OBJETIVO: Este estudo tem como objetivo a avaliação pós-operatória do tratamento endovascular de aneurismas da aorta abdominal por angiotomografia com multidetectores. MATERIAIS E MÉTODOS: Foram analisadas, retrospectivamente, angiotomografias de 166 pacientes (137 homens e 29 mulheres) com idade média de 73 anos portadores de aneurisma da aorta abdominal submetidos a terapêutica endovascular, no período de junho de 2005 a agosto de 2006. Os exames foram feitos em tomógrafo multidetector de 64 canais e os parâmetros adotados foram: colimação, 0,625 mm; pitch, 0,6-1; mAs, 300-400; kV, 120. Em todos os casos foi utilizado meio de contraste iodado não-iônico (350 mg/ml) administrado por meio de bomba infusora, com fluxo de 4 ml/s a 5 ml/s e com volume variável de 70 ml a 100 ml. Os exames foram avaliados quanto à presença de complicações. RESULTADOS: Dos 166 exames realizados, 93 pacientes não apresentaram complicações e 73 apresentaram os seguintes achados: endoleak (n=37), trombose circunferencial da endoprótese (n=29), angulação (n=17), coleção no sítio de punção (n=10), migração da prótese (n=7), dissecção dos vasos de acesso (n=7) e oclusão (n=6). CONCLUSÃO: O endoleak foi a complicação mais prevalente em nosso estudo, sendo o tipo II o mais comum.
Liposarcomas are the most common soft tissue sarcoma of adults, and primary mediastinal liposarcomas are rare. We present a case of a 50-year-old man with primary mediastinal liposarcoma without any invasion into the surrounding structures, such as the esophagus, trachea, or left atrium of the heart. Following surgical removal of the liposarcoma, the patient has had no recurrence after one year. Surgical removal is the treatment of choice for a mediastinal liposarcoma; however, careful long-term follow-up is necessary because the recurrence rate is very high.
Laryngeal cancer afflicts a large number of people worldwide, and some will need surgery to contain the disease. Currently, tracheoesophageal (TE) speech is a common method of voice rehabilitation for patients who have had their larynges excised. However, despite the relatively high success rate, not everyone is capable of producing the TE voice, usually due to the tonicity of the pharyngoesophageal segment (PES). The present work studies how the tonicity of the muscles of the PES affects TE phonation, focusing mainly on hypotonicity. A simplified collapsible channel model is used. Steady-state solutions are obtained and a linear stability analysis is performed. It is then shown that the steady-state solutions of the model are similar to the wide variety of possible PES configurations that are reported in the literature. The linear stability analysis results provide a simple expression for the estimation of the minimum tonicity required for self-sustained oscillations of the PES.
Background: PD-L1 tumor proportion score is presently the only biomarker used for selecting incurable NSCLC patients for immune check point inhibition (ICI). Performance score (ECOG) and comorbidities are useful, but no specified guidelines exist in this regard. New objective biomarkers are warranted. Khorana score (KS) is a validated tool used to predict venous thromboembolisms (VTE) in outpatients with cancer prior to chemotherapy. For NSCLC patients undergoing chemotherapy KS has recently been associated with prediction of early mortality and not VTE. KS has not previously been investigated in patients undergoing ICI. Method: Retrospective data from 118 incurable advanced/metastatic NSCLC patients treated with ICI in a single center during the period of September 2015-April 2018 was gathered. Baseline platelet count (PC), leucocyte count (LC), and hemoglobin count (HC) were registered. Baseline body mass index calculations were performed as well as KS (a minimum of KS 1 due the primary lung cancer disease). Based on follow-up data Kaplan Meier curve estimates of overall survival (OS) and progression free survival (PFS) were performed. Result: For patient, tumor and treatment characteristics see Table 1. Fourteen percent had known VTE prior to ICI. Two patients died from pulmonary embolisms. KS correlated significantly to OS but not to PFS. A median OS of 18.1 months [CI 12.8-23.4] and 8.4 months [CI 4.3-12-6] was found for groups with KS¼1-2 and KS3, respectively (log-rank test, p¼0.017). Conclusion: Baseline Khorana Score may represent a new clinical applicable prognostic biomarker for incurable NSCLC patients undergoing ICI. A KS 3 may be a predictor for early mortality but large prospective studies validating or rejecting this are warranted.
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