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Biomedical subjects

A Guerra

Publications and source records attributed to A Guerra.

At least 109 records · Page 6Linked to original sources
PubMed1985

Malignant fibrous histiocytoma of soft tissue. An analysis of 78 cases located and deeply seated in the extremities.

Seventy-eight cases of malignant fibrous histiocytoma (MFH) of soft tissues are reported. All tumors were deeply located in the extremities. An analysis is presented with regard to sex, age, site, macro- and microscopic features. The staging was assessed according to Enneking's classification (IB, one case; IIA, 25 cases; IIB, 42 cases; III, 10 cases). The recurrence rate after surgical treatment was high (37.5%) with significant differences after inadequate surgery (70%), wide excision (38%), or amputation (0%). Adjunctive radiotherapy rarely was effective in preventing local recurrence. The overall 5-year survival rate was 36%. The prognosis was worse in (1) tumors larger than 5 cm in diameter, (2) tumors that recurred early (less than 1 year) after surgery, and (3) tumors that had inadequate surgical treatment (intralesional or marginal excision).

Actuarial Analysis↗
PubMed1985

Pilot study of multiple-fraction daily radiotherapy alternating with chemotherapy in patients with stage IV non-oat cell lung cancer.

From March 1982, 31 patients with stage IV non-oat cell lung cancer have been treated. Radiotherapy was given as three 2.00-Gy fractions on Days 1 and 2, 8 and 9, 22 and 23, and 29 and 30, for a total dose of 48 Gy over a 30-32-day treatment period. A three-drug combination of cyclophosphamide (400 mg/m2), doxorubicin (17 mg/m2), and methotrexate (15 mg/m2) was given on Days 3 and 24 and repeated thereafter every 21 days. Three of 31 evaluable patients (10%) achieved objective complete response and 18 of 31 (58%) achieved partial response (ie, regression of 50%-90%), while no change or disease progression was observed in ten of 31 (32%). The overall response rate in our study was 68%, which is a response much higher than other results in extensive disease. However, controlled trials will be necessary to definitively establish the superiority of this regimen to conventional trials. There was a significant shift of performance status towards higher values after treatment: 12 of the 27 patients classified in the 70-80 Karnofsky category before treatment moved to the higher category, 13 remained in the same status, and only two shifted to the worst category, indicating that the treatment had been effective in giving patients a better quality of life during their survival. The median survival was 35 weeks for the entire group of patients and 44 and 15 weeks for the responders and nonresponders, respectively. One of the primary findings of this pilot study was the ability to give one course of 12 Gy of radiation as multiple fractions per day during each of the first 2 weeks of treatment alternated with one course of chemotherapy, with most patients having very mild or no side effects. Giving multiple daily fractions greater than or equal to 4 hours apart permits the delivery of a large amount of irradiation over a short time period (ie, 1-2 days) within the limits of normal tissue toxicity. Increasing the recovery time of radiotherapy by alternation with chemotherapy offers the possibility of increasing the total radiation dose beyond the upper limits now considered feasible by conventional radiation schedules for induction therapy.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenocarcinoma↗
PubMed1985

[Conservative surgical treatment in osteogenic sarcoma of the limbs].

The authors have treated a first series of 46 cases of osteogenic sarcoma of a limb by local resection between 1975 and April 1983. Cases with metastases were excluded. The surgical procedures used for reconstruction are described. The patients were operated on first and then treated by chemotherapy using several schemes of treatment. After an average follow-up of three years, 26 patients appeared to be free of any recurrence or metastasis. The importance of an extensive resection followed by appropriate chemotherapy is stressed. In a second series of 37 cases treated between May 1983 and March 1984, the patients were first treated by chemotherapy (methotrexate in high dosage and CDDP by intra-arterial perfusion) and then operated on. In the second series, the percentage of tumour necrosis seen in resected cases was found to be very high.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Description of redia and cercaria of Paragonimus peruvianus from experimentally infected Aroapyrgus colombiensis of Condebamba Valley, Peru.

Although no natural infections with lung flukes were encountered in the hydrobioid snail Aroapyrgus colombiensis from streams in the Condebamba Valley, Peru, laboratory-bred snails were readily susceptible to infection with miracidia of Paragonimus peruvianus. The redia and cercaria are described for the first time for those of neotropical lung flukes. Cercariae inside rediae did not have a stylet and development was apparently completed outside the rediae in snail tissues. The microcercous xiphidiocercaria had 2 groups of gland cells on each side; the outer consisted of 5 cells and the inner of 3 cells, all with ducts opening at the stylet. The excretory bladder was large, often triangular, was thick-walled, and of 1 layer of cuboidal cells. The redia lacked procrusculi and had a short intestine which was slightly longer than the pharynx.

Digestive System↗
PubMed1985

Extra-articular resection of the shoulder (Tikhoff-Linberg).

The authors have reviewed 21 cases of extra-articular resection of the shoulder, using the Tikhoff-Linberg technique, carried out at the Tumour Centre of the Rizzoli Institute. The effectiveness of this method has been evaluated both oncologically (by a study of the resected specimens) and functionally. The possible complications are considered. The authors describe a modification of the technique for tumours of the proximal humerus in which only part of the scapula is removed.

Adolescent↗
PubMed1985

[Resection with preservation of the lower limb in chondrosarcoma of the pelvis].

