RESUMO
BACKGROUND AND OBJECTIVE: Primary cutaneous lymphomas (PCL) are uncommon. Observations based on the first year of data from the Spanish Registry of Primary Cutaneous Lymphomas (RELCP, in its Spanish abbreviation) of the Spanish Academy of Dermatology and Venereology (AEDV) were published in February 2018. This report covers RELCP data for the first 5 years. PATIENTS AND METHODS: RELCP data were collected prospectively and included diagnosis, treatments, tests, and the current status of patients. We compiled descriptive statistics of the data registered during the first 5 years. RESULTS: Information on 2020 patients treated at 33 Spanish hospitals had been included in the RELCP by December 2021. Fifty-nine percent of the patients were men; the mean age was 62.2 years. The lymphomas were grouped into 4 large diagnostic categories: mycosis fungoides/Sézary syndrome, 1112 patients (55%); primary B-cell cutaneous lymphoma, 547 patients (27.1%); primary CD30+lymphoproliferative disorders, 222 patients (11%), and other T-cell lymphomas, 116 patients (5.8%). Nearly 75% of the tumors were registered in stage I. After treatment, 43.5% achieved complete remission and 27% were stable at the time of writing. Treatments prescribed were topical corticosteroids (1369 [67.8%]), phototherapy (890 patients [44.1%]), surgery (412 patients [20.4%]), and radiotherapy (384 patients [19%]). CONCLUSION: The characteristics of cutaneous lymphomas in Spain are similar to those reported for other series. The large size of the RELCP registry at 5 years has allowed us to give more precise descriptive statistics than in the first year. This registry facilitates the clinical research of the AEDV's lymphoma interest group, which has already published articles based on the RELCP data.
Assuntos
Dermatologia , Linfoma Cutâneo de Células T , Micose Fungoide , Neoplasias Cutâneas , Venereologia , Masculino , Humanos , Pessoa de Meia-Idade , Feminino , Linfoma Cutâneo de Células T/diagnóstico , Linfoma Cutâneo de Células T/epidemiologia , Linfoma Cutâneo de Células T/terapia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/terapia , Sistema de Registros , Micose Fungoide/patologiaRESUMO
INTRODUCCIÓN: La mayoría de muertes maternas se producen en países en vías de desarrollo; Perú el año 2007 fue el segundo país con la más alta tasa de mortalidad materna en Sudamérica, lo cual podría deberse a un déficit en la cobertura y la calidad de los servicios de salud. OBJETIVO: Evaluar la relación estadística entre el control perinatal y la mortalidad materna por departamentos en el Perú. MATERIAL Y MÉTODO: Estudio ecológico con corte transversal bivariado. Se estudiaron la razón de mortalidad materna y 6 indicadores del control perinatal (primera atención prenatal durante el primer trimestre de gestación, partos institucionales, entre otros) del año 2007 por departamentos en el Perú. La información se obtuvo de fuentes oficiales: Encuesta Nacional Demográfica y de Salud familiar y Ministerio de Salud. Se utilizó el programa Epidat 3.1. Se determinó Odds ratio y chi cuadrado y un nivel de confianza del 95 por ciento. RESULTADOS: Únicamente se encontró asociación estadísticamente significativa (p<0,05) entre mortalidad materna con: primera atención prenatal durante el primer trimestre de gestación, partos institucionales, partos atendidos por personal calificado y atención postnatal. Sólo se pudo calcular el Odds ratio para atención postnatal: probabilidad del 95,45 por ciento de que exista una alta razón de mortalidad materna cuando existe una pobre cobertura de atenciones postnatales. DISCUSIÓN: En el Perú, la poca cobertura de primera atención durante el primer trimestre, partos institucionales, y partos por profesional calificado están asociados a mortalidad materna. Un especial interés debe existir en la prevención de la mortalidad materna mejorando la atención postnatal.
INTRODUCTION: Most maternal deaths occur in developing countries, Peru was the second country with the highest maternal mortality rate in South America in 2007, which could be dueto gaps in coverage and quality of health services. OBJECTIVE: To evaluate the statistical relationship between perinatal care and maternal mortality in the departments of Peru. MATERIALAND METHOD: transversal bivariate ecological study. Maternal mortality ratio at 2007 and its relation to 6 indicators of perinatal care (first prenatal care during the first trimester of pregnancy, institutional births, among others) were studied using departments as analysis unit. The information was obtained from official sources: Encuesta demográfica y de salud familiar 2007 and Ministerio de Salud. Software Epidat 3.1 was used for the analysis. Odds ratio and chi squared were obtained with a confidence level of 95 percent. RESULTS: It was only found statistically significant association (p <0.05) between maternal mortality and first prenatal care during the first trimester of pregnancy, institutional births, births attended by skilled staff and postnatal care. It was only possible to calculate Odds ratio for postnatal care indicator, which showed 95.45 percent of probability of higher maternal mortality rate when there is poor postnatal care coverage. DISCUSSION: In Peru, the low coverage of first prenatal care during the first trimester of pregnancy, institutional births and births attended by qualified personnel are associated to maternal mortality. Postnatal care should be considered with special interest in order to prevent maternal mortality.
