RESUMO
Nowadays, social projects are usually oriented in such a way that after a given period of time, they can either support themselves independently or even allow a pecuniary reimbursement. In the latter case, experts speak of a profit-oriented reimbursement. On the other hand, there is so-called social reimbursement, which in contrast to the abovementioned form is not profit oriented, but, for example, considers its task fulfilled by the fact of successful knowledge transfer. The Spanish-German Society for ENT Medicine and Head and Neck Surgery (SDGHNO) launched the Latin America project in 2001 under the patronage of the then President Prof. Dr. Wolfgang Draf (Fulda). The goal of the SDGHNO was and is to create a professional as well as cultural platform for Spanish- and German-speaking ENT doctors. This platform can and should be used for professional purposes, e.g., for knowledge transfer. Since the beginning of its existence, the Latin America project has thus brought numerous scientific events into being and created specific contacts which have lasted until today or have even been continued and further developed. Particularly successful examples are Chile, Colombia, and Peru. This is a vivid example of social reimbursement, because the participating German-speaking members/speakers carried out their tasks on an entirely voluntary basis. Thus, the SDGHNO did not bear any travel, catering, or accommodation costs. The activities of the SDGHNO within the framework of the Latin America project are explained.
Assuntos
Otolaringologia , América Latina , Condições SociaisRESUMO
BACKGROUND: Non-small cell lung cancers (NSCLC) constitutes about 80% of all lung cancer cases. Although surgery is the only curative treatment of NSCLC, fewer than 20% of tumors can be radically resected. Radiotherapy is one of the main treatment modalities in lung cancer, contributing to both its cure and palliation. Endobronchial brachytherapy (EBB) has been used as one approach to improve local control either alone or in combination with other treatments. OBJECTIVES: To assess the effectiveness of palliative EBB in increasing survival and to control thoracic symptoms in patients with advanced NSCLC compared with external beam radiation therapy (EBRT) or other alternative endoluminal treatments. SEARCH STRATEGY: The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and other databases were searched, as were reference lists and handsearching of selected journals and conference proceedings. SELECTION CRITERIA: Randomized controlled trials (RCTs) comparing different regimens of palliative EBB with EBRT or other endobronchial interventions in patients with advanced NSCLC. DATA COLLECTION AND ANALYSIS: Thirteen RCTs were included. There were important differences in the doses of radiotherapy investigated, patient characteristics and the outcomes measured. Because of this heterogeneity no meta-analysis was attempted. MAIN RESULTS: We found trials comparing EBB to EBRT alone, EBB plus EBRT to EBRT alone, EBB plus chemotherapy to EBB alone, EBB to Nd-YAG laser and comparisons between diverse fractionation schedules of high dose rate EBB. From the heterogeneous information obtained from several small RCTs, we concluded that EBRT alone is more effective for palliation of NSCLC symptoms than EBB alone. Our findings did not provide conclusive evidence to recommend EBB plus EBRT to relieve symptoms compared to EBRT alone. Overall, for the primary endpoint of survival there was no evidence of benefit for EBB compared to EBRT and Nd-YAG laser or for the combination of EBB with chemotherapy. Additionally, findings from one trial suggested that twice 7.4 Gy was superior to the four times per week 3.8 Gy schedule for mean time of local control and fatal haemoptysis. No significant differences were found for fatal haemoptysis as an adverse event of EBB. AUTHORS' CONCLUSIONS: The evidence did not provide conclusive results that EBB plus EBRT improved symptom relief over EBRT alone. We were not able to provide conclusive evidence to recommend EBB with EBRT, chemotherapy or Nd-YAG laser. For patients previously treated by EBRT who are symptomatic from recurrent endobronchial central obstruction, EBB may be considered in selected cases.
Assuntos
Braquiterapia/métodos , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Neoplasias Pulmonares/radioterapia , Humanos , Cuidados Paliativos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Therapy with radiolabelled somatostatin analogue peptides is a promising new therapy to treat neuroendocrine tumours. The aim of this preliminary study is to present our experience with 177Lu-DOTATATE therapy, and evaluate tolerability and short-term efficacy in patients with tumours expressing somatostatin receptors. A total of 7 patients with metastatic neuroendocrine tumours were treated, each with 4 doses of 177Lu-DOTATATE. The treatment response was evaluated in the form of biochemical response (tumour markers), imaging methods (somatostatin receptor scintigraphy, computed tomography, and magnetic resonance), and functional and quality of life responses using the Karnofsky performance status scale. Treatment toxicity was also evaluated. The results obtained were as follows: Biochemical response: 60% of patients showed tumour marker levels returning to normal, while they decreased significantly in the remaining 40%. Imaging response: 85.7% had a partial response, while 14.3% showed stable disease. All (100%) patients showed a significant improvement in quality of life, with increased Karnofsky scale scores. No patient had acute or chronic toxicity, and subacute transient haematological toxicity was observed in 42.8% of patients. Despite being a preliminary study, it was found that treatment with 177Lu-DOTATATE is a safe treatment with few side effects, and an objective response was achieved in most patients.
