Tisotumab Vedotin as Second- or Third-Line Therapy for Recurrent Cervical Cancer.

BACKGROUND: Recurrent cervical cancer is a life-threatening disease, with limited treatment options available when disease progression occurs after first-line combination therapy. METHODS: We conducted a phase 3, multinational, open-label trial of tisotumab vedotin as second- or third-line therapy in patients with recurrent or metastatic cervical cancer. Patients were randomly assigned, in a 1:1 ratio, to receive tisotumab vedotin monotherapy (2.0 mg per kilogram of body weight every 3 weeks) or the investigator's choice of chemotherapy (topotecan, vinorelbine, gemcitabine, irinotecan, or pemetrexed). The primary end point was overall survival. RESULTS: A total of 502 patients underwent randomization (253 were assigned to the tisotumab vedotin group and 249 to the chemotherapy group); the groups were similar with respect to demographic and disease characteristics. The median overall survival was significantly longer in the tisotumab vedotin group than in the chemotherapy group (11.5 months [95% confidence interval {CI}, 9.8 to 14.9] vs. 9.5 months [95% CI, 7.9 to 10.7]), results that represented a 30% lower risk of death with tisotumab vedotin than with chemotherapy (hazard ratio, 0.70; 95% CI, 0.54 to 0.89; two-sided P = 0.004). The median progression-free survival was 4.2 months (95% CI, 4.0 to 4.4) with tisotumab vedotin and 2.9 months (95% CI, 2.6 to 3.1) with chemotherapy (hazard ratio, 0.67; 95% CI, 0.54 to 0.82; two-sided P<0.001). The confirmed objective response rate was 17.8% in the tisotumab vedotin group and 5.2% in the chemotherapy group (odds ratio, 4.0; 95% CI, 2.1 to 7.6; two-sided P<0.001). A total of 98.4% of patients in the tisotumab vedotin group and 99.2% in the chemotherapy group had at least one adverse event that occurred during the treatment period (defined as the period from day 1 of dose 1 until 30 days after the last dose); grade 3 or greater events occurred in 52.0% and 62.3%, respectively. A total of 14.8% of patients stopped tisotumab vedotin treatment because of toxic effects. CONCLUSIONS: In patients with recurrent cervical cancer, second- or third-line treatment with tisotumab vedotin resulted in significantly greater efficacy than chemotherapy. (Funded by Genmab and Seagen [acquired by Pfizer]; innovaTV 301 ClinicalTrials.gov number, NCT04697628.).

Atezolizumab and chemotherapy for advanced or recurrent endometrial cancer (AtTEnd): a randomised, double-blind, placebo-controlled, phase 3 trial.

