Yttrium-90 Selective Internal Radiation Therapy with Glass Microspheres for Hepatocellular Carcinoma: Current and Updated Literature Review.

Hepatocellular carcinoma is the most common primary liver cancer and it represents the majority of cancer-related deaths in the world. More than 70% of patients present at an advanced stage, beyond potentially curative options. Ytrrium-90 selective internal radiation therapy (Y90-SIRT) with glass microspheres is rapidly gaining acceptance as a potential therapy for intermediate and advanced stage primary hepatocellular carcinoma and liver metastases. The technique involves delivery of Y90 infused glass microspheres via the hepatic arterial blood flow to the appropriate tumor. The liver tumor receives a highly concentrated radiation dose while sparing the healthy liver parenchyma due to its preferential blood supply from portal venous blood. There are two commercially available devices: TheraSphere® and SIR-Spheres®. Although, Y90-SIRT with glass microspheres improves median survival in patients with intermediate and advanced hepatocellular carcinoma and has the potential to downstage hepatocellular carcinoma so that the selected candidates meet the transplantable criteria, it has not gained widespread acceptance due to the lack of large randomized controlled trials. Currently, there are various clinical trials investigating the use of Y90-SIRT with glass microspheres for treatment of hepatocellular carcinoma and the outcomes of these trials may result in the incorporation of Y90-SIRT with glass microspheres into the treatment guidelines as a standard therapy option for patients with intermediate and advanced stage hepatocellular carcinoma

Desafíos de las metrópolis: Efectos ambientales y sociales. Tendencias geográficas II

El libro está conformado de estudios realizados por profesores-investigadores de la Universidad Autónoma del Estado de México, de la Universidad de Varsovia, así como de la Universidad Pedagógica Comisión de Educación Nacional de Cracovia. En esta obra se exponen algunas investigaciones sobre los cambios en los factores sociales, naturales, económicos y ambientales como principales desafios que presentan las zonas de México, Polonia y de contextos de Sudamérica, tales como Sao Paulo, Quito y Bogotá y ciudades medias y pequeñas.Universidad Autónoma del Estado de Méxic

¿Qué opinión tiene el sector turístico sobre los cruceros?

Frente al debate sobre si el impacto económico del turismo de cruceros es real o está sobreestimado, este trabajo se centra en analizar la percepción que tiene el propio sector turístico de las ciudades que acogen cruceros sobre dicho impacto. Para ello se cuenta con una muestra de 371 gerentes de establecimientos turísticos del hinterland de dos puertos españoles de cruceros. La metodología está basada en regresiones ordered logit y multinomial logit. Las conclusiones confirman la buena imagen pública que tradicionalmente ha disfrutado el tráfico de cruceros. Concretamente, muestran un sector turístico que mayoritariamente defiende el turismo de cruceros como instrumento de desarrollo económico y turístico, especialmente en el segmento de turismo cultural y gastronómico, donde los gerentes le presuponen una contribución incluso mayor a la de las aerolíneas de bajo coste (LCCs). Aunque la visión de los gerentes no es uniforme sino que depende de las características del establecimiento turístico y su propia experiencia. Los gerentes también defienden la intervención directa de las administraciones públicas, incluso con ayudas económicas, para favorecer la implantación de los cruceros en sus ciudades. Incluso las agencias de viajes, tradicionalmente críticas con las ayudas a las LCCs, muestran un apoyo claro a este tipo de ayudas

Unusual Case of Superior Vena Cava Syndrome Caused by Intravascular Thyroid Metastasis

Superior cava venous obstruction use to show a typical clinical presentation and a CT scan or even an ultrasonography can be sufficient to achieve an accurate diagnosis, but in this case, to obtain the final diagnosis, a multimodal assessment is needed. This case report shows a multidisciplinary approach which helped diagnose a complicated case, where conventional diagnostic methods were not enough

Evaluación del desempeño atlético en Gimnasia Artística femenina en la disciplina de suelo en “Aries Gymnastic Academy”

