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1.
Recenti Prog Med ; 115(6): 21e-25e, 2024 Jun.
Artículo en Italiano | MEDLINE | ID: mdl-38853738

RESUMEN

Triple negative disease, defined by a lack of tumor cell expression of estrogen receptor, progesterone receptor and HER2, remains to date the worst prognosis subtype and especially in metastatic disease triple negative breast cancer is still un unmet clinical need. However, even in this setting, now we can use new drugs such as immunotherapy and antibodies drug conjugated to improve outcome. Particularly, sacituzumab govitecan is the first Ab drug conjugated demonstrating a significant improvement in terms of overall and progression free survival in patients affected by metastatic TNBC pretreated with 2-3 previous lines of therapy.


Asunto(s)
Recurrencia Local de Neoplasia , Neoplasias de la Mama Triple Negativas , Humanos , Neoplasias de la Mama Triple Negativas/tratamiento farmacológico , Neoplasias de la Mama Triple Negativas/patología , Femenino , Recurrencia Local de Neoplasia/tratamiento farmacológico , Factores de Tiempo , Anticuerpos Monoclonales Humanizados/administración & dosificación , Quimioterapia Adyuvante/métodos , Anticuerpos Biespecíficos/administración & dosificación , Persona de Mediana Edad , Camptotecina/análogos & derivados , Inmunoconjugados
2.
Recenti Prog Med ; 115(6): 31e-35e, 2024 Jun.
Artículo en Italiano | MEDLINE | ID: mdl-38853740

RESUMEN

The higher frequency of metastasization and poor prognosis of triple-negative breast cancer require suitable expertise in order to set up an appropriate and effective treatment plan for these patients. Our case describes the clinical history of a 63-year-old BRCA1/2 wild-type woman with excellent ECOG performance status and advanced PD-L1 negative breast cancer with brain, nodal and hepatic metastases. When occurred the brain progression within one year from neoadjuvant chemotherapy for a locally advanced tumor, the patient was treated with brain stereotaxis and a systemic platinum-based therapy that was not completed due to poor tolerance. Later instrumental examinations confirmed a new systemic and visceral progression, for which the patient underwent new therapy with sacituzumab govitecan (SG). During this treatment, we observed a reduction of the target liver and nodal lesions. The onset after several months of two very small cortico-subcortical metastases, on which stereotactic radiotherapy was performed, did not lead us to discontinuate the treatment, that was ongoing for another six months, with an excellent control both of brain and systemic disease without any symptoms, until a new disease progression at other sites requiring a therapeutic change. The use of antibody-drug conjugates allowed a significant prolongation of time to progression and overall survival in our clinical scenario characterized by poor prognosis due to early recurrence and brain involvement.


Asunto(s)
Anticuerpos Monoclonales Humanizados , Neoplasias Encefálicas , Camptotecina , Neoplasias de la Mama Triple Negativas , Humanos , Persona de Mediana Edad , Femenino , Neoplasias de la Mama Triple Negativas/tratamiento farmacológico , Neoplasias de la Mama Triple Negativas/patología , Anticuerpos Monoclonales Humanizados/administración & dosificación , Anticuerpos Monoclonales Humanizados/uso terapéutico , Anticuerpos Monoclonales Humanizados/farmacología , Neoplasias Encefálicas/secundario , Neoplasias Encefálicas/tratamiento farmacológico , Camptotecina/análogos & derivados , Camptotecina/administración & dosificación , Inmunoconjugados/administración & dosificación , Inmunoconjugados/farmacología , Factores de Tiempo , Progresión de la Enfermedad , Neoplasias Hepáticas/secundario , Neoplasias Hepáticas/tratamiento farmacológico , Resultado del Tratamiento
3.
Eur Rev Med Pharmacol Sci ; 28(10): 3650-3657, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38856141