BACKGROUND: At the time of AtTEnd trial design, standard treatment for advanced or recurrent endometrial cancer included carboplatin and paclitaxel chemotherapy. This trial assessed whether combining atezolizumab with chemotherapy might improve outcomes in this population. METHODS: AtTEnd was a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial done in 89 hospitals in 11 countries across Europe, Australia, New Zealand, and Asia. Enrolled patients were aged 18 years or older, and had advanced or recurrent endometrial carcinoma or carcinosarcoma, an Eastern Cooperative Oncology Group performance status of 0-2, and received no previous systemic chemotherapy for recurrence. Patients were randomly assigned (2:1) using an interactive web response system (block size of six) to either atezolizumab 1200 mg or placebo given intravenously with chemotherapy (carboplatin at area under the curve of 5 or 6 and paclitaxel 175 mg/m2 intravenously on day 1 every 21 days) for 6-8 cycles, then continued until progression. Stratification factors were country, histological subtype, advanced or recurrent status, and mismatch repair (MMR) status. Participants and treating clinicians were masked to group allocation. The hierarchically tested co-primary endpoints were progression-free survival (in patients with MMR-deficient [dMMR] tumours, and in the overall population) and overall survival (in the overall population). Primary analyses were done in the intention-to-treat population, defined as all randomly assigned patients who gave their full consent to participation in the study and data processing. Safety was assessed in all patients included in the intention-to-treat population who received at least one dose of study treatment. Here, we report the primary progression-free survival and the interim overall survival results. This study is ongoing and is registered with ClinicalTrials.gov, NCT03603184. FINDINGS: Between Oct 3, 2018, and Jan 7, 2022, 551 patients were randomly assigned to atezolizumab (n=362) or placebo (n=189). Two patients in the atezolizumab group were excluded from all analyses due to lack of consent. Median follow-up was 28·3 months (IQR 21·2-37·6). 81 (23%) patients in the atezolizumab group and 44 (23%) patients in the placebo group had dMMR disease by central assessment. In the dMMR population, median progression-free survival was not estimable (95% CI 12·4 months-not estimable [NE]) in the atezolizumab group and 6·9 months (6·3-10·1) in the placebo group (hazard ratio [HR] 0·36, 95% CI 0·23-0·57; p=0·0005). In the overall population, median progression-free survival was 10·1 months (95% CI 9·5-12·3) in the atezolizumab group and 8·9 months (8·1-9·6) in the placebo group (HR 0·74, 95% CI 0·61-0·91; p=0·022). Median overall survival was 38·7 months (95% CI 30·6-NE) in the atezolizumab group and 30·2 months (25·0-37·2) in the placebo group (HR 0·82, 95% CI 0·63-1·07; log-rank p=0·048). The p value for the interim analysis of overall survival did not cross the stopping boundary; therefore, the trial will continue until the required number of events are recorded. The most common grade 3-4 adverse events were neutropenia (97 [27%] of 356 patients in the atezolizumab group vs 51 [28%] of 185 in the placebo group) and anaemia (49 [14%] vs 24 [13%]). Treatment-related serious adverse events occurred in 46 (13%) patients in the atezolizumab group and six (3%) patients in the placebo group. Treatment-related deaths occurred in two patients (pneumonia in one patient in each group). INTERPRETATION: Atezolizumab plus chemotherapy increased progression-free survival in patients with advanced or recurrent endometrial carcinoma, particularly in those with dMMR carcinomas, suggesting the addition of atezolizumab to standard chemotherapy as first-line treatment in this specific subgroup. FUNDING: F Hoffmann-La Roche.

Everolimus plus endocrine therapy beyond CDK4/6 inhibitors progression for HR+ /HER2- advanced breast cancer: a real-world evidence cohort.

PURPOSE: Everolimus in combination with endocrine therapy (ET) was formerly approved as 2nd-line therapy in HR(+)/HER2(-) advanced breast cancer (aBC) patients (pts) progressing during or after a non-steroidal aromatase inhibitor (NSAI). Since this approval, the treatment landscape of aBC has changed dramatically, particularly with the arrival of CDK 4-6 inhibitors. Endocrine monotherapy after progression to CDK4/6 inhibitors has shown a limited progression-free survival (PFS), below 3 months. Evidence of the efficacy of everolimus plus ET after CDK4/6 inhibitors is scarce. METHODS: A retrospective observational study of patients with aBC treated with everolimus and ET beyond CDK4/6-i progression compiled from February 2015 to December 2022 in 4 Spanish hospitals was performed. Clinical and demographic data were collected from medical records. The main objective was to estimate the median progression-free survival (mPFS). Everolimus adverse events (AE) were registered. Quantitative variables were summarized with medians; qualitative variables with proportions and the Kaplan-Meier method were used for survival estimates. RESULTS: One hundred sixty-one patients received everolimus plus ET (exemestane: 96, fulvestrant: 54, tamoxifen: 10, unknown: 1) after progressing on a CDK4/6 inhibitor. The median follow-up time was 15 months (interquartile range: 1-56 months). The median age at diagnosis was 49 years (range: 35-90 years). The estimated mPFS was 6.0 months (95%CI 5.3-7.8 months). PFS was longer in patients with previous CDK4/6 inhibitor therapy lasting for > 18 months (8.7 months, 95%CI 6.6-11.3 months), in patients w/o visceral metastases (8.0 months, 95%CI 5.8-10.5 months), and chemotherapy-naïve in the metastatic setting (7.2 months, 95%CI 5.9-8.4 months). CONCLUSION: This retrospective analysis cohort of everolimus plus ET in mBC patients previously treated with a CDK4/6 inhibitor suggests a longer estimated mPFS when compared with the mPFS with ET monotherapy obtained from current randomized clinical data. Everolimus plus ET may be considered as a valid control arm in novel clinical trial designs.

Updated progression-free survival and final overall survival with maintenance olaparib plus bevacizumab according to clinical risk in patients with newly diagnosed advanced ovarian cancer in the phase III PAOLA-1/ENGOT-ov25 trial.

