1
|
Bernardez B, Mangues Bafalluy I, Martínez Callejo V, Fernández Ávila JJ, Marcos Rodríguez JA, Parada Aradilla MA, Martínez Bautista MJ. Risk stratification model for the pharmaceutical care of oncology patients with solid or hematologic neoplasms. Farm Hosp 2024:S1130-6343(23)00943-1. [PMID: 38461113 DOI: 10.1016/j.farma.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 03/11/2024] Open
Abstract
OBJECTIVE We aimed to develop of a risk stratification model for the pharmaceutical care (PC) of patients with solid or hematologic neoplasms who required antineoplastic agents or supportive treatments. METHOD The risk stratification model was collaboratively developed by oncology pharmacists from the Spanish Society of Hospital Pharmacy (SEFH). It underwent refinement through three workshops and a pilot study. Variables were defined, grouped into four dimensions, and assigned relative weights. The pilot study collected and analyzed data from participating centers to determine priority levels and evaluate variable contributions. The study followed the Kaiser Permanente pyramid model, categorizing patients into three priority levels: Priority 1 (intensive PC, 90th percentile), Priority 2 (60th-90th percentiles), and Priority 3 (60th percentile). Cut-off points were determined based on this stratification. Participating centers recorded variables in an Excel sheet, calculating mean weight scores for each priority level and the total risk score. RESULTS The participants agreed to complete a questionnaire that comprised 22 variables grouped into 4 dimensions: demographic (maximum score =11); social and health variables and cognitive and functional status (maximum = 19); clinical and health services utilization (maximum = 25); and treatment-related (maximum = 41). From the results of applying the model to the 199 patients enrolled, the cutoff points for categorization were 28 or more points for priority 1, 16 to 27 points for priority 2 and less than 16 for priority 3; more than 80% of the total score was based on the dimensions of 'clinical and health services utilization' and 'treatment-related'. Interventions based on the pharmaceutical care model were recommended for patients with solid or hematological neoplasms, according to their prioritization level. CONCLUSION This stratification model enables the identification of cancer patients requiring a higher level of pharmaceutical care and facilitates the adjustment of care capacity. Validation of the model in a representative population is necessary to establish its effectiveness.
Collapse
Affiliation(s)
- Beatriz Bernardez
- Departamento de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, España; Unidad de Farmacia Oncológica, Servicio de Farmacia, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España; Grupo de Farmacología, Instituto de Investigación Santiago de Compostela (IDIS), Santiago de Compostela, España.
| | - Irene Mangues Bafalluy
- Servicio de Farmacia, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, España; Grupo de Farmacoepidemiología y Farmacodinamia, Institut de Recerca Biomèdica, IRBLleida, Lleida, España
| | - Virginia Martínez Callejo
- Unidad de Farmacia Oncológica, Servicio de Farmacia, Hospital Universitario Marqués de Valdecilla, Santander, España
| | | | | | | | | |
Collapse
|
2
|
Pardo Lledias J, Martín Millán M, Mazariegos Cano JA, Aimar Marco C, Arias Martínez N, San Pedro Careaga B, Urizar Ursua E, Insua García MC, Lavin Gómez BA, Hernández Hernández JL. Incidental detection of raised serum levels of vitamin B12 and its association with neoplasms. Rev Clin Esp 2024; 224:10-16. [PMID: 38065526 DOI: 10.1016/j.rceng.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/10/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND AND OBJECTIVES Elevated serum levels of vitamin B12 have been associated with oncohematological diseases. However, the relevance of its incidental detection in subjects without a previous diagnosis of cancer is unknown. The aim of this study was to evaluate the relationship between incidental hypercobalaminemia (vitamin B12 > 1000 pg/mL) and the diagnosis of a tumor process in patients without a diagnosis and to establish the risk factors. MATERIAL AND METHODS Retrospective observational study of a cohort of patients with hypercobalaminemia. The incidence of neoplasms was compared with a cohort of patients with vitamin B12 levels <1000 pg/mL. RESULTS Vitamin B12 determinations of 4800 subjects were selected. Of them, 345 (7.1%) had levels >1000 pg/mL. 68 (28.4%) were excluded due to exogenous administration, 12 (5%) due to insufficient data and 15 (3%) due to having an active neoplasia, selecting 250 patients, with a median follow-up of 22 (IQR 12-39) months. Structural liver disease was detected in 59 (23.6%). 18.2% (44 patients) had solid organ cancer and 17 (7.1%) had malignant hemopathy. The average time from the detection of hypercobalaminemia to the diagnosis of cancer was about 10 months. The median until the diagnosis of neoplasia was higher in the high vitamin B12 group (13 vs. 51 months p < 0.001). Hypercobalaminemia (HR 11.8; 95% CI 2.8-49.6; p = 0.001) and smoking (HR 4.0; 95% CI, 2.15-7.59; p < 0.001) were independent predictors of neoplasia in the multivariate analysis. CONCLUSIONS Incidental detection of serum vitamin B12 levels >1000 pg/mL is high in the population. The diagnosis of solid organ and hematological neoplasia is frequent during the following year of follow-up, with hypercobalaminemia and smoking being predictors of a higher risk of cancer.
Collapse
Affiliation(s)
- J Pardo Lledias
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain.
| | - M Martín Millán
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain
| | - J A Mazariegos Cano
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain
| | - C Aimar Marco
- Servicio de Pediatría, Hospital Universitario Araba, Gasteiz, Spain
| | | | - B San Pedro Careaga
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain
| | - E Urizar Ursua
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain
| | - M C Insua García
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain
| | - B A Lavin Gómez
- Servicio de Análisis Clínico, Hospital Unversitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - J L Hernández Hernández
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain
| |
Collapse
|
3
|
Conca F, Rosso N, López Grove R, Savluk L, Santino JP, Ulla M. Esophageal tumors: The keys to diagnosis by pneumo-computed tomography. Radiologia (Engl Ed) 2023; 65:546-553. [PMID: 38049253 DOI: 10.1016/j.rxeng.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/28/2023] [Indexed: 12/06/2023]
Abstract
OBJECTIVE To review and describe the most characteristic radiological findings of the most frequent esophageal tumor lesions, with emphasis on the esophago-gastric distention technique pneumo-computed tomography performed in our institution. To know the main advantage of this distension technique. CONCLUSION Malignant tumor lesions (predominantly squamous cell carcinoma in the mid esophagus and adenocarcinoma in the distal esophagus) present as asymmetric wall thickening, mucosal irregularity, or mass extending into adjacent organs with lymph node involvement. Benign tumors (mainly leiomyoma being the most frequent and others such as lipoma) present as endoluminal growth, with defined borders and homogeneous attenuation. Post-contrast enhancement is scarce or moderate. The technique of computed tomography pneumotomography technique achieves an additional distension of the esophageal lumen in all cases. It allows delimiting the superior and inferior borders of the lesions, helping the surgeon to define the therapeutic strategy.
