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1.
Sci Total Environ ; 857(Pt 3): 159633, 2023 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-36280064

RESUMO

Microplastics (MPs) represent an emergent contamination marker. For this reason, we analyzed the vertical distribution of MPs in six sediment cores retrieved from the Patos-Mirim System, the world's largest coastal lagoonal system. The sediment cores span from mid Holocene to present times according to both radiocarbon and lead dating and are located close to both urban/industrial and agricultural regions. We identified a basal pre-disturbance MP-free zone in all cores and an uppermost contaminated 70-cm-zone, where a general increasing trend in MPs content resembling the human anthropization process was recorded. The predominant format of MPs was fiber, followed by fragments. The most commonly identified polymers were rayon, PVC, acrylate, polycarbonate and cellophane. Urban/industrial and agricultural activities were shown as clear sources of MPs, leading to comparable MPs concentration values in the sediment cores. Thus, MPs are collectively a reliable indicator of the Anthropocene onset, and in the Patos-Mirim System the most appropriate chronology can be assigned to the beginning of 1970s, matching the intensification of anthropogenic activities in the area.


Assuntos
Microplásticos , Poluentes Químicos da Água , Humanos , Plásticos , Sedimentos Geológicos , Monitoramento Ambiental , Poluentes Químicos da Água/análise , Biomarcadores , América do Sul
2.
Int J Oral Maxillofac Surg ; 51(3): 347-354, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34456081

RESUMO

Cleft palate lateral synechia (CPLS) syndrome is an extremely rare congenital malformation syndrome of unknown origin, characterized by the association of cleft palate and one or more intraoral lateral synechiae (OMIM # 119550). Fewer than 20 cases have been described to date. The clinical and histological findings and results of genetic investigations for two additional cases of CPLS are presented herein, in order to better delineate this syndrome, within the context of the relevant literature. The first case presented with a U-shaped cleft palate, bilateral synechiae, and Pierre Robin sequence, requiring early sectioning of the synechiae because of severe feeding problems. The second case presented with a V-shaped cleft palate and a single synechia, running from the left border of the cleft to the floor of the mouth, and was without feeding difficulties. In both cases, histopathological examination of the synechiae revealed an aspect of mucous membranes macroscopically, while staining of sections indicated lymphocyte infiltrates and parakeratosis with stratified squamous epithelium, associated with vessel and connective tissue abnormalities. Sequencing of candidate genes did not identify a genetic cause. Accurate clinical descriptions, histopathological diagnosis, and genetic investigations of patients with synechiae are lacking in the literature. Better characterization of future cases of CPLS will give new insights into its developmental causes.


Assuntos
Anormalidades Múltiplas , Fissura Palatina , Anormalidades Maxilomandibulares , Anormalidades da Boca , Síndrome de Pierre Robin , Fissura Palatina/complicações , Fissura Palatina/genética , Fissura Palatina/cirurgia , Humanos , Anormalidades da Boca/diagnóstico , Síndrome de Pierre Robin/complicações , Aderências Teciduais/congênito
3.
Forensic Sci Int ; 328: 111037, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34619560

RESUMO

In this paper a morphological differentiation tool of bovine and equine hair for their identification in forensic investigations is provided. 30 animals were used, fifteen adult bovines of the "Siboney de Cuba" breed and fifteen adult equines of the "Criolla" breed. These species are the most bred in Cuba and, at the same time, the most exposed to poaching and theft crimes. Hair from the cows was sampled from the dorsal region, the lateral region and the ventral region; on the other hand, the horses' hair was sampled from the dorsal region of the body, of the mane and of the tail. The sampled areas, different for bovine and equine, have been chosen because they represent the different types of hairs present in the two species under examination. Getty et al. (2004), infact, reported that both in cattle and horses the length and thickness of the hair is reduced in a dorsal-ventral direction towards the abdomen, increasing its density. The samples were observed at an optical microscope with LCD display, at lens 4X, 10X, 40X and 100X, to determine cuticle scales, cortex, medulla and medullary index. As a result, it was noticed that both bovine and equine hair show a morphological and histomorphometric pattern based on the characteristics of the constitutive structures: cuticle scales, cortex and medulla. The bovines show a thin cuticle, coronal scales in mosaic with serrated edges and flattened irregularly, while in the equines it is thin and imbricated with irregular waves and intermediate spaces. The cortex in the bovines is thin crust dark brown and not pigmented; in the equines the cortex is dark brown, with light texture and isolated dark brown and black pigments. In both species, the white hairs do not show pigments. Through this investigation it can be noticed that one of the most important aspects in the species identification in forensic analysis is the medullary index, since it allows differentiation between animal and human species. In the bovine it is shown with an average of 0.60, while the equine shows an average medullary index of 0.49.