OBJECTIVE: In the PAOLA-1/ENGOT-ov25 trial (NCT02477644), adding maintenance olaparib to bevacizumab provided a substantial progression-free survival benefit in patients with newly diagnosed advanced ovarian cancer and homologous recombination deficiency (HRD)-positive tumors, irrespective of clinical risk. Subsequently, a clinically meaningful improvement in overall survival was reported with olaparib plus bevacizumab in the HRD-positive subgroup. We report updated progression-free survival and overall survival by clinical risk and HRD status. METHODS: Patients in clinical response after first-line platinum-based chemotherapy plus bevacizumab received maintenance olaparib (up to 24 months) plus bevacizumab (up to 15 months in total) or placebo plus bevacizumab. This post hoc analysis evaluated 5-year progression-free survival and mature overall survival in patients classified by clinical risk and HRD status. RESULTS: Of 806 randomized patients, 74% were higher-risk and 26% were lower-risk. In higher-risk HRD-positive patients, the hazard ratio (HR) for progression-free survival was 0.46 (95% confidence interval (95% CI) 0.34 to 0.61), with 5-year progression-free survival of 35% with olaparib plus bevacizumab versus 15% with bevacizumab alone; and the HR for overall survival was 0.70 (95% CI 0.50 to 1.00), with 5-year overall survival of 55% versus 42%, respectively. In lower-risk HRD-positive patients, the HR for progression-free survival was 0.26 (95% CI 0.15 to 0.45), with 5-year progression-free survival of 72% with olaparib plus bevacizumab versus 28% with bevacizumab alone; and the HR for overall survival was 0.31 (95% CI 0.14 to 0.66), with 5-year overall survival of 88% versus 61%, respectively. No benefit was seen in HRD-negative patients regardless of clinical risk. CONCLUSION: This post hoc analysis indicates that in patients with newly diagnosed advanced HRD-positive ovarian cancer, maintenance olaparib plus bevacizumab should not be limited to those considered at higher risk of disease progression. Five-year progression-free survival rates support long-term remission and suggest an increased potential for cure with particular benefit suggested in lower-risk HRD-positive patients.

Safety of bevacizumab and olaparib as frontline maintenance therapy in advanced ovarian cancer: expert review for clinical practice.

Olaparib, a poly(ADP-ribose) polymerase inhibitor, in combination with the antiangiogenic agent bevacizumab, is approved as maintenance therapy for patients with newly diagnosed stage III or IV epithelial ovarian cancer who have homologous recombination deficient tumors with a deleterious or suspected deleterious BRCA mutation and/or genomic instability based on the long-lasting survival benefit observed in the PAOLA-1 trial. Despite treatment with olaparib and bevacizumab showing an acceptable safety profile, the rate of discontinuations due to adverse events was relatively high, and toxicity related to this regimen may restrict its clinical use. Proper management of olaparib/bevacizumab-related adverse events is important for the improvement of quality of life and maximization of the efficacy of maintenance therapy. Here, we summarize the safety results of the PAOLA-1 study, focusing on treatment discontinuation reasons and adverse event profiles. We sought to shed light on toxicity monitoring and prevention, providing concise recommendations for the clinical management of the most relevant side effects.

Tumor de células granulares intratiroideo / Intra-thyroid granular cell tumor

RESUMEN Fundamento: los tumores de células granulares son lesiones benignas infrecuentes de crecimiento lento que pueden aparecer en cualquier sitio del organismo. La región de cabeza y cuello incluye las localizaciones más frecuentes (entre el 30 y el 50 % de todos los tumores de este tipo, hasta los del sistema nervioso central). Objetivo: presentar un caso de tumor de células granulares intratiroideo. Caso clínico: se presenta el caso de una paciente femenina de 37 años de edad con enfermedad nodular de la glándula tiroides de crecimiento lento con escasa sintomatología, con confirmación histológica tumor de células de la granulosa. Al examen físico se identificó aumento de volumen en la región anterolateral del cuello, en relación con el lóbulo derecho de la glándula tiroidea, que correspondía con lesión tumoral de 3 cm, mal delimitada, adherida a planos profundos, no dolorosa a la palpación. En la ecografía se observó: lóbulo derecho del tiroides de 4,3 cm x 1,2 cm x 1,4 cm, no homogéneo con lesión nodular de 2,8 x 1,4 cm mal delimitada, de bordes irregulares. Se realizó biopsia transoperatoria que se reportó como positiva de células neoplásicas malignas, sin embargo, el estudio histológico extemporáneo reveló un tumor benigno de células granulares intratiroideo. El tratamiento quirúrgico es curativo en este caso. Conclusiones: el diagnóstico de tumor de células granulares intratiroideo benigno, se presenta con las características de una lesión tumoral maligna, debe tenerse en cuenta en el diagnóstico diferencial de los tumores de la glándula tiroides.

