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1.
Oncotarget ; 8(52): 89775-89792, 2017 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-29163787

RESUMO

Pediatric tumors arise upon oncogenic transformation of stem/progenitor cells during embryonic development. Given this scenario, the existence of non-tumorigenic stem cells included within the aberrant tumoral niche, with a potential role in tumor biology, is an intriguing and unstudied possibility. Here, we describe the presence and function of non-tumorigenic neural crest-derived progenitor cells in aggressive neuroblastoma (NB) tumors. These cells differentiate into neural crest typical mesectodermal derivatives, giving rise to tumor stroma and promoting proliferation and tumor aggressiveness. Furthermore, an analysis of gene expression profiles in stage 4/M NB revealed a neural crest stem cell (NCSC) gene signature that was associated to stromal phenotype and high probability of relapse. Thus, this NCSC gene expression signature could be used in prognosis to improve stratification of stage 4/M NB tumors. Our results might facilitate the design of new therapies by targeting NCSCs and their contribution to tumor stroma.

2.
An. pediatr. (2003. Ed. impr.) ; 87(3): 155-163, sept. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-166299

RESUMO

Introducción: El cáncer es la primera causa de muerte por enfermedad entre el primer año de vida y la adolescencia. Algunos tipos de enfermedad siguen constituyendo un reto en términos de curación. Existe por tanto una necesidad imperiosa de nuevos fármacos. Algunos descubrimientos recientes en la biología del cáncer abren la puerta al desarrollo de terapias dirigidas contra alteraciones moleculares concretas e inmunoterapia. Esto se ha traducido en resultados prometedores sobre todo en oncología de adultos, y en menor medida todavía en niños. Presentamos la actividad en ensayos clínicos precoces (fase i-ii) en oncología pediátrica en España. Material y métodos: A través de la Sociedad Española de Oncología y Hematología Pediátrica (SEHOP) contactamos a sus miembros para identificar los ensayos fase i-ii en cáncer pediátrico abiertos entre 2005 y 2015. Resultados: En este periodo se abrieron 30 ensayos: 21 (70%) en tumores sólidos y 9 (30%) en hemopatías malignas y se incluyó a 212 pacientes. La mayoría están promovidos por la industria farmacéutica (53%). Desde 2010, 4 centros se han integrado en el consorcio internacional ITCC cuyo objetivo es desarrollar nuevas terapias en cáncer infantil. Esto ha permitido ampliar el abanico de posibilidades terapéuticas. Los resultados de ensayos clínicos terminados muestran la contribución de los investigadores españoles, la introducción de terapias dirigidas y sus beneficios. Conclusiones: La actividad en ensayos clínicos precoces ha aumentado en estos años. La SEHOP está comprometida a desarrollar y participar en ensayos clínicos académicos colaborativos, que favorezcan el avance en las terapias frente al cáncer infantil (AU)


Introduction: Cancer is the leading cause of death between the first year of life and adolescence, and some types of diseases are still a major challenge in terms of cure. There is, therefore, a major need for new drugs. Recent findings in cancer biology open the door to the development of targeted therapies against individual molecular changes, as well as immunotherapy. Promising results in adult anti-cancer drug development have not yet been translated into paediatric clinical practice. A report is presented on the activity in early paediatric oncology trials (phase I-II) in Spain. Material and methods: All members of the Spanish Society of Paediatric Haematology Oncology (SEHOP) were contacted in order to identify early clinical trials in paediatric cancer opened between 2005 and 2015. Results: A total of 30 trials had been opened in this period: 21 (70%) in solid tumours, and 9 (30%) in malignant haemopathies. A total of 212 patients have been enrolled. The majority was industry sponsored (53%). Since 2010, four centres have joined the international consortium of Innovative Therapies for Children with Cancer (ITCC), which has as its aim to develop novel therapies for paediatric tumours. A significant number of new studies have opened since 2010, improving the treatment opportunities for our children. Results of recently closed trials show the contribution of Spanish investigators, the introduction of molecularly targeted agents, and their benefits. Conclusions: The activity in clinical trials has increased in the years analysed. The SEHOP is committed to develop and participate in collaborative academic trials, in order to help in the advancement and optimisation of existing therapies in paediatric cancer (AU)


Assuntos
Humanos , Criança , Drogas em Investigação , Avaliação de Medicamentos/tendências , Antineoplásicos/farmacologia , Neoplasias/tratamento farmacológico , Ensaios Clínicos como Assunto/estatística & dados numéricos , Medicina de Precisão/tendências
3.
An Pediatr (Barc) ; 87(3): 155-163, 2017 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-28279690

