RESUMO
This document is part of a series of documents designed by the French Physical and Rehabilitation Medicine Society (Sofmer) and the French Federation of PRM (Fedmer). These documents describe the needs for or a specific type of patients; PRM care objectives, human and material resources to be implemented, chronology as well as expected outcomes. "Care pathways in PRM" is a short document designed to enable the reader (physicians, decision-maker, administrator, lawyer or finance manager) to quickly apprehend the needs of these patients and the available therapeutic care structures for proper organization and pricing of these activities. Patients after knee ligament surgery are classified into four care sequences and two clinical categories, taking into account personal and environmental factors that could influence patients' needs, in accordance with the International Classification of Functioning (WHO).
Assuntos
Procedimentos Clínicos/organização & administração , Traumatismos do Joelho/reabilitação , Ligamentos Articulares/lesões , Assistência ao Convalescente , Procedimentos Clínicos/economia , Humanos , Traumatismos do Joelho/cirurgia , Ligamentos Articulares/cirurgia , Modalidades de Fisioterapia , Cuidados Pós-Operatórios , Cuidados Pré-OperatóriosRESUMO
This document is part of a series of documents designed by the French Physical and Rehabilitation Medicine Society (Sofmer) and the French Federation of PRM (Fedmer). These documents describe the needs for or a specific type of patients; PRM care objectives, human and material resources to be implemented, chronology as well as expected outcomes. "Care pathways in PRM" is a short document designed to enable the reader (physicians, decision-maker, administrator, lawyer or finance manager) to quickly apprehend the needs of these patients and the available therapeutic care structures for proper organization and pricing of these activities. Patients after rotator cuff tear surgery are classified into four care sequences and two clinical categories, taking into account personal and environmental factors that could influence patients' needs, in accordance with the International Classification of Functioning (ICF) (WHO).
Assuntos
Planejamento de Assistência ao Paciente/organização & administração , Lesões do Manguito Rotador , Assistência ao Convalescente , Humanos , Planejamento de Assistência ao Paciente/economia , Modalidades de Fisioterapia , Cuidados Pré-Operatórios , Reabilitação , Manguito Rotador/cirurgiaRESUMO
We report the case of a 49-year-old woman who presented a tailgut cyst lined by a variety of epithelium including squamous, columnar and transitional. Fortuitously a microscopic carcinoid tumor expressing immunohistochemically neuroendocrine markers was identified in the cystic wall. Tailgut cysts are congenital abnormalities located in the presacrococcygeal area occurring usually in adult patients. Clinical diagnosis is difficult because they are often asymptomatic. Patients may present symptoms resulting from local mass effects or complications. The differential diagnoses include rectal duplication cysts, cystic sacrococcygeal teratomas, epidermal cysts, epidermoid cysts, anal duct or gland cysts. Magnetic resonance imaging has recently become the modality of choice to image the cyst. Malignant transformation is rare; 23 cases including 10 carcinoid tumors have been reported in the literature. To our knowledge, this is the eleventh case of carcinoid tumor arising in a tailgut cyst.
Assuntos
Tumor Carcinoide/patologia , Cistos/patologia , Tumor Carcinoide/diagnóstico , Cistos/diagnóstico , Hamartoma/patologia , Humanos , Imageamento por Ressonância Magnética , Doenças Retais/patologia , Região SacrococcígeaRESUMO
High dose chemotherapy with autologous blood stem cell rescue becomes widely used for patients with hematologic malignancies and solid tumors. Recently, it has been demonstrated that stem cells characterized by the CD34 antigenic marker could be positively selected using an anti CD34 monoclonal antibody and an avidin biotin immunoabsorption device. We report our experience of twelve selections and ten grafts. A CD34+ cells enrichment of 1.9 log (purity: 72%) and a CFU-GM cells concentration of 1.6 log have been obtained. In ten transplanted patients, the hematological recovery was similar to that obtained with non selected blood stem cells. The CD34+ cells purification allows mini graft infusion and purge of residual tumor cells implicated in relapse after autologous stem cells transplantation.
Assuntos
Disgerminoma/terapia , Doenças Hematológicas/terapia , Transplante de Células-Tronco Hematopoéticas/métodos , Sarcoma de Ewing/terapia , Adulto , Antígenos CD34 , Criança , Terapia Combinada , Células-Tronco Hematopoéticas/imunologia , Humanos , Lactente , Transplante AutólogoAssuntos
Antígeno Ca-125/análise , Linfoma de Células B/diagnóstico , Neoplasias do Mediastino/diagnóstico , Adolescente , Adulto , Biomarcadores Tumorais , Antígeno Ca-125/sangue , Feminino , Humanos , Imuno-Histoquímica , Linfoma de Células B/patologia , Masculino , Neoplasias do Mediastino/patologia , Prognóstico , Radioimunoensaio , EscleroseRESUMO
A recent randomized multicentric French study has shown that intensification with stem cell rescue improves the response rate and progression-free survival in multiple myeloma. Transplantation with primed peripheral blood stem cells (PBSC) displays a faster hematological recovery, especially for platelets, as compared with a bone marrow stem cell graft. In multiple myeloma, the optimal mobilization method for PBSC is unknown. The present study compares mobilization with cyclophosphamide 4 g/m2 + G-CSF 5 micrograms/kg versus G-CSF 5 micrograms/kg alone versus G-CSF 10 micrograms/kg alone in two cases of multiple myeloma, using an intrapatient controlled evaluation of the amount of CD34-positive cells obtained during each leukapheresis. In both cases, the highest CD34-positive cells yield was obtained with G-CSF at 10 micrograms/kg. Despite the low number of cases, this method, devoid of life-threatening toxicity, might be of greatest interest in multiple myeloma.