Collapse
Affiliation(s)
- F Conca
- Servicio de Diagnóstico por Imágenes, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - N Rosso
- Servicio de Diagnóstico por Imágenes, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - R López Grove
- Servicio de Diagnóstico por Imágenes, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - L Savluk
- Servicio de Diagnóstico por Imágenes, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - J P Santino
- Servicio de Anatomía Patológica, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - M Ulla
- Servicio de Diagnóstico por Imágenes, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| |
Collapse
|
4
|
Sánchez-Bandala MA, Rubio AP, Abeldaño Zuñiga RA. Trajectories of Cancer Care in Latin America: A Scope Review: Trayectorias de atención al cáncer en América Latina. Una revisión de alcance. Value Health Reg Issues 2023; 38:47-60. [PMID: 37473586 DOI: 10.1016/j.vhri.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 04/10/2023] [Accepted: 06/14/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVES In recent decades there has been a development of research on cancer care trajectories in Latin America; however, the diversity of theoretical-methodological uses of this approach can be confusing and difficult for the academic and professional community to use. To analyze studies that have been carried out in Latin America on cancer care trajectories to propose a typology of the approaches developed and synthesize key findings. METHODS A scope review of studies published in journals indexed in PubMed, LILACS, and SciELO databases in the period 2006-2021 was conducted. RESULTS 22 articles were analyzed. A typology of descriptive, evaluative, and interpretative approaches was proposed. From the key findings, the following were identified: the importance of pleasure and the feeling of power in the development of risky practices; the role of popular explanatory models for the identification of abnormality and the search for attention; the interaction of various personal, interpersonal, organizational, and structural barriers that limited timely diagnosis and continuity of treatment; the sequential or parallel use of different forms of care, public and private; and the importance of social support networks. CONCLUSIONS The proposed typology clarifies the different uses of the approach. The informative synthesis evidences problematic knots regarding multiple barriers to access and allows us to propose as priorities in future research the study of types of cancer, stages, and populations that have been scarcely addressed, as well as the diversification of methodological approaches.
Collapse
Affiliation(s)
| | | | - Roberto Ariel Abeldaño Zuñiga
- Division of Postgraduate Studies, Universidad de la Sierra Sur, Miahuatlán de Porfirio Díaz, Oaxaca, México; Faculty of Social Sciences, University of Helsinki, Finland
| |
Collapse
|
5
|
Martínez Campos L, Pérez-Albert P, Ferres Ramis L, Rincón-López EM, Mendoza-Palomar N, Soler-Palacin P, Aguilera-Alonso D. Consensus document on the management of febrile neutropenia in paediatric haematology and oncology patients of the Spanish Society of Pediatric Infectious Diseases (SEIP) and the Spanish Society of Pediatric Hematology and Oncology (SEHOP). An Pediatr (Barc) 2023:S2341-2879(23)00111-4. [PMID: 37268527 DOI: 10.1016/j.anpede.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/24/2023] [Indexed: 06/04/2023] Open
Abstract
Febrile neutropenia is one of the main infectious complications experienced by paediatric patients with blood or solid tumours, which, despite the advances in diagnosis and treatment, are still associated with a significant morbidity and mortality. These patients have several risk factors for infection, chief of which are chemotherapy-induced neutropenia, the disruption of cutaneous and mucosal barriers and the use of intravascular devices. Early diagnosis and treatment of febrile neutropenia episodes based on the patient's characteristics is essential in patients with blood and solid tumours to improve their outcomes. Therefore, it is important to develop protocols in order to optimise and standardise its management. In addition, the rational use of antibiotics, with careful adjustment of the duration of treatment and antimicrobial spectrum, is crucial to address the increase in antimicrobial drug resistance. The aim of this document, developed jointly by the Spanish Society of Pediatric Infectious Diseases and the Spanish Society of Pediatric Hematology and Oncology, is to provide consensus recommendations for the management of febrile neutropenia in paediatric oncology and haematology patients, including the initial evaluation, the stepwise approach to its treatment, supportive care and invasive fungal infection, which each facility then needs to adapt to the characteristics of its patients and local epidemiological trends.
Collapse
Affiliation(s)
| | - Paula Pérez-Albert
- Servicio de Oncología y Hematología Pediátricas, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Laia Ferres Ramis
- Servicio de Oncohematología Pediátrica, Hospital Universitario Son Espases, Palma, Mallorca, Spain
| | - Elena María Rincón-López
- Sección Enfermedades Infecciosas Pediátricas, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Área de Enfermedades Infecciosas Pediátricas, Centro de Investigación Biomédica en Red del Instituto de Salud Carlos III (CIBERINFEC), Madrid, Spain
| | - Natalia Mendoza-Palomar
- Unidad de Patología Infecciosa e Inmunodeficiencias de Pediatría, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Grupo de investigación «Infección e inmunidad en el paciente pediátrico», Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
| | - Pere Soler-Palacin
- Unidad de Patología Infecciosa e Inmunodeficiencias de Pediatría, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Grupo de investigación «Infección e inmunidad en el paciente pediátrico», Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Departamento de Pediatría, Obstetricia y Ginecología y de Medicina Preventiva y Salud Pública, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - David Aguilera-Alonso
- Sección Enfermedades Infecciosas Pediátricas, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Área de Enfermedades Infecciosas Pediátricas, Centro de Investigación Biomédica en Red del Instituto de Salud Carlos III (CIBERINFEC), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain
| |
Collapse
|
6
|
Reynoso-Noverón N, Torres-Domínguez JA, Morales-Juárez L, Mohar-Betancourt A. Analysis of cancer mortality in Mexico using the results of the Global Burden of Disease 2021 study. GAC MED MEX 2023; 159:574-581. [PMID: 38386870 DOI: 10.24875/gmm.m24000833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/08/2023] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND In Mexico, cancer mortality rates have undergone changes over the past decades. OBJECTIVE To analyze the evolution of cancer mortality rates in Mexico between 1990 and 2021. MATERIALS AND METHODS Based on the Global Burden of Disease study, the mortality rates for the 10 most prevalent types of cancer in Mexico were obtained, at the national and regional level and by states, considering different age groups and gender. Global Burden of Disease reassigns misclassified causes and distributes them among different types of cancer; subsequently, it models and adjusts the causes to the total number of deaths with a model of a set of causes of death and a cause corrector, which corrects INEGI's mortality records. RESULTS The cancer mortality rate went from 117.87 in 1990 to 84.18 in 2021. In women, breast, cervical, stomach and lung cancers were the most frequent. In men, the most common were prostate, stomach, lung, and colon and rectum cancer. The decrease in cancer mortality for men and women stood out, particularly from lung and cervical cancer. CONCLUSIONS The results provide information for the development of health policies and specific prevention and control strategies to address the impact of cancer in Mexico.
Collapse
Affiliation(s)
| | | | - Linda Morales-Juárez
- Institute for Obesity Research, Public Policies Unit, Tecnológico de Monterrey, Mexico City, Mexico
| | - Alejandro Mohar-Betancourt
- Cancer Epidemiology and Biomedical Research Unit, Instituto Nacional de Cancerología, Mexico City, Mexico
- Institute of Biomedical Research, Universidad Nacional Autónoma de México, Mexico City, Mexico
| |
Collapse
|
7
|
Viteri Jusué A, Domínguez Fernández S, Pérez Persona E, Poza de Celis R. Urgent and unexpected findings in oncology and hematology patients: A practical approach to imaging. Radiologia (Engl Ed) 2022; 64:464-472. [PMID: 36243446 DOI: 10.1016/j.rxeng.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/09/2021] [Indexed: 06/16/2023]
Abstract
Urgent and unexpected findings are very common in oncology and haematology patients. This article reviews the most important points included in the European Society of Radiology's guidelines and proposes a practical approach to reporting and communicating these findings more efficiently. This approach is explained with illustrative examples. Radiologists can provide added value in the management of these findings by helping referring clinicians reach the best decisions. To this end, it is essential to know the imaging manifestations of the most common findings that must be reported urgently, such as the specific toxicity of different treatments, the complications of tumours and catheters, infections, and thrombosis. Moreover, it is crucial to consider the individual patient's treatment, risk factors, clinical situation, and immune status.
