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Versatility of therapeutic reduction mammoplasty in oncoplastic breast conserving surgery

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World Journal of Surgical Procedures 2015年第3期5卷 217-222页

作者： Fernando Hernanz Mónica gonzález-Noriega Rocío Vázquez Pérez manuel gómez-fleitas Department of Surgery Valdecilla Hospital

Oncoplastic breast conserving surgery is the gold standard approach for the surgical treatment of early breast cancer. There is a well defined technique named "therapeutic mammoplasty" which is characterized for using a reduction mammaplasty technique to treat breast cancer conservatively. In our current practice, "therapeutic mammoplasty" or therapeutic reduction mammaplasty is our favorite oncoplastic breast conserving approach which it used in almost half of our patients. This technique is very versatile allows us the resection of tumors located in all breast quadrants of patients with moderate-to large-sized breasts. We describe a series of 57 patients who were treated using a therapeutic reduction mammaplasty. All surgical procedures were carried out by one comprehensive breast surgeon who planned and designed the surgery performing both oncologic and reconstructive procedures. Surgical margins were insufficient in eight patients(14%). Nine patients(15.8%) had a complication in early postoperative period and in one of them adjuvant radiotherapy was delayed four months due to a wound dehiscence. The rate of synchronous contralateral symmetrization was 31.6%. Our conclusion is that reduction mammaplasty is a useful and safe skill to treat breast cancer conservatively playing a very important role therefore it must be situated in the priority of learning objectives.

关键词： Breast conserving surgery Oncoplastic Oncoplastic breast surgery Reduction mammoplasty Therapeutic mammaplasty

A novel viewpoint in glaucoma therapeutics: enriched environment

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Neural Regeneration Research 2022年第7期17卷 1431-1439页

作者： María F.gonzález fleitas Damián Dorfman Ruth E.Rosenstein Laboratory of Retinal Neurochemistry and Experimental Ophthalmology Department of Human BiochemistrySchool of Medicine/CEFyBOUniversity of Buenos Aires/CONICETBuenos AiresArgentina

glaucoma is one of the world’s most frequent visual impairment causes and leads to selective damage to retinal ganglion cells and their axons.Despite glaucoma’s most accepted risk factor is increased intraocular pressure(IOP),the mechanisms behind the disease have not been fully elucidated.To date,IOP lowering remains the gold standard;however,glaucoma patients may still lose vision regardless of effective IOP management.Therefore,the exclusive IOP control apparently is not enough to stop the disease progression,and developing new resources to protect the retina and optic nerve against glaucoma is a goal of vast clinical importance.Besides pharmacological treatments,environmental conditions have been shown to prevent neurodegeneration in the central nervous system.In this review,we discuss current concepts on key pathogenic mechanisms involved in glaucoma,the effect of enriched environment on these mechanisms in different experimental models,as well as recent evidence supporting the preventive and therapeutic effect of enriched environment exposure against experimental glaucomatous damage.Finally,we postulate that stimulating vision may become a non-invasive and rehabilitative therapy that could be eventually translated to the human disease,preventing glaucoma-induced terrible sequelae resulting in permanent visual disability.

关键词： brain-derived neurotrophic factor chondroitin sulfate enriched environment glaucoma optic nerve axons optic nerve glia retinal ganglion cells visual stimulation

Paraneoplastic hyperinsulinism and secondary hypoglycaemia in a patient with advanced colon cancer: A rare association

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World Journal of gastroenterology 2008年第12期14卷 1952-1954页

作者： Roberto Díaz Jorge Aparicio Andrea Mendizábal Marisa Faus Tania fleitas Francisco Aparisi Maria Martín Medical Oncology Unit University Hospital La Fe Avenida Campanar 19-21 Valencia 46009 Spain Internal Medicine Department University Hospital La Fe Avenida Campanar 19-21 Valencia 46009 Spain

We review the case of a 74-year-old patient with ad-vanced colon cancer who suffered recurrent bouts of hypoglycemia. A state of inappropriate, non-suppressed hyperinsulinism in the presence of severe hypoglycemia was diagnosed. We finally discuss the known mecha-nisms behind fasting hypoglycemia in patients with ad-vanced cancer, the diagnosis, and possible treatments of this rare paraneoplastic endocrine complication.

关键词：结肠癌低血糖胰岛功能亢进肿瘤

Development of a Method for Identification and Quantification of Sulfadiazine and Pyrimethamine in Serum of Congenital Toxoplasmosis Pediatric Patients

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Pharmacology & Pharmacy 2021年第8期12卷 155-166页

作者： Maria Elena Marson fleitas Ulises Pérez Montilla Carlos Prospitti Anabela Altcheh Jaime Moroni Samanta Moscatelli guillermo garcía Bournissen Facundo Mastrantonio guido área de Toxicología Departamento de Ciencias Biológicas Facultad de Ciencias Exactas Universidad Nacional de La Plata La Plata Provincia de Buenos Aires Argentina Laboratorio UPL Universidad Nacional de La Plata/Comisión de Investigaciones Científicas de la Provincia de Buenos Aires La Plata Argentina Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) La Plata Argentina Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas (IMIPP-CONICET) Servicio de Parasitología y Chagas Hospital de Ni&#241 os “Dr. Ricardo gutiérrez” Buenos Aires Argentina Division of Paediatric Clinical Pharmacology Department of Paediatrics Schulich School of Medicine and Dentistry Western Ontario University London Ontario Canada

