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Experiencia de primera aplicación de braquiterapia de alta tasa de dosis en nasofaringe
Vega Hernández,Manuel I; Alfonso Laguardia,Rodolfo; Silvestre Patallo,Ileana; Roca Muchulí,Carlos; García Heredia,Gilda L;
Revista Cubana de Medicina , 2006,
Abstract: a research was made by applying boost on the area of the nasopharynx relapse with high dose rate (hdr) in a diagnosis of nasopharynx carcinoma previously treated with telecobalt therapy, at a dose of 70 gy. there was persistence of the injury. three sessions were planned, with consecutive fractions of 6.5 gy in 15 days, with optimization, using a personal mould of autopolymerizable acrylic. the successful possibility to apply the high rate modern brachytherapy was reaffirmed, as a treatment complementary to teletherapy in case of persistence or relapse. a microselectron hdr equipment was used
Braquiterapia intersticial de alta tasa de rescate en cáncer cabeza cuello previamente radiado High-dose-rate (HDR) brachytherapy in previously irradiated recurrent head and neck cancer  [cached]
Lucía Gutiérrez-Bayard,María del Carmen Salas-Buzón,Esther Angulo-Pain,Esther González-Calvo
Revista Espa?ola de Cirugía Oral y Maxilofacial , 2011,
Abstract: A pesar de los avances en el tratamiento de cáncer de cabeza y cuello (CCC), el 15-50% de los pacientes presentan recurrencia locorregional. Para los pacientes que presentan enfermedad localmente recurrente o un segundo tumor primario en un campo previamente irradiado, las opciones terapéuticas de rescate son limitadas, siendo la resección quirúrgica con intención curativa la opción de elección para los pacientes con enfermedad limitada. Reirradiación con o sin la adición de quimioterapia puede ser una buena opción, obteniendo en pacientes seleccionados supervivencia a largo plazo. La braquiterapia de alta tasa de dosis (HDRBT) puede jugar un papel importante en el tratamiento de rescate en tumores de cabeza y cuello recurrentes. Presentamos un paciente de 56 a os diagnosticado de cáncer de lengua sometido a cirugía y radioterapia externa adyuvante, y recurrencia metastásica ganglionar cervical contralateral a los 18 meses. Recibió tratamiento multidisciplinar con quimioterapia, cirugía y braquiterapia intersticial. Despite advances in the treatment of head and neck cancer (HNC), 15-50% of patients present locoregional disease recurrence. The therapeutic options are limited for patients who present locally recurrent disease or a second primary tumor in a previously irradiated field. Surgical salvage with curative intent is the preferred option for patients with limited-volume disease. Re-irradiation with or without the addition of chemotherapy may hold promise for long-term survival for selected patients. High-dose-rate (HDR) brachytherapy can play an important role in the salvage treatment of previously irradiated recurrent head and neck cancer. The case reported was a 56-year old man diagnosed of tongue cancer who presented recurrent metastatic contralateral cervical node 1.5 years after radical treatment with surgery and adjuvant external radiotherapy. He received multidisciplinary treatment with chemotherapy, surgery and HDR interstitial brachytherapy.
Braquiterapia endoluminal HDR no tratamento de tumores primários ou recidivas na árvore traqueobr?nquica
Fortunato,Maria; Feijó,Salvato; Almeida,Telma; Mendon?a,Vera; Aguiar,Margarida; Jorge,Marília; Grillo,Isabel Monteiro;
Revista Portuguesa de Pneumologia , 2009,
Abstract: introduction: locally advanced tumours as the initial form of presentation of tumours in the bronchial tree are not a rare event. bronchogenic recurrence is frequent in the natural history of some tumours. the choice of therapeutic options from the raft available depends on such variables as initial therapy, place of recurrence, symptoms and patient?s physical status. aim: to demonstrate the advantages of endoluminal brachytherapy (ebt) with high dose rate (hdr) in primary and recurrent tumour of the bronchial tree. material and methods: a retrospective study of seven patients (pts) with primary tumours of the colon, trachea and lung. tracheobronchial recurrence (trachea, two pts, bronchus, five pts) occurred between march 2003 and september 2004. patients under-went ebt with hdr for primary or recurrent therapy in association with external radiotherapy, laser therapy and chemotherapy with palliative or curative intention. ebt with hdr doses of 5 to 7 gy in 2 to 4 fractions at 1 cm from the source axis were given. treatment included endoluminal application of ir192 with a french 6 catheter. results: there was symptomatic relief related to reduction of tumour in six of the seven patients treated. in one of the six patients studied, there was progression of the local disease between the second and third fractions of the treatment (obstruction of the trachea). in a mean follow up of 17 (2-40) months between ebt and this study, three patients are alive, one has no evidence of disease while two have had bronchial recurrence, four patients have died, one after massive haemoptysis and three due to disease progression. discussion and conclusions: patients undergoing brachytherapy for symptomatic primary tumours or endobronchial recurrence show good tolerance, important symptom relief and improved quality of life. despite the small size of our sample, it is clear that ebt with hdr plays an important role in the palliative/curative treatment of these patients.
