I tumori stromali gastrointestinali: realtà clinica in continua evoluzione. Caso clinico

case report di gist metastatico lungosopravvivent

Desenvolvimento motor de crianças prematuras e a termo: uso da Alberta Infant Motor Scale Desarrollo motor de niños prematuros y a término: uso de la Alberta Infant Motor Scale Motor development of preterm and term infants: using the Alberta Infant Motor Scale

OBJETIVOS: Comparar o desenvolvimento motor de crianças nascidas pré-termo e a termo aos quatro e seis meses de idade, aplicando a Alberta Infant Motor Scale-AIMS na versão brasileira. MÉTODOS: Estudo longitudinal, comparativo, realizado em Fortaleza-Ceará, entre novembro/ 2009 e maio/2010. amostragem por conveniência, foi constituída por 24 crianças pré-termo e 24 a termo. RESULTADOS: Nas crianças de quatro meses, verificou-se diferença estatisticamente significante na posição em pé (p=0,014) e, nas de seis meses, em todas as posições (prono, supina, sentada, em pé) e escores totais. Quanto ao percentil, aos quatro e seis meses, respectivamente, 37,5% das crianças pré-termo mostraram desempenho excelente e 54,2%, normais. CONCLUSÃO: A análise estatística do desempenho motor grosso entre os grupos de crianças estudadas mostrou diferenças no desenvolvimento e evolução dos percentis da AIMS.<br>OBJETIVOS: Comparar el desarrollo motor de niños nacidos pretérmino y a término a los cuatro y seis meses de edad, aplicando la Alberta Infant Motor Scale-AIMS en la versión brasileña. MÉTODOS: Estudio longitudinal, comparativo, realizado en Fortaleza-Ceará, entre noviembre/2009 y mayo/2010. La muestra por conveniencia, estuvo constituída por 24 niños pretérmino y 24 a término. RESULTADOS: En los niños de cuatro meses, se verificó una diferencia estadísticamente significativa en la posición podálica (p=0,014) y, en las de seis meses, en todas las posiciones (prona, supina, sentada, podálica) y scores totales. En cuanto al percentil, a los cuatro y seis meses, respectivamente, el 37,5% de los niños pretérmino mostraron desempeño excelente y el 54,2%, normales. CONCLUSIÓN: El análisis estadístico del desempeño motor grueso entre los grupos de niños estudiados mostró diferencias en el desarrollo y evolución de los percentiles de la AIMS.<br>OBJECTIVES: To compare the motor development of infants born preterm and term at four and six months of age, applying the Alberta Infant Motor Scale AIMS-Brazilian version. METHODS: Longitudinal, comparative study, conducted in Fortaleza, Ceara, between November/2009 and May/2010. A convenience sample was used, consisting of 24 preterm and 24 term infants. RESULTS: In children aged four months, there was a statistically significant difference in the standing position (p = 0.014) and in six months in all positions (prone, supine, sitting, standing) and total scores. In terms of the percentile, at four and six months respectively, 37.5% of preterm infants showed excellent performance and 54.2%, normal performance. CONCLUSION: Statistical analysis of gross motor performance between groups of children studied showed differences in the development and evolution of the percentiles of AIMS

Baseline Neutrophil–Lymphocyte and Platelet–Lymphocyte Ratios as Biomarkers of Survival in Cutaneous Melanoma: A Multicenter Cohort Study

Background: In the peripheral blood, the neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) change in response to malignancy. These biomarkers are associated with adverse outcomes in numerous cancers, but the evidence is limited in relation to melanoma. This study sought to investigate the association between these biomarkers and survival in Stages I–III cutaneous melanoma. Methods: This multicenter cohort study investigated a consecutive series of patients who underwent wide excision of biopsy-proven cutaneous melanoma and sentinel lymph node biopsy during a 10-year period. The baseline NLR and PLR were calculated immediately before sentinel lymph node biopsy. Adjusted hazard ratios (HRs) for overall and melanoma-specific survival were generated. Results: Overall, 1351 patients were included in the study. During surveillance, 184 of these patients died (14%), with 141 of the deaths (77%) attributable to melanoma. Worse overall survival was associated with a baseline NLR lower than 2.5 [HR 2.2; 95% confidence interval (CI) 2.0 to 2.3; p < 0.001] and a baseline PLR lower than 100 (HR 1.8; 95% CI 1.7 to 1.8; p < 0.001). Melanoma-specific survival also was worse, with a baseline NLR lower than 2.5 (HR 1.9; 95% CI 1.6 to 2.2; p < 0.001) and a baseline PLR lower than 100 (HR 1.9; 95% CI 1.7 to 2.2; p < 0.001). The 5-year survival for patients with sentinel lymph node metastases and a low NLR and PLR was approximately 50%. Conclusion: This study provides important new data on biomarkers in early-stage melanoma, which contrast with biomarker profiles in advanced disease. These biomarkers may represent the host inflammatory response to melanoma and therefore could help select patients for adjuvant therapy and enhanced surveillance