ABSTRACT Background: the granular cells tumors are uncommon benign lesions of slow growth that can appear in any place of the organism. The head and neck region includes the most frequent localizations (between the 30 and 50% of all the tumors of this type, including those of the central nervous system). Objective: to present a case of intra-thyroid granular cell tumor. Clinical case: a case of a 37 year-old female patient with nodular illness of the thyroid of slow growth with scarce symptoms, with histologic confirmation of granular cells tumor is presented. To the physical exam, an increase of volume was identified in the anterolateral region of the neck, in connection with the right lobe of the thyroid gland that corresponded with a tumoral lesion of 3cm approximately, not well defined, stuck to deep planes, not painful to the palpation. In the echography, it was observed: right lobe of the thyroid of 4.3 cm x 1.2cm x 1.4 cm, not homogeneous with a nodular lesion of 2.8 x 1.4 cm not well defined, of irregular borders. During the surgery, a frozen section was examined and reported as positive of malignancy, however, the untimely histologic study revealed a benign intra-thyroid granular cell tumor. The surgical treatment is healing in this case. Conclusions: the diagnosis of intra-thyroid benign granular cell tumor is presented with the characteristics of a malign tumor, it should be kept in mind in the differential diagnosis of the tumors of the thyroid.

Fisura tipo 7 de Tessier: presentación de un caso / Type 7 fissure of Tessier: a case presentation

Fundamento: la fisura tipo 7 de Tessier es una rara deformidad congénita que puede presentarse con diversos grados de severidad; de forma más frecuente unilateral e incompleta. Objetivo: reportar el primer paciente en Cuba con una fisura tipo 7 de Tessier bilateral de considerable severidad. Caso clínico: se describe un paciente gemelar, sexo femenino, raza blanca; nacido el diez de febrero de dos mil diez en el Hospital Universitario Ginebscostétrico de Camagüey, con una malformación severa de la cara y un peso de 1784gr. Se revisó la historia clínica neonatal y pediátrica de la paciente así como los artículos más recientes en base de datos computarizada que abordaron los siguientes tópicos: fisura tipo 7 de Tessier, fisura facial transversa y macrostoma bilateral. Discusión: luego de la revisión bibliográfica se encontró, que solo se han reportado hasta el año dos mil ocho noventa casos de macrostomía congénita bilateral, en nuestro país no se documenta sobre esta deformidad. Se presenta en el artículo un caso diagnosticado en el Hospital Materno de Camagüey con una severa fisura tipo siete de Tessier asociada a un paladar blando fisurado y una hipoplasia con retrusión mandibular, que fallece a los setenta y dos días de nacido, se discuten algunos elementos en su diagnóstico y tratamiento para casos futuros. Conclusiones: se concluye que este es el primer reporte en Cuba con una fisura tipo siete de Tessier de severa magnitud.

Background: type 7 fissure of Tessier is a strange congenital deformity that may be presented with diverse degrees of severity; in a unilateral and incomplete most frequent way. Objective: to report the first patient in Cuba with a bilateral type 7 fissure of Tessier of considerable severity. Clinical case: it is described a gemellary, female sex, white race patient; born on February 10th 2010 at the Maternal Hospital of Camagüey with a severe malformation of the face and a weight of 1784g. The neonatal clinical and pediatric history of the patient was reviewed as well as the most recent articles in on-line database dealt with the following topics: type 7 fissure of Tessier, transverse facial cleft and bilateral macrostomia. Discussion: after the revision was found that have been reported until the year 2008 just 90 cases of bilateral congenital macrostomia and in our country it is not documented on this deformity. A patient diagnosed at the Maternal Hospital of Camagüey with a severe type 7 fissure of Tessier associated to a fissured soft palate and a hypoplasia with mandibular retrusion that dies to the 72 days of been born and some elements in her diagnosis and treatment to further cases are discussed. Conclusions: it is concluded that this is the first report in Cuba with a type 7 fissure of Tessier with such a severe magnitude.

