RESUMEN
Literature on the role of multidisciplinary team (MDT) in cancer is still controversial. We aimed to investigate MDT impact on a panel of indicators in breast cancer care in a single-center retrospective study performed in a Cancer Reference Center in Italy. We analysed the diagnostic and therapeutic care pathway (DTCP) of 266 early breast cancer patients managed by our MDT during 2019-2020. Process indicators reflecting the change of the diagnostic and therapeutic care pathways occurred after the MDT discussion were computed. Further, the performance of some quality care indicators in breast cancer care since the establishment of the MDT activity and the breast cancer MDT members' perceptions were also investigated. According to our study, the MDT approach improves breast cancer management by increasing the completion of staging and by encouraging neo-adjuvant treatment and an appropriate and faster surgery. In MDT members' perspective it also improves decision-making and training and creates a positive work environment. Globally, our study encourages MDT rollout in breast cancer care. However, to enhance the reliability and comparability of the results of studies investigating MDT effectiveness in clinical practice, shared guidelines on its operationalisation are strongly desirable.
Asunto(s)
Neoplasias de la Mama , Humanos , Femenino , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/terapia , Vías Clínicas , Estudios Retrospectivos , Reproducibilidad de los Resultados , Percepción , Grupo de Atención al PacienteAsunto(s)
Androstenos/efectos adversos , Enfermedad de Hodgkin/tratamiento farmacológico , Inmunoterapia/métodos , Linestrenol/efectos adversos , Trombosis de la Vena/etiología , Adulto , Angiografía , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carmustina/uso terapéutico , Anticonceptivos Sintéticos Orales/efectos adversos , Citarabina/uso terapéutico , Etopósido/uso terapéutico , Femenino , Humanos , Relación Normalizada Internacional , Melfalán/uso terapéutico , Antagonistas de Receptores de Mineralocorticoides/efectos adversos , Riesgo , Factores de Riesgo , Factores de Tiempo , Warfarina/efectos adversosRESUMEN
A capture assay for the measurement of specific IgE in the serum of allergic patients is described, using monoclonal anti-human IgE (coated to the wells of a microtiter plate) and biotinylated allergens in solution. In a single incubation, IgE is bound to the solid phase through the Fc fragment and biotinylated allergens react with their specific IgE Fab regions, if present. In a second step, streptavidin-HRP conjugate is added to reveal the amount of biotin fixed on the solid phase. Quantitative determinations are obtained by comparison with a standard curve of total IgE incubated with a biotinylated monoclonal anti-IgE, complementary to the one employed as capture antibody. The assay is unaffected by allergen-specific IgG, shows good intra- and interassay reproducibility and is linear over a wide range of specific IgE concentrations. The method could be used with a wide range of different allergens.
Asunto(s)
Inmunoglobulina E/sangre , Animales , Especificidad de Anticuerpos , Humanos , Hipersensibilidad/inmunología , Inmunoglobulina G/sangre , Ratones , Ratones Endogámicos BALB C , Prueba de Radioalergoadsorción , Reproducibilidad de los ResultadosRESUMEN
The authors observed different clinical forms of Albright's hereditary osteodystrophy in 4 members of a family (two sisters, their mother and the maternal grandfather). The sisters were affected by pseudohypoparathyroidism type I, the older manifested the hypocalcemic variety, the younger the normocalcemic variety; the mother and the grandfather presented only with short stature and subcutaneous calcifications. The variety of clinical and biochemical alterations observed in these 3 generations supports evidence that Albright's hereditary osteodystrophy has a broad spectrum and that distinctions between the various forms of pseudohypoparathyroidsim should not be rigidly considered.
Asunto(s)
Displasia Fibrosa Ósea/genética , Displasia Fibrosa Poliostótica/genética , Adulto , Anciano , Estatura , Calcio/sangre , Huesos del Carpo/diagnóstico por imagen , Niño , AMP Cíclico/sangre , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Hormona Paratiroidea/sangre , Fósforo/sangre , Seudohipoparatiroidismo/genética , RadiografíaRESUMEN
The effects of 25-OHD3 on renal osteodystrophy have been studied in 6 patients on maintenance haemodialysis. Administration of 25-OHD3, 50 microgram/day, did not improve biochemical data and intestinal absorption of calcium. With a dose of 100 microgram/day in all patients an increase in blood calcium levels eventually reaching hypercalcemic values was observed. In two cases a fall in alkaline phosphatase toward normal values was noted. In the same cases the treatment-induced hyperphosphatemia, uncontrolled by AI(OH)3 supplementation and similarly high iPTH levels were observed. In two cases repeated bone biopsy following 8 months treatment and not show substantial improvement of bone lesions. In one case addition of 1,25-(OH)2D3 to the treatment with 25-OHD3 led to a more rapid improvement in biochemical parameters and iPTH serum levels. Doses of 25-OHD3 capable to correct blood calcium levels and intestinal absorption of calcium, may have minimal benefit on the osteitis fibrosa component of the bone lesion.