RESUMO
AIM OF THE STUDY: The aim of this retrospective study was to report the results of the surgical treatment for large bowel cancer in patients over 75 years of age. PATIENTS AND METHOD: From 1985 to 1996, 240 patients. 114 men and 126 women, aged 75 years or over (mean age: 82, range: 75 to 95 years) underwent surgical treatment for large bowel carcinoma. Tumors were located in the right colon (n = 120), left colon (n = 100), transverse colon (n = 5), or were multiple (n = 15). Clinical presentation was failure of general condition (25%), intestinal obstruction (20%), rectal bleeding (20%), abdominal pain (17%). ASA score was I (n = 1), II (n = 69), III (n = 134), or IV (n = 36). Emergency surgery was mandatory in 110 cases (43 urgent and 67 delayed procedures) and 130 patients underwent elective surgery. Surgical resection was performed in 221 cases, including 177 cases with curative intent (67%). Surgical procedures included right colectomy (n = 119), left colectomy (n = 59), transverse colectomy (n = 9) or subtotal colectomy (n = 31). Histopathological staging was Astler--Coller A (n = 8), B (n = 116), C (n = 54) et D (n = 62). RESULTS: The postoperative course was uneventful in 157 cases (65.4%). Medical complications occurred in 46 patients with 34 deaths; and surgical complications in 39 patients with 20 subsequent reoperations and 15 deaths. The overall postoperative mortality rate was 20.4% (n = 49). Postoperative mortality rate was higher after emergency operations (32.7% vs 10%), higher with the level of ASA grading (class II: 8.6%, Class III: 17.1%, Class IV: 38.8%), higher in patients over 90 years (37.4% vs. 19.1%) and in patients without surgical resection (42% vs 18.5%). Disease specific 5-year survival rate was 45% and did not differ when compared to patients younger than 75 years (42%, data not reported). CONCLUSIONS: Patients older than 75 years remain a high risk group, specially if operated on emergency. Nevertheless, age is not a limiting factor in the surgical treatment of colon cancer. Prognosis is mostly depending on ASA grading. Colectomy with curative intent has to be performed when possible.
Assuntos
Neoplasias do Colo/cirurgia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Estudos RetrospectivosRESUMO
Synopsis An analytical method has been developed that allows the determination of p-phenylene diamine derivatives in urinary samples collected from women after hair dyeing with commercial formulations. During an on-line flash hydrolysis of the urine, a number of metabolites of p-phenylene diamine were hydrolyzed to free p-phenylene diamine, which was then determined using gas chromatography-mass spectrometry. The excretion of metabolites of p-phenylene diamine could be followed during 24 or 48 hours after the dye had been applied. Most of the p-phenylene diamine cleaved by the flash hydrolysis procedure was, in fact, involved in the N,N'-diacetyl combination. The dose excretion for p-phenylene diamine as measured by this method was comparable to that found by other authors who made use of radioactively labelled material. The present analytical method can be used to evaluate procedures intended to decrease the percutaneous absorption of p-phenylene diamine. Thus, a five- to ten-fold decrease in its penetration was observed by protecting the scalp with clay before applying the dyeing composition.
RESUMO
The authors investigated sports-related precedents in two groups of male subjects, aged 40 years and over, of French nationality. One group had consulted for a degenerative, chronic rheumatic disorder, and the control group showed no signs of this type of disorder. Care was taken to verify that the two groups did not differ in terms of profession, means of commuting from home to work, and non-sporting leisure physical activities. The authors observed that the subjects of the first group (chronic degenerative rheumatic disease) more frequently engaged in a sports activity, and in a significant manner, than did the control subjects. A separate study of the certain kinds of sports and the various arthritic localisations also revealed significant correlations. Although this involved a retrospective enquiry, the authors feel that the results provide arguments in favor of the pathogenic role of sports activity, with regard to peripheral joints and the spine. However, this role of sports is probably only partial and irregular. The risks of sports activity must be put in perspective and balanced with the various advantages afforded by the practice of sports.
Assuntos
Traumatismos em Atletas/complicações , Artropatias/etiologia , Doenças Reumáticas/etiologia , Adulto , Dor nas Costas/etiologia , Articulação do Quadril , Humanos , Articulação do Joelho , Masculino , Osteoartrite/etiologia , Periartrite/etiologia , Ciática/etiologia , Articulação do OmbroAssuntos
Adaptação Fisiológica , Peixes/fisiologia , Hidrocortisona/farmacologia , Rim/efeitos dos fármacos , Prolactina/farmacologia , ATPase Trocadora de Sódio-Potássio/metabolismo , Animais , Cloretos/sangue , Dactinomicina/farmacologia , Água Doce , Brânquias/metabolismo , Rim/metabolismo , Concentração Osmolar , Sódio/sangueRESUMO
Only in SW fish, Prolactin (PRL) treatment increased natremia and especially chloremia. In gill, the decreases of Mg++ ATPase and SCN-sensitive, HCO3-ATPase observed in control fish after transfert from SW to FW, were more marqued in FW 8 days PRL treated fish. Renal enzyme activities were not affected by PRL treatment. If PRL treatment acts effectively on branchial ionic extrusion mechanisms, the connection between HCO3-ATPase anc Cl--transport remains to be elucidated. These results can be explained with reference to existence of two chloride-cell types.