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Biomedical subjects

A Marques

Publications and source records attributed to A Marques.

At least 37 records · Page 2Linked to original sources
PubMed1995

Survival predictors in advanced non-small cell lung cancer.

The authors studied the influence on survival of 21 clinical, anatomical, haematological and biochemical factors evaluated, at diagnosis, of 411 patients (pts) with advanced Non Small Cell Lung Cancer (NSCLC) followed in our department between 1984 and 1990. Most of the patients were male (347--84.4%) and only 64 (15.6%) were females. Median age was 62 years, but was slightly higher in females. Only 34 patients were aged under 45 years. Squamous cell carcinoma (215 pts--52%) and adenocarcinoma (152 pts--37%) were the most frequent histologic types. Performance status was poor--only 103 (25%) continued active; 120 (29%) spent at least half of the time in bed; 188 (46%) were severely limited. After staging, 179 (44%) presented locally advanced disease (stage IIIB) and 232 (56%) metastatic dissemination (stage IV). Therapy was defined by the oncologic group according to individual characteristics and based on clinical grounds. Anti-neoplastic therapy was performed in 225 (55%), chemotherapy alone in 121 (30%), radiation therapy alone in 67 (16%), and sequential combined treatment (chemotherapy and thoracic radiation) in 37 (9%). Until 1987, the main chemotherapy regimen was MACC (Metrotrexate + Adriamycine + Cyclophosphamide + Lomustin), afterwards VP(M) (Cisplatin + Vimblastin + Mitomycine). Radiation therapy was performed using Co60, 2 Gy/day, 5 days a week, for 4 weeks (approximately 45 Gy total). The response rate was poor--four complete responses (2%), 42 (19%) partial responses. The overall median survival was 4.3 months and only 5% of patients were alive after 18 months of follow up. Prognostic importance of each characteristic studied was initially done by unifactorial analysis, followed by multifactorial analysis according to two methods: Cox proportional hazards model and recursive partitioning amalgamation--RECPAM. Regardless of the method used, the main determinants of survival were found to be performance status (Zubrod), weight loss and serum albumin. Other factors such as the staging (presence or absence of metastasis), lymphocytes, lactic dehydrogenase, and hoarseness were also significant. It is noteworthy that age and histological type were irrelevant; sex and hoarseness only proved important when integrated within a multifactorial model. The overall prognostic evaluation and therapeutic decision of advanced NSCLC patients could be improved by combining the prognostic value of TNM with that of performance status, weight loss and serum albumin. These prognostic guidelines must be taken into account when designing new clinical trials.

Adenocarcinoma↗
PubMed1995

Surgical treatment of the fractured and dislocated condylar process of the mandible.

Most fractures of the mandible can be managed conservatively. This report is a retrospective evaluation of the clinical and radiological results in 17 patients with 21 dislocated fractures submitted to open reduction and fixation, employing steel wires and maxillomandibular fixation. Follow-up ranged from 7 to 55 months, (mean 29.5). Functional assessment showed good opening movements (mean 41.9 mm). There were no cases of ankylosis, pain, or paralysis of the facial nerve. Radiological assessment was normal when the lateral pterygoid muscle was maintained adherent to the fractured proximal segment. Radiological signs of bone resorption occurred when the fractured segment was detached from the lateral pterygoid muscle. In our opinion, dislocated condylar process fractures can be managed surgically and with steel wire ligatures and maxillomandibular fixation. Whenever possible, the lateral pterygoid muscle should be inserted into the fractured proximal segment, i.e. as an osteomuscular flap.

Adolescent↗
PubMed1995

Otoplasty and its origins for the correction of prominent ears.

The authors present a review of the literature concerning surgical correction of lop ear, re-examining the original procedures. Their own approach which combines the most suitable of several techniques described in the literature is presented. Using this approach they achieve good results stimulating them to continue utilizing this personal procedure.

Adolescent↗
PubMed1995

Plicature of abdominoplasties with Marlex mesh.

We propose reinforcing the abdominal wall in abdominoplasties with a polypropylene mesh over three fusiform plications. A marked degree of musculoaponeurotic reinforcement is achieved and maintained postoperatively, especially if these layers are very flaccid. Indications for the procedure and patient selection are described.

Abdominal Muscles↗
PubMed1995

[Echo endoscopy in the local staging of gastric cancer].

OBJECTIVES: to evaluate the accuracy of endoscopic ultrasonography (EUS) in the pre-operative T and N staging of gastric cancer. PATIENTS AND METHODS: 41 consecutive patients with gastric cancer (35 carcinomas and 6 lymphomas) underwent EUS using an Olympus GF-UM20, with 360 degrees sector scan and interchangeable frequency (7.5-12 MHz). They were classified as T1-T4 and N0-N2, according to the TNM system. These results were then compared with the surgical and pathological staging (SP), by the weighted K statistic (Kw). RESULTS: In 2 patients EUS staging was not possible due to cardiac stenosis and in other 4 patients, information about SP staging was not available. In the remaining 35 patients the EUS/SP agreement was good (Kw = 0.80) for stage T and moderate (Kw = 0.49) for stage N. Non-agreement was mostly due to EUS understaging, both T and N. CONCLUSIONS: 1) EUS is the most accurate procedure for pre-operative local staging of gastric cancer, and 2) EUS should preferably be performed by endoscopists with sonographic experience and a particular interest in the method.

Carcinoma↗
PubMed1995

Clear-cell sarcoma of tendons and aponeuroses studied by immunoscintigraphy.