RESUMO

INTRODUCTION: Cancer is the leading cause of death between the first year of life and adolescence, and some types of diseases are still a major challenge in terms of cure. There is, therefore, a major need for new drugs. Recent findings in cancer biology open the door to the development of targeted therapies against individual molecular changes, as well as immunotherapy. Promising results in adult anti-cancer drug development have not yet been translated into paediatric clinical practice. A report is presented on the activity in early paediatric oncology trials (phase I-II) in Spain. MATERIAL AND METHODS: All members of the Spanish Society of Paediatric Haematology Oncology (SEHOP) were contacted in order to identify early clinical trials in paediatric cancer opened between 2005 and 2015. RESULTS: A total of 30 trials had been opened in this period: 21 (70%) in solid tumours, and 9 (30%) in malignant haemopathies. A total of 212 patients have been enrolled. The majority was industry sponsored (53%). Since 2010, four centres have joined the international consortium of Innovative Therapies for Children with Cancer (ITCC), which has as its aim to develop novel therapies for paediatric tumours. A significant number of new studies have opened since 2010, improving the treatment opportunities for our children. Results of recently closed trials show the contribution of Spanish investigators, the introduction of molecularly targeted agents, and their benefits. CONCLUSIONS: The activity in clinical trials has increased in the years analysed. The SEHOP is committed to develop and participate in collaborative academic trials, in order to help in the advancement and optimisation of existing therapies in paediatric cancer.

5.
Pediatr Hematol Oncol ; 29(1): 50-4, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22304010

RESUMO

The purpose of this study was to retrospectively analyze the clinical presentation, treatment, and outcomes of children with Wilms tumor (WT) and intravascular extension who were treated at a single institution. A retrospective review was conducted of medical records of all children with Wilms tumor and intravascular extension treated at Virgen del Rocio Children's Hospital between 1992 and 2010. Seven patients (median age 3.4 years, range 2-8.1 years) were identified. At diagnosis, 6 of the 7 patients (85.7%) presented with tumor thrombus that reached the right atrium (RA) and 1 patient with infrahepatic inferior vena cava (IVC) thrombus. All patients received neoadjuvant chemotherapy (SIOP 2001 protocol) with vincristine, doxorubicin, and actinomycin D. Regression of the intravascular extension of the tumor was documented in all patients. Postchemotherapy level of extension was suprahepatic IVC in 1 patient, infrahepatic IVC in 2 patients, renal vein (RV) in 1 patient, and RA in 3 patients. Nephrectomy and thrombectomy were performed in all cases, requiring cardiopulmonary bypass for the 4 patients who presented with suprahepatic IVC and RA thrombus. The other 3 patients with infrahepatic IVC and RV involvement underwent cavotomy and thrombus extraction. Computed tomography, ultrasonography, and echocardiography were used for diagnosis and follow-up. All patients remain disease-free with a median follow-up of 6.3 years (range, 2-19 years). Neoadjuvant chemotherapy for WT with intravascular extension may facilitate the resection by decreasing the extent of the tumor thrombus. Cardiopulmonary bypass is indicated for suprahepatic IVC and RA involvement. Accurate diagnostic imaging is necessary.


Assuntos
Trombose/mortalidade , Trombose/cirurgia , Tumor de Wilms/mortalidade , Tumor de Wilms/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Ponte Cardiopulmonar/métodos , Criança , Pré-Escolar , Dactinomicina/administração & dosagem , Dactinomicina/efeitos adversos , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Masculino , Trombólise Mecânica/métodos , Estudos Retrospectivos , Taxa de Sobrevida , Trombose/etiologia , Vincristina/administração & dosagem , Vincristina/efeitos adversos , Tumor de Wilms/complicações
7.
J Pediatr Ophthalmol Strabismus ; 48(4): 204-12, 2011 Jul-Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20669882

RESUMO

Parasitic infections may damage various ocular tissues, thereby causing visual dysfunction. In 1950, Wilder described the first case in which larval forms of nematodal intestinal roundworms (Ascaridoidea: Ascaris, Toxocara, Ancylostoma, Necator, and Strongyloides) were implicated as a cause of intraocular disease. This review focuses on two disorders associated with parasitic infections: ocular toxocariasis and diffuse unilateral subacute neuroretinitis.