RESUMEN

OBJECTIVE: Spinal cord injury (SCI) damages an individual's sensory, motor, and autonomic functions and represents a social emergency, mostly in developed countries. Accurate and timely diagnosis of the severity of SCI must be carried out as quickly as possible to allow time for drug and therapy testing in the early stages after injury. MATERIALS AND METHODS: Male Dark Agouti (DA) rats underwent spinal cord cryoinjury at the T13 level of the spine. Under typical conditions, in vivo magnetic resonance imaging (MRI) T2 and echo-planar imaging - diffusion tensor imaging (EPI-DTI) examinations were conducted. This involved the reconstruction of nerve tracts and the measurement of the fractional anisotropy (FA) index, as well as measurements of the ratio of Hyper/Hypo intensive areas and spinal cord injury severity scores. RESULTS: Our study shows that, after cryoinjury, the FA significantly decreased in all animals. An increase in FA level, derived from EPI-DTI within 2 days after SCI, accurately predicts long-term locomotor function recovery. In rats with higher FA, recorded on day 2 after injury, complete restoration of locomotor function was observed, while at low FA values, the animals maintained stable monoplegia. CONCLUSIONS: Our results, though validating the T2 10-grade MRI scale for SCI, indicate that FA would represent the MRI technical instrument, which would better monitor the evolution of SCI and, accordingly, better objectively evaluate the impact of potentially therapeutic protocols for spinal cord traumatic injury. Despite the results achieved, significant difficulties must be overcome on the way to successful clinical implementation of the findings in humans.


Asunto(s)
Imagen de Difusión Tensora , Recuperación de la Función , Traumatismos de la Médula Espinal , Animales , Traumatismos de la Médula Espinal/diagnóstico por imagen , Traumatismos de la Médula Espinal/fisiopatología , Masculino , Ratas , Locomoción/fisiología , Imagen por Resonancia Magnética , Factores de Tiempo , Modelos Animales de Enfermedad
4.
J Acoust Soc Am ; 155(6): 3742-3759, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38856312

RESUMEN

Amplitude modulation (AM) of a masker reduces its masking on a simultaneously presented unmodulated pure-tone target, which likely involves dip listening. This study tested the idea that dip-listening efficiency may depend on stimulus context, i.e., the match in AM peakedness (AMP) between the masker and a precursor or postcursor stimulus, assuming a form of temporal pattern analysis process. Masked thresholds were measured in normal-hearing listeners using Schroeder-phase harmonic complexes as maskers and precursors or postcursors. Experiment 1 showed threshold elevation (i.e., interference) when a flat cursor preceded or followed a peaked masker, suggesting proactive and retroactive temporal pattern analysis. Threshold decline (facilitation) was observed when the masker AMP was matched to the precursor, irrespective of stimulus AMP, suggesting only proactive processing. Subsequent experiments showed that both interference and facilitation (1) remained robust when a temporal gap was inserted between masker and cursor, (2) disappeared when an F0-difference was introduced between masker and precursor, and (3) decreased when the presentation level was reduced. These results suggest an important role of envelope regularity in dip listening, especially when masker and cursor are F0-matched and, therefore, form one perceptual stream. The reported effects seem to represent a time-domain variant of comodulation masking release.


Asunto(s)
Estimulación Acústica , Umbral Auditivo , Enmascaramiento Perceptual , Humanos , Adulto Joven , Adulto , Factores de Tiempo , Femenino , Masculino , Audiometría de Tonos Puros , Percepción Auditiva/fisiología
5.
Ann Plast Surg ; 92(6S Suppl 4): S413-S418, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38857006