Avances en el diagnóstico de las lesiones cancerizables y malignas del complejo bucal / Advances in the diagnosis of cancerous and malignant lesions of the oral complex

Fundamento: los pacientes con cáncer bucal presentan una pobre supervivencia de cinco años. Muchas de las lesiones se desarrollan sobre leucoplasias y eritroplasias por lo que resulta necesario lograr avances en el diagnóstico del precáncer bucal. Objetivo: describir los avances recientes en el diagnóstico precoz del precáncer bucal que nos permitan valorar su progresión y recurrencia. Método: se revisaron los artículos más recientes utilizando base de datos computarizada: MEDLINE, CANCERLIT, EMBASE que abordaran los siguientes tópicos: lesiones y estados cancerizables, cambios moleculares en la carcinogénesis, examen clínico y técnicas diagnósticas. Resultados: los marcadores moleculares se convertirán en esenciales para el diagnóstico y manejo de pacientes con cáncer bucal. Ellos permiten el diagnóstico precoz y estadiamiento de los cambios tisulares antes que los cambios morfológicos que en las células ocurran, sin embargo conducen a una mejor supervivencia y tratamientos menos agresivos. Conclusiones: se concluye planteando que el examen clínico, la biopsia y el empleo de marcadores moleculares son fundamentales en el diagnóstico de las lesiones cancerizables y malignas del complejo bucal. Además, los avances logrados a nivel molecular mejoran nuestro entendimiento en la patogénesis del cáncer bucal.

Background: patients with oral cancer present a poor survival of five years. Many of the lesions are developed on leukoplakia and erythroplasia therefore it is necessary to achieve advances in the diagnosis of oral precancer. Objective: to describe recent advances in the precocious diagnosis of oral precancer that may allow us to value its progression and recurrence. Method: the most recent articles that were reviewed on computerized databases as: MEDLINE, CANCERLIT, EMBASE dealt with: injuries and cancerous states, molecular changes in carcinogenesis, clinical examination and diagnostic techniques. Results: molecular markers will become essentials for diagnosis and patient´s management with oral cancer. It allows for precocious diagnosis and the staging of tissular changes before morphological changes in the cells happen. Contribute therefore to achieve a better survival and less aggressive treatments. Conclusions: it is concluded that clinical examination, biopsy and the employment of molecular markers are fundamental in diagnosis of cancerous and malignant lesions of the oral complex. Also, advances achieved at molecular level have improved our understanding in the pathogenesis of oral cancer.

Tumor maligno mülleriano mixto: a propósito de un caso raro / Müllerian mixed malignant tumor: a rare case report

Fundamento: los tumores müllerianos mixtos malignos son neoplasias malignas muy infrecuentes. El sitio más común de su ocurrencia es el tracto genital del sexo femenino, dentro de él aparecen, el cuerpo del útero, el cuello, ovario, y trompas. Caso clínico: se presenta un caso con una gran dificultad diagnóstica tanto clínica, e imagenológica, con confirmación histológica de Tumor maligno mülleriano mixto gigante del cuello y el cuerpo del útero en una mujer postmenopáusica que se presentó con una masa abdominal grande, e historia de radioterapia hace ocho años para un carcinoma del cuello del útero. Al examen médico inicial y a la Tomografía axial computarizada impresionó como un tumor ovárico, durante el acto quirúrgico se observó un tumor gigante, deforme, irregular de cuerpo de útero, v/s sarcoma endometrial estromal , sin embargo, en el examen patológico reveló un tumor mülleriano mixto maligno de cuerpo y cuello de útero. El componente de epitelial maligno era un carcinoma escamoso, con un componente sarcomatoso homólogo. La paciente fue tratada quirúrgicamente. Conclusión: El diagnóstico exacto del Tumor maligno mülleriano mixto del cuello y cuerpo del útero es importante para el tratamiento apropiado del paciente.

Background: müllerian mixed malignant tumors are very infrequent neoplasms. The commonest site of occurrence is in the female genital tract; inside him the body of uterus, uterine neck, ovary, and tuba uterina appear. Case presentation: a great difficult diagnostic case both clinical and imaging is presented, with histological confirmation of giant müllerian mixed malignant tumor of cervix and body of uterus in a postmenopausal woman who was presented with a large abdominal mass and a radiotherapy history of eight years ago for a uterine neck carcinoma. To the initial medical examination and computerized axial tomography appeared to be an ovarian tumor, during the surgical act appear like giant and deformed irregular uterus tumor, v/s endometrial stromal sarcoma, however, the pathological examination revealed a müllerian mixed malignant tumor of cervix and body of uterus. The malignant epithelial component was a squamous carcinoma with a homologous sarcomatous component. The patient was surgically treated. Conclusion: Accurate diagnosis of cervix MMMT is important for the patient’s appropriate treatment.

