A method to correct nasal valve dysfunction

El colapso valvular es una causa común de obstrucción respiratoria. Presentamos el caso clínico de una mujer de 62 años con obstrucción nasal derecha. En la exploración física se observó la existencia de una estenosis de vávula nasal de predominio derecho. Se realizó la corrección quirúrgica de la misma mediante la suspensión valvular con hilos de sutura, utilizando una variación de la técnica de Paniello, obteniendo resultados satisfactorios desde la finalización de la cirugía. Proponiéndose esta técnica como una alternativa inicial a los diferentes métodos de corrección quirúrgica existentes hasta el momentoThe nasal alar collapse is a common cause of respiratory obstruction. We report the case of 62 years woman with right nasal obstruction. Physical examination reveals the existence of nasal valve stenosis with right predominance. Surgical correction is performed by the valve suspension with surgical thread, using a variation of the Paniello´s technique, obtaining satisfactory results from the completion of surgery. This technique is proposed as an alternative to the different surgical techniques existing to dat

A phase II randomized, multicenter, open-label trial of continuing adjuvant temozolomide beyond 6 cycles in patients with glioblastoma (GEINO 14-01).

Standard treatment for glioblastoma is radiation with concomitant and adjuvant temozolomide for 6 cycles, although the optimal number of cycles of adjuvant temozolomide has long been a subject of debate. We performed a phase II randomized trial investigating whether extending adjuvant temozolomide for more than 6 cycles improved outcome. Glioblastoma patients treated at 20 Spanish hospitals who had not progressed after 6 cycles of adjuvant temozolomide were centrally randomized to stop (control arm) or continue (experimental arm) temozolomide up to a total of 12 cycles at the same doses they were receiving in cycle 6. Patients were stratified by MGMT methylation and measurable disease. The primary endpoint was differences in 6-month progression-free survival (PFS). Secondary endpoints were PFS, overall survival (OS), and safety (Clinicaltrials.gov NCT02209948). From August 2014 to November 2018, 166 patients were screened, 7 of whom were ineligible. Seventy-nine patients were included in the stop arm and 80 in the experimental arm. All patients were included in the analyses of outcomes and of safety. There were no differences in 6-month PFS (control 55.7%; experimental 61.3%), PFS, or OS between arms. MGMT methylation and absence of measurable disease were independent factors of better outcome. Patients in the experimental arm had more lymphopenia (P  Continuing temozolomide after 6 adjuvant cycles is associated with greater toxicity but confers no additional benefit in 6-month PFS. 1. Extending adjuvant temozolomide to 12 cycles did not improve 6-month PFS.2. Extending adjuvant temozolomide did not improve PFS or OS in any patient subset.3. Extending adjuvant temozolomide was linked to increased toxicities