Background. In an attempt to decrease the toxic effects of fluorouracil, doxorubicin, and methotrexate (FAMTX) by reducing the dose of methotrexate from 1500 mg/m2, according to the original regimen, to 1000 mg/m2, the authors designed the modified FAMTX treatment that was evaluated in a prospective Phase II‐III randomized trial. Methods. Patients with advanced gastric cancer were randomized to receive modified FAMTX treatment or supportive measures only (control group). In the middle of the study, the randomization was interrupted because of strong evidence of benefit in terms of tumor reduction and projected survival in the treatment arm receiving chemotherapy. By the end of the study, 30 assessable patients had received chemotherapy and 10 had received supportive treatment. Results. The overall response rate was 50% (15 patients); 12 patients (40%) had partial responses and 3 (10%) had complete responses (CR). One patient with extensive peritoneal carcinomatosis attained a CR pathologically documented by laparoscopic examination and peritoneal biopsy. The median overall survival time of the treated group was 9 months, whereas that of the control group was only 3 months (P = 0.001). The median overall survival time of the responders was 16 months, and their median remission duration was 8 months. The regimen was well tolerated, with a very acceptable toxicity profile. There was one toxic death resulting from neutropenia and sepsis in a patient who did not receive adequate leucovorin rescue. Conclusions. This regimen appears to prolong survival in patients with advanced gastric cancer, and the reduction of the methotrexate dose does not seem to compromise its efficacy. Cancer 1993; 72:37–41.
Appendicitis is the most common abdominal emergency. While the clinical diagnosis may be straightforward in patients who present with classic signs and symptoms, atypical presentations may result in diagnostic confusion and delay in treatment. Abdominal pain is the primary presenting complaint of patients with acute appendicitis. Nausea, vomiting, and anorexia occur in varying degrees. Abdominal examination reveals localised tenderness and muscular rigidity after localisation of the pain to the right iliac fossa. Laboratory data upon presentation usually reveal an elevated leukocytosis with a left shift. Measurement of C-reactive protein is most likely to be elevated. The advances in imaginology trend to diminish the false positive or negative diagnosis. Radiographic image of faecal loading image in the caecum has a sensitivity of 97% and a negative predictive value that is 98%. In experienced hands, ultrasound may have a sensitivity of 90% and specificity higher than 90%. Helical CT has reported a sensitivity that may reach 95% and specificity higher than 95%. Despite all medical advances, the diagnosis of acute appendicitis continues to be a medical challenge.
objectIve. The purpose of this study was to assess the prevalence of alcohol, tobacco and psychotropic drug consumption by students of the Universidade Federal de Minas Gerais (UFMG) School of Medicine, Brazil, and to ascertain aspects related to substance use in this population. Methods. This study was carried out with students of all years of the UFMG Medicine course, who were invited to participate anonymously by answering a self-administered questionnaire that has previously been validated and adapted to the Brazilian reality. The instrument was based on World Health Organization methods for development of student drug use surveys and included 25 questions on substance use. The Student t test and chi-square testing were performed for comparison of means and proportions. results. Alcohol and tobacco were the most commonly used substances, consumed by 85.2% and 16.3% of students respectively. Among the psychotropic drugs, use of cannabis was reported by 16.5% of students, LSD by 6.9%, sedatives by 12%, amphetamines by 7.5% and inhalant substances by 16.8%. Use of cocaine, crack, opiates, anticholinergics and anabolic steroids was rarely mentioned. conclusIon. Alcohol was the most widely used substance, and its consumption was associated with other drug addictions. Drugs were used most frequently by single, male students who live alone and need not work to support themselves.