Artistic gymnastics is a sport with a high degree of difficulty due to the demand of exceptional physical conditions of the athlete accompanied by psychic and functional demands, in this research article they focused on the physical performance of female athletes in artistic gymnastics, they collected data from a gymnastics academy “Aries Gymnastic” where they chose 12 gymnasts, and by means of 10 tests they quantified two essential capacities of this discipline which are strength and flexibility. Strength is mainly provided by type II muscle fibers and flexibility is mainly provided by the fibrous tissue of the cartilage. After the tests were completed, the results gave them varied scores that confirm a low and regular score, concluding that the training should be more precise to improve the technique and achieve greater strength and flexibility in these gymnasts.La gimnasia artística es un deporte con un elevado grado de dificultad por la demanda de condiciones físicas excepcionales del atleta acompañado de exigencias psíquicas y funcionales, en este artículo investigativo se centraron en el desempeño físico de las atletas femeninas en gimnasia artística, recolectaron datos de una academia de gimnasia “Aries Gymnastic” donde escogieron 12 gimnastas, y por medio de 10 test cuantificaron dos capacidades imprescindibles de esta disciplina que es fuerza y flexibilidad. Fuerza otorgada principalmente por las fibras musculares de tipo II y flexibilidad trabajada en su mayoría por el tejido fibroso de los cartílagos. Culminadas las pruebas realizadas les dió como consecuencia variadas puntuaciones que les confirman una baja y regular puntuación, concluyendo en que el entrenamiento debe ser más preciso para mejorar la técnica y alcanzar una mayor fuerza y flexibilidad en estas gimnastas

Yttrium-90 Selective Internal Radiation Therapy with Glass Microspheres for Hepatocellular Carcinoma: Current and Updated Literature Review.

Hepatocellular carcinoma is the most common primary liver cancer and it represents the majority of cancer-related deaths in the world. More than 70% of patients present at an advanced stage, beyond potentially curative options. Ytrrium-90 selective internal radiation therapy (Y90-SIRT) with glass microspheres is rapidly gaining acceptance as a potential therapy for intermediate and advanced stage primary hepatocellular carcinoma and liver metastases. The technique involves delivery of Y90 infused glass microspheres via the hepatic arterial blood flow to the appropriate tumor. The liver tumor receives a highly concentrated radiation dose while sparing the healthy liver parenchyma due to its preferential blood supply from portal venous blood. There are two commercially available devices: TheraSphere® and SIR-Spheres®. Although, Y90-SIRT with glass microspheres improves median survival in patients with intermediate and advanced hepatocellular carcinoma and has the potential to downstage hepatocellular carcinoma so that the selected candidates meet the transplantable criteria, it has not gained widespread acceptance due to the lack of large randomized controlled trials. Currently, there are various clinical trials investigating the use of Y90-SIRT with glass microspheres for treatment of hepatocellular carcinoma and the outcomes of these trials may result in the incorporation of Y90-SIRT with glass microspheres into the treatment guidelines as a standard therapy option for patients with intermediate and advanced stage hepatocellular carcinoma

Hepatic artery stenosis angioplasty and implantation of Wingspan neurovascular stent: A case report and discussion of stenting in tortuous vessels.

BACKGROUND:Hepatic artery stenosis is a complication of orthotopic liver transplant occurring in 3.1%-7.4% of patients that can result in graft failure and need for re-transplantation. Endovascular therapy with angioplasty and stenting has been used with a high degree of technical success and good clinical outcomes, but tortuous hepatic arteries present a unique challenge for intervention. Suitable stents for this application should be maneuverable and conformable while also exerting adequate radial force to maintain a patent lumen. CASE SUMMARY:Herein we report our experience with a neurovascular Wingspan stent system in a challenging case of recurrent hepatic artery stenosis and discuss the literature of stenting in tortuous transplant hepatic arteries. CONCLUSION:Wingspan neurovascular stent is self-expanding, has good conformability, and adequate radial resistance and as such it could be added to the armamentarium of interventionalists in the setting of a tortuous and stenotic transplant hepatic artery