RESUMEN

BACKGROUND: Hourly flap checks are the most common means of flap monitoring during the first 24 hours following autologous breast reconstruction (ABR). This practice often requires intensive care unit (ICU) admission, which is a key driver of health care costs and decreased patient satisfaction. This study addresses these issues by demonstrating decreased cost and length of admission associated with a 4-hour interval between flap checks during the first 24 hours following ABR. METHODS: This is a retrospective review of ABR surgeries performed by multiple surgeons from 2017 to 2020. Two cohorts were identified, one that underwent flap checks every hour in the ICU (Q1 cohort) and the other that underwent flap checks every 4 hours on the hospital floor (Q4 cohort). Our primary outcome measures were length of stay (LOS), flap takebacks, flap loss, and encounter cost. RESULTS: Rates of flap takeback and loss did not differ between cohorts (P = 0.18, P = 0.21). The Q4 cohort's average LOS was shorter than the Q1 cohort (P = 0.002). The Q4 cohort's average cost was also $25,554.80 less than the Q1 cohort (P < 0.001). This association persisted after controlling for LOS, operating room takeback, timing and laterality of reconstruction, and flap configuration (hazard ratio = 0.65, P = 0.0007). CONCLUSION: This study demonstrates the benefits of lengthened flap check intervals during the first 24 hours following ABR. These intervals decrease the cost of ABR while also maintaining safety, making ABR a more accessible option for breast reconstruction patients.


Asunto(s)
Tiempo de Internación , Mamoplastia , Colgajos Quirúrgicos , Humanos , Mamoplastia/métodos , Mamoplastia/economía , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Factores de Tiempo , Tiempo de Internación/estadística & datos numéricos , Adulto , Cuidados Posoperatorios/métodos , Monitoreo Fisiológico/métodos , Trasplante Autólogo
7.
JACC Cardiovasc Interv ; 17(11): 1325-1336, 2024 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-38866455

RESUMEN

BACKGROUND: Conduction disturbances requiring a permanent pacemaker (PPM) are a frequent complication of transcatheter aortic valve replacement (TAVR) with few reports of rates, predictors, and long-term clinical outcomes following implantation of the third-generation, balloon-expandable SAPIEN 3 (S3) transcatheter heart valve (THV). OBJECTIVES: The aim of this study was to investigate the rates, predictors, and long-term clinical outcomes of PPM implantation following TAVR with the S3 THV. METHODS: The current study included 857 patients in the PARTNER 2 S3 registries with intermediate and high surgical risk without prior PPM, and investigated predictors and 5-year clinical outcomes of new PPM implanted within 30 days of TAVR. RESULTS: Among 857 patients, 107 patients (12.5%) received a new PPM within 30 days after TAVR. By multivariable analysis, predictors of PPM included increased age, pre-existing right bundle branch block, larger THV size, greater THV oversizing, moderate or severe annulus calcification, and implantation depth >6 mm. At 5 years (median follow-up 1,682.0 days [min 2.0 days, max 2,283.0 days]), new PPM was not associated with increased rates of all-cause mortality (Adj HR: 1.20; 95% CI: 0.85-1.70; P = 0.30) or repeat hospitalization (Adj HR: 1.22; 95% CI: 0.67-2.21; P = 0.52). Patients with new PPM had a decline in left ventricular ejection fraction at 1 year that persisted at 5 years (55.1 ± 2.55 vs 60.4 ± 0.65; P = 0.02). CONCLUSIONS: PPM was required in 12.5% of patients without prior PPM who underwent TAVR with a SAPIEN 3 valve in the PARTNER 2 S3 registries and was not associated with worse clinical outcomes, including mortality, at 5 years. Modifiable factors that may reduce the PPM rate include bioprosthetic valve oversizing, prosthesis size, and implantation depth.


Asunto(s)
Estenosis de la Válvula Aórtica , Válvula Aórtica , Estimulación Cardíaca Artificial , Prótesis Valvulares Cardíacas , Marcapaso Artificial , Diseño de Prótesis , Sistema de Registros , Reemplazo de la Válvula Aórtica Transcatéter , Humanos , Masculino , Femenino , Reemplazo de la Válvula Aórtica Transcatéter/efectos adversos , Reemplazo de la Válvula Aórtica Transcatéter/mortalidad , Reemplazo de la Válvula Aórtica Transcatéter/instrumentación , Factores de Riesgo , Anciano , Factores de Tiempo , Anciano de 80 o más Años , Resultado del Tratamiento , Estenosis de la Válvula Aórtica/cirugía , Estenosis de la Válvula Aórtica/diagnóstico por imagen , Estenosis de la Válvula Aórtica/fisiopatología , Estenosis de la Válvula Aórtica/mortalidad , Válvula Aórtica/cirugía , Válvula Aórtica/fisiopatología , Válvula Aórtica/diagnóstico por imagen , Medición de Riesgo , Arritmias Cardíacas/terapia , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/fisiopatología , Arritmias Cardíacas/etiología , Arritmias Cardíacas/mortalidad , Estados Unidos/epidemiología
9.
JACC Cardiovasc Interv ; 17(11): 1340-1351, 2024 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-38866457

