RESUMEN

BACKGROUND: Radiation-induced brain injury (RBI) and low-perfusion brain syndromes are mediated by ischemia and hypometabolism and have limited treatment options. Ozone therapy as treatment in vascular diseases has been described, but the effects on brain tissue have not been well documented. CASE REPORT: We describe a 75-year-old patient with vascular risk factors and meningioma who was treated with stereotactic radiosurgery. 14 months later the patient presented with progressive clinical impairment despite the use of acetylsalicylic acid and corticosteroids. Clinical and imaging evaluations before/after ozone therapy were done by magnetic resonance imaging (MRI), computed tomography (CT), single photon emission computed tomography (SPECT), and positron emission tomography (PET); performance status assessment was done using Barthel Index and World Health Organization/Eastern Cooperative Oncology Group Scale (WHO/ECOG Scale). Ozone therapy was performed by autohemotransfusion. RESULTS: Basal images showed brain areas with ischemia and hypometabolism compatible with ischemic processes and/or RBI. There were no changes in MRI or CT scan images following ozone therapy. However, improvements in brain perfusion and metabolism were demonstrable with SPECT and PET; they correlated with clinical development and performance status scales. CONCLUSION: This report supports our previous works about the effect of ozone therapy in cerebral blood flow, and it suggests the use of ozone therapy in ischemic and hypometabolic brain syndromes such as stroke or RBI.

Asunto(s)

RESUMEN

El cáncer de mama representa un grave problema de salud pública, en la mayoría de los casos se consulta tardíamente, en nuestro país existe una mortalidad de 22 por 100.000 mujeres. Se realizó un análisis retrospectivo que comprendió un período de cuatro años, donde se revisaron las mamografías realizadas en el servicio de diagnóstico por imágenes del Hospital Dr. Lucio Molas que cuenta con uno de los dos mamógrafos disponibles en el sector público de la provincia. La relación entre cáncer y despistaje fue: 3,1/1 000. Biopsias positivas en 51 por ciento. El tamaño tumoral promedio fue de 10 mm. La eficacia de este tipo de campañas ha sido corroborada por numerosos estudios, es necesario mejorar los resultados y reducir los inconvenientes que se les han atribuido a este tipo de estudio: el costo económico, los falsos positivos y negativos, las biopsias innecesarias, o la ansiedad generada en las pacientes.

The breast cancer represent a big and hard health public problem. In the majority of cases the patients consult us so late, in our country exist a mortality of 22 for 100.000 women. We realized a retrospective work in a period of four years in witch we review all the mammography’s realized in the diagnostic imagine service of Hospital Dr. Lucio Molas these hospital has one of the two mammography public machine for health public in the province area. The relation between cancer and screening was 3.1/1 000. The positive biopsies were in 51 percent. The tumor average size was 10 mm. The efficacy of this kind of campaign were corroborated for numerous studies, is necessary to improve the results and reduce the inconvenient describe for these kind of study: costs, false negative and positive, economic problem, the unnecessary biopsy’s and the anxiety genera rated in the studied patients.

Asunto(s)

RESUMEN

The purpose of this study was to evaluate the efficacy and toxicity of docetaxel as single-agent neoadjuvant chemotherapy in locoregionally advanced cervical carcinoma. Between April 1998 and August 2000, 38 untreated patients with International Federation of Gynecology and Obstetrics stages IIB to IVA were entered onto this study. The median age was 44 years (range: 25-66 years). Stages: IIB 22 patients, IIIB 15 patients, and IVA 1 pt. Treatment consisted of docetaxel 100 mg/m2 IV infusion during 1 hour. Standard premedication with dexamethasone, diphenhydramine, and ranitidine was used. Cycles were repeated every 3 weeks for three courses, followed by radical surgery when it was judged appropriate, or definitive radiotherapy. Both staging and response assessment were performed by a multidisciplinary team. 106 cycles of therapy were administered; all patients were evaluable for TX, whereas 35 were evaluable for response (3 patients refused further treatment after the first cycle of therapy). Complete response (CR): 1 patient (3%); partial response: 11 patients (31%), for an overall objective response rate of 34% (95% CI: 15-53%); no change (NC): 16 patients (46%); and progressive disease: 7 patients (20%). Six patients (17%) underwent surgery and a pathologic CR was confirmed in 1 of them. The median time to treatment failure and the median survival have not been reached yet. The limiting toxicity was leukopenia in 25 patients (69%) (G1-G2: 14 patients, G3: 10 patients, and G4: 1 patient). Neutropenia: 28 patients (78%) (G1-G2: 10 patients, G3: 8 and G4: 10). Myalgias: 17 patients (47%) (G1-G2: 15 patients and G3: 2 patients). Emesis: 21 patients (55%) (G1-G2: 19 patients and G3: 2 patients). Alopecia G3: 13 patients (36%); rash cutaneous 26 patients (68%) (G1-G2: 22 patients and G3: 4 patients). There were no hypersensitivity reactions or fluid-retention syndrome. The received dose intensity was 91% of that projected. Docetaxel is an active drug against advanced cervical carcinoma with moderate toxicity. Further evaluation in association with other agents is clearly justified.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

