Gastric cancer represents the fifth most common cancer diagnosis worldwide and the third leading cause of cancer-related mortality. In the USA, the overall 5-year survival rate is 31%, with distant disease nearing 5%. The most common sites of metastasis are the liver and peritoneum. Skeletal muscle involvement has been rarely reported. Since clinical and imaging findings overlap with primary sarcomas, a confirmatory biopsy is required for diagnosis. Prognosis remains poor with treatment options including palliative chemotherapy, radiotherapy and surgical resection. We report the case of a 57-year-old female presenting with extensive involvement of skeletal muscle 10 years after achieving remission. In addition to illustrating the refractoriness and poor outcomes associated with muscle involvement, this case and comprehensive review of the literature highlights important characteristics of disease biology and tumor genomics that warrant detailed discussion and exposition to a wider audience.
Introduction Umbilical cord (UC) abnormalities and their clinical relations in 434 newborns were analyzed. We had previously reported on clinical associations of long and short UCs with any kind of malformation. This study focuses on other UC features (insertion, vessels, entanglements, coiling, and knots) and their associations with clinical characteristics and neonatal prognosis. Methods An observational analytic study was performed on placentas from consecutive deliveries. Ordered logistic regression with bivariate and multivariate analysis was performed to evaluate the relationship between variables of interest concerning UC abnormalities. Results A total of 434 placentas made up the study. UC abnormalities were abnormal insertion, 82 (18.86%); coiling (hypo and hypercoiled), 177 (40.78%); single umbilical artery (SUA), 4 (0.92%); entanglements, 8 (1.84%); true knots, 3 (0.69%); webs in UC base, 9 (2.07%); and right twist, 68 (15.67%). After analyzing maternal and fetal complications during pregnancy, multivariate analysis confirmed the recognized association between malformations and SUA and male gender; further confirmation was also made between hypertensive disorders of pregnancy and true knots. Discussion UC abnormalities associated with undesirable outcomes are varied and should be recognized and described. Clinical factors associated with anatomical UC abnormalities are not completely understood and justify forthcoming studies.
Objetivo. Dar a conocer el estado del arte sobre eventos adversos odontológicos, su frecuencia y gestión, de esta manera se busca incentivar la implementación de programas para la seguridad del paciente. Método. El procedimiento utilizado fue la búsqueda de artículos científicos relacionados con eventos adversos en las bases de datos de relevancia y posterior a una revisión sistemática determinar y mostrar los hallazgos más importantes. Resultados. Esta revisión presenta al servicio de endodoncia como el de mayor frecuencia en presentar eventos adversos, de otra parte el diagnostico asociado a esta revisión fue el de periodontitis apical y la mayor prevalencia encontrada fue en el régimen subsidiado. Conclusión. Se pudo determinar que en la práctica de la odontología la prevalencia de los eventos adversos es una realidad que aunque presenta poca evidencia debido a la baja notificación y seguimiento de programas tendientes a la seguridad en el paciente, debe ser un tópico a promover dado los alcances y consecuencias de los mismos
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