Assuntos
Humanos , Feminino , Gravidez , Mortalidade Materna , Assistência Perinatal , Estudos Transversais , Peru/epidemiologia , Qualidade da Assistência à SaúdeRESUMO
BACKGROUND: Intravenous rituximab is a safe and effective option for the treatment of systemic non-Hodgkin B-cell lymphoma. The effectiveness of intralesional rituximab (ILR) in primary cutaneous B-cell lymphomas (PCBL) has been described in a small number of patients. OBJECTIVES: To evaluate the effectiveness, tolerance and adverse effects of ILR in patients with follicle centre (FCL) and marginal zone (MZL) PCBL. METHODS: This was an epidemiological observational multicentre study of patients with PCBL treated with ILR. RESULTS: Seventeen patients with MZL and 18 with FCL PCBL were included. The median number of lesions treated was two per patient. The treatment regimen used in 74% of the patients was a course of three injections in a single week at 1-month intervals. The dose per lesion and day of treatment was 10 mg in 71% of the patients. The median cumulative dose of rituximab per lesion was 60 mg (range 13-270) and per patient was 150 mg (range 20-360 mg). Complete response (CR) and partial response were achieved in 71% and 23% of patients, respectively. The median time to CR in patients who received 10 mg of ILR per lesion was 8 weeks. Similar response rates were observed in MZL and FCL. Median disease-free survival was 114·1 weeks. No parameters that significantly predicted CR were identified. Adverse reactions were recorded in 19 patients; the most frequent was localized pain at the injection site. Median follow-up was 21 months. CONCLUSIONS: Intralesional rituximab is a well-tolerated and effective treatment for FCL and MZL PCBL. It should be considered a useful alternative in patients with recurrent lesions and in which the sequelae of radiotherapy or surgery would be significant.
Assuntos
Anticorpos Monoclonais Murinos/administração & dosagem , Antineoplásicos/administração & dosagem , Linfoma de Células B/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Feminino , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Rituximab , Resultado do TratamentoAssuntos
Hematoma/diagnóstico , Úlcera da Perna/diagnóstico , Envelhecimento da Pele/patologia , Idoso de 80 Anos ou mais , Comorbidade , Desbridamento , Diagnóstico Diferencial , Feminino , Hematoma/diagnóstico por imagem , Hematoma/etiologia , Hematoma/patologia , Hematoma/cirurgia , Humanos , Perna (Membro)/irrigação sanguínea , Traumatismos da Perna/complicações , Úlcera da Perna/diagnóstico por imagem , Úlcera da Perna/etiologia , Úlcera da Perna/patologia , Úlcera da Perna/cirurgia , Necrose , Polimedicação , UltrassonografiaRESUMO
Cutaneous follicular center B-cell lymphomas are indolent tumors characterized by the presence of neoplastic follicular center cells. They contain a mixture of centrocytes with a variable number of centroblasts. The tumor is usually treated by surgery or radiotherapy, although other treatments may be used such as interferon-alpha, chemotherapy, and biological agents (rituximab). Rituximab is a chimeric monoclonal anti-CD20 antibody that can be administered intravenously or intralesionally. We report the case of a 41-year-old man who consulted for violaceous nodular lesions in the left scapular region and who was diagnosed with cutaneous follicular center B-cell lymphoma after biopsy, laboratory tests, thoracic-abdominal-pelvic computed tomography, abdominal ultrasound, and bone marrow biopsy. It was decided to treat him with 30 mg of intralesional rituximab administered for 1 week (3 times) every month for 4 months. Complete response was obtained. We also review the published cases of cutaneous B-cell lymphoma treated with intralesional rituximab.
Assuntos
Anticorpos Monoclonais/administração & dosagem , Antineoplásicos/administração & dosagem , Linfoma de Células B/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Anticorpos Monoclonais Murinos , Humanos , Injeções Intralesionais , Linfoma de Células B/patologia , Masculino , Rituximab , Neoplasias Cutâneas/patologiaRESUMO
Dermatomyositis (DM) is a dermatomyopathy with a broad spectrum of features, defined by Bohan et al as an objective set of clinical and laboratory criteria. Dermatomyositis has been associated with extracutaneous neoplasias, especially with ovarian carcinoma. The term <