Collapse
Affiliation(s)
- A Viteri Jusué
- Servicio de Radiodiagnóstico, Hospital Universitario Araba, Vitoria-Gasteiz, Spain.
| | | | - E Pérez Persona
- Servicio de Hematología, Hospital Universitario Araba, Vitoria-Gasteiz, Spain
| | - R Poza de Celis
- Servicio de Oncología Radioterápica, Hospital Universitario Araba, Vitoria-Gasteiz, Spain
| |
Collapse
|
8
|
Rey J, Pérez-Ríos M, Santiago-Pérez MI, Galán I, Schiaffino A, Varela-Lema L, Naveira G, Montes A, López-Vizcaíno ME, Giraldo-Osorio A, Mourino N, Mompart A, Ruano-Ravina A. Smoking-attributable mortality in the autonomous communities of Spain, 2017. Rev Esp Cardiol (Engl Ed) 2022; 75:150-158. [PMID: 33685853 DOI: 10.1016/j.rec.2020.10.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/23/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION AND OBJECTIVES To estimate smoking-attributable mortality (SAM) in the regions of Spain among people aged ≥ 35 years in 2017. METHODS SAM was estimated using a prevalence dependent method based calculating the population attributable fraction. Observed mortality was derived from the National Statistics Institute. The prevalence of smoking by age and sex was based on the Spanish National Health Survey for 2011 and 2017 and the European Survey for 2014. Relative risks were reported from the follow-up of 5 North American cohorts. SAM and population attributable fraction were estimated for each region by age group, sex, and causes of death. Cause-specific and adjusted SAM rates were estimated. RESULTS Smoking caused 53 825 deaths in the population aged ≥ 35 years (12.9% of all-cause mortality). SAM ranged from 10.8% of observed mortality in La Rioja to 15.3% in the Canary Islands. The differences remained after rates were adjusted by age. The highest adjusted SAM rates were observed in Extremadura in men and in the Canary Islands in women. Adjusted SAM rates in men were inversely correlated with those in women. The percentage of total SAM represented by cardiovascular diseases in each region ranged from 21.8% in Castile-La Mancha to 30.3% in Andalusia. CONCLUSIONS The distribution of SAM differed among regions. Conducting a detailed region-by-region analysis provides relevant information for health policies aiming to curb the impact of smoking.
Collapse
Affiliation(s)
- Julia Rey
- Área de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Mónica Pérez-Ríos
- Área de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Servicio de Epidemiología, Dirección General de Salud Pública, Xunta de Galicia, Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain; Grupo de Epidemiología, Salud Pública y Evaluación de Servicios de Salud del Instituto de Investigación Sanitaria (IDIS), Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
| | - María Isolina Santiago-Pérez
- Servicio de Epidemiología, Dirección General de Salud Pública, Xunta de Galicia, Santiago de Compostela, A Coruña, Spain
| | - Iñaki Galán
- Servicio de Enfermedades Crónicas, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Anna Schiaffino
- Direcció General de Planificació en Salut, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain; Dirección General para la Gestión del Conocimiento, Medicamento, Innovación e Investigación, Institut Català d'Oncologia, Barcelona, Spain
| | - Leonor Varela-Lema
- Área de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Agencia de Evaluación de Tecnologías Sanitarias, Agencia Gallega de Conocimiento, Santiago de Compostela, A Coruña, Spain
| | - Gael Naveira
- Servicio de Epidemiología, Dirección General de Salud Pública, Xunta de Galicia, Santiago de Compostela, A Coruña, Spain
| | - Agustín Montes
- Área de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | | | - Alexandra Giraldo-Osorio
- Área de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Departamento de Salud Pública, Universidad de Caldas, Manizales, Colombia; Departamento de becas de doctorado, Fundación Carolina Colombia, Bogotá, Colombia
| | - Nerea Mourino
- Área de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Anna Mompart
- Direcció General de Planificació en Salut, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Alberto Ruano-Ravina
- Área de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain; Grupo de Epidemiología, Salud Pública y Evaluación de Servicios de Salud del Instituto de Investigación Sanitaria (IDIS), Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| |
Collapse
|
9
|
Abella Cajigal JM, Fernández López C, García-Lamazares M. [Premalignant lesions of the penis]. Semergen 2021; 47:563-571. [PMID: 34144867 DOI: 10.1016/j.semerg.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Abstract
The dermatological conditions that affect the penis are diverse, and may be typical of this area or be part of systemic diseases. The anamnesis and inspection are often sufficient for diagnosis, but other times, it is difficult to distinguish between benign dermatoses and premalignant lesions. The delay in consulting, due to fear, shame or the doctor's own ignorance, can cause the lesions to progress to malignancy and require aggressive treatments that can alter the quality of life and physical and mental health of the patient. We must suspect premalignancy or malignancy any lesion of the penis that is not modified with specific or empirical treatment and refer for biopsy. HPV infections are the origin of 50% of premalignant lesions. After treatment and due to possible relapses and progression to infiltrating carcinomas, a strict follow-up plan is necessary.
Collapse
Affiliation(s)
- J M Abella Cajigal
- Medicina Familiar y Comunitaria, Centro de Salud Os Mallos, La Coruña, España.
| | - C Fernández López
- Medicina Familiar y Comunitaria, Centro de Salud Os Mallos, La Coruña, España
| | - M García-Lamazares
- Medicina Familiar y Comunitaria, Centro de Salud Os Mallos, La Coruña, España
| |
Collapse
|
10
|
Viteri Jusué A, Domínguez Fernández S, Pérez Persona E, Poza de Celis R. Urgent and unexpected findings in oncology and hematology patients: a practical approach to imaging. Radiologia (Engl Ed) 2021; 64:S0033-8338(21)00086-2. [PMID: 33985767 DOI: 10.1016/j.rx.2021.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 11/29/2022]
Abstract
Urgent and unexpected findings are very common in oncology and hematology patients. This article reviews the most important points included in the European Society of Radiology's guidelines and proposes a practical approach to reporting and communicating these findings more efficiently. This approach is explained with illustrative examples. Radiologists can provide added value in the management of these findings by helping referring clinicians reach the best decisions. To this end, it is essential to know the imaging manifestations of the most common findings that must be reported urgently, such as the specific toxicity of different treatments, the complications of tumors and catheters, infections, and thrombosis. Moreover, it is crucial to consider the individual patient's treatment, risk factors, clinical situation, and immune status.