Assuntos
Cor de Cabelo , Cabelo , Animais , Bovinos , Crime , Feminino , Cavalos , Microscopia , Pigmentação
4.
Annu Int Conf IEEE Eng Med Biol Soc ; 2021: 985-988, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34891453

RESUMO

To cope with the high intra-subject variability of muscle activation intervals, a large amount of gait cycles is necessary to clearly document physiological or pathological muscle activity patterns during human locomotion. The Clustering for Identification of Muscle Activation Pattern (CIMAP) algorithm has been proposed to help clinicians obtaining a synthetic and clear description of normal and pathological muscle functions in human walking. Moreover, this algorithm allows the extraction of Principal Activations (PAs), defined as those muscle activations that are strictly necessary to perform a specific task and occur in every gait cycle. This contribution aims at assessing the impact of the number of gait cycles on the extraction of the PAs. Results demonstrated no statistically significant differences between PAs extracted considering different numbers of gait cycles, revealing, on average, similarity values higher than 0.88.Clinical Relevance-This contribution demonstrates the potential applicability of the CIMAP algorithm to the analysis of subjects affected by neurological disorders, for whom the assessment of motor functions may be of the uttermost importance and only a reduced number of gait cycles can be acquired.


Assuntos
Marcha , Músculo Esquelético , Eletromiografia , Humanos , Locomoção , Caminhada
5.
BMC Sports Sci Med Rehabil ; 13(1): 163, 2021 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-34952624

RESUMO

PURPOSE: Single-limb stance is a demanding postural task featuring a high number of daily living and sporting activities. Thus, it is widely used for training and rehabilitation, as well as for balance assessment. Muscle activations around single joints have been previously described, however, it is not known which are the muscle synergies used to control posture and how they change between conditions of normal and lack of visual information. METHODS: Twenty-two healthy young participants were asked to perform a 30 s single-limb stance task in open-eyes and closed-eyes condition while standing on a force platform with the dominant limb. Muscle synergies were extracted from the electromyographical recordings of 13 muscles of the lower limb, hip, and back. The optimal number of synergies, together with the average recruitment level and balance control strategies were analyzed and compared between the open- and the closed-eyes condition. RESULTS: Four major muscle synergies, two ankle-dominant synergies, one knee-dominant synergy, and one hip/back-dominant synergy were found. No differences between open- and closed-eyes conditions were found for the recruitment level, except for the hip/back synergy, which significantly decreased (p = 0.02) in the closed-eyes compared to the open-eyes condition. A significant increase (p = 0.03) of the ankle balance strategy was found in the closed-eyes compared to the open-eyes condition. CONCLUSION: In healthy young individuals, single-limb stance is featured by four major synergies, both in open- and closed-eyes condition. Future studies should investigate muscle synergies in participants with other age groups, as well as pathological conditions.

6.
Environ Pollut ; 279: 116908, 2021 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-33774365

RESUMO

Plastics can enter biogeochemical cycles and thus be found in most ecosystems. Most studies emphasize plastic pollution in oceanic ecosystems even though rivers and estuaries are acknowledged as the main sources of plastics to the oceans. This review detected few studies approaching the transboundary issue, as well as patterns of estuarine gradients in predicting plastic distribution and accumulation in water, sediments, and organisms. Quantities of plastics in estuaries reach up to 45,500 items m-3 in water, 567,000 items m-3 in sediment, and 131 items per individual in the biota. The role of rivers and estuaries in the transport of plastics to the ocean is far from fully understood due to small sample sizes, short-term approaches, sampling techniques that underestimate small plastics, and the use of site-specific sampling rather than covering environmental gradients. Microfibres are the most commonly found plastic type in all environmental matrices but efforts to re-calculate pathways using novel sampling techniques and estimates are incipient. Microplastic availability to estuarine organisms and rising/sinking is determined by polymer characteristics and spatio-temporal fluctuations in physicochemical, biological, and mineralogical factors. Key processes governing plastic contamination along estuarine trophic webs remain unclear, as most studies used "species" as an ecological unit rather than trophic/functional guilds and ontogenetic shifts in feeding behaviour to understand communities and intraspecific relationships, respectively. Efforts to understand contamination at the tissue level and the contribution of biofouling organisms as vectors of contaminants onto plastic surfaces are increasing. In conclusion, rivers and estuaries still require attention with regards to accurate sampling and conclusions. Multivariate analysis and robust models are necessary to predict the fate of micro- and macroplastics in estuarine environments; and the inclusion of the socio-economic aspects in modelling techniques seems to be relevant regarding management approaches.