Infection with Toxoplasma gondii, is one of the most widespread zoonoses in the world. Congenital Toxoplasmosis (CT) is particularly risky due to its fetal complications. Sulfadiazine (SDZ) and Pyrimethamine (PYR) are usually used for CT treatment in Argentina, to prevent morbidity. Due to the lack of commercial pediatric formulations, these must be prepared in the hospital pharmacy. This is the first report of serum concentrations measures in pediatric CT therapy for this combination of drugs. A bioanalytical method was developed for identification and simultaneous quantification of SDZ and PYR by High Performance Liquid Chromatography (HPLC) with UV detection. The validated method was applied to residual serum samples obtained from 6 pediatric patients undergoing treatment with SDZ 42.20 a 93.70 mg/kg/day and PYR 0.77 a 2.70 mg/kg/day. Sample pretreatment consisted on a deproteinization step followed by centrifugation and then injection of supernatant. Limit of Detection (LOD) and Quantification (LOQ) were (0.17 ± 0.02 and 0.13 ± 0.02) μg/mL and (0.46 ± 0.01 and 0.36 ± 0.01) μg/mL for SDZ and PYR respectively, with an appropriate linear range. Concentrations range found were ( - 162.04 ± 0.02) μg/mL for SDZ and ( -

关键词： Toxoplasmosis Bioanalytics Pediatric Pharmacology Therapeutic Drug Monitoring Neglected Diseases

Thyroid Nodule: Alpha Score 2.0 Classification for FNAB Selection, Multicentric Study in Latin America

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Open Journal of Radiology 2021年第4期11卷 160-174页

作者： glenn Mena Maria Cristina Chammas Carlos Mario gonzalez Vasquez Lylian Rocío Villagómez Marco Alfredo Muñoz Pico Patricio Alejandro Montalvo Santiago Mena-Bucheli Julio Olmedo Elizabeth Quintero Pedro Henrique de Marqui Moraes Osmar Cassio Saito Hubertino Diaz Denise Romero gabriela Velalcazar Angel Ramón Sosa fleitas Yamil Oliver Quevedo Ontaneda Victor Ricardo Chara Alpha Imagen Radiología e Intervencionismo Quito Ecuador Hospital das Clínicas Faculdade de Medicina da Universidade de Sã o Paulo S&#227 o Paulo Brasil Hospital Pablo Tobón Uribe Medellin Colombia Hospital del Instituto Ecuatoriano de Seguridad Social Quito Sur Quito Ecuador Hospital San Francisco de Quito Quito Ecuador Hospital Edgardo Rebagliati Martins Lima Perú Hospital Carlos Andrade Marín Quito Ecuador Hospital de Clínicas San José de San Martín Buenos Aires Argentina Hospital Universitario de Los Andes Mérida Venezuela Hospital de la Policía Quito Ecuador Hospital Sisol Tacna Perú

Introduction: To perform a Latin-American multicentric study for the prediction of benign and malignant thyroid nodules using Alpha Score, and to compare it with ACR TIRADS® and Bethesda®. Materials and Methods: A pro... 详细信息

g>Introduction:g> To perform a Latin-American multicentric study for the prediction of benign and malignant thyroid nodules using Alpha Score, and to compare it with ACR TIRADS® and Bethesda®. g>Materials and Methods:g> A prospective multicentric study in 10 radiological hospitals and institutions of Latin America was performed and 818 thyroid nodules were analyzed by ultrasound and classified by using both ACR TIRADS® and Alpha Score;fine-needle aspiration biopsy was performed when needed and classified with Bethesda. The relationships between predictors were analyzed by using binary logistic regression, statistical significance was defined by a p-value of 0.05, with an error margin of 4% and 95% confidence intervals. g>Results:g> Alpha Score 2.0 establishes five types of malignant predictors: microcalcifications, irregular borders, taller-than-wide shape, predominant solid texture and hypoechogenicity;a diameter equal to or greater than 1.5 cm adds an extra point to the final score. Resulting classification divides TNs into 4 categories: benign (1.9%), low suspicion (8.7%), mild suspicion (13.6%) and high suspicion (75.7%) of malignancy probability;sensitivity of 82%, specificity of 74%, the positive predictive value of 94%, the negative predictive value of 51%, the statistical accuracy of 81%, odds ratio of 108.89 and correlation with ACR TIRADS of 0.77 and Bethesda of 0.91.g> Conclusions: g>Alpha Score 2.0 has superior diagnostic accuracy and performance compared to the previously published Alpha Score and is able to classify a benign TN in a precise, safe and accurate way, avoiding unnecessary FNABs or determining the necessity of FNAB in cases of moderate to high suspicion of malignancy.

关键词： Thyroid Cancer-Clinical Radiology-Imaging Thyroid Nodule Alpha Score TIRADS® Thyroid Ultrasonography

The antihiperglicemics in the glicemic control of the diabetic patient. El FZ （glicolit） an antihiperglicemic of natural origin

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The antihiperglicemics in the glicemic control of the diabet...