RESUMEN
OBJECTIVES: To detect prostate cancer in young black men and compare our results with those of western studies. PATIENTS AND METHODS: The authors conducted a prospective multicenter study from February 2008 to May 2009 on 220 men aged 40 to 49 years. All patients with an abnormal prostate suspicious of cancer and/or a PSA greater than 2.5 ng/ml had a prostate biopsy. RESULTS: The mean age of patients was 44.99 years. The mean PSA was 26.62 ng/ml and ranged from 0.3 to 5600 ng/ml, with a median PSA of 0.88 ng/ml. Eleven patients had a PSA greater than 2.5 ng/ml and three had abnormal prostates suspicious of cancer. Twelve patients had a prostate biopsy. Histologic studies of the specimens found one case of prostate adenocarcinoma (Gleason 4+4) and two cases of high grade prostate intraepithelial neoplasia (HGPIN), all within the 46 to 50 years age group. CONCLUSION: Due to the absence of prostate cancer within the 40 to 45 years age group, we would not recommend the screening of prostate cancer within this age group. This is only a preliminary study, and should be completed with the search for familial forms of prostate cancer. Also, a regular follow-up of patients already presenting with PSA greater than 2.5 ng/ml or HGPIN should be considered.
Asunto(s)
Diagnóstico Precoz , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/epidemiología , Adulto , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Antígeno Prostático Específico/sangre , Senegal/epidemiologíaRESUMEN
The authors investigate the complications of transnasal transsphenoidal endoscopic surgery in the treatment of 301 patients with pituitary adenomas. A retrospective analysis of complications in 301 patients submitted to transsphenoidal transnasal endoscopic surgery at the General Hospital of Fortaleza, Brazil between January 1998 and December 2009. The complications were divided in two groups: anatomical (oronasofacial, sphenoid sinus, intrasellar, suprasellar and parasellar) and endocrinological complications (anterior and posterior pituitary dysfunctions). We observed a total of 81 complications (26.9%) in our series. Anatomical complications occurred in 8.97% (27 cases): 8 CSF postoperative leaks (2.6%), 6 cases (1.9%) of delayed nasal bleeding, 5 cases (1.6%) of sphenoidal sinusitis, 3 cases (0.9%) of carotid artery lesion, 2 cases of meningitis (0.6%) and one case (0.3%) of each of the uncommon following complications: intrasella-suprasella hematoma, pontine hematoma and chiasmaplexy. Endocrinological complications occurred in 17.9% (54 cases): additional postoperative anterior lobe insufficiency in 35 cases (11.6%), and postoperative diabetes insipidus in 19 cases (6.3%). In our series, 3 cases of deaths (not directly related to the procedure) were also observed. Endoscopic transsphenoidal surgery represents an effective option for the treatment of patients with pituitary tumor. Complications still occur and must be reduced as much as possible. Successful endoscopic pituitary surgery requires extensive training in the use of an endoscope and careful planning of the surgery. Additional improvement can be expected with greater experience and new technical developments.
Asunto(s)
Adenoma/cirugía , Endoscopía/métodos , Neoplasias Hipofisarias/cirugía , Complicaciones Posoperatorias/epidemiología , Adenoma/epidemiología , Adolescente , Adulto , Anciano , Niño , Estudios de Cohortes , Endoscopía/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Neuroquirúrgicos/efectos adversos , Procedimientos Neuroquirúrgicos/métodos , Nariz , Neoplasias Hipofisarias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Hueso Esfenoides/cirugía , Resultado del Tratamiento , Adulto JovenRESUMEN
L'objectif du present travail est de presenter une technique rapide de preparation des immunoglobulines A; G et M avec un rendement suffisant et une purete immunoelectrophoretique a 100 pour cent pour etre utilises pour immuniser des chevres aux fins de production d'immunoserums