Assuntos
Plásticos , Poluentes Químicos da Água , Ecossistema , Monitoramento Ambiental , Estuários , Oceanos e Mares , Poluentes Químicos da Água/análise
7.
Forensic Sci Int ; 329: 111053, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34700246

RESUMO

Cannabis sativa is the most used controlled substance in Europe. With the advent of new and less restrictive European laws on cannabis sale for recreational use (including in Italy), an increase in indoor cannabis crops were observed. This increase was possible due to the availability of cannabis seeds through the internet market. Genetic identification of cannabis can link seizures and if in possession then might aid in an investigation. A 13-locus multiplex STR method was previously developed and validated by Houston et al. A collaborative exercise was organized by the Italian Forensic Geneticists - International Society of Forensic Genetics (Ge.F.I. - ISFG) Working Group with the aim to test the reproducibility, reliability and robustness of this multiplex cannabis STR kit. Twenty-one laboratories from three European countries participated in the collaborative exercise and were asked to perform STR typing of two cannabis samples. Cannabis DNA samples and the multiplex STR kit were provided by the University of Barcelona and Sam Houston State University. Different platforms for PCR amplification, capillary electrophoresis (CE) and genotyping software were selected at the discretion of the participating laboratories. Although the participating laboratories used different PCR equipment, CE platforms and genotyping software, concordant results were obtained from the majority of the samples. The overall genotyping success ratio was 96%. Only minor artifacts were observed. The mean peak height ratio was estimated to be 76.3% and 78.1% for sample 1 and sample 2, respectively. The lowest amount of -1 / + 1 stutter percentage produced, when the height of the parent allele was higher than 8000 RFU, resulted to be less than 10% of the parent allele height. Few common issues were observed such as a minor peak imbalance in some heterozygous loci, some artifact peaks and few instances of allelic drop-out. The results of this collaborative exercise demonstrated the robustness and applicability of the 13-locus system for cannabis DNA profiling for forensic purposes.


Assuntos
Cannabis , Cannabis/genética , DNA , Impressões Digitais de DNA , Humanos , Repetições de Microssatélites , Reação em Cadeia da Polimerase , Reprodutibilidade dos Testes
8.
Sci Total Environ ; 801: 149664, 2021 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-34418619

RESUMO

The palaeolimnological conditions of Mirim Lagoon, a large coastal shallow lagoon under the influence of historical human impacts related to the development of the primary sector of the economy were reconstructed. The first significant human impact consisted of locking the estuarine system to induce the transition from brackish to freshwater conditions. During this transition, the sedimentation rate consistently increased from pre-disturbance values of 0.25 cm yr-1 to >1 cm yr-1. A concomitant increase in nitrogen and carbon values was recorded indicating a related eutrophication process. The highest nutrient levels were achieved during the 1990s after the incorporation of cutting-edge technologies for agricultural production such as high-yielding varieties of rice resistant to climate variability and pests, and the use of inorganic fertilisers, pesticides and water supply controlled by irrigation. After 2011, the soybean production boosted and the area cultivated with this oilseed equalled the area of rice paddies, i.e., 2 × 105 ha. A sharp decrease in δ13C from -19 to -24‰ and in δ15N from 6 to 2‰ were observed in the sedimentary record, indicating a major shift in the composition of the organic matter after the agricultural intensification. Trace elements Cr, Cu, Ni and Zn showed a high positive correlation with Al and Fe, and enrichment factors near 1, indicating a natural and terrigenous source of these elements and also unpolluted conditions. However, the increase of As after 1990 and the positive correlation with Pb was associated with agricultural practices. All elemental ratios (K/Al, Ti/Al and V/Cr) showed constant pre-disturbance trends and a turning point ca. the 1990s. Microplastics were detected from the beginning of the 1990s and increased towards recent sediments, thus corroborating an anthropogenically impacted scenario. Therefore, the development of the primary sector of the economy exerted clear impacts on the environmental quality of the system.


