RESUMO
Gastrointestinal stromal tumors (GISTs) are sarcomas affecting the stomach and small intestine, with a rare subtype characterized by succinate dehydrogenase B (SDHB)-loss posing significant diagnostic and therapeutic challenges. A 62-year-old man with weight loss and abdominal pain was diagnosed with a gastric GIST showing SDHB-loss. Initial treatment with Imatinib reduced the tumor size, but surgery revealed no residual tumor. Despite adjuvant Imatinib, recurrence occurred, necessitating further surgical intervention. While GISTs typically benefit from surgery and tyrosine kinase inhibitors (TKIs), those with SDHB-loss are resistant to TKIs, requiring a different management approach. This case emphasizes the importance of surgical intervention for SDHB-deficient GISTs and the need for ongoing research into effective treatments for this subtype.
RESUMO
BACKGROUND: The endoscopic modified medial maxillectomy (MMM) and prelacrimal approach (PLA) are two routinely performed endoscopic approaches to the maxillary sinus when access via a middle meatal antrostomy is insufficient. However, there is no data in the literature that has compared outcomes and complication profile between the two procedures to determine which approach is superior. OBJECTIVE: To compare the approach related morbidity of PLA and MMM. METHODS: A retrospective cohort study of all consecutive adult patients undergoing either MMM or PLA from 2009 to 2023 were identified. The primary outcome was development of epistaxis, paraesthesia, lacrimal injury, iatrogenic sinus dysfunction within a minimum of 3 months post-operative follow up. RESULTS: 39 patients (44 sides) underwent PLA and 96 (96 sides) underwent MMM. There were no statistically significant differences between the rates of paraesthesia (9.1 % vs 14.6 %, p = 0.367) or prolonged paraesthesia (2.3 % vs 5.2 %, p = 0.426), iatrogenic maxillary sinus dysfunction (2.3 % vs 5.2 %, p = 0.426) or adhesions requiring removal (4.5 % vs 4.2 %, p = 0.918). No cases of epiphora or nasal cavity stenosis occurred in either arm in our study. CONCLUSIONS: According to our data, the endoscopic modified medial maxillectomy and prelacrimal approach are both equally safe approaches with their own benefits to access.
Assuntos
Endoscopia , Neoplasias do Seio Maxilar , Seio Maxilar , Humanos , Masculino , Feminino , Endoscopia/métodos , Estudos Retrospectivos , Pessoa de Meia-Idade , Neoplasias do Seio Maxilar/cirurgia , Seio Maxilar/cirurgia , Idoso , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Adulto , Resultado do Tratamento , Epistaxe/etiologia , Epistaxe/cirurgia , Estudos de Coortes , Parestesia/etiologiaRESUMO
Technology-facilitated sexual abuse refers to the use of information and communication technologies to facilitate both virtual and in-person sexual crimes. Research on this topic has focused on rates, risk factors, and consequences. This scoping review aims to understand whether and how forensic psychological procedures are adapted to assess adolescent victims and how Internet-based information might be useful as complementary data. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extensions for Scoping Reviews guidelines, searches were conducted in April 2023 in five electronic databases to include Portuguese, Spanish, or English quantitative, qualitative, or mixed-method peer-reviewed studies. Of the 2523 studies, six were considered eligible. Identified procedures include forensic interviews following the National Institute for Child Health and Human Development Protocol, and risk and trauma assessments. While discussing technology's role in abuse during interviews was informative, confronting adolescents with evidence of their abuse had adverse effects on their testimony and recovery. The assessment tools often had a narrow focus or overlooked the abuse unless explicitly disclosed, implied a referral, or when safeguarding concerns were raised. Clinical, forensic, and criminal implications are elaborated.