Electrochemotherapy as palliative treatment in patients with thyroid papillary carcinoma / Eletroquimioterapia como tratamento paliativo em pacientes com carcinoma papilar da tireoide

ABSTRACT INTRODUCTION: Local progression of papillary thyroid carcinoma (PTC) after failure of standard therapies may cause pain, ulceration, and bleeding. As patients are fully aware of the tumor growth, they might suffer high grade anxiety. Electrochemotherapy (ECT) is a new local palliative treatment for skin metastases of malignant melanoma or other tumors, including squamous head e neck cancer patients. OBJECTIVE: To evaluate the impact of ECT in patients with local progression of PTC. METHODS: Four patients with local progression of PTC were treated with ECT based on Bleomycin, and evaluated according to tumor response, local pain and side effects. RESULTS: In all cases, some grade of tumor response was observed, lasting 6, 7, 12 and 8 months, respectively. Also, reduction of local pain and anxiety was registered in all patients. Tumor infiltrated skin necrosis was the only collateral effect of the treatment. ECT induced a tumor response in all PTC patients with improvement of symptoms. CONCLUSIONS: ECT may be an option for local palliative treatment in PTC patients with local tumor progression.

Resumo Introdução: A progressão local do carcinoma papilífero de tireoide (CPT) após a falha da terapia de rotina pode causar dor, ulceração e sangramento. Considerando que os pacientes estão perfeitamente cientes do crescimento tumoral, podem apresentar um alto grau de ansiedade. A eletroquimioterapia (EQT) é um novo tratamento paliativo para metástases de pele de melanoma maligno ou de outros tumores, inclusive em pacientes com carcinoma escamoso de cabeça e pescoço. Objetivo: Avaliar o impacto da EQT em pacientes com progressão local de CPT. Método: Quatro pacientes com progressão local de CPT foram tratados com EQT com base em bleomicina, e avaliados em relação ao grau de resposta tumoral, dor local, efeitos colaterais. Resultados: Em todos os casos, foi observado algum grau de resposta tumoral, que perdurou por 6, 7, 12 e 8 meses, respectivamente. Da mesma forma, foi registrada diminuição da dor local e da ansiedade em todos os pacientes. Necrose cutânea na infiltração tumoral foi o único efeito colateral do tratamento. EQT induziu resposta tumoral em todos os pacientes com CPT, com melhora dos sintomas. Conclusões: EQT pode ser uma opção para o tratamento paliativo tópico em pacientes com CPT com progressão tumoral local.

Electrochemotherapy as palliative treatment in patients with thyroid papillary carcinoma.

INTRODUCTION: Local progression of papillary thyroid carcinoma (PTC) after failure of standard therapies may cause pain, ulceration, and bleeding. As patients are fully aware of the tumor growth, they might suffer high grade anxiety. Electrochemotherapy (ECT) is a new local palliative treatment for skin metastases of malignant melanoma or other tumors, including squamous head e neck cancer patients. OBJECTIVE: To evaluate the impact of ECT in patients with local progression of PTC. METHODS: Four patients with local progression of PTC were treated with ECT based on Bleomycin, and evaluated according to tumor response, local pain and side effects. RESULTS: In all cases, some grade of tumor response was observed, lasting 6, 7, 12 and 8 months, respectively. Also, reduction of local pain and anxiety was registered in all patients. Tumor infiltrated skin necrosis was the only collateral effect of the treatment. ECT induced a tumor response in all PTC patients with improvement of symptoms. CONCLUSIONS: ECT may be an option for local palliative treatment in PTC patients with local tumor progression.

A Cuban NGO perspective on disabilities: José Blanch MD MPH, National Association of Blind Persons. Interview by Gail Reed.

Dual specialties in epidemiology and labor medicine, as well as an advanced degree in public health, gave Dr José Blanch expertise on disabilities in Cuba from a population health perspective. However, when he began losing his sight due to a diabetic retinopathy while serving in Africa, he also began a difficult journey that would transform his life and career, giving him new personal and professional perspectives on disability and the potential of disabled persons. Active for the past several years in the National Association of Blind Persons (ANCI, its Spanish acronym), in 2010 Dr Blanch was elected President of the non-governmental organization. He spoke with MEDICC Review about ANCI's role and challenges in the context of Cuba today.

Tratamiento de la Osteoporosis

La osteoporosis es el síndrome más frecuente dentro de la enfermedad metabólica ósea. Su importancia aumenta de forma paralela al aumento de la esperanza de vida de la población y al envejecimieto de ésta; su complicación, la fractura, puede producir un enmpeoramiento severo de la calidad de vida, siendo la de cadera una causa importante de mortalidad en los ancianos. Al diagnosticar la existencia de la osteoporosis es importante caracterizar su etiología y grado de recambio óseo para iniciar el tratamiento, el cual puede dividirse en profiláctico y terapéutico sidno su objetivo final la prevención de complicaciones.Son múltiples los tratamiento propuestos para este proceso, apareciendo cada año nuevos fármacos. Los tratamientos tienden a mantener al paciente con niveles de densidad mineral ósea por encima del riesgo de fracturas, pero debido a que la pérdida de calcio es un fenómeno fisiológico, una vez se suspende el tratamiento, este proceso de pérdida se inicia de nuevo. La elección del fármaco será individualizada, deberá basarse en el tipo de osteoporosis, su remodelado óseo y la tolerancia y respuesta del paciente al fármaco