[en] It has been stated that the effectiveness of chemotherapy for the treatment of primary central nervous system lymphoma (PCNSL) has not been proved; however, the intravenous or intrathecal treatment with methotrexate dse has been used and satisfactory results have been obtained. The case of a patient with diagnosis of PCNSL and an intraparenchymatous infiltration on the left temporoparietal region at the onset of the disease, and later on the homo lateral pontocerebellar angle, is reported. Systemic and intrathecal onco specific polychemotherapy and holocranial radiotherapy were applied. All the reported lesions disappeared, and a satisfactory evolution was observed, although this patient had severe late alterations of his higher psychical functions with progressive cognoscitive and behavioral disorders. Lesions such as cortical atrophy, leukoatrophy, dilated ventricular system, and hyper intensive areas in the white matter of the brain without tumoral recurrence were evidenced in the imaging study. The positive impact of chemotherapy on the treatment of primary brain lymphoma was verified, as well as the neurotoxicity in the central nervous system caused by the onco specific treatment (radiotherapy and chemotherapy). It was considered that radiotherapy and combined therapy should be only used in relapses. It was recommended to conduct a comparative clinical study with periodical neuropsychological assessments to determine the possible neurotoxic effect caused by radiotherapy and chemotherapy. From the clinical and imaging point of view, the patient presented a neurotoxic atrophic leucoencephalopathy

[en] The results of technetium ⁹⁹m - methoxy-isobutyl-isonitrile scintigraphy in a one-day protocol: rest - physical or combined stress bicycle plus endovenoous dipyridamole were compared with those of coronary angiography in 20 women referred for the evaluation of pre cordial pain and of the usefulness of myocardial perfusion scintigraphy. The uptake of the radio drug under stress and at rest varied from 93 ⁺_-9 to 94 ⁺_- 7 % in the 204 segments with normal uptake under stress, from 67 He articulates it analyzes the reasons or utility of the employment of the radioactive iodine in the diagnosis and treatment of the thyroid affections ⁺_- 9 to 75 ⁺_- 17 % in the 89 with moderate reduction, and from 33 ⁺_- 9 to 64 ⁺_-28 % in the 27 with severe reduction. The qualitative and quantitative uptake analyses coincided in 18 patients. The perfusion scintigraphy and the angiography agreed in 70 % of the patients. It was concluded that the myocardial perfusion scintigraphy with technetium ⁹⁹-MIBI contributes to the diagnosis of the coronary artery disease in women

[en] As part of the stage I clinical trial with the murine monoclonal antibody IOR-T1 at repeated doses (200-800 mg) in patients carriers of cutaneous T-cell lymphoma, the pharmacokinetics and the response against the mouse protein (HAMA) were studied in the 10 patients under treatment. It was observed a great individual variation in the maximum concentration in serum, which was estimated at 2 hours. The mean life time of the monoclonal antibody was between 13.93 and 19.6 hours. Most of the patients developed antibodies against the monoclonal antibody IOR-T1. The presence of this second antibody did not alter significantly the pharmacokinetics of the administered monoclonal antibody

[en] The partial results of the administration of endovenous dipyridamole are compared with physical effort in 7 patients with complete left bundle branch block (CLBB) during myocardial scintigraphy with Tetrofosmin-TC99m. Exercise was undertaken according to the habitual protocol of our laboratory. The following segments were analyzed: septum, apex, inferoapical, posterolateral, anterolateral, anterior, inferior, postero-inferior and postero-basal. The highest heart rate (HR) on exertion was 90 n8 % and the maximum load was 61n 24 W. Heart rate, systolic and diastolic blood pressure under basal conditions had no significant changes, but when the stresses were compared they did (p<0.05). The global concordance for the reversibility or not of the uptake defect of the radiopharmaceutical was 96 %, k=0.83, whereas for identifying the type of defect it was 92 %, k=0.84. The worst concordance was for the septum 85 %, k=0.80; however, it was not significant in relation to other analyzed segments. Congruency was 71 % in the diagnostic result. Due probably to the unsuitability of the sample of studied patients, our results show a good concordance between the use of dipyridamole and physical effort with stress methods when only the images obtained are evaluated

[en] A research was made by applying boost on the area of the nasopharynx relapse with high dose rate (HDR) in a diagnosis of nasopharynx carcinoma previously treated with telecobalt therapy, at a dose of 70 Gy. There was persistence of the injury. Three sessions were planned, with consecutive fractions of 6.5 Gy in 15 days, with optimization, using a personal mould of autopolymerizable acrylic. The successful possibility to apply the high rate modern brachytherapy was reaffirmed, as a treatment complementary to teletherapy in case of persistence or relapse. A Micro Selectron HDR equipment was used