Clear-cell sarcoma is a rare tumor that arises in association with tendons and aponeuroses. Although it shares with malignant melanoma several histologic and ultrastructural features, it has a clinical course different from that of conventional melanomas. A case of clear-cell sarcoma studied by immunoscintigraphy with 99mTc-labeled F(ab')2 fragments of the monoclonal antibody 225.28 S is reported.

Adenocarcinoma, Clear Cell↗
PubMed1994

Phase II study of carboplatin as a single drug for relapsed Wilms' tumor: experience of the Brazilian Wilms' Tumor Study Group.

A total of 15 patients with relapsed Wilms' tumor were treated with carboplatin as a single agent. There were six females and nine males, aged between 2 and 9 years (median:5). The treatment consisted of carboplatin given I.V. as a single agent at a dose of 550 mg/m2 over 1 hour every 3 weeks. There were four (26%) complete responses, four (26%) partial responses, one stable disease, and six with progressive disease. In all patients a total of 56 courses were given and the toxicities found were leukopenia and thrombocytopenia. The overall response rate was encouraging and the toxicity was acceptable and reversible.

Abdominal Neoplasms↗
PubMed1994

Umbilicoplasty for the abdomen with a thin adipose layer.

The authors present a new technique for umbilicoplasty performed on nine patients who were followed up for at least a year. The method is based on the formation of four dermal flaps which after deepithelialisation and fixation reconstitute the umbilical anatomy. The depth of the new umbilicus depends upon the construction of a cylinder. This method is easily performed in patients with a thin abdominal adipose layer and gives good results.

Adipose Tissue↗
PubMed1994

Lifting of the upper lip using a single extensive incision.

In this report an operation to treat ageing of the upper lip is described, whereby a single strip of skin extending from one labial commissure, along the juxta-nasal part of the lip, to the other labial commissure is excised. Good results were obtained with this method in 12 patients operated on, and these results are presented.

Aged↗
PubMed1994

Autologous fat grafts: a quantitative and morphometric study in rabbits.

The aim of this study was to assess the fate of autologous fat tissue grafts harvested and processed by five different methods: blunt suction, sharp suction, dissection, treatment, and lavage. Fat was harvested from the subcutaneous tissue of the interscapular region in 25 rabbits and injected into the subcutaneous area of the convex surface of the ear. Harvesting was by either open surgical excision or suction. Where open surgical excision was used, the fragments were cut into smaller pieces with scissors. Suction in the blunt and sharp suction groups was through cannulas with blunt or sharp edged suction holes, respectively. In both suction groups and the dissection group the harvested tissue was injected without further processing. In the treatment group 2 ml of cell 199 culture medium and Earle's basic salt solution were added, and in the lavage group the tissue was washed with Ringer's lactate. Animals were killed at 7 (n = 9), 180 (n = 8), and 360 (n = 8) days. Serial cross sections were taken from each recipient area and the specimens processed for histology. The images from each section were digitised in a computer and, with the assistance of image analysis software, the volume of remaining fat cells was calculated for each recipient area. The percentage volumes of fat cells found in each group at 360 days were: blunt suction 14% sharp suction 35%, dissection 45%, treatment 27%, and lavage 16% (p = 0.003).

Adipocytes↗
PubMed1994

[Does Bolande's malignant tumor exist?].

Congenital mesoblastic nephroma (CMN) is a rare renal neoplasm which Bolande differentiated from Wilms tumour given its benign nature. We describe 7 cases of CMN which have been treated over the last ten years, in order to highlight to what extent a tumour which is generally considered to be benign can have an aggressive behaviour. 5 patients were diagnosed during their neonatal period (3 of them prenatally) and 2 after the third month of life. Clinical presentation, simple abdominal radiology, echography and abdominal CT scan, which showed characteristic images, led us to a final diagnosis. Tumoral resection was carried out in the 6 typical CMN. The atypical or aggressive CMN was urgently operated under critical circumstances due to spontaneous tumoral rupture. The pathological study showed a CMN of cellular variety with a sarcomatous component. Despite adjuvant chemotherapy, there was a tumoral recurrence which required a surgical second-look and subsequent chemotherapeutical treatment. Bolande's tumour is generally benign, but there is an aggressive cellular variant that fits into the intermediate zone of a pathological spectrum. This aggressive variant have different clinical, radiological and anatomo-pathological features and therefore it involves radical surgical treatment and additional chemotherapy with a rigorous follow-up in the short and the long term.

Abdomen↗
PubMed1993

[Echo Doppler in abdominal aortic dissection].

The authors present a case of abdominal aorta dissection--type B. The diagnosis was made by Doppler ultrasound and computerized tomography (CT). The use of Doppler ultrasound in the diagnosis and assessment of abdominal aorta dissection and visceral arterial involvement is discussed. Doppler ultrasound is also a useful imaging technique in follow-up evaluation if conservative treatment is employed.

Aortic Dissection↗
PubMed1992

Critical analysis of methods of reconstruction of exenterated orbits.

Reconstructive procedures were used on 14 patients who had undergone orbital exenteration and radiotherapy for malignant tumours. All patients were tumour free after a follow-up of between 5 and 18 years. Reconstruction was carried out in 3 stages. In the first operation the orbit was filled, in the second the orbital rims and eyelids were shaped, and in the third a cavity for a static eye prosthesis was created. Critical assessment of results showed that the first stage alone produced a marked improvement in appearance and occluded existing fistulae. The subsequent procedures improved aesthetic results further. Difficulties were encountered from retraction of the tissues and insufficient tissue mobility.

Child↗