RESUMO
Imaging in oncology is an essential tool for patient management but its potential is being profoundly underutilized. Each of the techniques used in the diagnostic process also conveys functional information that can be relevant in treatment decision-making. New imaging algorithms and techniques enhance our knowledge about the phenotype of the tumor and its potential response to different therapies. Functional imaging can be defined as the one that provides information beyond the purely morphological data, and include all the techniques that make it possible to measure specific physiological functions of the tumor, whereas molecular imaging would include techniques that allow us to measure metabolic changes. Functional and molecular techniques included in this document are based on multi-detector computed tomography (CT), 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET), magnetic resonance imaging (MRI), and hybrid equipments, integrating PET with CT (PET/CT) or MRI (PET-MRI). Lung cancer is one of the most frequent and deadly tumors although survival is increasing thanks to advances in diagnostic methods and new treatments. This increased survival poises challenges in terms of proper follow-up and definitions of response and progression, as exemplified by immune therapy-related pseudoprogression. In this consensus document, the use of functional and molecular imaging techniques will be addressed to exploit their current potential and explore future applications in the diagnosis, evaluation of response and detection of recurrence of advanced NSCLC.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Imagem Molecular/normas , Recidiva Local de Neoplasia/diagnóstico por imagem , Guias de Prática Clínica como Assunto/normas , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/terapia , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/terapia , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/terapiaRESUMO
OBJECTIVE: The purpose of this study is to characterize head and neck squamous cell carcinoma (HNSCC) in the Puerto Rican population. This is a follow-up to our initial published report on the first 134 patients. Specifically, demographic characteristics, stage at presentation, initial treatment given, and rate of recurrence were studied. METHODS: Relevant data was obtained from 445 histologically confirmed HNSCC cases identified through the University of Puerto Rico School of Medicine Otolaryngology Department Head and Neck Cancer Clinics between August 1993 and January 2003. Data collected after informed consent included demographic factors (sex, age, areas of residence, income); risk factors (occupation, alcohol intake, cigarette usage); and pathological variables (tumor location, histopathology, stage at presentation, current disease status, tumor recurrence). RESULTS: The average age at diagnosis was 64.0 years (range 18-98); 84.5 per cent of the patients were male, 16 per cent were females. The most frequent anatomical sites of the primary tumor were the larynx (36.4 per cent) and the oral cavity (29.9 per cent). The majority of patients (61.1 per cent) presented with advanced stage (III-IV) disease at the time of diagnosis and over half (55.5 per cent) had moderately-differentiated tumors. Most patients had less than 12 years of formal education (81.2 per cent). Prolonged use of tobacco and alcohol identified in 88.1 per cent and 79.8 per cent of patients, respectively. The most frequent therapeutic modality used was radiation therapy followed by the combination of radiation and surgery. Twenty five percent of the cases experienced a recurrence of disease during the follow-up period. CONCLUSIONS: These findings emphasize the need for early detection programs for HNSCC in Puerto Rican patients given the high rate of advanced-stage disease at time of diagnosis. The key role of heavy alcohol intake and tobacco use as risk factors in the development of HNSCC is once again highlighted.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Carcinoma de Células Escamosas/epidemiologia , Neoplasias de Cabeça e Pescoço/epidemiologia , Alcoolismo/epidemiologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Demografia , Seguimentos , Incidência , Recidiva Local de Neoplasia , Neoplasias Bucais/epidemiologia , Neoplasias Bucais/patologia , Neoplasias Bucais/terapia , Neoplasias Laríngeas/epidemiologia , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/terapia , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/terapia , Porto Rico/epidemiologia , Fatores de Risco , Tabagismo/epidemiologiaRESUMO
Se presenta un estudio de la incidencia de Trichocephalus trichiurus en Limon. Se analizaron 1427 muestras de heces de pacientes de todas las edades y sexo que se presentaron a la consulta externa del hospital de Limon, durante el ano 1981.Se determina la incidencia de Trichocephalus trichiuris siendo de 405 muestras positivas de los 1427 muestras analizadas (28.38 por ciento). Ademas se muestra un estudio comparativo del estado de esta parasitosis con respecto a otras, asi como el porcentaje de infeccion por edad y si se presenta en forma unica o multiple