Assuntos
Infecções Oculares Parasitárias , Toxocaríase , Animais , Olho , Infecções Oculares Parasitárias/parasitologia , Cabeça , Humanos , Retinite , Acuidade Visual
8.
Rep Pract Oncol Radiother ; 16(3): 103-9, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-24376965

RESUMO

BACKGROUND: Radiotherapy (RT) plays an important role in the multidisciplinary management of Ewing's Sarcoma (ES), especially in unresectable cases. AIM: Assessment of efficacy of RT in terms of local control in pediatric patients with primary ES of bone. MATERIALS AND METHODS: Thirty-six patients younger than 17 years old with ES treated with combined RT and chemotherapy with (N = 14) or without (N = 22) prior surgery from 1981 to 2008 were retrospectively reviewed. Since 1995, they were all treated according to the Spanish Society of Pediatric Oncology protocol (55.5% cases). Those patients received vincristine, ifosfamide, doxorubicin and etoposide. The TNM classification was as follows: 17 T1, 18 T2 and 1 T3; 36 N0; 29 M0, 5 M1a and 2 M1b. Analysis was stratified by treatment: definitive RT or pre/postoperative RT. RESULTS: The 36 patients (21 male; 15 female) had a median age of 10 years (range 2-17 years). Median follow-up of living patients was 105 months. The 2-year local control (LC) rate for all patients was 88%. Five-year LC rates for patients treated with definitive and pre/postoperative RT were 91% and 86%, respectively. Two-year overall survival and disease-free survival rates for all patients were 68% and 66%, respectively. Low phosphatase alkaline levels and local and distant recurrences were significantly predictive of worse prognosis (P = 0.021, P = 0.011, P = 0.007, respectively). CONCLUSION: Radiotherapy with and without surgery is a highly effective local treatment option in the multidisciplinary management of ES in pediatric patients.

9.
Rep Pract Oncol Radiother ; 16(5): 163-9, 2011 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-24376974

RESUMO

BACKGROUND: Attempts to improve survival outcomes of patients with high risk Ewing's sarcoma (ES) have focused on chemotherapy dose intensification strategies. AIM: The objective of this study is to retrospectively evaluate clinical characteristics and outcome of pediatric patients with high risk ES treated at a single institution. MATERIALS AND METHODS: From 1995 to 2008, seventeen patients (male:female, 14:3) were treated with dose-intensive therapy in our institution. Median age at diagnosis was 10 years (range: 2-15). Seven patients had metastases at diagnosis (lung in 6 cases and bone in one case). Eleven patients presented with unresectable disease. Fifteen (88.2%) received the Spanish Society of Pediatric Oncology protocol which includes six cycles of vincristine, doxorubicin, ifosfamide and etoposide. Two out of the six cases that were resectable received postoperative radiation. In addition, eleven patients received definitive radiation therapy. Finally, twelve (70.5%) out of 17 patients received myeloablative therapy with melphalan/etoposide. The rest of patients (N = 5) received busulfan/melphalan. RESULTS: Median follow-up was 78 months (range: 15-155 months). Initial responses were complete in all patients, but 9 of them developed progression disease. Seven patients became long-term event-free survivors. No patient died of toxicity after transplantation. The 2- and 5-year overall survival rates for all patients were 93% and 73%, respectively. Event-free survival rates were 74% and 54% at 2 and 5 years, respectively. CONCLUSION: This single-institution experience suggests that myeloablative therapy against high risk ES is effective and safe.

10.
Eur J Ophthalmol ; 21(4): 490-4, 2011 Jul-Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21188682

RESUMO

PURPOSE: To evaluate the anatomic and functional outcome after surgery in patients with complicated ocular toxocariasis. METHODS: A retrospective review of the medical records of pediatric patients who underwent a surgical procedure for ocular toxocariasis from July 1990 to January 2005. Patients with postoperative follow-up shorter than 6 months were excluded from the study. Best-corrected visual acuity (BCVA) was arbitrarily divided into 5 groups: 1) no light perception (NLP); 2) light perception (LP) and hand motion (HM); 3) finger counting (FC) to 20/400; 4) 20/300 to 20/60; and 5) 20/50 to 20/20. RESULTS: Forty-five patients with a mean age of 8.1 years (range 6-10) were included in the study. The ocular toxocariasis presentation most commonly encountered was peripheral granuloma (38%). Twenty-one eyes presented with BCVA in the LP/HM group, 18 (40%) eyes in the FC to 20/400 group, 5 (12%) eyes in the 20/300 to 20/60 group, and 1 (5%) eye in the 20/50 to 20/20 group. The most common surgical procedure was pars plana vitrectomy (PPV) in 58% of the eyes. Four eyes (9%) presented with postoperative BCVA of NLP, 2 eyes (4%) in the LP/HM group, 12 eyes (27%) in the FC to 20/400 group, 19 eyes (42%) in the 20/300 to 20/60 group, and 8 eyes (18%) in the 20/50 to 20/20 group. CONCLUSIONS: Surgical treatment of severe ocular complications secondary to toxocara infections results in satisfactory anatomic results and may improve the overall visual outcome of these patients.