Twenty-seven chondrosarcomata of the pelvis were treated by local resection with preservation of the limb. Twenty-two were grade I or II, and 5 were grade III or IV. Attention is drawn to the importance of tomodensitometry in assessing the extent of the tumor before operation. An en bloc resection was well wide of the tumour in 16 cases, close to the tumour in 10 cases and involved the tumour in one case. Post-operative complications were varied. There were 6 nerve paralyses after iliac resection, 3 cases of sepsis after resection of the anterior part of the pelvic ring, and 3 cases of sepsis and 2 vascular complications after peri-acetabular resections. The average follow-up was 5 years. Three had metastases and three had local recurrences, one of whom died later from pulmonary metastases. No local recuRrence was seen in cases with wide resection. The functional results were satisfactory in 6 out of 7 partial resections of the ilium and in 4 out of 5 resections of the anterior part of the pelvic ring. They were only fair after peri-acetabular resections and complete resections of the ilium. After peri-acetabular resections, the results were about the same after ilio-femoral arthrodesis or Girdlestone operations. It is not appropriate to reconstruct the pelvic ring after resection limited to the anterior part of the pelvis but it is indicated after resections of the whole of the ilium, particularly in children to avoid shortening of the limb with pelvic shift.

Adult↗
PubMed1984

Malignant fibrous histiocytoma of bone. The experience at the Rizzoli Institute: report of 90 cases.

Ninety cases of malignant fibrous histiocytoma (MFH) of bone are reported. An analysis is presented with regard to sex, age, site, symptoms, radiography, macroscopic, and microscopic features. The staging was assessed according to the following classification: I B: 3 cases; II A: 11 cases; II B: 66 cases; III: 10 cases. Among nonmetastatic patients, 68 had surgical treatment (adequate, 46; inadequate, 22); 8 had radiotherapy, and 3 refused any treatment. Among surgically treated patients, 20 had adjuvant chemotherapy, also. Follow-up information was obtained in all cases. Overall survival rates were 34% at 5 years, and 28% at 10 years. Surgery alone did not appear to be successful (5-year survival, 28%). Adjuvant chemotherapy improved the survival rate only in patients who underwent adequate surgery (5-year survival, 57%). The recurrence rate after surgical treatment was high (31%) with significant differences after inadequate (64%), wide (19%), or radical (6.5%) surgical treatment. Adjuvant chemotherapy was ineffective in preventing local recurrence. Radiation therapy effected a clinical cure in three cases; the authors believe that radiation therapy has to be used only in inoperable tumors.

Adolescent↗
PubMed1984

Parosteal osteosarcoma.

Forty-one cases of parosteal osteosarcoma were reviewed clinically, radiologically and pathologically. The fibrous and cartilaginous elements of each tumour were graded from I to IV for malignancy. Primary intramedullary involvement was found in one third of Grade I lesions, two-thirds of Grade II and nearly 90% of Grade III lesions. Thirty-five patients with adequate follow-up were also studied and evaluated as to the adequacy of surgical management in relation to the later development of local recurrence or metastasis or both. No metastases were seen from Grade I tumours despite a number of local recurrences. One third of patients with Grade II and half of those with Grade III tumours developed pulmonary metastases and died, all with involvement of the medullary cavity before distant spread. No patients with adequate surgical management developed local recurrence; in those with inadequate treatment there was an 88% local recurrence rate.

Adolescent↗
PubMed1983

Combined radiation and drugs: the effect of intra-arterial chemotherapy followed by radiotherapy in head and neck cancer.

This study was designed to ascertain whether a prior reduction of tumor size by drugs could affect the final outcome of tumors treated with radiation. 142 patients with head and neck cancer (oropharynx, maxillary antrum and intra-oral) were randomized for the study. In 72 cases, irradiation was preceded by a continuous intra-arterial infusion of 3-5 mg/day methotrexate to a total dose of 90-120 mg; the other 70 patients were treated with radiotherapy alone. Chemotherapy, given prior to radiotherapy, caused a shift in the tumor stage (i.e. a reduction in tumor size) in more than one third of the cases. The overall 5-year survival was 43% in the combined treatment group and 25% in the group treated with radiation alone (statistical difference: p less than .05). However, when analysed separately the difference was statistically significant only in oral cavity tumors (5-year survival of 54% in the combined modality group vs. 27% in the control group), although local control rates after both single and combined modalities were not statistically different from those of oropharynx and maxillary antrum tumors. In these last lesions, however, the dissemination of disease was more frequent; therefore, the lack of improvement of cure rate with the combined modality in these cases seems to be related to both the higher tendency of these tumors to disseminate and the low effectiveness of intra-arterial chemotherapy in controlling distant metastases. Mild and transient local and systemic toxicities were observed during chemotherapy infusion, but no radiosensitising effect on normal skin and mucosa was seen during radiotherapy in patients who had received pre-irradiation chemotherapy.

Combined Modality Therapy↗
PubMed1983

The treatment of pulmonary metastases in osteosarcoma. Preliminary observations on 30 cases.

Thirty cases of pulmonary metastases in osteosarcoma are analysed from the point of view of evaluating the indications for localised excision, and also to report the results obtained. This group is compared with 42 analogous cases in which the metastases were not treated surgically. The results of pulmonary surgery is shown to be effective in the multidisciplinary treatment of osteosarcoma with pulmonary metastases.

Adolescent↗
PubMed1982

Transolecranal dislocations.

The authors report the results obtained in the treatment of twenty-four cases of transolecranal dislocation (anterior dislocation of the elbow accompanied by fracture of the olecranon). Follow up examinations were performed after one to eight years. Discussion of the types of dislocation is followed by a description of the operations necessary to reduce and stabilise the individual lesions. In the light of the results obtained the authors still consider it advisable for the elbow to be immobilised in plaster for three weeks to allow the capsulo-ligamentous lesions caused by the dislocation to cicatrize.

Adolescent↗