Retinoblastoma seeds: impact on American Joint Committee on Cancer clinical staging

Aim To investigate whether the American Joint Committee on Cancer (AJCC) clinical category cT2b needs to be subclassified by the type and distribution of retinoblastoma (RB) seeding. Methods Multicentre, international registry-based data were collected from RB centres enrolled between January 2001 and December 2013. 1054 RB eyes with vitreous or subretinal seeds from 18 ophthalmic oncology centres, in 13 countries within six continents were analysed. Local treatment failure was defined as the use of secondary enucleation or external beam radiation therapy (EBRT) and was estimated with the Kaplan-Meier method. Results Clinical category cT2b included 1054 eyes. Median age at presentation was 16.0 months. Of these, 428 (40.6%) eyes were salvaged, and 430 (40.8%) were treated with primary and 196 (18.6%) with secondary enucleation. Of the 592 eyes that had complete data for globe salvage analysis, the distribution of seeds was focal in 143 (24.2%) and diffuse in 449 (75.8%). The 5-year Kaplan-Meier cumulative globe-salvage (without EBRT) was 78% and 49% for eyes with focal and diffuse RB seeding, respectively. Cox proportional hazards regression analysis confirmed a higher local treatment failure risk with diffuse seeds as compared with focal seeds (hazard rate: 2.8; p<0.001). There was insufficient evidence to prove or disprove an association between vitreous seed type and local treatment failure risk(p=0.06). Conclusion This international, multicentre, registry-based analysis of RB eyes affirmed that eyes with diffuse intraocular distribution of RB seeds at diagnosis had a higher risk of local treatment failure when compared with focal seeds. Subclassification of AJCC RB category cT2b into focal vs diffuse seeds will improve prognostication for eye salvage.Ophthalmic researc

Virgilio, Georgiche, ed. Della Corte

Si tratta dello stesso brano delle Georgiche che Vi ho già fornito, ma questa volta in un'edizione che Vi può essere più semplice da usare per prepararVi all'esame, dato che contiene un commento più esauriente, ed una traduzione più scolastica. Scusate le sottolineature gialle, e le note, l'ho prima controllata. Buon lavoro

НЕАЛКОГОЛЬНАЯ ЖИРОВАЯ БОЛЕЗНЬ ПЕЧЕНИ У ДЕТЕЙ

Metabolic syndrome that represents a totality of interrelated carbohydrate metabolism and lipid disorders, as well as a mechanism regulating arterial tension and endothelium function is one of the critical issues in pediatrics. In recent years, children with metabolic syndrome are increasingly diagnosed with liver injuries symptoms that are associated with a fatty transformation of the liver [1–3]. In this case, non-alcoholic fatty liver disease (NAFLD), a liver manifestation of metabolic syndrome is diagnosed. The diagnosis is confirmed in the absence of alcohol abuse in the past medical history, virus and autoimmune liver disease markers, elimination of toxic and drug influence, as wells as disorders of copper and iron exchange in the patient’s system. One of the key risk factors for developing NAFLD in children is overeating and reduced physical activities. It was believed in the past that NAFLD is relatively benign, however, there is evidence in current literature that this is a pathological condition that may develop and result in extreme fibrotic alterations in the liver parenchymatous tissue all the way to cirrhosis and hepatocellular carcinoma [4]. Early-stage identification and timely launch of therapy for NAFLD in children represents one of the most important objectives in modern healthcare. Key words: metabolic syndrome, non-alcoholic fatty liver disease, children, steatohepatosis. (Pediatric Pharmacology. – 2010; 7(6):68-72)Метаболический синдром, представляющий собой комплекс взаимосвязанных нарушений углеводного и липидного обмена, а также механизмов регуляции артериального давления и функции эндотелия, является одной из актуальных проблем педиатрии. В последние годы в рамках метаболического синдрома у детей все чаще диагностируются признаки поражения печени, которые связаны с ее жировой трансформацией. В этом случае принято говорить о неалкогольной жировой болезни печени (НАЖБП) — печеночном проявлении метаболического синдрома. Диагноз подтверждается при отсутствии злоупотребления алкоголем в анамнезе, маркеров вирусных и аутоиммунных болезней печени, исключении токсических и лекарственных воздействий, а также нарушений обмена меди и железа в организме. Одними из основных факторов риска развития НАЖБП у детей являются переедание и снижение физической активности. Ранее считалось, что течение НАЖБП относительно доброкачественное, однако в современной литературе появились данные о том, что это патологическое состояние может прогрессировать и приводить к развитию выраженных фибротических изменений в печеночной паренхиме вплоть до цирроза и гепатоцеллюлярной карциномы. Раннее выявление и своевременное начало терапии НАЖБП у детей представляет собой одну из наиболее важных задач современного здравоохранения. Ключевые слова: метаболический синдром, неалкогольная жировая болезнь печени, дети, стеатогепатоз.(Педиатрическая фармакология. – 2010; 7(6):68-72