RESUMEN

BACKGROUND: The etiology of transcatheter aortic valve (TAV) degeneration is poorly understood, particularly noncalcific mechanisms. OBJECTIVES: The authors sought to investigate noncalcific and calcific mechanisms of TAV degeneration and evaluate their impact on leaflet function by bench testing, imaging, and histology. METHODS: TAV explants were obtained from the EXPLANT THV registry and clinical institutions. Hydrodynamic assessment was performed using a heart valve pulse duplicator system under physiological conditions. Micro-computed tomography, high-resolution photography, high speed video, and hematoxylin and eosin staining were used to evaluate the morphological appearance, leaflet kinematics, and calcium burden of TAVs. RESULTS: A total of 14 explants were evaluated: 10 self-expanding CoreValve/Evolut TAVs (Medtronic), 3 balloon-expandable SAPIEN 3 TAVs (Edwards Lifesciences), and 1 mechanically expandable Lotus TAV (Boston Scientific). The median patient age at explantation was 73.0 years (Q1-Q3: 64.5-80.0 years), with a time to explantation of 4 years 1 month (1 year 5 months to 4 years 11 months). Six TAV explants were found to have leaflet calcification (162.4 mm3; 58.8-603.0 mm3), and 8 had no calcification detectable by micro-computed tomography and histology. All samples had impaired leaflet kinematics. There was no significant difference in the hydrodynamic mean gradient between calcified (47.2 mm Hg; 26.6-74.1 mm Hg) and noncalcified (27.6 mm Hg; 15.2-36.7 mm Hg; P = 0.28) TAVs. Leaflet calcification had a weak but nonsignificant association with the hydrodynamic mean gradient (r = 0.42; P = 0.14). CONCLUSIONS: TAV function can be severely impacted by noncalcific and calcific mechanisms of tissue degeneration. Importantly, functional stenosis can occur in TAVs in the absence of obvious and significant calcification.


Asunto(s)
Válvula Aórtica , Calcinosis , Prótesis Valvulares Cardíacas , Hidrodinámica , Diseño de Prótesis , Falla de Prótesis , Sistema de Registros , Reemplazo de la Válvula Aórtica Transcatéter , Microtomografía por Rayos X , Humanos , Anciano , Válvula Aórtica/fisiopatología , Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/cirugía , Válvula Aórtica/patología , Calcinosis/fisiopatología , Calcinosis/diagnóstico por imagen , Calcinosis/patología , Calcinosis/cirugía , Femenino , Anciano de 80 o más Años , Masculino , Reemplazo de la Válvula Aórtica Transcatéter/instrumentación , Reemplazo de la Válvula Aórtica Transcatéter/efectos adversos , Persona de Mediana Edad , Factores de Tiempo , Remoción de Dispositivos , Estenosis de la Válvula Aórtica/fisiopatología , Estenosis de la Válvula Aórtica/diagnóstico por imagen , Estenosis de la Válvula Aórtica/cirugía , Hemodinámica , Fenómenos Biomecánicos , Ensayo de Materiales , Grabación en Video
10.
J Cardiovasc Electrophysiol ; 35(6): 1174-1184, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38867544

