The radiographic assessment was performed with a Mobile DaRt Evolution device (Shimadzu, Kyoto, Japan) with protocol set in 64 kV and 16 mA). RESULTS: From the 245 dry skulls, 17 presented metopism. The length of the metopic suture in the skulls, considering the distances between nasio and bregma craniometric landmarks, ranged between 114 mm and 137 mm. Radiographic exams were performed on 16 skulls (one skull was not analysed radiographically because of extensive destruction). Only one skull (6.25%) had the frontal sinus absent. Besides the agenesis, the present study also found four (12.5%) skulls with aplasia and eight (25.0%) hyperplasia of the frontal sinus in dry skulls with metopism. CONCLUSION: The present study found a low prevalence rate of the agenesis of frontal sinuses in dry skulls with metopism.
Asunto(s)
Suturas Craneales/anatomía & histología , Seno Frontal/anomalías , Adolescente , Adulto , Seno Frontal/diagnóstico por imagen , Humanos , Persona de Mediana Edad , Prevalencia , Adulto JovenRESUMEN
PURPOSE: The treatment of recurrent high-grade gliomas (HGG) is controversial. There are different therapeutic schedules but without a clear orientation about which of them should be used in each clinical situation. In addition, when patients suffer a second recurrence or they have poor performance status, they are excluded from clinical trials, although second recurrences and poor performance status are indeed more and more real and common situations in the clinical setting. In this study, we assessed the efficacy and safety of fotemustine (FTM) in HGG [fundamentally, glioblastomas (GB)], independent of time of recurrence or performance status. METHODS/PATIENTS: Retrospective study in HGG patients treated with FTM in second or further line according to standard, the Addeo or any other scheme, starting treatment prior to 30 November 2012. Included patients reflect the regular situation in which the drug is used in terms of comorbidities and analytic situation (hematologic, renal and hepatic functions). Response assessment was performed by MRI and according to the clinical protocols of each center (every 8-12 weeks). Clinical situation and supportive care drugs were evaluated in each medical consultation. Clinical end-points analyzed, among others, were: PFS-6, PFS, OS, response rates, toxicity, quality of life and neurocognitive impact. RESULTS: In terms of activity, an overall response rate of 8 % was observed: partial response 6 % (7 patients) and complete response 2 % (2 patients). The median time to achieve the greater response with FTM was 73 days (4-841 days). Patients treated according to the Addeo schedule had a shorter time to greater response in comparison with other schedules (85.9 vs 114 days), although without statistical significance. There were no significant differences in progression-free survival (PFS) when comparing different FTM schedules or using FTM in first or second recurrence. Median PFS: 3 months. PFS-6: 30.3 %. Overall survival (OS): although without significant differences, a tendency to better survival when using the Addeo schedule versus other schedules was observed (at 6 months, 44.6 vs 34.5 %; at 12 months, 25 vs 23.6 %; at 18 months, 11.5 vs 7.9 %), as well as if earlier use (second vs third line) concerning OS-12 (33.7 vs 18.2 %). Median OS: 5.2 months. Grades 3-4 toxicity was 28 % (31 patients), being neutropenia (4 %) and thrombocytopenia (17 %) the most frequent adverse reactions. From quality of life and neuro-cognitive function perspectives, 11 patients (10 %) and 16 (14 %) improved the Karnofsky Index and neurological impairment, respectively, after FTM treatment. CONCLUSION: This study has shown that FTM is safe and has a comparable activity with other available therapeutic options of use in the treatment of recurrent HGG.
Asunto(s)
Antineoplásicos/uso terapéutico , Neoplasias Encefálicas/tratamiento farmacológico , Glioma/tratamiento farmacológico , Recurrencia Local de Neoplasia/tratamiento farmacológico , Compuestos de Nitrosourea/uso terapéutico , Compuestos Organofosforados/uso terapéutico , Adulto , Anciano , Neoplasias Encefálicas/mortalidad , Femenino , Glioma/mortalidad , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
PURPOSE: The standard adjuvant treatment for glioblastoma is temozolomide concomitant with radiotherapy, followed by a further six cycles of temozolomide. However, due to the lack of empirical evidence and international consensus regarding the optimal duration of temozolomide treatment, it is often extended to 12 or more cycles, even in the absence of residual disease. No clinical trial has shown clear evidence of clinical benefit of this extended treatment. We have explored the economic impact of this practice in Spain. MATERIALS AND METHODS: Spanish neuro-oncologists completed a questionnaire on the clinical management of glioblastomas in their centers. Based on their responses and on available clinical and demographic data, we estimated the number of patients who receive more than six cycles of temozolomide and calculated the cost of this extended treatment. RESULTS: Temozolomide treatment is continued for more than six cycles by 80.5 % of neuro-oncologists: 44.4 % only if there is residual disease; 27.8 % for 12 cycles even in the absence of residual disease; and 8.3 % until progression. Thus, 292 patients annually will continue treatment beyond six cycles in spite of a lack of clear evidence of clinical benefit. Temozolomide is covered by the National Health Insurance System, and the additional economic burden to society of this extended treatment is nearly 1.5 million euros a year. CONCLUSIONS: The optimal duration of adjuvant temozolomide treatment merits investigation in a clinical trial due to the economic consequences of prolonged treatment without evidence of greater patient benefit.