[en] A review was made to go deep into the understanding of vascular dementias that behave as the second cause of dementia in practice. Binswanger's disease is one of the most important among them. Its detection has progressively increased with the continual improvement of the radiological diagnostic tools that allow to identify the ischemic damage of the hemispherical cerebral white matter and the presence of lacunar infarctions. It is a disease of chronic course and inexorably progressive that is characterized by the association of subcortical cognitive dysfunction, evidence of cerebrovascular disease, Parkinsonian rigidity and vesicle dysfunction with a characteristic imaging picture. The clinical picture and the main imaging characteristics are explained in this paper and the pathogens of the disease is briefly described

[en] In order to evaluate the capacity of myocardial perfusion scintigraphy with Tc99m-MIBI to predict the evolution of women referred for evaluation of precordial pain, the rates of cardiovascular events at one year were studied in a group of patients with normal scintigraphy (group 1: 17 patients) and in another with reversible perfusion defects (group 2: 17 patients). The one-day protocol was applied for scintigraphy with Tc99m-MIBI (rest/stress) with combined stress (ergometrin bicycle plus 0.28 mg/Ig of dipyridamole) in those cases where it was necessary. A quantitative and qualitative analysis of the regional uptake was made. Patients from group 1 were younger than those from group 2 (average age: 49 vs 55, respectively, p = 0.04) and they had less hypercholesterolemia (112 % vs 59 %, respectively, p = 0.01). The rates of appearance of cardiovascular events at one year were calculated for patients from group 2 by using the Kaplan-Meier's method. The rates of appearance of clinical events (myocardial infarction and unstable angina) and of revascularization procedures (percutaneous transluminal coronary angioplasty and aortocoronary bypass surgery) were 0.24 in both cases. Only a patient from group 1 presented varying angina at 5 months. No deaths were reported in any of the groups. 94 % of the patients with normal perfusion scintigraphy were free of events after a one-year follow-up, whereas only 53 % of those with reversible perfusion defects showed a similar behavior. It was concluded that myocardial perfusion scintigraphy with Tc99m-MIBI is a useful tool to predict the evolution of women referred for evaluation of precordial pain at one year

[en] Radiotherapy is one of the basic therapeutical tools in the management of malignant tumors: 50-60% is susceptible to radiation in the course of their evolution, either for curative or palliative purposes. The objectives of radiotherapy are to apply the most homogenous adequate dose to the tumor volume, to preserve the healthy tissues and to have minimum exposure of the health care staff. To assure these objectives, it is necessary to apply a quality control or assurance that covers closely related medical and physical aspects. Among the medical aspects there are: a) those comprising the therapeutical programs or policies which define the proposed techniques, the external radiation, brachytherapy, dose, areas or volumes to be irradiated, taking into account tumor staging, locations, etc. and specify certain actions according to the steps to be followed (multidisciplinary evaluation, therapeutical decision, treatment planning, implementation and verification of therapy), actions that cover not only medical steps but also physical aspects such as dosimetry, immobilization devices, blockage, etc; b)those comprising technical and physical elements such as check-ins in simulation equipment, radiation equipment, and the daily correct application of the prescribed and planned treatment, and c)systematic reviews of treatment programs, follow-up of cases and obtained results. It may be inferred from the above-mentioned that it is required to have and apply a quality control program for radiotherapy that assures an optimum quality treatment

[en] In the course of the specific oncologic treatment, there are frequent complications such as nausea and vomiting. The radiation-induced emetic reflex depends on various factors: primary site of radiation, administered dose, fractioning, irradiated volume, the sensory and psychic characteristics of the patient as well as the chemotherapy association. It is known that the afferent path to the so-called center of vomiting is determined by chemical mediators, protuberance receptors of the intracranial pressure and the unleashing chemoreceptor zone. In radiation-induced emesis, the exact mechanism is yet to be determined but it is known that radiation stimulates the production of chemical mediators and serotonin released by enterochromaffin cells that act upon the center of vomiting and vagal nucleus. Most of patients who are exposed to irradiation of their upper and middle hemibody as well as all the patients exposed to whole-body irradiation present with nausea and vomiting. The therapeutical anti-emetic recommendations are based on the neurochemical control of vomiting and the emetogenic effect of radiotherapy. 5HT3 receptor-antagonists are evaluated as effective agents in the control of radiation-induced emesis

[en] A prospective work was made to highlight the value of the ultrasonido in the diagnosis of the affections of the digestive tract. In total 282 patients were explored constituted in 2 groups integrated by 82 and 200 sick persons, respectively. In the first group they were included patient to those that were detected a lesion of the digestive tract during an exploration ultrasonografica in a casual way. In the second group there are 100 patients that have previous diagnosis of lesion of the digestive tract and that they were studied later on with ultrasonido and 100 healthy to those that equally were carried out a study ultrasonografico. The results were: sensibility of 100%, specificity of 97%, value positive predictivos of 98,7%