Assuntos
Metais Pesados , Oligoelementos , Poluentes Químicos da Água , Monitoramento Ambiental , Eutrofização , Sedimentos Geológicos , Humanos , Metais Pesados/análise , Plásticos , Oligoelementos/análise , Água , Poluentes Químicos da Água/análise
9.
Forensic Sci Int Genet ; 44: 102206, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31765878

RESUMO

We present the results obtained on DNA extracted from ocular (scleral/corneal) swabs collected from exhumed bodies at different times of burial. To our knowledge, there are no publications in the scientific forensic literature dealing with sclera/cornea as a source of DNA in the forensic laboratory. The obtained results demonstrate that cornea/sclera swabbing might be a promising alternative to the sampling of other tissues for DNA extraction even in highly putrefied bodies.


Assuntos
Córnea/química , DNA/isolamento & purificação , Exumação , Esclera/química , Manejo de Espécimes/métodos , Restos Mortais , Impressões Digitais de DNA , Genética Forense/métodos , Humanos , Repetições de Microssatélites , Reação em Cadeia da Polimerase
10.
Annu Int Conf IEEE Eng Med Biol Soc ; 2019: 1525-1528, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31946184

RESUMO

The muscle synergy theory was widely used in literature to assess the modular organization of the central nervous system (CNS) during human locomotion. The extraction of muscle synergies may be strongly influenced by the preprocessing techniques applied to surface electromyographic (sEMG) signals. The aim of this contribution is to assess the robustness improvement in muscle synergy extraction obtained using an innovative pre-processing technique with respect to the standard procedure. The new pre-processing technique that we propose is based on the extraction of principal muscle activation intervals (necessary to accomplish a specific biomechanical task during gait) from the original sEMG signals, discarding the secondary muscle activation intervals (activations that occur only in some strides with auxiliary functions). Results suggest that the extraction of the principal activation intervals from sEMG provide a more consistent and stable description of the modular organization of the CNS with respect to the standard pre-processing procedure.


Assuntos
Eletromiografia , Marcha , Músculo Esquelético , Análise de Dados , Eletromiografia/métodos , Humanos , Locomoção
11.
IEEE Trans Neural Syst Rehabil Eng ; 27(4): 772-779, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30843847

RESUMO

Gait asymmetry is typically evaluated using spatio-temporal or joint kinematics parameters. Only a few studies addressed the problem of defining an asymmetry index directly based on muscle activity, extracting parameters from surface electromyography (sEMG) signals. Moreover, no studies used the extraction of the muscle principal activations (activations that are necessary for accomplishing a specific motor task) as the base to construct an asymmetry index, less affected by the variability of sEMG patterns. The aim of this paper is to define a robust index to quantitatively assess the asymmetry of muscle activations during locomotion, based on the extraction of the principal activations. SEMG signals were analyzed combining statistical gait analysis (SGA) and a clustering algorithm that allows for obtaining the muscle principal activations. We evaluated the asymmetry levels of four lower limb muscles in: (1) healthy subjects of different ages (children, adults, and elderly); (2) different populations of orthopedic patients (adults with megaprosthesis of the knee after bone tumor resection, elderly subjects after total knee arthroplasty, and elderly subjects after total hip arthroplasty); and (3) neurological patients (children with hemiplegic cerebral palsy and elderly subjects affected by idiopathic normal pressure hydrocephalus). The asymmetry index obtained for each pathological population was then compared to that of age-matched controls. We found asymmetry levels consistent with the expected impact of the different pathologies on muscle activation during gait. This suggests that the proposed index can be successfully used in clinics for an objective assessment of the muscle activation asymmetry during locomotion.


