RESUMO
PURPOSE: Immunotherapy (IT) agents and BRAF inhibitors (BRAFi) are effective treatments for patients with advanced BRAF-mutant melanoma although the optimal sequence remains to be elucidated. The aim of this study was to compare the outcomes of two different cohorts of patients treated with BRAFi first, then IT or the reverse sequence. PATIENTS AND METHODS: This is a retrospective study on two groups of patients: a cohort was treated first with BRAFi followed by immunotherapy (BRAFi-IT) and the other cohort with the reverse sequence (IT-BRAFi). Baseline characteristics and clinical outcomes were compared between the two cohorts. RESULTS: A total of 25 patients were included in the study. Sixteen patients were given BRAFi-IT sequence and nine received IT-BRAFi sequence. No differences were observed in the characteristics of patients prior to each treatment between cohorts. Objective response rate (ORR) achieved by BRAFi were not different among groups. ORR achieved by IT was higher when administered after BRAFi (43.8 vs 0 %). Survival rates at 1-2 years were similar in both cohorts and median overall survival was not different for BRAFi-IT and IT-BRAFi (log rank test p = 0.97). CONCLUSIONS: No differences were observed in OS between the two cohorts. These results support the indistinct use of IT or BRAFi as initial treatment in patients with metastatic BRAF-mutant melanoma, although higher rate of response to IT was observed when administered after BRAFi. Prospective randomized clinical trials are needed on this issue.
Assuntos
Anticorpos Monoclonais/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Imunoterapia , Melanoma/tratamento farmacológico , Mutação/genética , Inibidores de Proteínas Quinases/uso terapêutico , Proteínas Proto-Oncogênicas B-raf/antagonistas & inibidores , Proteínas Proto-Oncogênicas B-raf/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Melanoma/imunologia , Melanoma/patologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Adulto JovemRESUMO
The ultrasonic diagnosis of salivary gland tumors can give a more accurate information than clinical data alone. For example, it will help differentiate intraglandular from extraglandular tumors and benign from malignant processes. We conducted a prospective study in 39 patients with parotidal or submaxillary tumors. Patients were evaluated with a physical exam and a with ultrasound. Results indicate that only 53.86% of the physical examinations were correct in their diagnosis compared to 87.18% of the those done by ultrasound. Specificity and sensibility for malignancy was 96.43% and 81.81% respectively. These results were similar to those reported by other authors. We conclude that the use of ultrasound techniques in the study of salivary gland pathology is well justified, due to its capacity to provide high resolution, improving clinical diagnosis.
Assuntos
Neoplasias das Glândulas Salivares/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade , UltrassonografiaRESUMO
Liver infection as a result of tuberculosis is well known; there are several histological lesions, the most important being epithelioid cell granuloma. There are 3 anatomo-clinic variants: military or micronodular type, macronodular or pseudotumoral and pericanalicular of cholestatic. A case of a 66 year old male with a diagnosis of hepatic pseudotumoral tuberculosis, confirmed by means of a laparoscopy, is presented. The rareness of this particular presentation is discussed, as well as the difficult diagnosis due to confusion with primary or metastatic tumors of the liver.
Assuntos
Granuloma/diagnóstico , Neoplasias Hepáticas/diagnóstico , Tuberculose Hepática/diagnóstico , Idoso , Diagnóstico Diferencial , Humanos , MasculinoRESUMO
We show the culicids collected in the Guajaibón zone, in Havana Province, in order to characterize the present population according to ecological parameters and the possible risk for man. We show that Aedes scapularis is numerically and ecologically dominant over the rest of the species that attack men, as well as the possible indirect influence of culicid populations in crab caves upon human beings.
Assuntos
Arbovírus , Culicidae , Ecologia , Insetos Vetores , Adulto , Aedes/classificação , Aedes/virologia , Animais , Infecções por Arbovirus/transmissão , Cuba , Culicidae/classificação , Culicidae/virologia , Humanos , Insetos Vetores/classificação , Insetos Vetores/virologia , Densidade Demográfica , Dinâmica Populacional , Fatores de RiscoRESUMO
The collections of culicidae made in the Guajaibón area, North coast of Havana province, are analyzed with arbovirologic purposes. The predominance of Aedes scapularis in the human bait collections is confirmed. The possibility of arbovirus circulation in the area is suggested.