Autism spectrum disorders (ASD) may present with macrocephaly. Few studies have analyzed the association with psychiatric comorbidity. Participants were 94 children with any ASD with an age range from 2 to 16 years (Mdn 6 years), 82% were boys. It was found that 20% of the sample had macrocephaly and 1% microcephaly. There was no association between the presence of macrocephaly and subtype of ASD. The most associated comorbidity was attention-deficit/hyperactivity disorder (ADHD) 54.2%, followed by specific phobia 34%, dysthimia 29.7%, oppositional defiant disorder 13.83% motor tics 11.7%, separation anxiety 9.5% and Gilles de la Tourette 8.5%. In conclusion, macrocephaly and psychiatric comorbidity in this clinical sample of children with ASD is similar to the international literature results.
Background:In laryngeal cancer, multidisciplinary treatment improves the patient's quality of life and the possibility of preserving the larynx. Most cases occur in a locally advanced stage. The aim is to present the results according to the stage. Method: A retrospective study which analyzed the clinical stage, type of primary treatment, outcomes, and survival was analyzed. Results: A total of 451 patients were included in the study. The median age was 66 years. The majority of the tumors presented in advanced stage (72%) and the most affected subsite was the glottis (84.5%). In the early stage, the most frequent treatment was radiotherapy as the only treatment modality. In Stages III and IVA, 65% were resectable. In Stage IVB, the management was non-surgical, with control in 26% of the cases. Survival at 10 years was related to the clinical stage: 81.7% for Stage I and 0% for Stages IVB and IVC. Conclusions: Patients with laryngeal cancer should be treated according to the clinical stage, through a multidisciplinary approach. Long-term follow-up showed a worse prognosis for advanced clinical stages.
La clasificación del cáncer de mama en subtipos mediante la expresión de receptores hormonales (RH) y del receptor 2 del factor de crecimiento epidérmico humano (HER2) por inmunohistoquímica (IHQ) es una práctica estándar para la toma de decisiones terapéuticas. Objetivo: Conocer las características y supervivencia de cada subtipo de pacientes, que es indispensable para poder diseñar futuros estudios. Método: Realizamos un estudio retrospectivo evaluando las características clinicopatológicas y la supervivencia por subtipo mediante IHQ en mujeres con cáncer de mama. Resultados: 211 mujeres con cáncer de mama RH(+)/HER2(-), 53 con RH(+)/HER2(+), 16 con HER2(+) y 23 con RH(-)/HER2(-), con una mediana de supervivencia global en meses de 39 (20.5-62.7), 42 (25.5-65), 42 (13.7-67.7) y 26 (11-78), respectivamente, para un cociente de riesgo (HR por sus siglas en inglés, Hazard Ratio): 3.7 (IC 95%: 1.3-10.3) en el grupo triple negativo comparado con RH(+)/HER2(-) (p = 0.01). Conclusión: Los subtipos con RH positivos por IHQ son los más frecuentes y este grupo de pacientes tienen una mejor supervivencia global comparada con las pacientes triple negativo.
Antecedentes: El tratamiento de sarcomas de partes blandas (SPB) en centros de bajo volumen y una cirugía no planeada (CNP) representan un grave y frecuente problema Objetivo: Analizar la literatura acerca del impacto de realizar una CNP en centros no especializados. Métodos: búsqueda en PubMed y EBSCO con las palabras clave: SPB, amputación, supervivencia, CNP, hospitales de referencia. Los resultados fueron analizados y discutidos por los autores. Resultados: El tratamiento de SPB de extremidades en hospitales de bajo volumen y una CNP se asocian a un peor control local, mayor morbilidad y probabilidad de amputación, aunque sin impacto en la supervivencia. En sarcomas retroperitoneales o del tronco, el tratamiento en un centro de bajo volumen se asocia a una mayor mortalidad a los 60 y 90 días después de la cirugía. Conclusiones: El manejo de los SPB debe realizarse en centros especializados en sarcomas. En nuestro país se necesitan más hospitales dedicados a esta neoplasia y la creación de redes en sarcomas, así como guías nacionales que agilicen la referencia de estos enfermos.Palabras clave: Sarcoma. Neoplasias de partes blandas. Cirugía en sarcomas. Diagnóstico de neoplasias raras. Centros de referencia. Neoplasias residuales.
5 . Currently, thanks to the advances in the field of molecular biology, breast cancer has been classified into four molecular subtypes, which Perou et al. 6 describe, based on their gene expression, as luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) overexpression and basal. Clinical evolution of each breast cancer molecular subtype is different and sets the standard for treatment along with other clinicopathological characteristics. Thus, luminal tumors, which are characterized by the expression of hormone
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