Collapse
Affiliation(s)
- A Viteri Jusué
- Servicio de Radiodiagnóstico, Hospital Universitario Araba, Vitoria-Gasteiz, España.
| | | | - E Pérez Persona
- Servicio de Hematología, Hospital Universitario Araba, Vitoria-Gasteiz, España
| | - R Poza de Celis
- Servicio de Oncología Radioterápica, Hospital Universitario Araba, Vitoria-Gasteiz, España
| |
Collapse
|
11
|
Serra-García L, Morgado-Carrasco D. RF-Prurigo Nodularis: Associations With Neoplasms, Recommendations for Additional Testing, and Novel Treatments. Actas Dermosifiliogr (Engl Ed) 2021; 112:S0001-7310(21)00093-4. [PMID: 33675720 DOI: 10.1016/j.ad.2019.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 08/07/2019] [Indexed: 11/25/2022] Open
Affiliation(s)
- L Serra-García
- Departamento de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
| | - D Morgado-Carrasco
- Departamento de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España.
| |
Collapse
|
12
|
Finello M, Suasnabar DF, García MDJ, Díaz MV, Richetta L, Toranzo A, Hernández D, Cometto MA, Vázquez SM, Caeiro JP, Sierra J, Saad EJ. [Clinical and microbiological characteristics of bloodstream infections in adult neutropenic patients]. Rev Argent Microbiol 2021; 53:183-193. [PMID: 33388181 DOI: 10.1016/j.ram.2020.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 09/07/2020] [Accepted: 11/03/2020] [Indexed: 11/16/2022] Open
Abstract
Bloodstream infections (BI) are relevant in neutropenic patients because they are associated with an increased number of complications and death. The objective was determinate the epidemiologic and microbiologic features of the BI in neutropenic patients with solid neoplasm (SN) and hematologic neoplasm (HN). Retrospective study in two third level hospitals between 2009 and 2016. They were included all the patients older than 18 years-old with active oncologic disease and neutropenia, who had BI. Patients with dermatologic cancer other than melanoma where excluded. A total of 143 BI in neutropenic were observed, of which 80.4% occurred in HN. Around 97.9% of the patients had a high-risk neutropenia without differences between both groups. The most frequent site of BI was primary bacteremia (46.9%) and catheter-associated infection (21%), without significant differences between the two groups. The gram negatives bacilli (GNB) predominated over the gram positive cocci (GPC) and they represented 74.1% of the isolated bacteria, being Escherichia coli the most frequent (32.8%). Among the gram positive cocci, Staphylococcus aureus (28.1%) was the most frequent isolated, followed by coagulase-negative Staphylococci (CNS). There were no differences in microbiological isolates between both groups. With regard to the antimicrobial susceptibility 67.5% of the CNS, 17.6% of the E. coli and 27.6% of the Klebsiella pneumoniae were multiresistant with no differences between both groups. Only 11.1% of S. aureus isolates were methicillin resistant. In conclusion BI of the neutropenic patients where most frequents within patients with HN, GNB were the main microbiological isolates. High mortality was observed in neutropenic patients with BI.
Collapse
Affiliation(s)
- Malena Finello
- Servicio de Clínica Médica, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | | | - Mercedes de Jesús García
- Servicio de Hematología y Oncología, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - María Victoria Díaz
- Servicio de Hematología y Oncología, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Luis Richetta
- Servicio de Anestesiología, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Agustín Toranzo
- Servicio de Diagnóstico por Imágenes, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Daniela Hernández
- Laboratorio de Microbiología, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - María Aldana Cometto
- Laboratorio de Microbiología, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Sofía Mariela Vázquez
- Laboratorio de Microbiología, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Juan Pablo Caeiro
- Servicio de Enfermedades Infecciosas, Hospital Privado Universitario de Córdoba, Córdoba, Argentina; Instituto Universitario de Ciencias Biomédicas de Córdoba, Córdoba, Argentina
| | - Jeremías Sierra
- Servicio de Hematología y Oncología, Hospital Privado Universitario de Córdoba, Córdoba, Argentina; Instituto Universitario de Ciencias Biomédicas de Córdoba, Córdoba, Argentina
| | - Emanuel José Saad
- Servicio de Clínica Médica, Hospital Privado Universitario de Córdoba, Córdoba, Argentina; Instituto Universitario de Ciencias Biomédicas de Córdoba, Córdoba, Argentina.
| |
Collapse
|
13
|
Vargas-Mora P, Morgado-Carrasco D, Fustà-Novell X. Porokeratosis: A Review of Its Pathophysiology, Clinical Manifestations, Diagnosis, and Treatment. Actas Dermosifiliogr (Engl Ed) 2020; 111:545-560. [PMID: 32401728 DOI: 10.1016/j.ad.2020.03.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 03/14/2020] [Accepted: 03/30/2020] [Indexed: 12/17/2022] Open
Abstract
Porokeratosis comprises a group of heterogeneous and uncommon acquired or congenital skin diseases of unknown origin characterized by a keratinization disorder resulting from abnormal clonal expansion of keratinocytes. Numerous genetic mutations are thought to be involved. These conditions are characterized histologically by the presence of a cornoid lamella. Clinical manifestations are variable, with localized, disseminated, and even eruptive forms. Porokeratosis has been associated with immunosuppression, ultraviolet radiation, and systemic, infectious, and neoplastic diseases. Many authors consider it to be a premalignant condition because of the potential for malignant transformation to squamous cell or basal cell carcinoma. Therefore, long-term follow-up is a key component of treatment, which is usually complex and often unsatisfactory. We review the latest advances in our understanding of the pathogenesis, diagnosis, and treatment and propose a treatment algorithm.
Collapse
Affiliation(s)
- P Vargas-Mora
- Departamento de Dermatología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - D Morgado-Carrasco
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, España.
| | - X Fustà-Novell
- Servicio de Dermatología, Althaia, Xarxa Assistencial Universitària de Manresa, España
| |
Collapse
|
14
|
Ekinci O, Eren T, Kurtoglu Yakici M, Gapbarov A, Aydemir MA, Saglam ZA, Alimoglu O. Relationship Between Metabolic Syndrome and Postmenopausal Breast Cancer. Cir Esp 2020; 98:540-546. [PMID: 32197778 DOI: 10.1016/j.ciresp.2019.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 12/24/2019] [Accepted: 12/30/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Metabolic syndrome is associated with an increased risk of diabetes mellitus (DM) and coronary heart disease. It may also be associated with a higher risk of some common cancers. The objective of this study was to determine the relationship between metabolic syndrome and breast cancer in postmenopausal women. METHODS We present a prospective cohort study of postmenopausal women. This cohort was divided into two groups: the «benign diagnosis group», including women who were studied after breast cancer screening; and the «malignant tumor group», including patients with breast cancer that had been diagnosed by biopsy. Age, weight, height, body mass index (BMI), abdominal perimeter, serum glucose, LDL, HDL and insulin levels were analyzed as variables under study. The HOMA-IR homeostatic model formula was used to assess insulin resistance. The differences were considered statistically significant when P<.05. RESULTS Two hundred women with a mean age of 61.5±9.6 (range: 37-93) were enrolled in the study, consisting of 150 (75%) patients with a benign diagnosis and 50 (25%) patients with a malignant tumor. BMI and abdominal perimeter were higher in the group with a malignant tumor (P<.05). The incidence of DM and metabolic syndrome was higher in the malignant tumor group (P<.005). In the malignant tumor group, much higher incidences correlated with fasting glycemic levels >100mg/dL, insulin levels >10mIU/L and HOMA-IR scores >2.7 (P<.05). CONCLUSIONS There is a relationship between metabolic syndrome and postmenopausal breast cancer. More studies are needed to establish methods for the prevention of breast cancer in women with metabolic syndrome.