This prospective phase II clinical trial was performed to explore the activity and efficacy of the combination of paclitaxel and 5-fluorouracil in the treatment of advanced gastric adenocarcinoma. Thirty-one patients ages 18 to 70 years, with Karnofsky performance status (KPS) >50, adequate cardiac, renal, and hepatic functions, measurable metastatic or locally unresectable disease, life expectancy > or =3 months, signed written informed consent, and without any previous chemotherapy were assigned to receive on an outpatient basis: paclitaxel--175 mg/m2, in a 3-hour infusion on day 1 and 5-fluorouracil--1.5 g/m2, also in a 3-hour infusion on day 2 every 21 days, for a maximum of seven cycles. A system to assess clinical benefit based on KPS, analgesic consumption, and weight gain was also used in this trial. Median age was 61 years (range, 31-70 years). The 29 patients eligible for response and toxicity evaluation underwent 147 cycles of chemotherapy. There were 19 (65.5%) objective responses (95% confidence interval: 48%-83%), including 7 (24.1%) complete responses and 12 (41.4%) partial responses. Three patients had the complete response pathologically confirmed. In three of six patients who went to second-look laparotomy, a potentially curative esophagogastrectomy was possible. The toxicity of this combination was considered low, predictable, and manageable and was characterized mainly by reversible alopecia, peripheral neuropathy, myalgia, and mild neutropenia. Fifteen (51.7%) patients attained a clinical benefit response. The median overall survival was 12 months (range, 2-30+ months) and the 30-month overall survival was 20%. This novel regimen appears to be very effective in advanced gastric cancer. The projected 2-year survival of 20% is higher than that achieved with other first-line regimens. These encouraging results indicate the need for further studies to confirm the merit of this regimen.
Current diagnostic alternatives for lesions of the small intestine are sometimes insufficient. Peroperative enteroscopy is presented as a useful method to identify and treat intestinal polyposis and angiodysplasias that can not be found by other methods. This technique was used on two patients. In both cases, this procedure was helpful and the appropriate treatment successfully completed.
The Brazilian scientific community claimed for a definitive systematization and for comprehensive and realistic national rules, to provide guidance and regulation, instead of sanctions, so that the question of scientific research involving animals could be better contemplated. This is beginning to occur now with Law n.º 11.794, sanctioned by the President of the Republic on November 8, 2008. Purpose: To describe the evolution of Brazilian regimentation for scientific use of animals and to analyze Law n.º 11.794. Methods:The legislation about the use of animals in teaching and in scientific research in Brazil and in Rio de Janeiro State was identified and discussed. Results: Until now, there was no updated general and systematizing rule regarding animal vivisection and experimentation for didactic or scientific purposes. The only specific law dates back to1979 and was not regimented. More recent laws equated the practice of scientific experiments to acts of abuse and mistreatment of animals, when alternative technology was available. Municipal laws that restricted the scientific practice of vivisection and experimentation with animals were created in the cities of Rio de Janeiro and Florianopolis. Conclusion: With the claim and collaboration of the scientific community, the sanction of Law n.º 11.794 regarding to the scientific use of animals represented an invaluable advance in spite of the presence of some points that eventually may require another type of treatment. The new Law states that it will be regimented within 180 (one-hundred-and-eighty) days, when some of these points could be better elucidated. Key words: Experimentation; Law; Animals; Teaching; Scientific Research. RESUMOA comunidade científica brasileira clamava por uma norma federal abrangente e realista, mais orientadora e reguladora, e menos sancionadora, na qual a questão do uso científico dos animais pudesse ser mais bem contemplada. Isto agora começa a se materializar, com a Lei n.º 11.794, sancionada pelo Presidente da República no dia 8 de novembro de 2008. Objetivo: Relatar a evolução na regulamentação brasileira sobre o uso científico de animais e analisar a Lei n.º 11.794. Métodos: Foi identificada e discutida a evolução na legislação existente no Brasil e em alguns municípios brasileiros acerca da utilização de animais no treinamento e na pesquisa científica, até a sanção da nova Lei. Resultados: Até agora, não existia norma geral sistematizadora atualizada referente à vivissecção e experimentação com animais, nem para fins didáticos, nem científicos. A única lei referente a esse tópico datava de 1979 e não chegou a ser regulamentada. Leis mais recentes equiparavam a prática de experimentos científicos aos atos de abuso e maus tratos de animais, na presença de tecnologia alternativa. Nos municípios do Rio de Janeiro e de Florianópolis foram criadas Leis Municipais que cerceavam a prática científica da vivissecção e da experimentação com animais. Conclusão: A partir do clamor e da colaboração da comunidade científica nacional, a...
Subtotal splenectomy may be useful in the treatment of severe injuries of the distal part of the spleen, when the vessels of its pedicle are damaged, or both.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
334 Leonard St
Brooklyn, NY 11211
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.