1.Unilateral Cervical Facet Fractures: Relevance of Acute Disc Injury in Conservative Treatment Failure
Juan Ignacio Cirillo TOTERA ; Gabriel Hernández VARGAS ; Ignacio Farías MARTINI ; Marcos Gimbernat ROMERO ; Alejandro Urzúa BACCIARINI ; José Vicente Ballesteros PLAZA
Asian Spine Journal 2023;17(1):30-36
Methods:
Patients were categorized into two groups: six patients (16.2%) with conservative treatment failure (defined as the appearance of neurological symptoms, listhesis >3.5 mm, kyphotic deformation >11°, and/or non-union), and 31 patients (83.7%) with successful conservative management (defined as complete consolidation confirmed by computed tomography [CT] at the 6-month followup). All participants were fitted with rigid collars of the Miami type, and standardized follow-up was performed until consolidation or failure. CT and magnetic resonance imaging (MRI) was used to examine imaging characteristics. Sagittal balance parameters were assessed using CT, and signs of acute disc injury, prevertebral edema, facet synovitis, and interspinous hyperintense signal were assessed using MRI.
Results:
Thirty-seven patients were diagnosed with unilateral cervical facet fractures between 2009 and 2020. In this sample, acute disc injury had a significative association to failure of conservative treatment in F2 and F3 AOSpine facet fractures, 100% of the failure group presented with traumatic disc injury compared to 9.7% of the successful group, for the other variables: prevertebral edema, 83.7% vs. 41.9%; facet synovitis, 100% vs. 77.4%; and interspinous hyperintensity, 71.4% vs. 38.7%, respectively. With conservative management, all F1 fractures healed successfully. Conservative treatment failed in 20% of F2 fractures and 50% of F3 fractures, respectively. In terms of cervical sagittal balance parameters, there were no significant differences between groups.
Conclusions
Conservative management was successful in all F1 fractures. In F2 and F3 types, there was a significant association between acute disc injury and conservative treatment failure.
2.Trabectedin therapy as an emerging treatment strategy for recurrent platinum-sensitive ovarian cancer.
José Antonio LÓPEZ-GUERRERO ; Ignacio ROMERO ; Andrés POVEDA
Chinese Journal of Cancer 2015;34(1):41-49
Epithelial ovarian cancer (OC) is a common gynecologic malignancy in women. The standard treatment for OC is maximal cytoreductive surgical debulking followed by platinum-based chemotherapy. Despite the high response rate to primary therapy, approximately 85% of patients will develop recurrent ovarian cancer (ROC). This review identifies the clinical use of trabectedin in the treatment algorithm for ROC, with specific emphasis on platinum-sensitive ROC, for which trabectedin in combination with pegylated liposomal doxorubicin has been approved as a treatment protocol. The main mechanisms of action of trabectedin at the cellular level and in the tumor microenvironment is also discussed as bases for identifying biomarkers for selecting patients who may largely benefit from trabectedin-based therapies.
Antineoplastic Agents, Alkylating
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therapeutic use
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Clinical Trials as Topic
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DNA Damage
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Dioxoles
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administration & dosage
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pharmacology
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therapeutic use
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Doxorubicin
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administration & dosage
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analogs & derivatives
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Female
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Humans
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Neoplasm Recurrence, Local
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drug therapy
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Neoplasms, Glandular and Epithelial
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drug therapy
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Ovarian Neoplasms
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drug therapy
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Polyethylene Glycols
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administration & dosage
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Tetrahydroisoquinolines
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administration & dosage
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pharmacology
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therapeutic use
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Tumor Microenvironment