RESUMEN
AIM: In the last five years we cured 81 patients divided in two groups: the first was managed inordinately, the second according to a diagnostic and therapeutic protocol. METHODS: The first 23 patients were differently evaluated, before surgery, by means of traditional sialography, US, CT, CT sialography, MR, larger bore needles and FNAB. Neoplasm enucleations, atipic resections, superficial and total conservative parotidectomies were performed. The following 58 patients were evaluated and cured according to a diagnostic and therapeutic protocol. RESULTS: Diagnostic and therapeutic time were shortened, patients endurance improved and cost lowered. DISCUSSION: We think that many diagnostic procedures are useless and delay operation that, if possible, must be performed according to principles of radical extirpation.
Asunto(s)
Adenoma Pleomórfico/diagnóstico , Neoplasias de la Parótida/diagnóstico , Adenoma Pleomórfico/diagnóstico por imagen , Adenoma Pleomórfico/patología , Adenoma Pleomórfico/cirugía , Biopsia con Aguja , Manejo de Caso , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Neoplasias de la Parótida/diagnóstico por imagen , Neoplasias de la Parótida/patología , Neoplasias de la Parótida/cirugía , Guías de Práctica Clínica como Asunto , Sialografía , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , UltrasonografíaAsunto(s)
Cefotetán/uso terapéutico , Cefoxitina/uso terapéutico , Enfermedades de la Vesícula Biliar/microbiología , Sepsis/tratamiento farmacológico , Antibacterianos/uso terapéutico , Bacterias Aerobias/efectos de los fármacos , Bacterias Aerobias/aislamiento & purificación , Bacterias Anaerobias/efectos de los fármacos , Bacterias Anaerobias/aislamiento & purificación , Temperatura Corporal , Cefotetán/farmacocinética , Cefoxitina/farmacocinética , Enfermedades de la Vesícula Biliar/tratamiento farmacológico , Semivida , Humanos , Sepsis/complicaciones , Choque Séptico/tratamiento farmacológicoAsunto(s)
Profilaxis Antibiótica , Procedimientos Quirúrgicos del Sistema Biliar/efectos adversos , Cefotetán/uso terapéutico , Cefoxitina/uso terapéutico , Complicaciones Posoperatorias/prevención & control , Sepsis/prevención & control , Infección de la Herida Quirúrgica/prevención & control , Anciano , Ensayos Clínicos Controlados como Asunto , Femenino , Humanos , Masculino , Factores de RiesgoAsunto(s)
Infecciones Bacterianas/prevención & control , Cefotetán/uso terapéutico , Cefoxitina/uso terapéutico , Procedimientos Quirúrgicos del Sistema Digestivo/efectos adversos , Procedimientos Quirúrgicos Electivos/efectos adversos , Infección de la Herida Quirúrgica/prevención & control , Antibacterianos/uso terapéutico , Profilaxis Antibiótica , Infecciones Bacterianas/clasificación , Infecciones Bacterianas/epidemiología , Enfermedades del Colon/cirugía , Ensayos Clínicos Controlados como Asunto , Humanos , Enfermedades del Recto/cirugíaAsunto(s)
Adenoma Pleomórfico/patología , Neoplasias Palatinas/patología , Neoplasias de las Glándulas Salivales/patología , Glándulas Salivales Menores/patología , Adenocarcinoma/diagnóstico , Adenocarcinoma/patología , Adenocarcinoma/cirugía , Adenoma Pleomórfico/diagnóstico , Adenoma Pleomórfico/cirugía , Biopsia con Aguja , Carcinoma Adenoide Quístico/diagnóstico , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/cirugía , Carcinoma Mucoepidermoide/diagnóstico , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/cirugía , Humanos , Imagen por Resonancia Magnética , Neoplasias Palatinas/diagnóstico , Neoplasias Palatinas/cirugía , Estudios Retrospectivos , Neoplasias de las Glándulas Salivales/diagnóstico , Neoplasias de las Glándulas Salivales/cirugía , Glándulas Salivales Menores/cirugía , Tomografía Computarizada por Rayos XRESUMEN
Papillary carcinoma (PTC) is the most frequently occurring thyroid carcinoma. The aim of the present work is to perform a retrospective study to assess 172 patients with PTC who have been treated surgically, with radium-iodine (except microca) and LT4 from 1989 to 1999. The incidence of local, regional and systemic recurrence of the disease was verified together with the results at distance. Great importance on survival have preoperative cytological diagnosis, radical surgery and a modulated radio-iodine therapy. Age and tumor stage have been found as major prognostic factors, while no significant difference according to sex has been documented.
Asunto(s)
Carcinoma Papilar/cirugía , Neoplasias de la Tiroides/cirugía , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
The authors carried out a study to assess the efficacy of an antibiotic treatment (cefotetan or cefoxitin) in 22 stratified patients with biliary sepsis, at low and high risk. The severity of sepsis was assessed by a biliary sepsis score (B.S.S.). No significant difference in results was observed between the two treatments in low-risk groups (cefotetan 80%, cefoxitin 75% satisfactory), while the difference between the high risk groups was significant (cefotetan 75%, cefoxitin 40% satisfactory). In the low risk group it can be stated that better nutritional and immunological status provide adequate host defences and that the antibiotic treatment is less important in determining surgical outcome. In high risk patients the efficacy of an antibiotic, cefotetan in this case, can significantly improve clinical results.