Assuntos
Lutécio/uso terapêutico , Tumores Neuroendócrinos/radioterapia , Octreotida/análogos & derivados , Compostos Organometálicos/uso terapêutico , Radioisótopos/uso terapêutico , Compostos Radiofarmacêuticos/uso terapêutico , Adulto , Idoso , Biomarcadores Tumorais/análise , Feminino , Humanos , Avaliação de Estado de Karnofsky , Lutécio/efeitos adversos , Lutécio/farmacocinética , Masculino , Pessoa de Meia-Idade , Proteínas de Neoplasias/análise , Tumores Neuroendócrinos/secundário , Octreotida/efeitos adversos , Octreotida/farmacocinética , Octreotida/uso terapêutico , Compostos Organometálicos/efeitos adversos , Compostos Organometálicos/farmacocinética , Qualidade de Vida , Radioisótopos/efeitos adversos , Radioisótopos/farmacocinética , Cintilografia/métodos , Compostos Radiofarmacêuticos/efeitos adversos , Compostos Radiofarmacêuticos/farmacocinética , Receptores de Somatostatina/análise , Distribuição Tecidual , Resultado do Tratamento , Imagem Corporal Total/métodos , Adulto JovemRESUMO
A new system for the ultrafast characterization of resistive switching phenomenon is developed to acquire the current during the Set and Reset process in a microsecond time scale. A new electronic circuit has been developed as a part of the main setup system, which is capable of (i) applying a hardware current limit ranging from nanoampers up to miliampers and (ii) converting the Set and Reset exponential gate current range into an equivalent linear voltage. The complete system setup allows measuring with a microsecond resolution. Some examples demonstrate that, with the developed setup, an in-depth analysis of resistive switching phenomenon and random telegraph noise can be made.
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Structured information provided by manual annotation of proteins with Gene Ontology concepts represents a high-quality reliable data source for the research community. However, a limited scope of proteins is annotated due to the amount of human resources required to fully annotate each individual gene product from the literature. We introduce a novel method for automatic identification of GO terms in natural language text. The method takes into consideration several features: (1) the evidence for a GO term given by the words occurring in text, (2) the proximity between the words, and (3) the specificity of the GO terms based on their information content. The method has been evaluated on the BioCreAtIvE corpus and has been compared to current state of the art methods. The precision reached 0.34 at a recall of 0.34 for the identified terms at rank 1. In our analysis, we observe that the identification of GO terms in the "cellular component" subbranch of GO is more accurate than for terms from the other two subbranches. This observation is explained by the average number of words forming the terminology over the different subbranches.
RESUMO
A small epidemic of tinea corporis due to M. gypseum is reported. There were 13 children affected, ages 1-15 years. These children belonged to 6 neighbouring families and all used a common "playground", an empty lot located nearby. Cultures were positive for M. gypseum in the 13 children and the agent was also isolated from 2 soils collected in the playing-ground. Soil isolates were classified as N. gypsea. Clinically, the lesions were circinated and had active borders, they were preferentially located in the trunk. Most children (8/13) had multiple lesions. These and other pertinent aspects are discussed in the text.
Assuntos
Surtos de Doenças , Tinha , Adolescente , Criança , Pré-Escolar , Colômbia , Reservatórios de Doenças , Feminino , Humanos , Lactente , Masculino , Microsporum/isolamento & purificação , Microbiologia do Solo , Tinha/microbiologiaRESUMO
Slow or no reflow (SNR) complicates 10-15% of cases of percutaneous intervention (PI) in saphenous vein bypass graft (SVG). To date there have been limited options for the prevention and treatment of this common and potentially serious complication. We evaluated the procedural outcome of 143 consecutive SVG interventions. We compared patients who received pre-intervention intra-graft adenosine boluses with those who did not. In addition we examined the efficacy of adenosine boluses to reverse slow-no reflow events. Angiograms were reviewed and flow graded (TIMI grade) by film readers blinded to the use of any intraprocedural drug or clinical history. Seventy patients received intragraft adenosine boluses before percutaneous intervention (APPI), 73 received no preintervention adenosine (NoAPPI). There were no significant angiographic differences between the two groups at baseline. A total of 20 patients experienced SNR. The incidence of SNR was similar in the two groups (APPI = 14.2% vs. NoAPPI = 13.6%, P = 0.9). SNR was treated with repeated, rapid boluses (24 microg each) of intra-graft adenosine. Reversal of SNR was observed in 10 of 11 patients (91%) who received high doses of adenosine (>/=5 boluses, mean 7.7 +/- 2.6) and in 3 of 9 (33%) of those who received low doses (<5 boluses, mean 1.5 +/- 1.2). Final TIMI flow was significantly better in the high dose than in the low dose group (final TIMI 2.7 +/- 0.6 vs. 2 +/- 0.8, P = 0.04). No significant untoward complications were observed during adenosine infusion. These findings suggest that SNR after PI in SVG is not prevented by pre-intervention adenosine, but it can be safely and effectively reversed by delivery of multiple, rapid and repeated boluses of 24 microg of intra-graft adenosine.
