Oncological resection, myasthenia gravis and staging as prognostic factors in thymic tumours: a Chilean case series.

BACKGROUND: Thymic epithelial tumours are rare and highly heterogeneous. Reports from the United States suggest an overall incidence of 0.15 per 100,000/year. In contrast, the incidence of these tumours in Latin America is largely unknown and reports are scarce, somewhat limited to case reports. METHODS: Herein, we report a series of 38 thymic tumours from a single institution, retrospectively incorporated into this study. Patient characteristics and outcomes including age, sex, stage, paraneoplastic syndromes, treatment regimens and the date of decease were obtained from medical records. RESULTS: Most cases in our series were females and young age (<50 years old) and early stage by Masaoka-Koga or the Moran staging systems. Also, a 34% of patients had myasthenia gravis (MG). Next, we analysed overall survival rates in our series and found that the quality of surgery (R0, R1 or R2), MG status and staging (Masaoka-Koga, Moran or TNM) were prognostic factors. Finally, we compared our data to larger thymic tumour series. CONCLUSIONS: Overall, our study confirms complete surgical resection as the standard, most effective treatment for thymic epithelial tumours. Also, the Masaoka-Koga staging system remains as a reliable prognostic factor but also the Moran staging system should be considered for thymomas.

[Surgery for pulmonary tuberculosis. Review of 33 operated patients]. / Cirugía pulmonar en tuberculosis.

BACKGROUND: Surgical treatment for pulmonary tuberculosis is mainly limited to the management of sequelae such as bronchiectasis, hemoptysis and brochopleural fistulae. AIM: To review the data of patients who underwent surgical treatment for pulmonary tuberculosis. MATERIAL AND METHODS: Retrospective review of 33 patients aged 18 to 73 years (24 males) who underwent lung resection surgery for the management of pulmonary tuberculosis. Follow-up data were obtained from outpatient visit records and registries of the national tuberculosis program. RESULTS: The reasons to perform surgery were the following: fifteen for hemoptysis, nine for lung destruction and nine for an active and multiresistant disease. No patient died in the postoperative period. The morbidity observed included empyema (n =5), pneumothorax (n =2), bronchopleural fistula (n =2) and hemothorax (n =2). At six months of follow up, six of the nine patients with active tuberculosis had negative acid-fast bacilli on sputum smear. Two of these patients died, one due to respiratory failure and another by an unrelated cause. Both dead patients had negative acid-fast bacilli on sputum smear. CONCLUSIONS: Surgery in pulmonary tuberculosis has a high rate of complications but may be useful in selected patients.

Cirugía pulmonar en tuberculosis / Surgery for pulmonary tuberculosis: Review of 33 operated patients

Background: Surgical treatment for pulmonary tuberculosis is mainly ¡imited to the management of sequelae such as bronchiectasis, hemoptysis and brochopleural fistulae. Aim: To review the data of patients who underwent surgical treatment for pulmonary tuberculosis. Material and methods: Retrospective review of 33 patients aged 18 to 73 years (24 males) who underwent lung resection surgery for the management of pulmonary tuberculosis. Follow-up data were obtained from outpatient visit records and registries of the national tuberculosis program. Results: The reasons to perform surgery were the following: fifteen for hemoptysis, nine for lung destruction and nine for an active and multiresistant disease. No patient died in the postoperative period. The morbidity observed included empyema (n =5), pneumothorax (n =2), bronchopleural fístula (n =2) and hemothorax (n =2). At six months offollow up, six of the nine patients with active tuberculosis had negative acid-fast bacilli on sputum smear. Two of these patients died, one due to respiratory failure and another by an unrelated cause. Both dead patients had negative acid-fast bacilli on sputum smear. Conclusions: Surgery in pulmonary tuberculosis has a high rate of complications butmay be usefulin selected patients.

El efecto de los contaminantes sobre la capa de ozono / The effect of contaminants upon de ozone layer

La capa de ozono se encuentra en una zona atmosférica estática, en la que tanto la acumulación de contaminantes, como su dispersión son riesgosas y de muy lenta depuración. La disminución del ozono atmosférico se debe, tanto a fenómenos dinámicos de la atmósfera, como a fenómenos clínicos producidos por el hombre, siendo estos últimos los mas nocivos. Los clorofluocarbonos son compuestos capaces de destruir el ozono atmosférico y de su control puede derivar un real beneficio. Los derivados del nitrógeno son altamente dañinos para la capa de ozono y entre ellos especialmente el óxido nítrico y sus fuentes, como los trasportes supersónicos y las explosiones atómicas, deben ser muy bien estudiadas y controladas para prevenir un gran desastre ecológico. El estudio realizado en 1987 en la Antártica arroja resultados importantes que llegan a concluir que si bien son los factores químicos los causantes de la disminución del ozono, los movimientos atmosféricos son los responsables de las grandes variaciones que este experimenta durante el día. El territorio mas afectado por la disminución de la capa de ozono es el territorio antártico, en el que se han encontrado mermas de hasta un 50 por ciento de su concentración. La disminución de la capa de ozono produce un aumento de las radiaciones ultravioletas, fenómeno que guarda directa relación con el aumento de fotoenvejecimiento de las quemaduras cutáneas, el cáncer a la piel y de los melanomas. Esta reducción de la capa de ozono, puede tener, además, insospechadas consecuencias a futuro, sobre todo en el resto de los sistemas bioecológicos