Biomedical subjects
Publications and source records attributed to I Fleischer.
A multidisciplinary team evaluated four replacement mattresses. The mattress that was found to be most effective in preventing pressure ulcers was then compared to the static air mattress. The study's results and outcomes are presented.
Hidradenitis suppurativa is a chronic, suppurative, and cicatricial cutaneous disease with clinical manifestations including inflammatory lesions and nodules, abscesses, and sinus tracts. We describe an unusual case of peristomal lesions that may represent hidradenitis suppurativa. Peristomal hidradenitis suppurativa has not been previously reported. This unusual complication demonstrates the need for a thorough patient history to identify any systemic disease that may contribute to peristomal skin problems.
The presence of a black or brown stoma may indicate a serious problem, such as a necrotic stoma, or may be the result of a benign pigmentation disorder known as melanosis coli. Melanosis coli is caused by anthraquinone laxative abuse and has no associated morbidity. The case report involves a 63 year old white female admitted to the hospital emergency room. Secondary to uterine choriocarcinoma, an end sigmoid colostomy was created. The mucosa was moist but black, despite the fact that the serosa had been pink and bled easily. Biopsy revealed neither necrotic stoma nor infarcted bowel but melanosis coli related to the patient's 20 year history of laxative use for chronic constipation. Melanosis coli does not require medical or surgical intervention and is considered a benign pigmentation disorder. However, knowledge of this condition and of the bowel patterns and habits of patients prior to their ostomy surgery, is essential to establishing the differential diagnosis for a brown or black stoma.
In order to investigate the medical treatment of anal canal carcinoma (ACC), 27 patients (pts) were treated with cisplatin, fluorouracil and radiotherapy, in an alternating schedule. Eleven pts received mitomycin C, fluorouracil and radiotherapy, in a concurrent scheme. Finally, six pts were included in a new outpatient scheme with cisplatin, fluorouracil, leucovorin, mitomycin C and concurrent radiotherapy. Within the first schedule, 25 pts were evaluable and 18 achieved complete response. All of them are disease free until now. With the second scheme, 7/10 pts had a complete response and 5 of them are alive and disease free. All the pts included in the last schedule (6/6) achieved complete remission. There were no deaths related to toxicity. Our experience is one of the earliest in oncology using cisplatin as a first line drug, in the non-surgical treatment of ACC. We think that the use of cisplatin is feasible, its toxicity is manageable, and its effectivity is similar to other schedules, as observed in our last scheme.
We present the clinical case of a 16 year old patient with an "epithelioid leiomyosarcoma" (malignant leiomyoblastoma) diagnosis. Taking into consideration the rarity of this diagnosis in this age group, we review this case from the clinical and bibliographical point of view.
Aims of the cures for children and adolescents after malignant diseases consist in the promotion and stabilisation of the physical and psychological welfare. It is reported on the experiences from 108 cures with 65 patients. Under the selected conditions of the cure the physical fitness and psychological situation improved. The objective measurement of results must be progressed.
We describe a clinical case of esophageal oat-cell carcinoma, which is an exceptional histological presentation. We consider the possibility of a multifocal origin of this tumor.
Pancreatic liposarcoma are tumors frequently located in extremities and retroperitoneum. Visceral located tumors of this histology are exceptional. We present a clinical case of nonresectable pancreatic liposarcoma. A general review is made on this subject.
5 fluorouracil (5FU) is considered the most important chemotherapeutic agent for gastrointestinal cancer treatment. High dose 5FU (3 gr./m2), given together with allopurinol to prevent normal tissue toxicity may be used to get a better therapeutic index. Toxic effects are specially considered in this paper, where effects in 20 advanced gastrointestinal patients are evaluated. Taking into consideration the results obtained, we consider it can be safely used in this way.
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Up to now, there has been no real evidence about the effectiveness of adjuvant surgical treatments in colo-rectal cancer in patients with no evidence of disease. Investigations are frequently out of the rules that must be followed to accept the effectiveness of some treatment. Results with radiotherapy as a loco-regional treatment and chemotherapy or immunotherapy as systemic treatments are contradictory. Our opinion is that, at least in patients with Dukes'C stage, efforts must persist to find the best adjuvant scheme to prolong the free-disease interval, or ideally, increasing the number of patients healed by surgery.
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We relate the experience obtained by treatment of 20 advanced digestive cancer patients, with the association of 5 fluorouracil and methyl-C.C.N.U. Objective response was found in 4 patients (20%). Toxicity consisted of leucopenia in 3 patients, allergic phenomena in 2 and diarrhea in 1 patient. Mean survival is increased in 3 months in responders, when compared with non-responders, although this difference has not statistical value.
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