Eficacia del azul de toluidina y lugol en el diagnóstico precoz del cáncer bucal / Effectiveness of the toluidine blue and lugol in the precocious diagnosis of oral cancer

Fundamento: el cáncer bucal representa un significativo reto a nivel mundial y resulta necesario el conocimiento y utilización de medios auxiliares de diagnóstico. Objetivo: evaluar la eficacia del azul de toluidina y lugol en el diagnóstico precoz del cáncer bucal. Método: se realizó un ensayo clínico fase II multicéntrico, abierto y no secuencial. El universo de estudio se constituyó por ciento ochenta y dos pacientes de ambos sexos con lesiones cancerizables del complejo bucal que acudieron a las consultas de Diagnóstico Precoz del Cáncer Bucal de los Hospitales Manuel Ascunce Doménech y María Curie de Camagüey entre enero del 2005 y enero del 2010. El número de lesiones analizadas se calculó según la fórmula para tamaños muéstrales correspondientes al diseño de poblaciones infinitas, obteniéndose una muestra de dos ciento sesenta y siete lesiones. Resultados: para el azul de toluidina se encontró una sensibilidad (S) del 93 por ciento, especificidad (E) del 98 por ciento, valor predictivo positivo (VPP) del 84 por ciento, valor predictivo negativo (VPN) del 99 por ciento, eficacia global (Eg) del 97 por ciento, y razón de verosimilitud positiva y negativa (LR+ y LR-) de 44.4 y 0.06 respectivamente. Para el lugol: S=90 por ciento, E=92 por ciento, VPP=60 por ciento, VPN=98 por ciento, Eg=92 por ciento, LR+=12.8 y LR-=0.1. Cuando se combinaron ambas tinciones con el requerimiento de que fueran positivas lo más significativo fue el aumento en la especificidad. Conclusiones: se concluye planteando la alta eficacia de las tinciones en el diagnóstico precoz del cáncer bucal.

Background: the oral cancer represents a significant challenge at world level and it is necessary the knowledge and use of auxiliary diagnostic tools. Objective: to evaluate the effectiveness of the toluidine blue and lugol in the precocious diagnosis of oral cancer. Method: a multicentric phase II, open and not sequential clinical trial was performed. The study universe was constituted by one-hundred eighty-two patients of both sexes with cancerigenic lesions of the oral complex assisted at the consultations of Precocious Diagnostic of oral Cancer in the Hospitals Manuel Ascunce Domenech and María Curie from Camagüey between January 2005 and January 2010. The number of analyzed lesions was calculated according to the sample sizes formula corresponding to the design of infinite populations, being obtained a sample of two-hundred sixty-seven lesions. Results: for the toluidine blue was found a sensibility (S) of 93 percent, specificity (E) of 98 percent, positive predictive value (PPV) of 84 percent, negative predictive value (NPV) of 99 percent, global effectiveness (GE) of 97 percent, and reason of positive and negative verisimilitude (LR+ and LR -) of 44.4 and 0.06 respectively. For the lugol: S=90 percent, E=92 percent, PPV=60 percent, NPV=98 percent, GE=92 percent, LR+=12.8 and LR-=0.1. When both tinctions were combined with the requirement of being positive the most significant was the increase in specificity. Conclusions: it is concluded the high effectiveness of the tinctions in the precocious diagnosis of the oral cancer.

Parálisis cerebral infantil.: Mortalidad en menores de 15 años en la provincia de Camagüey / Infantile cerebral paralysis.: Mortality in youngers of 15 years in Camagüey province

Fundamento: La parálisis cerebral (PC) constituye potencialmente una limitación para la expectativa de vida. Objetivo: Evaluar el comportamiento de la mortalidad y sus causas en niños afectados por la parálisis cerebral infantil. Método: Se realizó un estudio descriptivo, retrospectivo de pacientes portadores de esta afección, fallecidos en edades menores de 15 años y nacidos en el período 1986-2005 en la provincia de Camagüey, 58 en total. Resultados: El mayor número de muertes ocurrió en edades de un año o menos, nueve pacientes (15,51%) y a los 13 años siete (12,06%). La causa de muerte reportada fue en el 100% de los pacientes la sepsis respiratoria. Conclusiones: Se les realizó el estudio post-mortem a un bajo número de pacientes ocho (13,8%), lo que llamó la atención.