Prevalencia de bacterias potencialmente patógenas en la nasofaringe de ni os sanos de un círculo infantil de Ciudad de La Habana Prevalence of potentially pathogenic bacteria in nasopharynx of healthy children attending a day care center in Havana City  [cached]
Isabel Villasusa Páez,Isabel Martínez Motas,Niurka álvarez García,Mayelín Mirabal Sosa
Revista Cubana de Medicina Tropical , 2006,
Abstract: Se realizó durante el primer semestre de 2001, un estudio transversal descriptivo de portadores en ni os sanos de un círculo infantil de Ciudad de La Habana, con el objetivo de conocer la prevalencia de bacterias potencialmente patógenas y su relación con posibles factores de riesgo asociados. En el dise o se tuvieron en cuenta las exigencias bioéticas regulatorias nacionales e internacionales. Se tomó exudado a 160 ni os de la nasofaringe posterior, la muestra se sembró directamente en agar cerebro corazón más sangre de carnero desfibrinada y agar cerebro corazón más NAD, hemina y bacitracina; se incubó 18-24 h. La identificación de los aislamientos obtenidos se realizó por técnicas convencionales y el sistema API NH. Predominó el grupo de ni os de 3-4 a os de edad y sexo masculino. Se detectó un porcentaje elevado de portadores y entre estos, Haemohilus se aisló en 92,50 %, correspondiendo a Haemophilus influenzae 54,72 %. Otros patógenos observados fueron: Streptococcus pneumoniae, Streptococcus β-hemolítico, Staphylococcus aureus y Moraxella catarrhalis. Existió diferencia estadísticamente significativa cuando se compararon portadores y no portadores de S. pneumoniae en los menores de 2 a os. Se pudieron conocer los patrones de colonización de bacterias potencialmente patógenas en ni os de un círculo infantil de Ciudad de La Habana. During the first six-month period of 2001, a descriptive cross-sectional study of carriage in healthy children attending a day-care center in Havana City was performed. The objective was to find out the prevalence of potentially pathogenic bacteria and its association with possible risk factors. The design took into account the international and domestic regulatory bioethical requirements. Swabs of posterior nasopharynx of 160 children were directly cultured in brain heart agar plus sheep blood and in brain heart agar plus NAD, hemine and bacitracin and incubated for 18-24 h. Resulting isolates were identified using conventional techniques and the API NH system. Male children aged 3-4 years were predominant. A high percentage of nasopharyngeal carriage was detected; Haemophilus was isolated in 92.50% of cases, being Haemophilus influenzae present in 54.72% of children. Other pathogens were Streptococcus pneumoniae, β-hemolythic Streptococcus, Staphylococcus aureus and Moraxella catarrhalis. A statistically significant difference was observed when comparing S. pneumoniae carriage and non-carriage in less than 2 years-old children. The colonizing patterns of potentially pathogenic bacteria were disclosed in children attend
Dise o, construcción y uso de aplicador vaginal intracavitario multicanal periférico para braquiterapia Design, construction, and use of peripheral multichannel intracavitary vaginal applicator for brachytherapy  [cached]
Manuel Vega Hernández,Rodolfo Alfonso Laguardia
Revista Cubana de Medicina , 2006,
Abstract: La braquiterapia vaginal intracavitaria es frecuentemente administrada con aplicadores cilíndricos de un solo canal con fuentes HDR. El cilindro multicanal (8 canales) vaginal intracavitario permite el tratamiento preferencial de una parte de la mucosa vaginal, se se desarrolla para perfeccionar y ampliar la capacidad de la braquiterapia intracavitaria. El aplicador permite activar los canales que se entienden útiles, con longitudes variables, para irradiar volúmenes blancos de la vagina, evitando sobreirradiar las regiones sanas. Se obtiene un gradiente de dosis en la superficie del aplicador vaginal multicanal periférico favorable al tratamiento de lesiones superficiales de la mucosa vaginal, con lo que se disminuye las dosis de recto en el orden del 12 %. Se realizó este estudio con el objetivo de