Assuntos
Adenosina/uso terapêutico , Ponte de Artéria Coronária , Circulação Coronária , Complicações Pós-Operatórias/prevenção & controle , Veia Safena/transplante , Vasodilatadores/uso terapêutico , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fluxo Sanguíneo Regional , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Percutaneous intervention in acute myocardial infarction has been associated with a high incidence of "no reflow," ranging from 11% to 30%, with an increased risk of complications. The role of intracoronary adenosine for the prevention of this phenomenon has not been evaluated fully. We studied the procedural outcomes of 79 patients who underwent percutaneous intervention in the context of acute myocardial infarction. Twenty-eight patients received no intracoronary adenosine, and 51 received intracoronary adenosine boluses (24-48 microg before and after each balloon inflation). Eight patients who were not given adenosine experienced no reflow (28.6%) and higher rates of in-hospital death, while only three of 51 patients (5.9%; P = 0.014) in the adenosine group experienced no reflow. No untoward complications were noted during adenosine infusion. Intracoronary adenosine bolus administration during percutaneous intervention in the context of acute myocardial infarction is easy and safe and may significantly lessen the incidence of no reflow, which may improve the outcome of this procedure.
Assuntos
Adenosina/administração & dosagem , Angioplastia Coronária com Balão , Vasos Coronários/fisiopatologia , Infarto do Miocárdio/terapia , Grau de Desobstrução Vascular , Adenosina/uso terapêutico , Adulto , Idoso , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/fisiopatologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Se realizó un estudio abierto, no controlado, multicéntrico, realizado con intención de tratar, en 60 pacientes con dorsolumbalgia mecánica, en el cual evaluó la efectividad y seguridad de nimesulide 100 mg dos veces al día, administrado durante 15 días. El tratamiento produjo un alivio significativo en los escores de dolor entre el día de inicio del tratamiento y los 5 días, con un alivio adicional importante entre los días 5 y 10, sin alivios adicionales para el día 15. El tiempo medio para la desaparición total del dolor fue de 8,5 días. La limitación funcional fue evaluada el día 0 y el día 15, obteniéndose una mejoría significativa desde el punto de vista estadístico. Se reportaron efectos adversos en 4 de los pacientes, de los cuales sólo uno ameritó la suspensión del tratamiento
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Humanos , Masculino , Feminino , Anti-Inflamatórios não Esteroides , Dorso , Dor Lombar/terapia , VenezuelaRESUMO
La rinitis alergica es uno de las patologias más frecuentemente vistas en la consulta de otorrinolaringologia. En la etiologia se han involucrado una serie de agentes inhalantes, alimenticios y medicamentosos, que ocasionan sintomas, muchas veces incapacitantes; es por esto que el conocimiento de la fisiopatologia de la enfermedad, asi como las alternativas terapeuticas disponibles, nos permite afrontar el problema de una manera racional. El presente trabajo muestra en forma profunda y esquemática, los mecanismos productores o responsables de la sintomatologia. En segundo lugar se presentan las diferentes alternativas terapeuticas disponibles en el tratamiento de la rinitis alergica
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Rinite Alérgica Perene/cirurgia , Rinite Alérgica Perene/diagnóstico , Rinite Alérgica Perene/tratamento farmacológicoRESUMO
Los sindromes dolorosos de la articulación temporomandibular (ATM) se presentan muy frecuentemente en la práctica medica diaria y en muchas ocasiones pasa desapercibido este diagnostico debido a la gran variabilidad de su presentación clinica, ya que generalmente no causa sintomas articulares locales sino un gran espectro de síntomas en estructuras relaciónadas con esta articulación. En el presente articulo se presenta inicialmente una revision de la anatomia básica de la ATM, la clasificación de las disfunciones de la ATM y factores predisponentes para estos trastornos; posteriormente se hace enfasis en el diagnostico de estos sindromes, basándose en la historia clinica, examen fisico complementado con la imagenologia; finalmente se revisan las diversas modalidades terapeuticas, desde el manejo ultraconservador hasta las diversas opciones quirurgicas