Collapse
Affiliation(s)
- Ozgur Ekinci
- Departamento de Cirugía General, Facultad de Medicina, Istanbul Medeniyet Üniversitesi, Estambul, Turquía
| | - Tunc Eren
- Departamento de Cirugía General, Facultad de Medicina, Istanbul Medeniyet Üniversitesi, Estambul, Turquía.
| | - Melike Kurtoglu Yakici
- Departamento de Medicina Familiar, Facultad de Medicina, Istanbul Medeniyet Üniversitesi, Estambul, Turquía
| | - Aman Gapbarov
- Departamento de Cirugía General, Facultad de Medicina, Istanbul Medeniyet Üniversitesi, Estambul, Turquía
| | - Muhammet Ali Aydemir
- Departamento de Cirugía General, Facultad de Medicina, Istanbul Medeniyet Üniversitesi, Estambul, Turquía
| | - Zuhal Aydan Saglam
- Departamento de Medicina Familiar, Facultad de Medicina, Istanbul Medeniyet Üniversitesi, Estambul, Turquía
| | - Orhan Alimoglu
- Departamento de Cirugía General, Facultad de Medicina, Istanbul Medeniyet Üniversitesi, Estambul, Turquía
| |
Collapse
|
15
|
Cammarata-Scalisi F, Avendaño A, Stock F, Callea M, Sparago A, Riccio A. Beckwith-Wiedemann syndrome: clinical and etiopathogenic aspects of a model genomic imprinting entity. ARCH ARGENT PEDIATR 2019; 116:368-373. [PMID: 30204990 DOI: 10.5546/aap.2018.eng.368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 03/08/2018] [Indexed: 11/12/2022]
Abstract
The Beckwith-Wiedemann syndrome is the most common genetic entity in overgrowth, with an approximate incidence of 1 in 10 00013 700births. Its broad clinical spectrum includes pre- and postnatal macrosomia, macroglossia, pinna abnormalities, abdominal wall defects, visceromegaly, and hyperinsulinemic hypoglycemia. This syndrome predisposes to childhood cancer and is caused by diverse genetic and/or epigenetic disorders that usually affect the regulation of genes imprinted on chromosome 11p15.5. The knowledge of (epi) genotype-phenotype correlations has prompted recommendations to propose different health care strategies, including tumor surveillance protocols based on molecular classification, aimed at standardizing clinical practice. The objective of this article is to describe the current status of the Beckwith-Wiedemann syndrome, a model of genomic imprinting.
Collapse
Affiliation(s)
- Francisco Cammarata-Scalisi
- Unidad de Genética Médica, Departamento de Puericultura y Pediatría, Universidad de Los Andes, Mérida, Venezuela. francocammarata19@ gmail.com
| | - Andrea Avendaño
- Unidad de Genética Médica, Departamento de Puericultura y Pediatría, Universidad de Los Andes, Mérida, Venezuela
| | - Frances Stock
- Unidad de Oncología Pediátrica, Instituto Autónomo Hospital Universitario de Los Andes, Mérida, Venezuela
| | - Michele Callea
- Unit of Dentistry, Bambino Gesù Children's Hospital -IRCCS, Rome, Italy
| | - Angela Sparago
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Andrea Riccio
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Caserta, Italy.,Institute of Genetics and Biophysics "Adriano Buzzati-Traverso", Consiglio Nazionale delle Ricerche (CNR), Naples, Italy
| |
Collapse
|
16
|
Quimbayo-Arcila C, Moreno-Torres B, López-Guerrero M, Orradre-Romeo J. [Intratumoral endometriosis in renal angiomyolipomas associated to medium vessel necrotizing vasculitis in a patient with Wünderlich syndrome. A rare finding]. Rev Esp Patol 2019; 52:202-204. [PMID: 31213263 DOI: 10.1016/j.patol.2018.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/28/2018] [Accepted: 09/18/2018] [Indexed: 10/27/2022]
Abstract
Spontaneous perirenal hematoma or Wünderlich syndrome is a rare entity that requires urgent attention. The most frequent causes are renal neoplasms, mainly renal angiomyolipoma, and vascular diseases (vasculitis). We present a case of a woman with a history of renal angiomyolipomas associated with tuberous sclerosis complex, who developed Wünderlich's syndrome associated with medial vessel vasculitis as well as an uncommon instance of intratumoral endometriosis.
Collapse
Affiliation(s)
| | | | | | - Juan Orradre-Romeo
- Servicio de Anatomía Patológica, Hospital Virgen de la Salud, Toledo, España
| |
Collapse
|
17
|
Raposo Rodríguez L, Fernández García N, Tovar Salazar DJ, Gómez Illán R, Díaz Sánchez TB. Imaging findings for mucinous tumors of the abdomen and pelvis. Radiologia (Engl Ed) 2019; 61:370-87. [PMID: 31078302 DOI: 10.1016/j.rx.2019.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 02/25/2019] [Accepted: 03/15/2019] [Indexed: 11/23/2022]
Abstract
This article aims to describe the imaging findings for mucinous tumors of the abdomen and pelvis, which have a similar appearance on imaging tests regardless of the organ in which they develop. Due to the high water content of mucus, the appearance of these tumors is generally similar to that of water on ultrasonography, computed tomography, and magnetic resonance imaging. Another common feature of mucin-producing tumors is that calcifications are often present. The rupture of these lesions and accumulation of mucinous material in the peritoneal cavity gives rise to pseudomyxoma peritonei. It is important to identify mucinous tumors because they have a different prognosis and clinical course than non-mucinous tumors and require different management. Depending on their anatomic location and their imaging characteristics, the treatment approach varies from follow-up to radical surgery together with chemotherapy or radiotherapy or both.
Collapse
|
18
|
Juenemann M, Nef H, Möllmann H, Singh P, Troidl C, Schramm P, Kaps M, Gerriets T, Blaes F, Tschernatsch M. No evidence for humoral autoimmunity against cardiomyocytes, adrenergic or muscarinic receptors in patients with Tako-Tsubo cardiomyopathy. Immunobiology 2019; 224:220-2. [PMID: 30554740 DOI: 10.1016/j.imbio.2018.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 11/13/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND An association between Tako-Tsubo cardiomyopathy (TTC) and underlying malignancies has been observed, suggesting that TTC might be the consequence of paraneoplastic phenomena. This study investigates the presence of autoantibodies against cardiomyocytes as well as adrenergic (β1, β2) and muscarinic (M2) receptors in patients with TTC. METHODS AND RESULTS Serum from 20 TTC patients and 20 controls with ischemic heart disease was obtained. Indirect immunofluorescence testing for intracellular autoantibodies against cardiomyocytes showed a homogenous distribution, as in both groups 9 of 20 sera displayed a characteristic binding pattern of antibodies including vascular walls and intracellular structures. Flow cytometry analysis revealed no difference between TTC and controls in the binding of autoantibodies to the surface antigens of cardiomyocyte HL-1 cells (p = 0.569, t-test). Flow cytometry analysis of nontransfected wild type cells (p = 0.633, t-test), M2 receptor-transfected cells (p = 0.687, t-test), β1 receptor-transfected cells (p = 0.444, t-test) and β2 receptor-transfected cells (p = 0.632, t-test) showed similar results for control and TTC sera. Likewise, the binding pattern of TTC patients with a history of neoplasia compared to those without or to controls did not differ significantly (p > 0.05, u-test). CONCLUSION Findings suggest that the presumed paraneoplastic etiology of TTC cannot be attributed to the formation of these antibodies.
