RESUMO
AIMS: This paper describes a national audit of the indications for, and techniques and toxicity of, palliative splenic radiotherapy in haematological disorders. MATERIALS AND METHODS: A postal questionnaire was sent to consultant clinical oncologists treating haematological malignancies in the UK. RESULTS: The response rate was 76%. The audit shows chronic lymphocytic leukaemia, myelofibrosis and chronic myeloid leukaemia to be the most common underlying conditions in which splenic irradiation is used. Painful splenomegaly and hypersplenism were the most common indications. Dose fractionation schedules vary widely across the UK, and also the level of full blood counts used to interrupt radiotherapy. CONCLUSIONS: Palliative splenic radiotherapy continues to be widely used in the UK in small numbers of patients and seems to be well tolerated. Re-irradiation for further symptomatic progression is also commonly carried out.
Assuntos
Doenças Hematológicas/radioterapia , Auditoria Médica , Cuidados Paliativos , Esplenopatias/radioterapia , Doenças Hematológicas/complicações , Humanos , Radioterapia/estatística & dados numéricos , Baço/efeitos da radiação , Esplenopatias/etiologia , Reino UnidoRESUMO
Neurophysiological assessment of the preterm human neonatal oromotor system has been limited due to their fragile medical state, and methodological limitations. A new, noninvasive technology known as the actifier was developed and used to evoke perioral motor unit activity during non-nutritive suck in preterm infants. A significant ontologic trend for the early component of the perioral reflex (R1) was discovered in the context of spontaneous, centrally-patterned oromotor behavior.
Assuntos
Equipamentos para Lactente , Recém-Nascido/fisiologia , Recém-Nascido Prematuro/fisiologia , Comportamento de Sucção/fisiologia , Eletromiografia , Nervo Facial/fisiologia , Humanos , Mecânica , Reflexo de Estiramento/fisiologia , Nervo Trigêmeo/fisiologiaAssuntos
Neoplasias/tratamento farmacológico , Cuidados Paliativos/métodos , Neoplasias da Mama/tratamento farmacológico , Feminino , Neoplasias Gastrointestinais/tratamento farmacológico , Neoplasias dos Genitais Femininos/tratamento farmacológico , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Relações Médico-PacienteRESUMO
A multi-focal multi-centric, malignant tumour of vascular origin arising in bone in a 55-year-old man is described. The presenting symptoms were pain and weight loss. Radiologically, multiple lytic lesions were demonstrated in the long bones of both legs and throughout the pelvis. Histological examination demonstrated an angiosarcoma which was predominantly low grade in nature but with focal areas of intermediate grade. Turnout cells expressed the endothelial markers CD31, CD34 and von Willebrand's factor. There was rapid radiological progression of disease with no response to radiotherapy. Pain abated within a few days of institution of doxorubicin, 75 mg m(-2), but the patient died of massive pulmonary thromboembolism 14 days later, 11 months after the first symptoms.