Suchergebnisse

Introduction: Pulmonary carcinoma
is the leading cause of cancer deaths in the world; the
expression of the epidermal growth factor receptor in lung
carcinoma tissue occurs in the adenocarcinoma lineage. The
use of tyrosine kinase inhibitors that act on said receptor
has increased survival beyond two years in mutated EGFR
patients. Objective: To know the effect of tyrosine kinase
inhibitors in the survival of patients with pulmonary
adenocarcinoma, mutated EGFR. Material and methods: An
observational, analytical, retrospective, transversal study
was conducted over a period of two years (2013 to 2015),
including patients with a confi rmed diagnosis of lung
cancer and the presence of the mutated EGFR performed by
FISH (fluorescent in situ hybridization). The survival was
evaluated by Kaplan-Meier test/Cox regression, considering
a statistical significance associated with a p ? 0.005.
Results: Thirteen patients were included; their average age
was 66.77 ± 9.356 years, with a median of 67 years; 46.2%
were women and 53.8% men. The most common type of deletion
was of exon 19 (in 61.5%); the second was of L858R (in
38.5%). Three (23%) patients were smokers and 10 (77%)
reported not to be; eight (61%) presented deletion of exon
19 and five (39%) deletion of L858R. By the end of the
study, six patients had survived (46%) and seven died
(54%). The Kaplan-Meier method showed 21.95 months of
survival (95% CI 17.3-26.61).

BACKGROUND: Coronary artery
disease is the most common single cause of death in all
countries of the world, corresponding to 12.8% of all
deaths. Complications in the acute phase may lead the
patient to a state of cardiogenic shock being the leading
cause of death in patients hospitalized for acute
myocardial infarction with 50% mortality despite
reperfusion therapy, optimal medical treatment and
intraaortic balloon support. OBJECTIVE: To reduce mortality
secondary to cardiogenic shock due to anteroapical
ST-segment elevation acute myocardial infarction (STEMI).
MATERIALS AND METHODS: We included patients with
anteorapical STEMI who coronary blood flow was restored by
primary angioplasty and continue with cardiogenic shock
despite various supportive therapies. By angioplasty
technique the "containment balloon", an angioplasty balloon
was placed on the left anterior descending artery, which
was the diameter according to the vessel and 80 mm in
length covering the entire course of the artery and it was
inflated with contrast undiluted, leaving it for 12 hours,
new measurements were made (pulmonary capillary wedge
pressure, cardiac index) with the pulmonary artery catheter
during this time. At the end of 12 hours the balloon was
deflated and removed from the coronary, then bare metal
stents were placed distal to proximal. RESULTS: In this
study we observed higher mortality with standard treatment
than the reported in the literature. However, making an
intervention with the containment balloon this mortality is
reduced by 66.6 % (p< 0.01) in the control group. It
could be demonstrated an increase in ejection fraction at
48 hours average of 34% (p< 0.01) in patients treated by
containment balloon. CONCLUSION: It is a novel, useful,
reproducible and no learning curve technique with superior
survival benefit in patients with cardiogenic shock due to
anteroapical STEMI. The cost of this technique is less than
the cost of different ventricular assist
devices.