demostrar la utilidad del uso de aplicadores multicanales en vagina y recto, se expresaron los resultados de la construcción de aplicadores y sus características The intracavitary vaginal brachytherapy is often administered using single-channel cylindrical applicators with HDR sources. The intracavitary vaginal multichannel cylinder (8 channels) allows the preferential treatment of a part of the vaginal mucosa, and it is developed to improve and to widen the intracavitary brachytherapy capacity. The applicator makes possible to activate channels considered useful, with variable lengths, to irradiate the target volumes of the vagina, avoiding the overirradiation of the healthy regions. A dose gradient is achieved in the surface of the peripheral multichannel vaginal applicator favouring the treatment of the superficial injuries of the vaginal mucosa, dropping the dose of the rectum by 12 %. This study was undertaken to demonstrate the usefulness of the multichannel applicators in the vagina and rectum. The results of the construction of applicators and their characteristics were explained
Tumores de la nasofaringe en la infancia
José Vargas Díaz,Lucía Novoa López,Eliseo Prado González
Revista Cubana de Pediatr?-a , 2002,
Abstract: Los tumores de la nasofaringe son poco frecuentes en la infancia. Su forma clínica de presentación característica y la posibilidad de realizar un diagnóstico temprano e indicar el tratamiento oportuno, permitiría modificar favorablemente la evolución y el pronóstico de estos pacientes. Se reporta una serie de 4 ni os con tumores de la nasofaringe (2 linfoepiteliomas y 2 neuroblastomas) atendidos en el Hospital Infantil Docente "Pedro Borrás Astorga". Todos los pacientes mostraron en algún momento de su evolución obstrucción nasal unilateral y epistaxis. El 50 % de los casos comenzó su enfermedad presentando cefaleas y uno de ellos lo hizo con compromiso de pares craneales (VII, VI, IV, VI). La radioterapia representa la modalidad de tratamiento más útil y la resonancia magnética nuclear resulta de gran valor para el diagnóstico inicial, así como para la identificación de la recidiva tumoral. Nasopharyngeal tumors are infrequent in childhood. Their characteristic clinical presentation and the possibility of making an early diagnosis and indicating an adequate treatment will allow positively changing the development and prognosis of the patients. Four children with nasopharyngeal tumors (two lymphoepitheliomas and two neuroblastomas), who were seen at "Pedro Borrás Astorga" Teaching Pediatric Hospital, are reported. All the patients showed at some moment of the disease development unilateral nasal obstruction and epistaxis. 50% of the cases had headaches at the beginning of the disease whereas one of them had involvement of cranial pairs (7th,6th, 4th,6th). Radiotherapy represents the most useful treatment and nuclear magnetic resonance is of great value for the initial diagnosis and the identification of tumor relapse.
Corpo estranho na nasofaringe: a propósito de um caso  [cached]
Sobrinho Fernando P. G.,Jardim Alena M. B.,Sant'Ana Iara C. de,Lessa Hélio A.
Revista Brasileira de Otorrinolaringologia , 2004,
Abstract: A ingest o acidental de corpo estranho constitui um problema comum nas unidades de emergência e pronto atendimento, principalmente em crian as. Embora raro, um corpo estranho supostamente deglutido ou aspirado pode ser projetado e impactar-se na nasofaringe, existindo, a respeito, alguns relatos de caso na literatura. O exame clínico e o estudo radiológico de rotina podem n o evidenciar qualquer anormalidade. Portanto, neste relato de caso, os autores recomendam a realiza o de radiografia do cavum e/ou a visualiza o da rinofaringe, executada com cautela, utilizando-se o espelho de García, telescópio tipo Hopkins ou naso-fibroscópio flexível nos casos em que a radiografia cervical n o evidenciar adequadamente a nasofaringe, sendo a visualiza o instrumental particularmente importante na presen a de corpo estranho radiotransparente. O diagnóstico precoce se imp e, haja vista a possibilidade de significativas complica es.