Assuntos
Músculo Esquelético/fisiologia , Adulto , Idoso , Algoritmos , Artroplastia de Quadril , Fenômenos Biomecânicos , Criança , Análise por Conglomerados , Eletromiografia , Feminino , Marcha , Voluntários Saudáveis , Hemiplegia/fisiopatologia , Hemiplegia/reabilitação , Humanos , Hidrocefalia , Articulações/anatomia & histologia , Articulações/fisiologia , Prótese do Joelho , Extremidade Inferior/fisiologia , Masculino , Pessoa de Meia-Idade
12.
Annu Int Conf IEEE Eng Med Biol Soc ; 2017: 2502-2505, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29060407

RESUMO

The extraction of muscle synergies in human locomotion may be biased by the kind of pre-processing applied to electromyographic (EMG) data. The aim of this contribution is to analyze the differences in the muscle synergies extracted using a standard pre-processing procedure and a new procedure. The new procedure is based on the selection of the muscle's principal activations (necessary actuations of the muscle to accomplish its specific biomechanical task during gait), discarding secondary activations (with an auxiliary function in motor control). EMG signals were recorded from 12 muscles of a healthy volunteer who was asked to walk, at self-selected pace, for 5 minutes. A dataset of 193 gait cycles was collected and divided into 19 epochs of 10 concatenated gait cycles. The application of the new pre-processing procedure provided 5 instead of 6 muscle synergies accurately reconstructing the original EMG data matrix, and clearer and more stable neural activation commands. The new preprocessing procedure may be easily extended to the extraction of muscle synergies in other cyclic movements, such as running, stair climbing, cyclo-ergometer exercising, and swimming.


Assuntos
Locomoção , Eletromiografia , Marcha , Humanos , Músculo Esquelético
13.
Clin Ter ; 168(5): e307-e316, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29044353

RESUMO

Postpartum hemorrhage (PPH) is one of the most frequent causes of mortality and morbidity in the obstetric population globally, causing about a quarter of maternal deaths yearly, and is the leading cause of maternal death worldwide. The management of PPH remains a topic of great debate, even in view of new diagnostic and therapeutic possibilities in recent years, for which, however, the body of evidence available thus far is still scarce, as the standard values are lacking. The protocol hereby presented was developed after a literature review and during several meetings of an Italian multidisciplinary task group of specialists adopting a modified Delphi method, and is the result of the synthesis of therapeutic operational protocols for the treatment of PPH applied by the different specialties within the team. This protocol is intended to represent a practical proposal to support clinicians in the management of a particularly complex event that requires the intervention of a multidisciplinary team and the implementation of dedicated management protocols.


Assuntos
Hemorragia Pós-Parto/terapia , Protocolos Clínicos , Terapia Combinada , Feminino , Humanos , Itália , Período Pós-Parto , Gravidez
14.
Laryngoscope ; 95(2): 203-5, 1985 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-3968954

RESUMO

The postoperative course was evaluated for 458 consecutive patients, all over the age of 56 years, who had undergone laryngeal conservation surgery in the last 10 years. One hundred seventy-one patients aged 66 and over made up the "elderly" group and 287 patients, aged between 56 and 65 years formed the control group. It was confirmed that cordectomy and frontolateral laryngectomy are feasible even in elderly patients. Bronchopneumonia is the most frequent and serious complication after supraglottic laryngectomy. Therefore this operation should be performed in the elderly patient only after a thorough evaluation of cardiac and respiratory function. Prophylactic neck dissection should not be done for N0 necks and the second therapeutic neck dissection in N2 cancers should be staged 6 or more weeks later. Hemilaryngopharyngectomy and subtotal reconstructive laryngectomy with cricohyoidpexis are not advisable in elderly patients.


Assuntos
Neoplasias Laríngeas/cirurgia , Fatores Etários , Idoso , Cartilagem Cricoide/cirurgia , Glote , Humanos , Osso Hioide/cirurgia , Laringectomia/métodos , Pessoa de Meia-Idade , Neoplasias Faríngeas/cirurgia , Prega Vocal/cirurgia
15.
J Laryngol Otol ; 99(1): 73-83, 1985 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-3968477

RESUMO

The authors describe a rare complication of radical neck dissection, a 'pseudotumor' with fracture of the medial portion of the clavicle. Out of 899 radical neck procedures carried out in the ENT Department of Florence University, there were four such cases.