Assuntos
Infecções Oculares Parasitárias/cirurgia , Toxocara canis/isolamento & purificação , Toxocaríase/cirurgia , Vitrectomia , Animais , Criança , Infecções Oculares Parasitárias/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Estudos Retrospectivos , Toxocaríase/fisiopatologia , Transtornos da Visão/fisiopatologia , Acuidade Visual/fisiologia
11.
Pediatr Hematol Oncol ; 27(8): 641-5, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20863161

RESUMO

Kasabach-Merritt phenomenon (KMP) is a serious coagulopathy with severe thrombocytopenia (<10,000/mm³) that occurs in the presence of an enlarging vascular tumor such as kaposiform hemangioendothelioma (KHE) and tufted angioma (TA). The natural history and treatment of these lesions remain controversial. The authors report a KHE case and a TA case that presented with KMP, describing their successful pharmacological management with vincristine, ticlopidine, and aspirin.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Aspirina/uso terapêutico , Ticlopidina/uso terapêutico , Neoplasias Vasculares/tratamento farmacológico , Vincristina/uso terapêutico , Coagulação Intravascular Disseminada/complicações , Coagulação Intravascular Disseminada/diagnóstico , Coagulação Intravascular Disseminada/tratamento farmacológico , Feminino , Hemangioma Capilar/complicações , Hemangioma Capilar/diagnóstico , Hemangioma Capilar/tratamento farmacológico , Humanos , Lactente , Síndrome de Kasabach-Merritt , Resultado do Tratamento , Neoplasias Vasculares/complicações , Neoplasias Vasculares/diagnóstico
12.
Arch Ophthalmol ; 128(7): 884-7, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20625050

RESUMO

OBJECTIVES: To determine the effects of intraocular pressure (IOP) and needle diameter on the amount of reflux after intravitreous bevacizumab injection. METHODS: Prospective randomized interventional study. Twelve New Zealand white rabbits weighing approximately 2.5 to 3.5 kg each were randomized 1:1 to group 1 or group 2. Bevacizumab stained with trypan blue was used for intravitreous injection. To lower the IOP, eyes in group 2 underwent anterior chamber paracentesis before intravitreous injection. Two eyes in each group were injected using 27-, 30-, or 32-gauge needles. If a subconjunctival bleb formed after intravitreous injection, its diameter was measured using a caliper. RESULTS: The median IOP in group 1 was 17.5 mm Hg. Eyes injected using 27-gauge and 30-gauge needles showed stained subconjunctival blebs with median sizes of 3 mm and 1.7 mm, respectively; eyes injected using 32-gauge needles showed no subconjunctival bleb formation. The median IOP in group 2 was 10.3 mm Hg. Eyes injected using 27-gauge needles showed stained subconjunctival blebs with a median size of 0.7 mm, and eyes injected using 30-gauge and 32-gauge needles showed no subconjunctival bleb formation. CONCLUSION: Decreasing the IOP before intravitreous injection and using a smaller-gauge needle reduce the risk of drug reflux after intravitreous bevacizumab injection. CLINICAL RELEVANCE: Intravitreous injection is an increasingly common route of drug delivery to treat ocular diseases. Techniques that maximize bioavailability are examined in this study.


