1.The Rare and Challenging Presentation of Gastric Cancer during Pregnancy: A Report of Three Cases.
Sergio PACHECO ; Enrique NORERO ; Claudio CANALES ; José Miguel MARTÍNEZ ; María Elisa HERRERA ; Carolina MUÑOZ ; Nicolás JARUFE
Journal of Gastric Cancer 2016;16(4):271-276
Pregnancy-associated gastric cancer is extremely rare. In many cases, it is diagnosed at an advanced stage because the symptoms during pregnancy are generally overlooked. We report three cases of gastric cancer during pregnancy with various outcomes. The first case included a patient with stage IV gastric cancer who received palliative chemotherapy. This patient had a preterm birth and died 7 months after diagnosis. The second case received neoadjuvant chemotherapy during pregnancy and a total gastrectomy was performed after delivery. She then received adjuvant chemoradiotherapy. This patient developed pulmonary metastasis and died of recurrence 41 months after surgery. In the third case, a distal subtotal gastrectomy was performed at week 14 of pregnancy, with no complications. The patient received adjuvant chemoradiotherapy. She is currently without recurrence 14 months after surgery. In patients with pregnancy-associated gastric cancer, treatment decisions are predominantly influenced by clinical stage and gestational age at diagnosis.
Carcinoma, Signet Ring Cell
;
Chemoradiotherapy, Adjuvant
;
Diagnosis
;
Drug Therapy
;
Gastrectomy
;
Gestational Age
;
Humans
;
Neoplasm Metastasis
;
Pregnancy*
;
Premature Birth
;
Recurrence
;
Stomach Neoplasms*
2.Association between Heart Failure and Clinical Prognosis in Patients with Acute Ischemic Stroke: A Retrospective Cohort Study
Jose Luis Lozano VILLANUEVA ; Javier Francisco TORRES ZAFRA ; Fabián Cortés MUÑOZ ; Fernán del Cristo MENDOZA BELTRÁN ; Jenny Carolina Sánchez CASAS ; Luis Alfonso Barragán PEDRAZA
Journal of Clinical Neurology 2021;17(2):200-205
Background:
and Purpose Ischemic stroke is a common cause of death worldwide. In clinical practice it is observed that many individuals who have experienced an ischemic stroke also suffer from simultaneous comorbidities such as heart failure, which could be directly associated with a worse clinical prognosis. Therefore, this study analyzed outcomes in terms of the severity of the event, inhospital mortality, duration of hospital stay, and inhospital recurrence of the episode, in order to determine the implications resulting from the presentation of both pathologies.
Methods:
This was a retrospective-cohort, hospital-based study.
Results:
The study included 110 subjects with heart failure (exposed) and 109 subjects without heart failure (nonexposed). The incidence of inhospital mortality was 27.27% in exposed patients and 9.17% in nonexposed patients (p<0.001), and the presence of heart failure increased the risk of death by 92% (p=0.027). According to scores on the National Institutes of Health Stroke Scale, the median severity was worse in exposed than nonexposed patients (16.1 vs. 9.2, p=0.001). The median hospital stay was 9 days in subjects with heart failure and 7 days in nonexposed patients (p=0.011). The rate of inhospital stroke did not differ significantly between exposed and nonexposed patients (1.82% vs. 0.92%, p=0.566).
Conclusions
Individuals with heart failure who suffer from an acute ischemic stroke show worse clinical outcomes in terms of mortality, event severity, and duration of hospital stay.
3.Association between Heart Failure and Clinical Prognosis in Patients with Acute Ischemic Stroke: A Retrospective Cohort Study
Jose Luis Lozano VILLANUEVA ; Javier Francisco TORRES ZAFRA ; Fabián Cortés MUÑOZ ; Fernán del Cristo MENDOZA BELTRÁN ; Jenny Carolina Sánchez CASAS ; Luis Alfonso Barragán PEDRAZA
Journal of Clinical Neurology 2021;17(2):200-205
Background:
and Purpose Ischemic stroke is a common cause of death worldwide. In clinical practice it is observed that many individuals who have experienced an ischemic stroke also suffer from simultaneous comorbidities such as heart failure, which could be directly associated with a worse clinical prognosis. Therefore, this study analyzed outcomes in terms of the severity of the event, inhospital mortality, duration of hospital stay, and inhospital recurrence of the episode, in order to determine the implications resulting from the presentation of both pathologies.
Methods:
This was a retrospective-cohort, hospital-based study.
Results:
The study included 110 subjects with heart failure (exposed) and 109 subjects without heart failure (nonexposed). The incidence of inhospital mortality was 27.27% in exposed patients and 9.17% in nonexposed patients (p<0.001), and the presence of heart failure increased the risk of death by 92% (p=0.027). According to scores on the National Institutes of Health Stroke Scale, the median severity was worse in exposed than nonexposed patients (16.1 vs. 9.2, p=0.001). The median hospital stay was 9 days in subjects with heart failure and 7 days in nonexposed patients (p=0.011). The rate of inhospital stroke did not differ significantly between exposed and nonexposed patients (1.82% vs. 0.92%, p=0.566).
Conclusions
Individuals with heart failure who suffer from an acute ischemic stroke show worse clinical outcomes in terms of mortality, event severity, and duration of hospital stay.