RESUMEN
BACKGROUND: This study examined whether axillary lymph node dissection (ALND) with removal of many normal lymph nodes resulted in a reduced rate of axillary recurrence and better survival, as reported in recent studies. METHODS: The follow-up analyses were based on 8657 patients with node-negative primary breast cancer treated solely by surgery. Median follow-up was 9 years. RESULTS: The number of lymph nodes removed correlated with a reduction in the rate of subsequent axillary recurrence (from 2.1 to 0.4 per cent; P = 0.037), local recurrence (from 7.4 to 3.8 per cent; P < 0.001) distant metastases (from 15.0 to 10.3 per cent; P < 0.001) and death as first event (from 7.5 to 5.5 per cent; P = 0.012). CONCLUSION: When ALND is indicated, at least ten axillary lymph nodes should be retrieved. The role of ALND as primary treatment has decreased significantly during the past decade. The findings leave the concept of the sentinel node biopsy intact, as a highly specific procedure compared to ALND.
Asunto(s)
Neoplasias de la Mama/cirugía , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Axila , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/mortalidad , Quimioterapia Adyuvante , Femenino , Humanos , Estimación de Kaplan-Meier , Escisión del Ganglio Linfático/mortalidad , Metástasis Linfática , Mastectomía/métodos , Mastectomía/mortalidad , Persona de Mediana Edad , Recurrencia Local de Neoplasia/mortalidad , Cuidados Posoperatorios/métodos , Estudios Prospectivos , Resultado del TratamientoRESUMEN
Nephropathia epidemica (NE) is an infectious disease caused by hantavirus of the Bunyavirus family and carried by little rodents, in Denmark presumably by the bank vole (Clethrionomys glareolus). The disease usually presents with self-limiting renal failure, thrombocytopenia, fever, lower back and/or abdominal pain. As such it might be confused with for example acute abdomen as shown by the two cases given. Final diagnosis is based upon demonstrating antibody formation against hantavirus.
Asunto(s)
Abdomen Agudo/diagnóstico , Infecciones por Hantavirus/diagnóstico , Abdomen Agudo/etiología , Adulto , Diagnóstico Diferencial , Infecciones por Hantavirus/inmunología , Humanos , Masculino , Pruebas SerológicasRESUMEN
This review regards the liver damaging side-effects of anabolic-androgenic steroids (AAS). It seems that AAS can cause development of peliosis hepatis, subcellular changes of hepatocytes, hepatocellular hyperplasia and hepatocellular adenomas. On the other hand, it has not been convincingly proved that AAS can cause development of hepatocellular carcinomas when used in usual therapeutical doses. Tumours reported as hepatocellular carcinomas caused by AAS seem to be hyperplastic lesions of a benign nature that are able to regress on withdrawal of the putative agent. The effect of untraditional combinations of AAS and high-dose AAS is not yet known, leaving the possibility of a carcinogenic effect in those cases.
Asunto(s)
Anabolizantes/efectos adversos , Hígado/efectos de los fármacos , Anabolizantes/uso terapéutico , Andrógenos/efectos adversos , Andrógenos/uso terapéutico , Carcinoma Hepatocelular/inducido químicamente , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Humanos , Hipogonadismo/tratamiento farmacológico , Hígado/patología , Neoplasias Hepáticas/inducido químicamente , MasculinoRESUMEN
This review examines the liver-damaging side effects of anabolic-androgenic steroids (AAS). It seems that AAS can cause development of peliosis hepatis, subcellular changes of hepatocytes, hepatocellular hyperplasia and hepatocellular adenomas. On the other hand, it has not been convincingly proved that AAS can cause development of hepatocellular carcinomas when used in the usual therapeutic doses. Tumours reported as hepatocellular carcinomas caused by AAS seems to be hyperplastic lesions of a benign nature able to regress with withdrawal of the putative agent. The effects of untraditional combinations and high-dose AAS are not yet known, leaving the possibility of a carcinogenic effect in those cases.