Assuntos
Inibidores da Angiogênese/administração & dosagem , Anticorpos Monoclonais/administração & dosagem , Pressão Intraocular/fisiologia , Agulhas , Animais , Anticorpos Monoclonais Humanizados , Bevacizumab , Disponibilidade Biológica , Injeções , Estudos Prospectivos , Coelhos , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Corpo Vítreo
13.
J Pediatr Hematol Oncol ; 32(5): e202-6, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20523247

RESUMO

BACKGROUND: Glioblastomas occur infrequently in children, and the prognosis is better than for glioblastomas seen in adults. Aggressive treatment is justified in pediatric patients. OBSERVATIONS: We present the case of a 6-year-old child with malignant posterior temporal glioma treated with surgery, radiotherapy, local chemotherapy with carmustine wafers, and oral therapy with temozolomide, both at initial diagnosis and at relapse 18 months later. After 6 years, the patient seems healthy with no focal neurologic signs, and imaging studies show no evidence of disease. CONCLUSION: Multimodal therapy was found to have a very positive outcome for a child with malignant glioma.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Encefálicas/tratamento farmacológico , Glioblastoma/tratamento farmacológico , Neoplasias Encefálicas/patologia , Carmustina/administração & dosagem , Criança , Terapia Combinada , Craniotomia , Dacarbazina/administração & dosagem , Dacarbazina/análogos & derivados , Glioblastoma/patologia , Humanos , Imagem por Ressonância Magnética , Retratamento , Temozolomida , Resultado do Tratamento
14.
Ophthalmology ; 112(12): 2110-4, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16242189

RESUMO

PURPOSE: To describe the clinical features and management of the largest reported series to date of patients with diffuse unilateral subacute neuroretinitis (DUSN). DESIGN: Observational case series. METHODS: The charts of all patients coded as having DUSN in a vitreoretinal clinic in Caracas, Venezuela between July 1979 and August 2000 were retrospectively reviewed. MAIN OUTCOME MEASURES: Demographic information, presenting visual acuity, clinical course, and treatment were evaluated. RESULTS: We identified 82 eyes of 78 patients with DUSN. The mean age at diagnosis was 16.7 years, significantly younger than the mean age of the Venezuelan population. Sixty-five (83.3%) patients were 20 years old or younger (P<0.001 when compared with the population of Venezuela). Thirty-three (42.3%) of the patients were female. The presenting visual acuity was 20/400 or worse in 69 eyes (84.1%). The subretinal nematode was identified in 33 eyes (40.2%). All nematodes were small, approximately 400 microm in length. CONCLUSIONS: In Venezuela, DUSN is seen primarily in young patients without a significant gender predilection. The vast majority of patients in this population presented with severe vision loss that was irreversible.


Assuntos
Retinite/epidemiologia , Doença Aguda , Adolescente , Adulto , Distribuição por Idade , Albendazol/uso terapêutico , Antiprotozoários/uso terapêutico , Criança , Terapia Combinada , Feminino , Lateralidade Funcional , Humanos , Fotocoagulação a Laser , Masculino , Pessoa de Meia-Idade , Retinite/diagnóstico , Retinite/parasitologia , Retinite/terapia , Estudos Retrospectivos , Distribuição por Sexo , Venezuela/epidemiologia , Acuidade Visual
15.
Am J Ophthalmol ; 137(6): 1105-15, 2004 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15183797

RESUMO

PURPOSE: To determine the prevalence of and risk factors for proliferatative vitreoretinopathy (PVR) in eyes with rhegmatogenous retinal detachment but no previous vitreoretinal surgery. DESIGN: Observational case series. METHODS: Prospective study. SETTING: A private vitreoretinal clinic in Caracas, Venezuela. STUDY POPULATION: 119 eyes of 119 patients who presented with rhegmatogenous retinal detachment but no previous vitreoretinal surgery between 1995 and 1998. OBSERVATION PROCEDURES: Data from detailed preoperative and postoperative examinations of each eye were recorded prospectively and entered into an electronic database. MAIN OUTCOME MEASURES: Prevalence of PVR of any type and severe PVR, preoperative risk factors for PVR of any type and severe PVR, effect of PVR and retinal detachment duration on initial and final visual acuity, and surgical complexity. RESULTS: The prevalence of PVR of any type was 52.9% and of severe PVR was 26.9%. The mean retinal detachment duration (+/-SD) was 58.4 (+/-129.1) days, and the mean time from initial examination to surgical treatment (+/-SD) was 24.3 (81.2) days. By univariable analysis, long retinal detachment duration, poor initial visual acuity, and large retinal detachment extent were significantly associated with PVR prevalence and severity. The presence of vitreous hemorrhage was significantly associated with PVR prevalence, and cataract was significantly associated with PVR severity. By multivariable analysis, long retinal detachment duration and large retinal detachment extent were simultaneous risk factors for PVR prevalence, while long retinal detachment, large retinal detachment extent, and poor initial visual acuity were simultaneous risk factors for PVR severity. Eyes with longer retinal detachment duration, PVR of any type, and severe PVR had worse initial and final visual acuities than eyes with shorter retinal detachment duration or those without PVR, respectively. Eyes with PVR had more complex surgery than those without PVR. CONCLUSIONS: PVR occurred very frequently in this population and was associated with more complex surgery and worse visual outcomes than among eyes without PVR. We have identified preventable risk factors associated with PVR that suggest a specific and significant need for better access to ophthalmologic care and patient education in this group of patients.


