Assuntos
Otite Externa/tratamento farmacológico , Otite Externa/microbiologia , Vibrio cholerae O139 , Vibrio cholerae não O1 , Adulto , Antibacterianos/uso terapêutico , Praias , Orelha Interna/microbiologia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por MatrizRESUMO
OBJECTIVES: To analyze oncologic results, prognostic factors, and consideration of transglottic tumors as a separate entity in 73 patients with T3 glottic carcinoma treated by surgery +/- radiation therapy at La Paz University Hospital from 1984 to 1994. METHODS: Sixty-four patients underwent a total laryngectomy; neck dissection was performed in 50 patients; 29 patients received postoperative radiotherapy. RESULTS: The 5-year overall survival, cause-specific survival, and relapse-free survival rates were 58.1%, 66.8%, and 63.7%. Univariate analysis revealed prognostic significance for age, dyspnea, initial tracheostomy, and pathologic lymph node status. No difference was found when comparing survival and relapse rates between transglottic and glottic tumors. CONCLUSION: Surgery provides acceptable rates of cancer control and survival for patients with T3 glottic carcinoma. Older patients, patients with positive neck nodes, and those presenting with dyspnea have worse prognosis. The term transglottic is merely descriptive and has little impact on prognosis.
Assuntos
Carcinoma de Células Escamosas/cirurgia , Glote , Neoplasias Laríngeas/cirurgia , Laringectomia , Idoso , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/radioterapia , Feminino , Humanos , Neoplasias Laríngeas/mortalidade , Neoplasias Laríngeas/radioterapia , Masculino , Esvaziamento Cervical , Prognóstico , Radioterapia Adjuvante , Estudos RetrospectivosRESUMO
Despite recent advances in the diagnosis and therapy of patients with chronic renal failure and secondary hyperparathyroidism (HPT), 5% of these patients may need parathyroidectomy. The purpose of this article is to present our experience with parathyroid surgery in 30 patients with chronic renal failure at "La Paz" University Hospital, analyzing the clinical and biochemical evolution after surgery as well as the recurrence rate. In the first month after surgery, calcium, parathyroid hormone, phosphorus, and alkaline phosphatase levels, as well as bone pain and pruritus, all decreased significantly. Within the first postoperative year, 24 patients remained asymptomatic, and no recurrent secondary HPT was detected. Within the second year after surgery, 15 patients were asymptomatic, and 3 patients showed a recurrence. According to these results, parathyroidectomy is an appropriate surgical procedure for patients with severe overt secondary HPT.