El comunicar diagnóstico de enfermedades de pronóstico incierto, esconde detrás un sin número de variables relacionadas a cada paciente. En este trabajo se trata de establecer si lo que recibe el pacientes realmente lo que desea, enfatizando en: La persona encargada de transmitir el diagnóstico, forma en que se transmite el diagnóstico, quien decide el tratamiento y el papel de la familia. Se realizó un trabajo descriptivo cuantitativo a partir de una encuesta anónima a 100 pacientes oncológicos mayores de 18 a±os; 28 fueron del Hospital Provincial Lucio Molas de Santa Rosa de La Pampa y 72 del Hospital Privado de Córdoba, durante octubre de 1999 a julio del 2000. Vislumbramos las siguientes tendencias: el médico fue quien le informó el diagnóstico a la mayoría de los pacientes y lo hizo en forma directa, lo cual era similar a los que los pacientes deseaban; el tratamiento fue decidido en similares porcentajes por el médico y entre este y el paciente; la familia, en general tuvo un acompa±amiento constante. Proponemos que la manera de transmitir el diagnóstico esta sujeta a cada paciente, para la cual el médico debe evaluar su personalidad y entorno emocional. Creemos conveniente la presencia de un servicio de medicina paliativa en los hospitales. ABSTRACT: Communicate uncertain prognostic illness diagnosis hide countless number of variables related with each patient. In this work we try to establish what the patient receives and what he really desires, emphasizing on: the person in charge to communicate the diagnosis; the way they used to do that; who decides the treatment; and the family's roll. It was effectuated a quantitative descriptive work. It was used a nameless poll on 100 oncological patients of 18 year old or more, 28 patient belong to Lucio Molas Hospital of Santa Rosa , La Pampa and 72 were from Hospital Privado of Cordoba, during October 1999 to July of 2000. We glimpse the following tendencies: the doctor communicated the diagnosis in the majority of the patient and they did it in a direct way, which was similar amount by the doctor and between this and the patient; and finally, family had a constantly attendance. We propose that that the way to communicate diagnosis depends on each patient and the doctor has evaluate in each case personality and his emotional surrounding. We believe that his convenient the presence of a palliative medicine service in hospital

Asunto(s)

RESUMEN

El comunicar diagnóstico de enfermedades de pronóstico incierto, esconde detrás un sin número de variables relacionadas a cada paciente. En este trabajo se trata de establecer si lo que recibe el pacientes realmente lo que desea, enfatizando en: La persona encargada de transmitir el diagnóstico, forma en que se transmite el diagnóstico, quien decide el tratamiento y el papel de la familia. Se realizó un trabajo descriptivo cuantitativo a partir de una encuesta anónima a 100 pacientes oncológicos mayores de 18 a±os; 28 fueron del Hospital Provincial Lucio Molas de Santa Rosa de La Pampa y 72 del Hospital Privado de Córdoba, durante octubre de 1999 a julio del 2000. Vislumbramos las siguientes tendencias: el médico fue quien le informó el diagnóstico a la mayoría de los pacientes y lo hizo en forma directa, lo cual era similar a los que los pacientes deseaban; el tratamiento fue decidido en similares porcentajes por el médico y entre este y el paciente; la familia, en general tuvo un acompa±amiento constante. Proponemos que la manera de transmitir el diagnóstico esta sujeta a cada paciente, para la cual el médico debe evaluar su personalidad y entorno emocional. Creemos conveniente la presencia de un servicio de medicina paliativa en los hospitales. ABSTRACT: Communicate uncertain prognostic illness diagnosis hide countless number of variables related with each patient. In this work we try to establish what the patient receives and what he really desires, emphasizing on: the person in charge to communicate the diagnosis; the way they used to do that; who decides the treatment; and the familys roll. It was effectuated a quantitative descriptive work. It was used a nameless poll on 100 oncological patients of 18 year old or more, 28 patient belong to Lucio Molas Hospital of Santa Rosa , La Pampa and 72 were from Hospital Privado of Cordoba, during October 1999 to July of 2000. We glimpse the following tendencies: the doctor communicated the diagnosis in the majority of the patient and they did it in a direct way, which was similar amount by the doctor and between this and the patient; and finally, family had a constantly attendance. We propose that that the way to communicate diagnosis depends on each patient and the doctor has evaluate in each case personality and his emotional surrounding. We believe that his convenient the presence of a palliative medicine service in hospital

Asunto(s)

Asunto(s)

Asunto(s)