Collapse
|
19
|
Hilario A, Hernandez-Lain A, Sepulveda JM, Lagares A, Perez-Nuñez A, Ramos A. Perfusion MRI grading diffuse gliomas: Impact of permeability parameters on molecular biomarkers and survival. Neurocirugia (Astur) 2018; 30:11-18. [PMID: 30143443 DOI: 10.1016/j.neucir.2018.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 05/04/2018] [Accepted: 06/01/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND PURPOSE Our objectives were: (1) compare dynamic susceptibility-weighted (DSC) and dynamic contrast-enhanced (DCE) permeability parameters, (2) evaluate diagnostic accuracy of DSC and DCE discriminating high- and low-grade tumors, (3) analyze relationship of permeability parameters with overall (OS) and progression-free survival (PFS) and (4) assess differences in high-grade tumors classified according to molecular biomarkers. MATERIALS AND METHODS 49 patients with histologically proved diffuse gliomas underwent DSC and DCE imaging. Parametric maps of cerebral blood volume (CBV), CBV-leakage corrected, volume transfer coefficient (Ktrans), fractional volume of the extravascular extracellular space (EES) (Ve), fractional blood plasma volume (Vp) and rate constant between EES and blood plasma (Kep) were calculated. High-grade gliomas were also classified according to isocitrate dehydrogenase (IDH), alpha-thalassemia/mental retardation syndrome X-linked (ATRX) and O6-methylguanine-dna-methyltransferase promoter methylation (MGMT) status. RESULTS There is correlation between parameters leakage, Ktrans and Vp. ROC curve analysis showed significance in both Ktrans and Ve for glioma grading. Threshold value of 0.075 for Ve generated the best combination of sensitivity (80%) and specificity (75%) in tumor gradation. Leakage was the only permeability parameter related to OS (P=0.006) and PFS (0.012); with prolonged survival for leakage values lower than 1.2. IDH-mutated high-grade tumors showed lower leakage and Ktrans values. High-grade tumors with loss of ATRX presented lower leakage and Vp values. CONCLUSIONS Both DSC and DCE permeability parameters serve as non-invasive method for glioma grading. Leakage was the unique permeability parameter related to survival and the best discriminating high-grade gliomas classified according to IDH and ATRX status.
Collapse
Affiliation(s)
- Amaya Hilario
- Department of Radiology, Neuroradiology Section, Universitary Hospital 12 de Octubre, Madrid, Spain.
| | | | | | - Alfonso Lagares
- Department of Neurosurgery, Universitary Hospital 12 de Octubre, Madrid, Spain
| | - Angel Perez-Nuñez
- Department of Neurosurgery, Universitary Hospital 12 de Octubre, Madrid, Spain
| | - Ana Ramos
- Department of Radiology, Neuroradiology Section, Universitary Hospital 12 de Octubre, Madrid, Spain
| |
Collapse
|
20
|
Ahumada-Martínez O, Hernandez-López J, A Liñán-Cabello M. Occurrence of tumors among gastropods Plicopurpura pansa (Gastropoda: Neogastropoda) in the Port of Manzanillo, Mexico. Environ Sci Pollut Res Int 2018; 25:24064-24072. [PMID: 29948680 DOI: 10.1007/s11356-018-2369-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 05/22/2018] [Indexed: 06/08/2023]
Abstract
In order to evaluate the health of Plicopurpura pansa, a species considered vulnerable, a population of this gastropod living in proximity to the port of greatest cargo movement in Mexico was monitored seasonally during 1 year. Morphometric characteristics and sexual proportion were recorded. A macroscopic analysis was carried out to detect malformations and imposex; a histological analysis was performed to evaluate disseminated and gonadal neoplasias; the presence/absence in soft tissues of butyltin species (BTs) as possible contamination agents was also estimated. A total of 508 P. pansa specimens were collected. The largest specimens were obtained in winter. The coefficients of determination inside the port were low (R2 = 0.453). In general, there was a greater proportion of females than males throughout the year. Distinctive foot malformations (tumors) were recorded, but without signs of imposex. The histological examination confirmed the presence of disseminated neoplasias in the foot and gonads of P. pansa in the Port of Manzanillo. The comparative analysis of the morphological and histological features of the studied gastropod population allowed us to recognize impact patterns in relation to proximity to the port. There were high concentrations of monobutyltin (MBT) and greater abundance of tumors in heavier specimens; this was associated with port proximity zones. P. pansa could therefore serve as a sensitive bioindicator of environmental health in marine systems.
Collapse
Affiliation(s)
- Omar Ahumada-Martínez
- Facultad de Ciencias Marinas, Universidad de Colima, Km 19.5 Carretera Manzanillo Barra de Navidad, C.P. 28860, Manzanillo, Colima, Mexico
| | - Julieta Hernandez-López
- Facultad de Ciencias Marinas, Universidad de Colima, Km 19.5 Carretera Manzanillo Barra de Navidad, C.P. 28860, Manzanillo, Colima, Mexico
| | - Marco A Liñán-Cabello
- Facultad de Ciencias Marinas, Universidad de Colima, Km 19.5 Carretera Manzanillo Barra de Navidad, C.P. 28860, Manzanillo, Colima, Mexico.
| |
Collapse
|
21
|
Escobar J, Pérez B, Acevedo Á, Carvajal J, Rueda MC, Velez-Esquivia MA. [Application of immunocytochemistry as a diagnostic aid: Experience in a tertiary university hospital in Cali, Colombia]. Rev Esp Patol 2018; 52:27-32. [PMID: 30583828 DOI: 10.1016/j.patol.2018.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 03/23/2018] [Accepted: 04/10/2018] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Immunocytochemistry is very useful in the differentiation of benign and malignant lesions, through the use of specific antibodies that differentiate the cells according to their origin. This study aims to describe the application of immunohistochemistry to the cytological study of different sample types at the Valle del Lili Foundation. MATERIALS AND METHODS A descriptive, retrospective, observational study was carried out with cytologies registered in the database of the pathology department of the Fundación Valle del Lili, between December 2015 and October 2017. RESULTS Fifty-four cytological samples with immunocytochemistry were included. It was possible to perform both the cell block and the liquid-based cytology button to 38.88% (n=21) of the total samples, finding from the results of both types of cytology, a Cohen's Kappa coefficient of 0.80 (95%CI: (0.4-1.0), P<.001. The most commonly used markers were: Calretinin, MOC-31, EMA, TTF1, PAX8, and Calcitonin. Out of the cytological studies positive for malignancy, a definitive diagnosis was made with a biopsy in 58.1% (n=25), with a Cohen's Kappa coefficient of 1.0 (95%CI: 1.0-1.0), P<.001. DISCUSSION This study provided data that permits the implementation of liquid-based cytology button for immunocytochemical studies, using assessable markers with agreement with cell-block cytology. Furthermore, it provides data useful for future research in this field.
Collapse
Affiliation(s)
- Juliana Escobar
- Departamento de Patología, Fundación Valle del Lili, Cali, Colombia; Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia.
| | - Bladimir Pérez
- Departamento de Patología, Fundación Valle del Lili, Cali, Colombia; Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
| | - Álvaro Acevedo
- Programa de Medicina, Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
| | - Jossman Carvajal
- Programa de Medicina, Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
| | - María Camila Rueda
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
| | - María A Velez-Esquivia
- Departamento de Patología, Fundación Valle del Lili, Cali, Colombia; Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
| |
Collapse
|
22
|
Teimoorian F, Ranaei M, Hajian Tilaki K, Shokri Shirvani J, Vosough Z. Association of Helicobacter pylori Infection With Colon Cancer and Adenomatous Polyps. Iran J Pathol 2018; 13:325-332. [PMID: 30636955 PMCID: PMC6322532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 08/18/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVE Helicobacter pylori infection is one of the most common chronic bacterial infections in the world, especially in the developing countries. This bacterium is the cause of many diseases such as lymphoma, gastritis, peptic ulcers, and stomach cancer. According to recent reports, H. pylori infection can potentially increase the risk of colon cancer. The current study aimed at investigating the association of H. pylori infection and the risk of colorectal cancer and adenomatous polyps. METHODS The current study was conducted on 50 patients with colon cancer and adenomatous polyps as the case group and 100 subjects with no specific pathologies (i e, polyps, neoplasms, or inflammatory diseases) as the control group. Blood samples were collected from the patients in order to assess the presence of anti-Helicobacter pylori infection antibodies, and the serum titer levels of anti-Helicobacter pylori IgG and IgA antibodies were measured using indirect enzyme-linked immunosorbent assay (ELISA) and a kit procured by Pishtaz Teb Company (Iran). RESULTS A total of 33 patients in the current study had adenomatous polyps and 17 had colon cancer. H. pylori infection (IgA >20 U/mL and IgG >10 U/mL) was significantly more prevalent in the patients with colon cancer and adenomatous polyps compared with the healthy controls (P= 0.003, P= 0.039, respectively). CONCLUSION The obtained results suggested that H. pylori infection can be considered as a risk factor for colon cancer and adenomatous polyps.