Assuntos
Neoplasias Ósseas/diagnóstico , Clavícula , Esvaziamento Cervical , Idoso , Clavícula/lesões , Diagnóstico Diferencial , Fraturas Espontâneas/etiologia , Humanos , Luxações Articulares/etiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Pseudoartrose/diagnóstico
16.
Ultrasonics ; 40(1-8): 605-10, 2002 May.
Artigo em Inglês | MEDLINE | ID: mdl-12160009

RESUMO

An important task in nondestructive materials evaluation is the development of techniques to characterize the bond quality of adherent joints. Binding forces are nonlinear and cause a nonlinear modulation of transmitted and reflected ultrasonic waves. As a consequence, the higher harmonics generated by an insonified monochromatic wave give information about the adhesive bonds. The local binding forces in thin bonded interfaces can be obtained by the amplitudes of the ultrasonic waves of the insonified frequency and its higher harmonics as transmitted through the interface. Additional phase measurements may enable one to obtain the evaluation of the full hysteretic cycle of the interaction force. In order to gain a deeper understanding of the interface region and to improve the technique, numerical simulations of the ultrasonic wave propagation through specimens of two bonded elements can be used. A simple model based on the local interaction simulation approach (LISA) is described in this contribution, and a comparison between the results of the simulations and the experimental data is presented. Besides its intrinsic relevance for NDE, the problem considered in this paper may be very useful to analyze and test models for the simulation of ultrasonic wave propagation in nonclassical nonlinear mesoscopic elastic materials.

17.
Acta Otorhinolaryngol Ital ; 9(1): 41-54, 1989.
Artigo em Italiano | MEDLINE | ID: mdl-2728898

RESUMO

The authors present the developments made in the use of cutaneous cervical flaps in the reconstruction of the hypopharyngo-cervical esophagus since Mikulicz first introduced the technique in 1886. Mention is made of the most recent, valid reconstructive possibilities which have resulted in a progressive reduction in the use of cervical flaps. The advantages and disadvantages of the Wookey-operation are enumerated and considerations are made regarding the validity of this technique. The authors conclude that the use of cutaneous cervical flaps remains an effective method, particularly when more limited extirpation and/or further reconstructive stages are required or when a patient's poor general state contraindicates more stressing procedures.


Assuntos
Esôfago/cirurgia , Hipofaringe/cirurgia , Retalhos Cirúrgicos , Humanos , Métodos
18.
Acta Otorhinolaryngol Ital ; 9(6): 587-98, 1989.
Artigo em Italiano | MEDLINE | ID: mdl-2699146

RESUMO

During the surgical treatment of head and neck cancers the surgeon may have to face the problem of deciding what measures to adopt when the tissue at the margin of the surgical sections proves histologically to be cancerous. Many factors may influence the decision for supplementary therapy; among these, of primary importance are stage and site of the tumor, the effectiveness of non surgical therapy, and the psychophysical status of the patient. In order to better consider this problem a retrospective study, limited to laryngeal surgery, and a review of the literature have been carried out. Review of the patients undergoing surgery from 1972 to 1988 has revealed that histological examination of section margins during or after laryngeal surgery was performed in 56 cases: 10 stripping vocal cords, 11 cordectomies, 2 frontolateral laryngectomies, 2 hemilaryngectomies, 20 horizontal supraglottic laryngectomies, 10 total laryngectomies and 1 subtotal laryngectomy with cricohyoidopexis. The margin was negative in 35 cases while tumor lesions of various types were present in 21 cases. An invasive tumor was present in 14 patients and in 7 an 'in situ' tumor or premalignant diskeratosis was found. A policy of abstention was adopted in all but one of the cases. All cases of 'in situ' cancer and of invasive premalignant change were grouped together as they have in common base membrane integrity and the fact that the second lesion is to be considered precancerous. The following results were obtained: in 14 cases of invasive cancer at the section margin there were 8 recurrences (57.1%) 4 after total laryngectomy; 6 patients showed no evidence of disease (NED) after from 3 to 7 years. In the 7 cases of 'in situ' cancer and premalignant lesions at the surgical margin, 4 showed recurrence (57%) and of these 2 underwent surgery. The 3 other cases have been NED for 3 to 5 years. On the other hand, even in the group of 35 margin free patients 8 developed recurrences (22.3%) and of these 3 underwent surgery and 1 radiotherapy. It appears evident that in conservative surgery of the larynx the presence of tumor cells at the surgical margin does not necessarily lead to a recurrence; such recurrences vary from 18% to 60% depending on the study. Nonetheless, it is certain that a real possibility of recovery exists in 50% of these patients. It is, however, impossible to specify which patient manifesting a positive margin actually runs the risk of developing a recurrence.(ABSTRACT TRUNCATED AT 400 WORDS)


