肺癌脑膜转移癌诊疗的研究进展

脑膜转移癌（leptomeningeal metastases, LM）是晚期肺癌中进展迅速、预后dee;的常见并发症。脑膜转移癌临床诊断率低，治疗手段有限，疗效dee;，自然生存时间短。脑脊液细€de;学作为诊断脑膜转移癌的金标准，但是目前临床症状及影像学阳性的患者脑脊液首次细€de;病理学阳性诊断率一般不超过50%，导致脑膜转移癌患者的诊断延迟、治疗延误。随着驱动基因阳性肺癌靶向治疗、驱动基因阴性肺癌免疫治疗的进展，肺癌患者生存期延长，但是脑膜转移癌发病率逐年增加，如何提高诊断率、寻找有效的治疗手段是目前临床研究的热点。本文就肺癌脑膜转移癌诊断及治疗研究进展予以综述。     

Analgesic, anti-inflammatory and antioxidant properties of Buddleja globosa, Buddlejaceae

ETHNOPHARMACOLOGICAL RELEVANCE: Buddleja globosa, known as "matico", is employed in Chile for wound healing. AIM OF THE STUDY: To validate the traditional use of the crude drug through in vivo and in vitro evaluation of the anti-inflammatory, analgesic and antioxidant properties of its extracts. MATERIALS AND METHODS: Sequential hexane, dichloromethane, methanol and total methanol extracts were studied using bioguided fractionation. The following activities were investigated: analgesic (writhing test), oral and topic anti-inflammatory (paw- and ear-induced edema), free radical scavenging and antioxidant activities (1,1-diphenyl-2-picrylhydrazyl, DPPH, superoxide anion, lipid peroxidation and xanthine oxidase inhibition). Sodium naproxen, nimesulide, indomethacin were used as reference drugs for in vivo, quercetin and allopurinol for in vitro assays. RESULTS: A mixture of alpha- and beta-amyrins was isolated from the hexane extract that showed 41.2% of analgesic effect at 600 mg/kg, inhibited by 47.7 and 79.0% the arachidonic acid (AA) and 12-deoxyphorbol-13-decanoate (TPA)-induced inflammation at 3mg/20 microL/ear, respectively. A mixture of beta-sitosterol, stigmasterol, stigmastenol, stigmastanol and campesterol was isolated from the fraction CD4-N and beta-sitosterol-glycoside from the fraction CD5-N, reducing TPA-induced inflammation by 78.2 and 83.7% at 1mg/20 microL/ear, respectively. The fraction CD4-N at 300 mg/kg also showed analgesic activity (38.7%). The methanol extract at 600mg/kg per os showed anti-inflammatory effect (61.4%), topic anti-inflammatory (56.7% on TPA) and analgesic activity (38.5%). Verbascoside and luteolin-7-O-glucoside were the major components of the methanol extract; apigenin 7-O-glucoside was also detected. Inhibition of superoxide anion, lipoperoxidation, and DPPH bleaching effect was found in the methanol serial and global extracts. CONCLUSIONS: The present report demonstrate the analgesic and anti-inflammatory properties of Buddleja globosa and validate its use in Chilean traditional medicine.     

Encuesta SEGO. Tratamiento de la amenaza de parto pretérmino en los hospitales españoles

Objective

To determine how threatened preterm labor is treated in Spanish hospitals.

Material and method

Under the aegis of the Spanish Society of Obstetrics and Gynecology, an Internet questionnaire on basic aspects of the treatment of threatened preterm labor was sent to 41 Spanish hospitals (37 public and four private hospitals).

Results

All hospitals use tocolysis in threatened preterm labor before 34th weeks. The most widely used tocolytic agent is atosiban (73,7%), followed by betamimetics (21.9%) and nifedipine (4.9%). Only 7.3% of the hospitals use tocolytics in threatened preterm labor after 34 weeks. All the hospitals use corticosteroids to accelerate lung maturation: 92.7% use betamethasone and 7.3% prefer dexamethasone. In 90% of the hospitals, steroid therapy is not repeated. In multiple pregnancies, the same steroid dose as that used in single pregnancies is administrated in all centers.

Conclusions

The most widely used tocolytic agent in Spanish hospitals is atosiban and the preferred corticosteroid is betamethasone.     

Tumores malignos ginecológicos sincrónicos. Casuística del Hospital de Manacor

Objective

To alert clinicians to the possibility of synchronous tumors in patients with gynecological cancer. An important tool in diagnosis is the family history. We describe several familial syndromes involving the development of synchronous gynecological tumors.

Subjects and methods

We studied all cases of synchronous gynecological tumors in the Manacor Hospital from 1997 to 2006.

Results

Synchronous gynecologic tumors represented 0.83% of all gynecological neoplasms treated in our center in the period studied.

Conclusions

This kind of tumor is uncommon but should be considered by clinicians, especially in women with a familial history of cancer or in those with certain genetic syndromes. Examination aimed at excluding the presence of synchronous tumors is recommended.     

The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: clinical description and genetics

The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is characterized by congenital aplasia of the uterus and the upper part (two-third) of the vagina. It may be isolated (type I) or associated with other malformations (type II or MURCS association). These latter involve the upper urinary tract, the skeleton and, to a lesser extent, the otologic sphere or the heart. The incidence of MRKH syndrome has been estimated as 1 in 4500 women. The prime feature is a primary amenorrhea in women presenting otherwise with normal development of secondary sexual characteristics and normal external genitalia. However, the vagina is reduced to a vaginal dimple with variable depth. The ovaries are normal and functional as well as the endocrine status. Karyotype is 46,XX, with no visible chromosome modification. The phenotypic manifestations of MRKH syndrome overlap with various other syndromes or malformations and thus require accurate delineation as well as differential diagnosis. For a long time, the syndrome has been considered as a sporadic anomaly, but increasing familial cases now support the hypothesis of a genetic cause currently under investigation. The syndrome appears to be transmitted as an autosomal dominant trait with incomplete penetrance and variable expressivity.     

Valoración ecográfica del endometrio en pacientes tratadas con tamoxifeno

Objective

To measure endometrial thickness and characterize ultrasonographic endometrial images induced by tamoxifen, as well as to determine changes in ultrasonographic patterns throughout treatment.

Patients and methods

We analyzed 278 patients with breast cancer between 1995 and 2000 under adjuvant therapy with tamoxifen for 5 years. Annual ultrasonographic examination was performed. Endometrial thickness and the morphological endometrial patterns in stored ultrasonographic images were retrospectively analyzed.

Results

Endometrial thickness significantly increased during treatment from a mean of 7.84 mm in the first year to 16.67 mm in the fifth year. Five endometrial patterns were found on ultrasonography in patients receiving tamoxifen: linear, heterogeneous-hyperechoic, homogeneoushyperechoic, endometrial polyp, and suspicious for malignancy. The homogeneous-hyperechoic pattern predominated in the first year and the heterogeneous-hyperechoic pattern in the fifth year.

Conclusions

Tamoxifen increases endometrial thickness in the course of treatment and induces five ultrasonographic patterns which change year-by-year.     

Pregnancy and lung cancer: a case report and review of the literature

Lung cancer is a frequent pathology among women, as a result of tobacco increase. Lung cancer among pregnant women is especially rare when revealed by Pancoast-Tobias syndrome. Foetal injury is possible. The approach is multidisciplinary. Prognosis is bad.