Assuntos
Descolamento Retiniano/epidemiologia , Vitreorretinopatia Proliferativa/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fatores de Risco , Venezuela/epidemiologia , Acuidade Visual
16.
Rev. oftalmol. venez ; 59(4): 67-78, oct.-dic. 2003. ilus
Artigo em Espanhol | LILACS | ID: lil-406129

RESUMO

El manejo de los melanomas malignos de la uvea posterior (cuerpo ciliar y coroides) ha sido siempre un reto para los oftalmólogos y todavía representa un tópico de grandes controversias. En los últimos años han ocurrido grandes avances en el diagnóstico y manejo de los pacientes con melanoma maligno de la uvea. Nuestro propósito es proveer un conocimiento general del estado actual de las técnicas diagnosticas y de las modalidades terapéuticas disponibles


Assuntos
Humanos , Melanoma , Técnicas de Diagnóstico Oftalmológico/instrumentação , Neoplasias Uveais , Oftalmologia
17.
Rev. oftalmol. venez ; 59(3): 56-60, jul.-sept. 2003. ilus
Artigo em Espanhol | LILACS | ID: lil-406133

RESUMO

Se presentan los resultados del tratamiento con placas epiesclerales radioactivas cargadas con ruthenio106 (106Ru/106Rh) a 11 pacientes portadores de melanoma maligno uveal posterior. Se aplicó una dosis calculada de acuerdo a la altura del tumor. El grado de regresión de la lesión se correlacionó de una forma estadísticamente significativa con la dosis al ápex del tumor. Se evitó la enucleación en el 90,9 por ciento de los pacientes. Nuestros resultados demuestran que el tratamiento con placas epiesclerales radioactivas cargadas con Ruthenio106 es un método efectivo en el control del melanoma maligno uveal posterior


Assuntos
Humanos , Braquiterapia , Melanoma , Radioterapia , Rutênio , Resultado do Tratamento , Neoplasias Uveais , Oftalmologia , Venezuela
18.
J Refract Surg ; 18(6): 708-14, 2002 Nov-Dec.
Artigo em Inglês | MEDLINE | ID: mdl-12458864

RESUMO

PURPOSE: To report the characteristics and surgical outcomes of rhegmatogenous retinal detachments in myopic eyes after laser in situ keratomileusis (LASIK). METHODS: Clinical charts of patients that developed rhegmatogenous retinal detachment after LASIK were reviewed. Surgery to repair rhegmatogenous retinal detachment was performed in 31 eyes (mean follow-up of 14 months after vitreoretinal surgery). RESULTS: A total of 38,823 eyes underwent surgical correction of myopia from -0.75 to -29.00 D (mean -6.00 D). Thirty-three eyes (27 patients; frequency .08%) developed rhegmatogenous retinal detachment after LASIK; detachments occurred between 12 days and 60 months (mean 16.3 mo) after LASIK. Eyes that developed a rhegmatogenous retinal detachment had a mean -8.75 D before LASIK. Most rhegmatogenous retinal detachment and retinal breaks occurred in the temporal quadrants (71.1%). Final best spectacle-corrected visual acuity (BSCVA) of 20/40 or better was obtained in 38.7% of the 31 eyes (two patients refused surgery). Poor final visual acuity (20/200 or worse) occurred in 22.6% of eyes. Information regarding visual acuity after LASIK and before the development of rhegmatogenous retinal detachment was available in 24 eyes; 45.8% (11/24 eyes) lost two or more lines of visual acuity after vitreo-retinal surgery. Reasons for poor visual acuity included the development of proliferative vitreo-retinopathy (n=5), epiretinal membrane (n=1), chronicity of rhegmatogenous retinal detachment (n=1), new breaks (n=1), displaced corneal flap (n=1), and cataract. CONCLUSIONS: Rhegmatogenous retinal detachment after LASIK for myopia is a serious complication. Final visual acuity may be limited by myopic degeneration, amblyopia, or delayed surgical repair.