Braquiterapia endobronquial de alta tasa de dosis en pacientes con obstrucción de la vía aérea central: Experiencia en el Instituto Nacional del Cáncer y revisión de la literatura High dose rate endobronchial brachytherapy in patients with central airway obstruction  [cached]
ALEJANDRO SANTINI B,DIONIS ISAMITT D,BENJAMíN BIANCHI G,MARIBEL BRUNA F
Revista Chilena de Enfermedades Respiratorias , 2010,
Abstract: Introducción: La indicación principal de la braquiterapia endobronquial moderna (BTEB) de alta tasa de dosis (HDR), es la paliación de síntomas por crecimiento endobronquial de cánceres pulmonares. Métodos: Se realizó BTEB HDR a 27 pacientes sintomáticos de patología tumoral endobronquial o traqueal, debido a patologías primarias bronquiales o secundarias metastásicas. Los tumores se ubicaban en tráquea, carina o a nivel bronquialproximal. Para observar mejorías en la sintomatología clínica, a todos se les realizó una fibrobroncoscopía (FBC) para medir el grado de obstrucción bronquial e instalar catéteres endobronquiales de braquiterapia. Se administraron entre 1 y 4 fracciones de 7 a 7,5 Gy. Se registró subjetivamente la disnea, tos y hemoptisis antes y después del tratamiento, de acuerdo a una escala internacionalmente validada. Resultados: Tras el tratamiento todos los síntomas disminuyeron considerablemente, desapareciendo toda sintomatología severa. La hemoptisis y disnea desaparecieron en el 100% y 40% de los pacientes respectivamente, y la tos desapareció o disminuyó a grado leve en el 90% de los pacientes. Introduction: The main indication of modern high dose rate end bronchial brachyherapy (HDR EBBT) is the palliation of symptoms related to the growth of the endobronchial lung cancer. Methods: EBBT was performed to 27 patients who suffered symptomatic tumoral endobronchial or tracheal pathology, due to primary bronchial disease or secondary metastasis cancer, evaluating the rate of clinical benefit. The tumors were located at tracheal, carinal or proximal bronchial level. Fibrobronchoscopy was performed to all the patients to measure the degree of airway obstruction and to install brachytherapy endobronchial catheters. Between 1 to 4 fractions of 7 to 7.5 Gy were administered. Dyspnea, cough and hemoptysis were subjectively registered before and after treatment, according to an international validated scale. Results: After treatment, all symptoms considerably decreased, disappearing all of the severe categories. Hemoptysis and dyspnea resolved in a 100% and 40% of patients, respectively; and cough disappeared or was reduced to a minimum grade in 90% of cases.
Vivências de mulheres submetidas à braquiterapia: compreens o existencial  [cached]
Maria Tereza Scramin Rosa,Catarina Aparecida Sales
Revista Eletr?nica de Enfermagem , 2008,
Abstract: Neste estudo, busquei compreender as vivências de mulheres portadoras de cancer uterino antes de submeterem ao tratamento braquiterápico. Trata-se de uma pesquisa qualitativa embasada na fenomenologia existencial de Martin Heidegger que possibilitou a apreens o dos momentos vividos por esses seres. Para participar dessa pesquisa, procurei por mulheres que haviam iniciado algum tipo de tratamento para cancer uterino. Selecionei aquelas que se submeteram à radioterapia em uma clínica de radioterapia situada no noroeste do Paraná, e, a posteriori, seriam submetidas à braquiterapia no período compreendido entre os meses de abril a maio de 2006. Foram entrevistadas quatro mulheres em um hospital especialista em oncologia no norte do Paraná, antes de iniciarem a braquiterapia. Para buscar os discursos dos sujeitos, utilizei a seguinte quest o norteadora: “O que você sente antes de vivenciar a braquiterapia”? Da interpreta o emergiram três temáticas: O ser-com-o-outro inautêntico no convívio do hospital; angústia ante o desconhecimento do tratamento; religiosidade: o caminho da esperan a. Os resultados obtidos revelam a importancia do cuidado holístico ao Ser que vivencia esta facticidade, pois, muitas vezes, a subjetividade do cuidado fica absorvida pela massifica o das regras e normas institucionais.
Braquiterapia de alta taxa de dose associada a radioterapia externa no tratamento de angiossarcoma extenso do couro cabeludo: relato de caso  [cached]
Gentil André Cavalcanti,Soboll Danyel Scheidegger,B. Júnior Carlos Genésio,Novaes Paulo Eduardo R.S.
Radiologia Brasileira , 2001,
Abstract: Os autores apresentam um caso de extenso angiossarcoma do couro cabeludo submetido a radioterapia exclusiva, pela associa o de roentgenterapia de ortovoltagem e braquiterapia de alta taxa de dose utilizando um molde. Descrevem os aspectos clínicos, técnicos e a evolu o terapêutica. Destacam as particularidades e a utilidade da braquiterapia de alta taxa de dose, nesta situa o em particular, e fazem uma análise comparativa das dificuldades e limita es caso a braquiterapia de baixa taxa de dose fosse empregada. Concluem ser a braquiterapia de alta taxa de dose uma op o útil, prática e segura para as les es neoplásicas superficiais do escalpe, podendo ser considerada uma alternativa ao tratamento com elétrons.
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