RESUMEN

INTRODUCTION: The left ventricular summit (LVS) is the highest point on the epicardial surface of the left ventricle. A part of the LVS that is located between the left coronary arteries (lateral-LVS) is one of the major sites of idiopathic ventricular arrhythmia (VA) origins. Some idiopathic epicardial VAs can be ablated at endocardial sites adjacent to the epicardial area septal to the lateral-LVS (septal-LVS). This study examined the prevalence and electrocardiographic and electrophysiological characteristics of septal-LVS VAs. METHODS: We studied consecutive patients with idiopathic VAs originating from the LVS (67 patients) and aortic root (93 patients). RESULTS: Based on the ablation results, among 67 LVS VAs, 54 were classified as lateral and 13 as septal-LVS VAs. As compared with the lateral-LVS VAs, the septal-LVS VAs were characterized by a greater prevalence of left bundle branch block with left inferior-axis QRS pattern, later precordial transition, lower R-wave amplitude ratio in leads III to II, lower Q-wave amplitude ratio in leads aVL to aVR, and later local ventricular activation time relative to the QRS onset during VAs (V-QRS) in the great cardiac vein. The electrocardiographic and electrophysiological characteristics of the septal-LVS VAs were similar to those of the aortic root VAs. However, the V-QRS at the successful ablation site was significantly later during the septal-LVS VAs than aortic root VAs (p < .0001). The precordial transition was significantly later during the septal-LVS VAs than aortic root VAs (p < .05). CONCLUSIONS: Septal-LVS VAs are considered a distinct subgroup of idiopathic VAs originating from the left ventricular outflow tract.


Asunto(s)
Potenciales de Acción , Ablación por Catéter , Electrocardiografía , Técnicas Electrofisiológicas Cardíacas , Valor Predictivo de las Pruebas , Humanos , Femenino , Masculino , Prevalencia , Persona de Mediana Edad , Adulto , Anciano , Resultado del Tratamiento , Frecuencia Cardíaca , Ventrículos Cardíacos/fisiopatología , Ventrículos Cardíacos/cirugía , Taquicardia Ventricular/fisiopatología , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/cirugía , Taquicardia Ventricular/epidemiología , Estudios Retrospectivos , Factores de Tiempo
11.
Clin Lab ; 70(6)2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38868893

RESUMEN

BACKGROUND: Acute promyelocytic leukemia (APL) is a specific type of acute myeloid leukemia [1,2], the onset of the disease is insidious and the disease progresses rapidly, and failure to detect it in time or missing the best time to seek medical treatment is likely to cause secondary cerebral hemorrhage and lead to early death (ED: deaths occur in the first 30 days post diagnosis) [3-5]. METHODS: A patient with APL was rapidly identified by peripheral blood image, fibrinogen (FIB), and D-dimer within 24 hours. Finally, APL was confirmed by bone marrow cell morphology, molecular biology, and cytogenetics. RESULTS: The presence of faggot cells with Auer rods in the peripheral blood image and the coagulation function changes abnormally at the same time. Once the above abnormal results are found, APL should be highly suspected and timely reported to the clinic for corresponding treatment. CONCLUSIONS: APL is a critical disease, the time limit for definitive diagnosis should be calculated in hours rather than days. Peripheral blood smear microscopic examination can effectively screen out rare promyelocytes and combine with abnormal FIB and D-dimer results that are highly suspicious of APL. These methods have important clinical significance in the initial screening, early diagnosis, and reduction of early mortality due to APL.


Asunto(s)
Productos de Degradación de Fibrina-Fibrinógeno , Leucemia Promielocítica Aguda , Humanos , Leucemia Promielocítica Aguda/diagnóstico , Leucemia Promielocítica Aguda/sangre , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Masculino , Fibrinógeno/análisis , Fibrinógeno/metabolismo , Factores de Tiempo
12.
J Exp Biol ; 227(12)2024 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-38869075