Background: The cerebral paralysis potentially constitutes a limitation for life expectancy. Objective: To evaluate the mortality behavior and its causes in children affected by the infantile cerebral paralysis. Method: A retrospective, descriptive study was performed in patients carriers of this affection, the dead in ages under 15 years and the born in the period 1986-2005 in Camagüey province, 58 in total. Results: The greater number of death occurred in ages of one year or less, nine patients (15, 51%) and at the 13 years, seven (12, 06%). The respiratory sepsis the cause of death in the 100% of patients was reported. Conclusions: A post-mortem study to a low number of patients eight (13, 8%), which attracted the attention.

La historia de aa anatomía patológica universaly en Cuba contada a través de ssus protagonistas / The history of the universal pathologic anatomy and in Cuba told by its protagonists

Se realizó una revisión de la literatura sobre la historia de la Anatomía Patológica, que incluyó la búsqueda por INTERNET de un gran número de bibliografías que abordaran su evolución histórica, principales figuras, diferentes métodos de estudio, en el mundo y en nuestro país, con la finalidad de conocer, ampliar y contribuir a divulgar los conocimientos al respecto. Se encontró que la patología puede dividirse para su estudio en diferentes períodos, correspondiéndose con el desarrollo y la evolución del hombre a través de la historia universal, transitando por el surgimiento de la Anatomía Patológica, el advenimiento del microscopio, surgimiento de la patología celular, la patología quirúrgica, hasta llegar a los orígenes de las ciencias patológicas en Cuba y su desarrollo en el siglo XIX, XX y el período posterior a 1959. Se acompañan los textos de 11 imágenes correspondientes a los diferentes protagonistas históricos u obras de trascendencia. Resaltamos el respaldo alcanzado por la especialidad a partir del triunfo revolucionario, que ha permitido el desarrollo tecnológico de los profesionales del sector en el país, en beneficio del diagnóstico a las afecciones de los pacientes.

A review of the literature about the history of the Pathologic Anatomy, was carried out, that included the search by INTERNET of a great number of bibliographies that approach its historical evolution, main figures, different study methods in the world and in our country, with the purpose to know, to further and to contribute to make public the knowledge on the matter. It was found that pathology may be divided for its study in different periods, which correspond with the development and man evolution through the universal history, traveling for the arise of the Pathologic Anatomy, the arrival of the microscope, the arise of the cellular and surgical pathology, until to arrive at the origins of the pathological sciences in Cuba and its development in the XIX, XX centuries, and in the period after 1959. The texts of 11 images pertaining to different historical protagonists or significance works are accompanied. We stand out the support reached by the specialty departing from the revolutionary triumph, that has permitted the technological development of the professionals of the sector in the country, for the benefit of the diagnosis to the affections of patients.

Quistes no neoplásicos y neoplásicos de ovario en edad pediátrica / Ovarian neoplastic and nonneoplastic cysts in infancy and children

En Cuba los tumores y quistes de ovario en la infancia ocupan aproximadamente el 1 por ciento de todos los procesos tumorales, durante esta etapa de la vida, más del 50 por ciento de estos tumores corresponden como quistes simples, teratomas benignos, y quistes foliculares, por lo que se realizó un estudio retrospectivo longitudinal en niños con incidencias de estos tumores en el Hospital Pediátrico Eduardo Agramonte Piña, Camagüey, desde julio de 1973 a julio de 2004, con el objetivo de valorar la incidencia de estos tumores en niños. El universo y muestra lo constituyeron los 170 pacientes ingresados por dicha enfermedad. Se revisaron las historias clínicas de los enfermos. Se confeccionó un formulario que incluyó variables como. la edad, la forma de presentación, el lado más afecto, el histología, los complementarios realizados y las complicaciones, donde predominó el rango de edad entre los 11y15 años con 122 pacientes para un 71.8 por ciento. Existió un aumento de la incidencia en el ovario derecho para un 71.8 por ciento. Las lesiones de mayor prevalencia fueron los tumores quísticos benignos (teratomas quísticos) con 107 de los pacientes, seguido de los quistes no neoplásicos (foliculares) para un 12.4 por ciento.El Rx simple de abdomen y el USG abdominal fueron los complementarios de mayor utilidad