Assuntos
Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Miopia/cirurgia , Descolamento Retiniano/etiologia , Perfurações Retinianas/complicações , Perfurações Retinianas/etiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reoperação/efeitos adversos , Descolamento Retiniano/fisiopatologia , Descolamento Retiniano/cirurgia , Perfurações Retinianas/cirurgia , Estudos Retrospectivos , Fatores de Tempo , Acuidade Visual
19.
Rev. oftalmol. venez ; 56(1): 23-9, ene.-mar. 2000. tab
Artigo em Espanhol | LILACS | ID: lil-278871

RESUMO

El carboplatino es un análogo del cisplatino que forma enlaces cruzados de DNA-interfibra para reducir la actividad tumoral. Ha sido utilizado en el tratamiento del Retinoblastoma, el cual constituye el tumor intraocular más frecuente de la infancia. Su administración por vía sistémica ocasiona numerosos efectos adversos, es por ello que en los últimos tiempos se ha empleado en forma local logrando un gran avance en la reducción del tamaño de la tumoración, en este sentido, la quimiorreducción representa una alternativa en el manejo de ésta patología, sin embargo la administración por vía local no es efectiva en siembras vítreas ni subretinianas, teniendo que reforzar este tratamiento con quimioterapia o crioterapia, y a pesar de ello muchos de estos ojos terminan en enucleación. En búsqueda de procedimientos menos agresivos tanto locales como sistémicos, decidimos realizar este estudio para investigar el grado de toxicidad de este medicamento, principalmente en la retina y el resto de las estructuras oculares en conejos albinos de Nueva Zelanda, colocando dosis iguales por vía intravítrea y subtenoniana, obteniendo alteraciones en todas las estructuras oculares de los ojos de conejos en donde se administró la droga por vía intravítrea en comparación con los ojos de conejos donde se colocó carboplatino en cuyo caso no observamos altraciones histopalógicas de las estructuras oculares


Assuntos
Animais , Camundongos , Carboplatina/administração & dosagem , Carboplatina/efeitos adversos , Retinoblastoma , Venezuela
20.
Rev. oftalmol. venez ; 55(1): 40-50, ene.-mar. 1999. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-251814

RESUMO

El DUSN (Diffuse Unilateral Subacute Neuroretinitis) o Neurorretinitis Subaguda Difusa Unilateral es una enfermedad inflamatoria que compromete principalmente la retina y el nervio óptico. La etiolgía no ha sido todavía identificada con presición y son varios los nemátodos involucrados: Baylisascaris proscyonis, Dirofilarie immitis y D.tenuis, Ancylostoma caninum y Toxocara canis. Este último es la causa más frecuente de la larva migrans visceral y ocular en el humano. Además, presenta características epidemiológicas, morfológicas y de respuesta inmunológica en el huésped similares con algunas de las larvas en el DUSN. Por ello nos planteamos inicialmente una relación entre la enfermedad y la presencia de la larva de este parásito en el globo ocular. Esto se quiso confirmar mediante el estudio clínico y comparativo de la respuesta inmune humoral anti-Toxocara canis en humor acuoso y suero de pacientes con DUSN y toxocariasis ocular. Para ello se conformaron tres grupos de estudio con 7 pacientes cada uno: Grupo I de pacientes con DUSN, Grupo II de pacientes con toxocariasis ocular y un tercer grupo con pacientes controles. Se les realizó evaluación oftalmológica completa y se les tomaron muestras de humor acuoso y sangre para determinar la presencia de la respuesta inmunológica humoral mediante prueba de ensayo inmunoenzimático (ELISA) para toxocara canis. Los resultados fueron negativos en el ELISA para Toxocara canis del humor acuoso en todos los pacientes con DUSN y positivos para todos los pacientes con toxocariasis ocular, independientemente de los títulos obtenidos en suero de todos ellos. por esta razón, la relación que en un principio nos propusimos establecer no se confirmó


Assuntos
Humanos , Masculino , Feminino , Angiofluoresceinografia/métodos , Humor Aquoso , Ensaio de Imunoadsorção Enzimática , Doenças Retinianas , Retinite/diagnóstico , Retinite/terapia , Toxocara canis/parasitologia , Toxocaríase/diagnóstico , Toxocaríase/terapia , Venezuela
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