RESUMEN

Lepidosaurian reptiles, particularly snakes, periodically shed the outer epidermal layers of their skin (ecdysis) to restore or enhance vital functions such as regulating water and gaseous exchange, growth, and protection against insult, infection or physical injury. Although many studies have focused on the nature and mechanisms of skin shedding, little attention has been paid to the timing of the first ecdysis in neonates following birth or hatching. A recent study investigated patterns of the time to first postnatal ecdysis in snakes based on a large dataset taken from the literature. The analysis demonstrated patterns in the time to first postnatal ecdysis related to phylogeny as well as several life history traits. While this assessment provides important advances in our knowledge of this topic, data on known biophysical drivers of ecdysis - temperature and humidity - were largely unavailable and were not evaluated. The first postnatal ecdysis of neonatal snakes can be viewed as an adaptive adjustment to the transition from the aqueous environment of the embryo to the aerial environment of the newborn. Hence, the timing of the first postnatal ecdysis is logically influenced by the aerial environment into which a newborn snake or hatchling finds itself. Therefore, in this Commentary, we first emphasize the putative plasticity of ecdysis with respect to epidermal lipids that structure the water permeability barrier and are established or renewed during ecdysis to reduce transepidermal evaporative water loss. We then discuss the likely importance of biophysical variables as influential covariates that need future investigation as potential co-determinants of the timing of first postnatal ecdysis.


Asunto(s)
Muda , Serpientes , Animales , Serpientes/fisiología , Serpientes/crecimiento & desarrollo , Muda/fisiología , Factores de Tiempo , Animales Recién Nacidos/fisiología , Animales Recién Nacidos/crecimiento & desarrollo
14.
Br J Anaesth ; 133(1): 14-15, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38879264

RESUMEN

Promptly calling for assistance in an anaesthetic emergency is important. However, emergency call systems are not present in all locations where anaesthesia is administered, and in those that do have an emergency call system, the call button is often obscured by other equipment or in an unfamiliar location. Placing a red stripe from the ceiling, down the wall, to the emergency call button significantly reduces delays in activating an emergency call, demonstrating a simple but effective system change to the layout of operating theatres.


Asunto(s)
Anestesia , Quirófanos , Humanos , Anestesia/métodos , Sistemas de Comunicación entre Servicios de Urgencia , Factores de Tiempo , Servicios Médicos de Urgencia/métodos
16.
Gan To Kagaku Ryoho ; 51(5): 549-552, 2024 May.
Artículo en Japonés | MEDLINE | ID: mdl-38881066

RESUMEN

An 80-year-old male patient presented with a 2.5 cm-sized submucosal tumor on the greater curvature side of the upper gastric body during an endoscopic examination in 200X. We diagnosed gastric GIST by biopsy and performed laparoscopic- assisted partial gastrectomy. Imatinib was started as postoperative adjuvant therapy, but was discontinued after 1 month due to eyelid edema. The patient was followed up with a contrast-enhanced CT scan and a PET-CT scan. A 7 cm-sized mass in the gastrosplenic region was discovered on a 200X+7 years CT scan; this mass was thought to be possible recurrence of peritoneal dissemination. The patient did not want to undergo surgery or drug treatment, and was followed up. Five months later he complained of abdominal pain. The CT scan showed that the mass had shrunk slightly, but a small amount of ascites was observed, and tumor rupture was suspected. Therefore, we performed resection of the tumor in the office. Numerous disseminated nodules were found in the intra-abdominal cavity. Pathological examination revealed recurrence of GIST, and the patient was started on imatinib 200 mg/day. The dose was temporarily increased to 300 mg/day, but was reduced again to 200 mg/day 1 month later due to eyelid edema. Thereafter, the dose was temporarily discontinued due to stomatitis, and from 200X+8 years, 200 mg/day was administered for 2 weeks and then discontinued for 2 weeks. At present, 14 years after the first surgery and 6 years after recurrence, he remains alive thanks to imatinib continuation.