Assuntos
Carcinoma/cirurgia , Neoplasias Laríngeas/cirurgia , Lesões Pré-Cancerosas/cirurgia , Carcinoma in Situ/cirurgia , Seguimentos , Secções Congeladas , Humanos , Neoplasias Laríngeas/patologia , Laringectomia , Laringe/patologia , Recidiva Local de Neoplasia , Fatores de Tempo , Prega Vocal/cirurgia
19.
Acta Otorhinolaryngol Ital ; 10(5): 447-51, 1990.
Artigo em Italiano | MEDLINE | ID: mdl-2095104

RESUMO

Carcinoma of the lip is a common lesion which is not always acknowledged as as a potentially lethal disease. The risk of cancer occurs most commonly among aging white men. The risk factors normally associated with lip cancer are rural residence and outdoor occupation. In addition, both actinic radiation and tobacco smoking have been considered casually related to lip cancer. The present study is based on a retrospective review of 86 patients (82 males, 4 females, mean age 65) affected by carcinoma of the lip, treated in Florence from 1970 to 1988. The most frequent site for carcinoma of the lip proved to be the lower lip (71 cases); other sites included the upper lip (7) and the commissure (8). The lip tumor was a squamous cell carcinoma in 82 patients and a basal cell carcinoma in the remaining four. Good prognosis was found for all those with relatively small lesions (T1-T2). On the contrary, the prognosis proved quite poor for those who exhibited tumor fixation to the mandible or erosion of the mandible (23.5%, 5 year survival). Primary radiotherapy may be used for the smaller lesions as cure rates proved equivalent to those achieved surgically although the authors found surgery is always preferable as a primary method of treatment. Surgical excision of the tumor is a relatively minor procedure with a minimum of morbidity as compared with radiation therapy which may lead to local tissue reaction and may disturb function. Surgical management is also recommended as it bears the advantage of being to give a histologically accurate tumor margin assessment. Moreover, with surgery, functional results are good.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/cirurgia , Neoplasias Labiais/cirurgia , Idoso , Braquiterapia , Carcinoma Basocelular/mortalidade , Carcinoma Basocelular/radioterapia , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/radioterapia , Terapia Combinada , Feminino , Humanos , Neoplasias Labiais/mortalidade , Neoplasias Labiais/radioterapia , Masculino , Prognóstico , Estudos Retrospectivos
20.
Acta Otorhinolaryngol Ital ; 10(4): 337-46, 1990.
Artigo em Italiano | MEDLINE | ID: mdl-1966400

RESUMO

A retrospective study has been performed on 155 cases of surgically treated hypopharyngeal carcinomas in order to bring to light what effect the type of surgery has on survival and the reasons for failure. The following operations were performed: 103 hemipharyngectomies with total laryngectomy (HPTL); 28 total circular pharyngectomies with total laryngectomy (CPTL); 16 hemipharyngectomies with partial laryngectomy (HPPL); 4 exereses in lateral pharyngectomy; 2 total laryngectomies and 2 hemipharyngectomies in lateral pharyngotomy. Analysis of the results is only performed on the three most numerous groups of patients. The overall neoplastic mortality rate at 5 years was 79% for the HPTL group while it was 50% and 61% in the CPTL and HPPL groups, respectively. The actuarial survival curves show a higher, statistically significant, cumulative 5-year survival rate for the CPTL group (55.9%) than for the HPTL group (30.5%). The authors conclude that, considering the particular submucosa spreading to which hypopharyngeal carcinoma is subject and the good functional recovery which can be obtained with modern reconstructive surgery of the alimentary tract, CPTL should be the treatment of choice, even in the less advanced cases, in order to significantly reduce the risk of local recurrences.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Hipofaríngeas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Adenoide Cístico/patologia , Carcinoma Adenoide Cístico/cirurgia , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Feminino , Seguimentos , Humanos , Neoplasias Hipofaríngeas/mortalidade , Neoplasias Hipofaríngeas/patologia , Hipofaringe/patologia , Laringectomia , Masculino , Pessoa de Meia-Idade , Faringectomia , Estudos Retrospectivos , Fatores de Tempo
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