[Collagen-polyvinylpyrrolidone: a new therapeutic option for treatment of sequelae after radical mastectomy in women with breast cancer. Preliminary study]. / Colágeno-polivinilpirrolidona, nueva opción para tratar secuelas de la mastectomía radical en mujeres con cáncer mamario. Informe preliminar.

BACKGROUND: Approximately 30% of women who undergo mastectomy without reconstructive treatment due to breast cancer present sequelae. These include paresthesias, keloid healing, hypoesthesia, lymphedema and limitation of the function of the ipsilateral upper extremity. We undertook this study to present the results using collagen-polyvinylpyrrolidone (Clg- Pvp) as treatment for posmastectomy sequelae in women with breast cancer. METHODS: We conducted a unicentric, longitudinal and prospective clinical trial between August 1, 2007 and July 31, 2008. Included variables were age, lymphedema, limitation of the function of the ipsilateral upper extremity, collapse of the wound, keloid healing, paresthesias, and appearance of the surgical area. The appearance of the surgical area (aesthetic aspect) was evaluated before and 6 months after treatment was initiated. Clg-Pvp was administered weekly for a 6-month period. RESULTS: Seven women were included with a median age of 49 years (range: 40-72 years). One patient (14.28%) presented lymphedema, two patients (28.57%) presented collapse of the wound, two patients (28.57%) had keloid healing, three patients (42.85%) experienced paresthesias, five patients (71.4%) reported pain, and five patients (71.4%) reported limitation of the function of the ipsilateral upper extremity. At the completion of the treatment, aesthetic improvement was statistically significant (p = 0.0020, Mann-Whitney U test). CONCLUSIONS: Clinical and aesthetic results are good after application of Clg-Pvp for treating sequelae in women with breast cancer who underwent mastectomy without reconstructive surgery.

Use of rituximab in patients with systemic lupus erythematosus: an update.

Systemic lupus erythematosus (SLE) is a chronic, occasionally life threatening, multisystem disorder. Patients suffer from a wide group of symptoms and have a variable prognosis that depends of the severity and type of organ involvement. The clinical manifestations include fever, skin lesions, arthritis, neurologic, renal, cardiac, and pulmonary disease. The pathogenesis of this serious multisystem autoimmune disease is based on polyclonal B cell immunity, which involves connective tissue and blood vessels. The novel biologic therapies have raised hope for more effective and safer treatment for SLE. Although definitive studies are still under development, the impressive preliminary results of therapies specifically targeting B cells and the signaling pathways involved in B-T-cell interactions suggest that the depletion of memory cells accounts, at least in part, for the clinical efficacy of rituximab therapy in patients whose disease is resistant to other immunosuppressive therapies. However these findings, although provocative, require further investigation in larger cohorts.