Assuntos
Política de Saúde/legislação & jurisprudência , Fumar/legislação & jurisprudência , Indústria do Tabaco/legislação & jurisprudência , Adolescente , Adulto , Política de Saúde/tendências , Humanos , Responsabilidade Legal/economia , Fumar/mortalidade , Prevenção do Hábito de Fumar , Indústria do Tabaco/economia , Estados UnidosRESUMO
BACKGROUND: Pancreatic islet cell tumors are categorized as either functioning or nonfunctioning. Functioning islet cell tumors (FIT) elaborate a variety of hormones, producing dramatic symptoms, while the initial presentation of non-functioning islet cell tumors (NIT) is commonly an abdominal mass or symptom complex related to invasion of adjacent structures. As a result, NIT are purported to present at a later stage, with lower resectability rates, and an overall poorer prognosis, when compared to FIT. In addition, a number of reports have indicated that the incidence of NIT has increased significantly in recent years. PATIENTS AND METHODS: Twenty-eight patients were studied retrospectively. All had islet cell tumors of the pancreas and were seen at the University of Nebraska Medical Center and affiliated Nebraska Methodist Hospital during a 19-year period. RESULTS: There were 9 patients (32%) in the NIT group and 19 (68%) in the FIT group. The mean ages at presentation were 61 years for the NIT and 52 years for the FIT group. In the NIT group, all presented with either abdominal pain (n = 7) or jaundice (n = 2). In contrast, over 90% of the patients with FIT had symptoms referable to the specific hormone elaborated by the tumor. Primary tumor size for NIT was 4.1 +/- 0.7 cm versus 5.0 +/- 0.6 cm for the FIT group. No significant difference was found for NIT versus FIT with respect to the incidence of metastatic disease at presentation (44% versus 53%), resectability rate with curative intent (44% versus 53%), or disease-free survival at 2 years (67% versus 40%). CONCLUSIONS: This series, in contrast to earlier reports, suggests that nonfunctioning islet cell tumors do not present at a more advanced stage, have lower resectability rates, or an overall poorer long-term prognosis when compared to functioning tumors.
Assuntos
Adenoma de Células das Ilhotas Pancreáticas/fisiopatologia , Neoplasias Pancreáticas/fisiopatologia , Adenoma de Células das Ilhotas Pancreáticas/diagnóstico , Adenoma de Células das Ilhotas Pancreáticas/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/cirurgia , Prognóstico , Estudos RetrospectivosAssuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias de Cabeça e Pescoço/cirurgia , Esvaziamento Cervical , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/secundário , Terapia Combinada , Contraindicações , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Metástase Linfática , Esvaziamento Cervical/métodos , Estadiamento de Neoplasias , Cuidados Pós-OperatóriosRESUMO
We retrospectively studied subclavian catheter infection rates involving 481 patients from October 1983 to September 1985. Over this period of time 496 subclavian catheters including 252 single lumen catheters (SLC) and 244 triple lumen catheters (TLC) were inserted. These studies involved all catheters inserted during the 24-month period. The Methodist Hospital IV Team regularly cared for and recorded catheter-related problems. Charts were then retrospectively reviewed and data accumulated. The incidence of catheter tip infections in SLC was 4/248 (1.6%) compared to an incidence of 12/232 (4.9%) for TLC, p = 0.065. There was no significant difference between the incidence of infections at the insertion site of TLCs, 1/243 and SLCs, 1/251. We believe that the increase in catheter-related infections in the TLC is related to the increased utilization afforded by the multiple injection ports.
Assuntos
Cateterismo Venoso Central/efeitos adversos , Infecções Estafilocócicas/etiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Cateterismo Venoso Central/instrumentação , Cateteres de Demora/efeitos adversos , Estudos de Avaliação como Assunto , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Veia SubcláviaAssuntos
Anamnese/normas , Neoplasias/diagnóstico , Encaminhamento e Consulta , Neoplasias da Mama/diagnóstico , Carcinoma de Células Pequenas/diagnóstico , Neoplasias do Colo/diagnóstico , Terapia Combinada , Feminino , Doença de Hodgkin/diagnóstico , Hospitais Comunitários , Humanos , Neoplasias Pulmonares/diagnóstico , Masculino , Neoplasias/terapia , Neoplasias Ovarianas/diagnóstico , Equipe de Assistência ao Paciente , Neoplasias da Próstata/diagnóstico , Neoplasias Retais/diagnóstico , Neoplasias Testiculares/diagnósticoRESUMO
The records of 198 women over 80 years of age with breast cancer were reviewed to identify characteristics of breast cancer and to determine the effect of age in management of the disease in elderly women. Twenty percent of the patients were not staged at diagnosis. Axillary lymph node status was undetermined in 40 percent of the patients because operation was limited to lumpectomy or mastectomy (either simple or total). Complications were related to the operative wound. Breast cancer and cardiovascular disease accounted for 115 of 146 deaths and the 5 year survival rate was 35.6 percent. We have concluded that breast cancer in elderly women can be treated with appropriate surgical therapy and should not be limited because of age.
Assuntos
Adenocarcinoma Esquirroso/cirurgia , Adenocarcinoma/cirurgia , Neoplasias da Mama/cirurgia , Carcinoma Intraductal não Infiltrante/cirurgia , Adenocarcinoma/mortalidade , Adenocarcinoma Esquirroso/mortalidade , Fatores Etários , Idoso , Neoplasias da Mama/mortalidade , Carcinoma Intraductal não Infiltrante/mortalidade , Feminino , Humanos , Mastectomia/métodos , Complicações Pós-Operatórias/etiologia , Estudos RetrospectivosRESUMO
Plasma cell infiltrates in the thyroid are rare. They may represent several processes, such as localized plasmacytoma, multiple myeloma, or plasma cell granuloma (PCG). It may be difficult to distinguish these disorders on the basis of morphologic features in sections stained with hematoxylin-eosin. All may be composed of mature plasma cells, without admixed macrophages or lymphocytes, that infiltrate the thyroid and adjacent connective tissue. The identification of the uncommon, but benign, PCG is facilitated by immunohistochemical staining to demonstrate an admixture of plasma cells with cytoplasmic kappa and lambda light chains. The polyclonal nature of the plasma cell infiltrate distinguishes PCG from neoplastic plasma cell proliferation.
Assuntos
Granuloma de Células Plasmáticas/patologia , Granuloma/patologia , Doenças da Glândula Tireoide/patologia , Feminino , Granuloma de Células Plasmáticas/imunologia , Humanos , Imunoglobulinas/análise , Pessoa de Meia-Idade , Doenças da Glândula Tireoide/imunologiaAssuntos
Transformação Celular Neoplásica/patologia , Cisto Epidérmico/patologia , Neoplasias da Mama/cirurgia , Carcinoma/cirurgia , Carcinoma de Células Escamosas/patologia , Cisto Epidérmico/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/patologia , Região SacrococcígeaRESUMO
Anatomical variations in the biliary tract are reported with sufficient frequency to be of concern to the operating surgeon. They are often not identified prior to surgery. Drainage of both intrahepatic ducts into the gallbladder was identified in a case as the gallbladder was removed. The common bile duct proximal to the cystic duct was atretic. The problem was treated by a choledochoduodenostomy at the confluence of the hepatic ducts in the gallbladder bed.