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Antineoplásicos Alquilantes/administración & dosificación , Neoplasias Encefálicas/tratamiento farmacológico , Dacarbazina/análogos & derivados , Glioblastoma/tratamiento farmacológico , Antineoplásicos Alquilantes/economía , Neoplasias Encefálicas/economía , Quimioterapia Adyuvante/economía , Quimioterapia Adyuvante/métodos , Análisis Costo-Beneficio , Dacarbazina/administración & dosificación , Dacarbazina/economía , Glioblastoma/economía , Humanos , Pautas de la Práctica en Medicina , España , Encuestas y Cuestionarios , TemozolomidaRESUMEN
CO adsorption on Ru-Sn/SiO(2) catalysts of various Sn/(Ru+Sn) ratios was examined by Diffuse Reflectance Infrared Fourier-Transform Spectroscopy (DRIFTS). The catalysts were prepared by the incipient wetness impregnation method. Catalysts were activated by H(2) reduction at 773 K. CO adsorbed on the catalysts shows spectra whose band frequencies are divided into three groups: (i) High Frequency Region (HFR), containing a band at 2065 cm(-1), (ii) Low Frequency Region 1 (LFR(1)), containing bands at 2040-2015 cm(-1), (iii) Low Frequency Region 2 (LFR(2)), containing bands at 1990 and 1945 cm(-1). The types of adsorbed CO species formed strongly depend on the ratio Sn/(Ru+Sn) in the catalyst, CO pressure and temperature of adsorption. Adsorption of CO on Ru sites in the Ru/SiO(2) catalyst results in LFR(1) bands at 2040-2015 cm(-1), which are independent of the CO pressure but the adsorption complexes are easily destroyed by raising the temperature. The addition of Sn to the catalyst creates new sites for CO adsorption. After adsorption at 298 K, the HFR band at 2065 cm(-1) and LFR(2) bands at 1990-1950 cm(-1) are observed. The relative intensities of these bands increase with increasing Sn-content in the samples. The LFR bands are thermally stable while the HFR band is not. The formation of the corresponding species is favored by increasing the CO pressure. Adsorbed CO species giving LFR(1) bands are assigned to linearly-adsorbed CO on the Ru(0) and/or on the Ru-Sn alloy sites. Adsorbed CO species giving HFR bands are assigned to CO adsorption on Ru(delta+)-O-Sn sites. After low temperature CO adsorption on samples with high Sn-content, only species that show bands at 1990 and 1945 cm(-1) in LFR(2) are observed.
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Monóxido de Carbono/química , Rutenio/química , Dióxido de Silicio/química , Estaño/química , Espectroscopía Infrarroja por Transformada de FourierRESUMEN
This paper presents a full reconstruction process of magnetic resonance images. The first step is to bring the acquired data from the frequency domain, using a Fast Fourier Transform algorithm. A Tomographic Image Interpolation is then used to transform a sequence of tomographic slices in an isotropic volume data set, a process also called 3D Reconstruction. This work describes an automatic method whose interpolation stage is based on a previous matching stage using Delaunay Triangulation. The reconstruction approach uses an extrapolation procedure that permits appropriate treatment of the boundaries of the object under analysis.
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Procesamiento de Imagen Asistido por Computador/instrumentación , Imagen por Resonancia Magnética/instrumentación , Algoritmos , Recolección de Datos/instrumentación , Humanos , Fantasmas de Imagen , Programas InformáticosRESUMEN
Submetemos a exame parasitologico de fezes pelo metodo de Hoffmann, Pons e Janer 272 criancas de zero a 14 anos de idade da zona de Cambui-MG. Encontramos 73,2% de positividade para protozoarios e (ou) helmintos. Notamos, no entanto, que a parasitose mais encontrada em todas as faixas etarias, ao contrario dos trabalhos ate agora publicados, foi a giardiase a partir de oito meses de idade, com media de incidencia de 70,3%. Analisando laboratorialmente o sedimento da agua do reservatorio e da distribuicao para a cidade, encontramos cistos de Giardia lamblia. Assim sendo apesar de contarmos com rede de esgotos e agua encanada servindo a maior parte da populacao (carca de 90%), continuamos com altos indices de parasitoses intestinais, principalmente giardiase. Concluimos entao que tambem sao fundamentais a educacao sanitaria, as condicoes socio-economicas da populacao e o controle de qualidade da agua distribuida a populacao