Sitio web de patología general para estudiantes de medicina y estomatología: validación final / General Pathology Website for Medicine and Odontology students: final evaluation

Se realizó un estudio analítico para la validación final de un sitio Web de Patología General dirigido a estudiantes de Medicina y Estomatología durante el curso 2005-2006 en la Universidad Médica Carlos J Finlay de Camagüey, Cuba, en el que fueron mejorados aquellos aspectos que no tuvieron evaluación de bien o excelente en el estudio preliminar. El sitio fue creado según el programa de la asignatura Anatomía Patológica, y los objetivos planteados para la formación del profesional que debemos lograr. El texto desarrolla siete temas fundamentales de esta materia, además cuenta con una galería de imágenes con 150 fotos macroscópicas y microscópicas que enriquecen la exposición, y posibilitan la mejor comprensión de los temas abordados. Dispone además de un glosario con más de 180 términos comunes de la asignatura, una sección dedicada a la autoevaluación individual de los estudiantes y una ayuda. La mayoría de las variables estudiadas obtuvieron calificación de excelente

Osteomielitis esclerosante de Garré: reporte de un caso / Chronic sclerosing Garres osteomyelitis: case report

Se presenta un caso de un niño de nueve años de edad, con el diagnóstico de osteomielitis esclerosante crónica de Garré, con dos meses de evolución, el cual fue ingresado en nuestro servicio de ortopedia y traumatología infantil y necesitó tratamiento quirúrgico. Se ilustran y discuten los hallazgos clínicos, imagenológicos y patológicos

Sitio web de patología general para estudiantes de medicina y estomatología: validación preliminar / A general pathology site for medical and dental students: a preliminary validation

Se realizó un estudio analítico para la validación de un sitio Web de Patología General dirigido a estudiantes de Medicina y Estomatología durante el curso 2004-2005 en la Universidad Médica “Carlos J. Finlay” de Camagüey, Cuba. El sitio fue creado según el programa de la asignaturaAnatomía Patológica y los objetivos planteados para la formación del profesional que debemos lograr. El texto desarrolla siete temas fundamentales de esta materia, se ejemplifican procesos de carácter general con entidades específicas o particulares, que resultan de interés por su frecuencia y significación y además cuenta con 120 fotos macroscópicas o microscópicas que enriquecen laexposición y posibilitan la mejor comprensión de los temas abordados. Dispone también de un glosario con los términos más comunes de la asignatura, una galería de imágenes, una sección dedicada a la autoevaluación individual de los estudiantes y una ayuda. La mayoría de las variables estudiadas obtuvieron calificación de bien y excelente. El tamaño de la letra obtuvocalificación por debajo del parámetro de aceptable

Granuloma eosinofílico de ganglio linfático. Presentación de un caso / Eosinophilic granuloma of lymphatic ganglion. Case presentation

Se presenta un paciente de un año y medio de edad con adenopatías cervicales correspondientes a un granuloma eosinofílico. El estudio radiológico del esqueleto y la evolución confirmaron la localización ganglionar primaria de esta variante de granulomatosis de células de Langerhans (histiocitosis X).

A patient of one year old an a half presented with cervical adenopathies corresponding to an eosinophilic granuloma. Radiologiocal study of the spine and its evolution confirmed the primary ganglionic localization of this variant of Langerhands' cells granulomatosis (histiocytosis X).

Poliposis juvenil familiar del colon en una adolescente / Family polyposi scoli in an adolescent

Paciente con sangramiento digestivo bajo, con antecedente familiar de poliposis del colon, ya operados; se realizó estudio radiológico, endoscópico e histológico y se comprobó una poliposis juvenil familiar del colon. Se le realizó intervención quirúrgica (Colectomía total), con buena evolución

Corioangiomatosis de la placenta: presentación de 1 caso / Chorioangiomatosis of placenta: report of a case

Se presenta el caso de una muerte fetal anteparto asociada con corioangiomas múltiples de la placenta. Se señala que si bien el peso del feto no se traduce como un retardo del crecimiento intrauterino, la presencia de estas lesiones múltiples, al causar un desvío de sangre placentaria con la consiguiente anoxia crónica, pudo comprometer la oxigenación fetal y producir la muerte intrauterina