Mucinous adenocarcinoma (MA) is a rare entity. Indeed, the pathogenesis of fistula-associated perianal MA is still controversial. Due to the lack of informed evidence regarding this malignancy, no guidelines have been established concerning diagnostic and treatment strategies. The aim of this article is to report our experience and outcomes after three cases of large perianal MA treated in our center. From our retrospective chart review, we identified three male patients with chronic perianal fistula-in-ano who progressively developed perianal MA, confirmed by pelvic magnetic resonance (MRI) and histopathological examination performed on biopsy. We hereby, in accordance with the Surgical CAse REport (SCARE) guidelines, describe the management and further follow-up of each patient. The three patients underwent preoperative chemoradiation therapy, followed by ischioanal abdominoperineal resection (APR). Perineal reconstruction was needed in every case, using a vertical rectus abdominis myocutaneous (VRAM) flap and, punctually, a left fasciocutaneous flap was used too. Also, two of three patients completed the treatment with adjuvant chemotherapy. Neither recurrences nor distant metastases have been observed during the followup in both cases that finished the multimodal treatment. MA arising from chronic perianal fistula has an indolent growth with locoregional aggressiveness and a high risk of local recurrence. Therefore, although an ischioanal APR remains the surgical treatment of choice, an aggressive multimodal approach combining preoperative chemoradiation and adjuvant chemotherapy may achieve favorable effectiveness and promising response rates.
Inserting a chest tube is a therapeutic tool of great value not without complications. Our objective is to highlight a new treatment option using interventional radiological techniques that avoid the risks of surgery in selected patients. We present the case of a multi-pathological patient with a diagnosis of the left pulmonary empyema who accidentally inserted a chest tube into the splenic superior pole. The comorbidities of the patient and the presence of hemodynamic stability advocated conservative treatment through supraselective splenic catheterization and the introduction of surgical glue in the withdrawal of the tube.
El cuerpo-artista en tono estético de la educación corporal
ResumenEl lugar desde el cual se plantea el estudio del cuerpo-artista en tono estético es el de la educación corporal en perspectiva pedagógica. Para nosotros este lugar se convierte en un imperativo concreto que nos permite hacer relaciones entre el cuerpo y la educación. Las consideraciones de orden estético, el conocimiento sensible, el cuerpo como campo plural de fuerzas, el pensar la educación, el cuerpo-artista, son rodeos necesarios para otorgarle una signifi cación pedagógica al tema del cuerpo en la educación en conexión con ciertas consideraciones de orden estético relacionadas con el conocimiento sensible. Estamos pensando el cuerpo desde la educación en sentido formativo como actividad que tiene que ver con la subjetividad de las personas y con los modos de existencia. La metodología empleada en la investigación se inscribe en el enfoque fenomenológico hermenéutico y es de carácter teórico-documental. La investigación documental es un proceso de indagación en forma de espiral sobre el problema de estudio que se centra en el análisis, crítica e interpretación -hermeneusis-de documentos o textos escritos. El cuerpo-artista concibe el mundo como fenómeno estético, da forma, da valores, toma posesión. Esto es, ver en las actividades propias del mundo procesos de creación. La realidad son formas de hacer, de crear y esto lo convierte en proceso estético. Las formas de hacer tiene como producto la creación sin modelos predeterminados. El mundo es un agitado devenir donde surgen y desaparecen las formas.
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.