Asunto(s)
Antineoplásicos , Gastrectomía , Tumores del Estroma Gastrointestinal , Mesilato de Imatinib , Recurrencia , Neoplasias Gástricas , Humanos , Masculino , Tumores del Estroma Gastrointestinal/cirugía , Tumores del Estroma Gastrointestinal/tratamiento farmacológico , Neoplasias Gástricas/patología , Neoplasias Gástricas/cirugía , Neoplasias Gástricas/tratamiento farmacológico , Anciano de 80 o más Años , Mesilato de Imatinib/uso terapéutico , Antineoplásicos/uso terapéutico , Antineoplásicos/administración & dosificación , Factores de Tiempo , Terapia Combinada
17.
Gan To Kagaku Ryoho ; 51(5): 561-565, 2024 May.
Artículo en Japonés | MEDLINE | ID: mdl-38881069

RESUMEN

A 73-year-old woman underwent a descending colectomy for descending colon cancer. The tumor was graded as pStage Ⅲb(pT3[SS], pN1b, pM0, Cur A), according to the 9th edition of the Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma. Postoperative treatment of adjuvant chemotherapy comprised oral tegafur/uracil and Leucovorin for 6 months with no evident recurrence. However, contrast-enhanced CT and FDG-PET/CT examination 8 years and 7 months after surgery revealed a 30 mm irregular recurrent tumor in the left iliac fossa. Since the tumor was adjacent to the left psoas muscle, it was considered that RM0(no tumor identified at the radial margin)could not be achieved in that region. Owing to the patient's good general condition, systemic chemotherapy with CAPOX+bevacizumab was administered. Although adverse events prompted discontinuation of the treatment during the first course, the recurrent tumor had significantly regressed. Systemic chemotherapy with mFOLFOX6+bevacizumab as selected subsequent treatment achieved a significant tumor shrinkage to date. Although a recurrence more than 5 years after curative resection of colorectal cancer is extremely rare, the possibility of late recurrence must be considered in patients with well-differentiated tumors who received adjuvant chemotherapy and had negative vascular invasion.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica , Colectomía , Neoplasias del Colon , Recurrencia , Humanos , Anciano , Femenino , Neoplasias del Colon/tratamiento farmacológico , Neoplasias del Colon/cirugía , Neoplasias del Colon/patología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Factores de Tiempo , Colon Descendente/patología , Colon Descendente/cirugía , Bevacizumab/administración & dosificación , Resultado del Tratamiento , Leucovorina/administración & dosificación , Leucovorina/uso terapéutico
20.
Ying Yong Sheng Tai Xue Bao ; 35(4): 1007-1015, 2024 Apr 18.
Artículo en Chino | MEDLINE | ID: mdl-38884235

RESUMEN

Soil matrix infiltration is an important pathway for plantations to obtain water, which affects ecological benefits and water conservation function of plantations. The changes of soil matrix infiltration and its influencing factors in different growth stages of Chinese fir plantations remain unclear. We measured soil matrix infiltration process using a tension infiltrometer in Chinese fir plantations (5, 8, 11, and 15 years old) of Beijiang River Forest Farm in Rongshui, Guangxi, and analyzed soil basic physicochemical properties to identify the dominant factors influencing soil matrix infiltration. The results showed that initial infiltration rate, stable infiltration rate, and cumulative infiltration increased with stand ages. The ranges of different stand ages were 141-180 mm·h-1, 109-150 mm·h-1, and 188-251 mm, respectively. The initial infiltration rate, stable infiltration rate, and cumulative infiltration were significantly positively correlated with soil capillary porosity, soil organic matter, soil water stable macroaggregate, sand content, and clay content, while negatively correlated with soil bulk density and silt content. Early thinning had a positive effect on soil matrix infiltration, but thinning measures after 11 years did not enhance soil matrix infiltration further. Philip model was optimal for describing soil matrix infiltration process in this region. In conclusion, soil matrix infiltration capacity of Chinese fir plantations gradually increased from young to middle-aged stands, but matrix infiltration capacity tended to stabilize after 11 years old. Silt content and water stable macroaggregate were the dominant factors influencing matrix infiltration.


Asunto(s)
Suelo , Suelo/química , China , Cunninghamia/crecimiento & desarrollo , Agua/análisis , Ecosistema , Factores de Tiempo , Abies/crecimiento & desarrollo
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