Collapse
Affiliation(s)
- Fatemeh Teimoorian
- Dept of Pathology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Ranaei
- Clinical Research Development Center, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran,Dr. Mohammad Ranaei, Clinical Research Development Center, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran E-mail:
| | - Karimollah Hajian Tilaki
- Dept of Statistic and Epidmiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Javad Shokri Shirvani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zeinab Vosough
- Dept of Pathology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| |
Collapse
|
23
|
Cordero A, López-Palop R, Carrillo P, Núñez J, Frutos A, Bertomeu-González V, Yépez F, Alcantara N, Ribes F, Juskova M, Bertomeu-Martínez V. Prevalence and Postdischarge Incidence of Malignancies in Patients With Acute Coronary Syndrome. Rev Esp Cardiol (Engl Ed) 2018; 71:267-73. [PMID: 29126971 DOI: 10.1016/j.rec.2017.07.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 07/05/2017] [Indexed: 12/11/2022]
Abstract
INTRODUCTION AND OBJECTIVES Malignancies are the second cause of death in developed countries after cardiovascular disease and both share common risk factors. METHODS This prospective study assessed the prevalence and postdischarge incidence of malignancies in all consecutive patients admitted for an acute coronary syndrome. RESULTS A total of 1819 patients were included. On admission, the prevalence of malignancies was 3.4%, and 41.9% of the patients were considered disease-free; of the 1731 discharged patients, the incidence was 3.1% (53 cases) and the most common locations were the colon, lung, bladder, and pancreas. Patients with prevalent malignancies were older and had more comorbidities and complications. There were no differences in the revascularization rate, but implantation of drug-eluting stents was less frequent in patients with prevalent malignancies. During follow-up, the median time to diagnosis of incident malignancies was 25 months. On multivariate analysis, independent risk factors were age and current or former smoking. All-cause mortality was much higher in patients with incident (64.2%) or prevalent (40.0%) malignancies. Multivariate analysis showed that prevalent and incident malignancies increased the risk of all-cause mortality by 4-fold. CONCLUSIONS Among patients admitted for an acute coronary syndrome, 3.8% had a history of malignancy, with less than 50% considered cured. The incidence of new malignancies was 3.4% and both types of malignancies substantially impaired the long-term prognosis.
Collapse
|
24
|
Gordillo Altamirano F, Fierro Torres MJ, Cevallos Salas N, Cervantes Vélez MC. [Mental Health Determines the Quality of Life in Patients With Cancer-Related Neuropathic Pain in Quito, Ecuador]. ACTA ACUST UNITED AC 2017; 46:154-160. [PMID: 28728799 DOI: 10.1016/j.rcp.2016.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/13/2016] [Accepted: 07/19/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To identify the main factors determining the health related quality of life (HRQL) in patients with cancer-related neuropathic pain in a tertiary care hospital. METHODS A cross-sectional analytical study was performed on a sample of 237 patients meeting criteria for cancer-related neuropathic pain. Clinical and demographic variables were recorded including, cancer type, stage, time since diagnosis, pain intensity, physical functionality with the Palliative Performance Scale (PPS), and anxiety and depression with the Hospital Anxiety and Depression Scale (HADS). Their respective correlation coefficients (r) with HRQL assessed with the SF-36v2 Questionnaire were then calculated. Linear regression equations were then constructed with the variables that showed an r≥.5 with the HRQL. RESULTS The HRQL scores of the sample were 39.3±9.1 (Physical Component) and 45.5±13.8 (Mental Component). Anxiety and depression strongly correlated with the mental component (r=-.641 and r=-.741, respectively) while PPS score correlated with the physical component (r=.617). The linear regression model that better explained the variance of the mental component was designed combining the Anxiety and Depression variables (R=77.3%; P<.001). CONCLUSIONS The strong influence of psychiatric comorbidity on the HRQL of patients with cancer-related neuropathic pain makes an integral management plan essential for these patients to include interventions for its timely diagnosis and treatment.
Collapse
|
25
|
Pereira VPL, Robazzi TCMV. Biological therapy and development of neoplastic disease in patients with juvenile rheumatic disease: a systematic review. Rev Bras Reumatol Engl Ed 2017; 57:174-181. [PMID: 28343623 DOI: 10.1016/j.rbre.2016.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 09/08/2016] [Indexed: 01/07/2023] Open
Abstract
Juvenile rheumatic diseases affect the musculoskeletal system and begin before the age of 18. These conditions have varied, identifiable or unknown etiologies, but those of an autoimmune inflammatory nature have been associated with an increased risk of development of cancer, regardless of treatment. This study aims to assess, through a systematic review of the literature according to Prisma (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) quality criteria, the risk of cancer in patients with juvenile rheumatic disease, and its association with biological agents. The criteria described by the Strengthening the Reporting of Observational Studies in Epidemiology initiative were used in order to assess the methodological quality of those individual items selected in this study. We analyzed nine publications, from a total of 251 papers initially selected. There was an increase in cancer risk in the population with juvenile rheumatic disease versus the general population. Most specified cancers were of a lymphoproliferative nature. Seven studies did not specify the treatment or not defined an association between treatment and cancer risk. Only one study has suggested this association; in it, their authors observed high risk in patients diagnosed in the last 20 years, a period of the advent of new therapies. One study found an increased risk in a population not treated with biological agents, suggesting a disease in its natural course, and not an adverse effect of therapy. Studies have shown an increased risk of malignancy associated with juvenile rheumatic disease, and this may be related to disease activity and not specifically to the treatment with biological agents.
Collapse
|
26
|
Calderón MDR, Delgado E, García Campos F. Acromegaly and associated tumours: what should gastroenterologists know? Gastroenterol Hepatol 2017; 40:41-47. [PMID: 26966026 DOI: 10.1016/j.gastrohep.2015.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 11/21/2015] [Accepted: 12/04/2015] [Indexed: 06/05/2023]
Abstract
Acromegaly is a clinical syndrome caused by the excessive production of growth hormone. It is associated with high morbidity and significantly increased mortality, mainly due to cardiovascular and respiratory complications, and cancer. Mortality is reduced to that of the general population following successful treatment, in other words, when insulin-like growth factor (IGF-I) and growth hormone values return to normal levels. Not all tumours associated with this syndrome benefit from cost-effective early diagnosis programmes. An in-depth knowledge on the part of clinicians of the morbidity and mortality associated with acromegaly, allowing them in many cases to anticipate the expected clinical course of the disease, is the best therapeutic and follow-up strategy in these patients.
Collapse
|
27
|
Teixeira JFC, Maia-Lemos PDS, Cypriano MDS, Pisani LP. The influence of antineoplastic treatment on the weight of survivors of childhood cancer. J Pediatr (Rio J) 2016; 92:559-566. [PMID: 27327565 DOI: 10.1016/j.jped.2016.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 03/23/2016] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Obesity is a late effect in survivors of childhood cancer and correlates with chronic complications. Survivors of leukemia, brain tumors, and hematopoietic stem cell transplantation are more likely to develop obesity resulting from treatment modalities such as radiotherapy and glucocorticoids. This paper analyzes and integrates the current data available to health professionals in order to clarify strategies that can be used to treat and prevent obesity in childhood cancer survivors. SOURCES This is a literature review from on scientifically reliable electronic databases. We selected articles published in the last five years and earlier articles of great scientific importance. DATA SYNTHESIS The mechanisms involved in the pathophysiology of obesity in cancer survivors are not completely understood, but it is believed that damage to the hypothalamus and endocrine disorders such as insulin resistance, leptin resistance, and hormone deficiency may be involved. The body composition of this group includes a predominance of adipose tissue, especially in those undergoing hematopoietic stem cell transplant and total body irradiation. The use of body mass index in these patients may lead to an underestimation of individuals' risk for metabolic complications. CONCLUSION Early identification of groups using accurate anthropometric assessments, interventional treatment, and/or preventative measures and counseling is essential to minimize the adverse effects of treatment. Physical activity and healthy eating to promote adequacy of weight in the whole population should be encouraged.
Collapse
Affiliation(s)
| | - Priscila Dos Santos Maia-Lemos
- Instituto de Oncologia Pediátrica/Grupo de Apoio ao Adolescente e à Criança com Câncer (IOP/GRAACC), São Paulo, SP, Brazil
| | - Mônica Dos Santos Cypriano
- Instituto de Oncologia Pediátrica/Grupo de Apoio ao Adolescente e à Criança com Câncer (IOP/GRAACC), São Paulo, SP, Brazil
| | | |
Collapse
|
28
|
Martínez-Nicolás I, Ángel-García D, Saturno PJ, López-Soriano F. [Cancer pain management: Systematic review and critical appraisal of clinical practice guidelines]. ACTA ACUST UNITED AC 2015; 31:55-63. [PMID: 26420516 DOI: 10.1016/j.cali.2015.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Revised: 06/12/2015] [Accepted: 06/22/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Although several clinical practice guidelines have been developed in the last decades, cancer pain management is still deficient. The purpose of this work was to carry out a comprehensive and systematic literature review of current clinical practice guidelines on cancer pain management, and critically appraise their methodology and content in order to evaluate their quality and validity to cope with this public health issue. MATERIALS AND METHODS A systematic review was performed in the main databases, using English, French and Spanish as languages, from 2008 to 2013. Reporting and methodological quality was rated with the Appraisal of Guidelines, Research and Evaluation II (AGREE-II) tool, including an inter-rater reliability analysis. Guideline recommendations were extracted and classified into several categories and levels of evidence, aiming to analyse guidelines variability and evidence-based content comprehensiveness. RESULTS Six guidelines were included. A wide variability was found in both reporting and methodological quality of guidelines, as well as in the content and the level of evidence of their recommendations. The Scottish Intercollegiate Guidelines Network guideline was the best rated using AGREE-II, while the Sociedad Española de Oncología Médica guideline was the worst rated. The Ministry of Health Malaysia guideline was the most comprehensive, and the Scottish Intercollegiate Guidelines Network guideline was the second one. CONCLUSIONS The current guidelines on cancer pain management have limited quality and content. We recommend Ministry of Health Malaysia and Scottish Intercollegiate Guidelines Network guidelines, whilst Sociedad Española de Oncología Médica guideline still needs to improve.
Collapse
Affiliation(s)
- I Martínez-Nicolás
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
| | - D Ángel-García
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - P J Saturno
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - F López-Soriano
- Área de Gestión IV, Servicio Murciano de Salud, Hospital Comarcal de Caravaca, Caravaca, Murcia, España
| |
Collapse
|
29
|
Segura-Grau A, Herzog R, Díaz-Rodriguez N, Segura-Cabral JM. [Ultrasound of the urinary system]. Semergen 2015; 42:388-94. [PMID: 25982474 DOI: 10.1016/j.semerg.2015.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 03/18/2015] [Accepted: 03/20/2015] [Indexed: 01/29/2023]
Abstract
Ultrasound techniques are able to provide a fairly complete examination of the urinary system, achieving a high sensitivity in relevant-pathology detection, especially in the kidney, bladder and prostate. Early detection of pathologies such as tumors or urinary tract obstructions, sometimes even before their clinical manifestation, has improved their management and prognosis in many cases. This, added to its low cost and harmlessness, makes ultrasound ideal for early approaches and follow-up of a wide number of urinary system pathologies. In this article, the ultrasound characteristics of the main urinary system pathologies that can be diagnosed by this technique, are reviewed.
Collapse
Affiliation(s)
- A Segura-Grau
- Unidad de Ecografía San Francisco de Asís, Madrid, España; Centro de Diagnóstico Ecográfico, Madrid, España; Grupo de Trabajo de Ecografía de SEMERGEN, Madrid, España
| | - R Herzog
- Unidad de Ecografía San Francisco de Asís, Madrid, España; Centro de Diagnóstico Ecográfico, Madrid, España; Grupo de Trabajo de Ecografía de SEMERGEN, Madrid, España; Servicio de Atención Rural, Mejorada del Campo, Madrid, España.
| | - N Díaz-Rodriguez
- Centro de Salud A Valenza, Ourense, España; Grupo de Trabajo de Ecografía de SEMERGEN, Ourense, España
| | - J M Segura-Cabral
- Unidad de Ecografía San Francisco de Asís, Madrid, España; Centro de Diagnóstico Ecográfico, Madrid, España
| |
Collapse
|
30
|
Zapata-Tarrés M, Ibarra-Ríos D, Cruz-Rodríguez IV, Juárez-Villegas LE, Peña-Del Castillo H. [Malignant neoplasms in the neonate]. Bol Med Hosp Infant Mex 2014; 71:261-270. [PMID: 29421614 DOI: 10.1016/j.bmhimx.2014.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 05/30/2014] [Indexed: 11/16/2022] Open
Abstract
Cancer in children has characteristics that differentiate it from other types reported in later ages. Overall survival at 3 years is up to 70% depending on the tumor studied. Major organs and systems affected are the hematopoietic system, central nervous system and sympathetic and mesenchymal tissues. The increased incidence of neonatal tumors observed in this and other studies is based on the increasing number of solid tumors (teratomas and neuroblastomas) because cases of central nervous system tumors and leukemias have remained constant. Ultrasonography is the first line of approach and can detect up to 70% of fetal anomalies. The physiology of the newborn causes the necessary multidisciplinary treatment in neoplastic disease to be modified substantially in this age group to avoid toxicity and sequelae. The most common treatment is surgery. Achieving timely diagnostic treatment options are effective in improving the survival of these patients.
Collapse
Affiliation(s)
- Marta Zapata-Tarrés
- Servicio de Oncología, Instituto Nacional de Pediatría, México D.F., México.
| | - Daniel Ibarra-Ríos
- Departamento de Neonatología, Hospital Infantil de México Federico Gómez, México D.F., México
| | | | | | | |
Collapse
|