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[PMID]:27773666
[Au] Autor:Korevaar DA; Crombag LM; Cohen JF; Spijker R; Bossuyt PM; Annema JT
[Ad] Endereço:Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands. Electronic address: d.a.korevaar@amc.uva.nl.
[Ti] Título:Added value of combined endobronchial and oesophageal endosonography for mediastinal nodal staging in lung cancer: a systematic review and meta-analysis.
[So] Source:Lancet Respir Med;4(12):960-968, 2016 12.
[Is] ISSN:2213-2619
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Guidelines recommend endosonography with fine-needle aspiration for mediastinal nodal staging in non-small-cell lung cancer, but most do not specify whether this should be through endobronchial endoscopy (EBUS), oesophageal endoscopy (EUS), or both. We assessed the added value and diagnostic accuracy of the combined use of EBUS and EUS. METHODS: For this systematic review and random effects meta-analysis, we searched MEDLINE, Embase, BIOSIS Previews, and Web of Science, without language restrictions, for studies published between Jan 1, 2000, and Feb 25, 2016. We included studies that assessed the accuracy of the combined use of EBUS and EUS in detecting mediastinal nodal metastases (N2/N3 disease) in patients with lung cancer. For each included study, we extracted data on the age and sex of participants, inclusion criteria regarding tumour stage on imaging, details of the endoscopic testing protocol, duration of each endoscopic procedure, number of lymph nodes sampled, serious adverse events occurring during the endoscopic procedures, the reference standard, and 2 × 2 tables for EBUS, EUS, and the combined approach. We evaluated the added value (absolute increase in sensitivity and in detection rate) of the combined use of EBUS and EUS in detecting mediastinal nodal metastases over either test alone, and the diagnostic accuracy (sensitivity and negative predictive value) of the combined approach. This study is registered with PROSPERO, number CRD42015019249. FINDINGS: We identified 2567 unique manuscripts by database search, of which 13 studies (including 2395 patients) were included in the analysis. Median prevalence of N2/N3 disease was 34% (range 23-71). On average, addition of EUS to EBUS increased sensitivity by 0·12 (95% CI 0·08-0·18) and addition of EBUS to EUS increased sensitivity by 0·22 (0·16-0·29). Mean sensitivity of the combined approach was 0·86 (0·81-0·90), and the mean negative predictive value was 0·92 (0·89-0·93). The mean negative predictive value was significantly higher in studies with a prevalence of 34% or less (0·93 [95% CI 0·91-0·95]) compared with studies with a prevalence of more than 34% (0·89 [0·85-0·91]; p=0·013). We found no significant differences in mean sensitivity and negative predictive value between studies that did EBUS first or EUS first, or between studies that used an EBUS-scope or a regular echoendoscope to do EUS. INTERPRETATION: The combined use of EBUS and EUS significantly improves sensitivity in detecting mediastinal nodal metastases, reducing the need for surgical staging procedures. FUNDING: No external funding.
[Mh] Termos MeSH primário: Broncoscopia/métodos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem
Endossonografia/métodos
Neoplasias Pulmonares/diagnóstico por imagem
Linfonodos/diagnóstico por imagem
Mediastino/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Carcinoma Pulmonar de Células não Pequenas/patologia
Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos
Esôfago/diagnóstico por imagem
Feminino
Seres Humanos
Neoplasias Pulmonares/patologia
Linfonodos/patologia
Masculino
Mediastino/patologia
Meia-Idade
Estadiamento de Neoplasias
Valor Preditivo dos Testes
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:27770251
[Au] Autor:Tertemiz KC; Alpaydin AO; Karacam V
[Ad] Endereço:Department of Pulmonary Diseases, Dokuz Eylul University Medical Faculty, 35340, Balcova, Izmir, Turkey. tkemalcan@yahoo.com.
[Ti] Título:The role of endobronchial ultrasonography for mediastinal lymphadenopathy in cases with extrathoracic malignancy.
[So] Source:Surg Endosc;31(7):2829-2836, 2017 Jul.
[Is] ISSN:1432-2218
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Many extrathoracic malignancies can metastasize to lungs and mediastinal lymph nodes. Whether mediastinal lesions are metastasis in these patients changes staging, prognosis, and treatment strategy. In this study, we aimed to find out the contribution of EBUS-TBNA to the diagnosis in cases with extrathoracic malignancy. MATERIALS AND METHODS: Patients who had been previously diagnosed as extrapulmonary solid organ malignancy and in whom mediastinal or hilar lymphadenopathy developed during their follow-up and EBUS-TBNA was applied for diagnostic purposes were retrospectively included in this study. RESULTS: A total of 91 patients consisting of 35 females (38.5 %) and 56 males (61.5 %) were included in the study. The mean age of the patients was 60.5 (±11.4). Malignancy was not observed in 54 (59.3 %) patients; primary malignancy metastasis was detected in 33 (36.3 %) patients, and primary lung cancer was detected in 4 (4.4 %) patients with EBUS-TBNA. The sensitivity of EBUS-TBNA in extrathoracic malignancies was determined as 90.2 %; its specificity was determined as 100 %, its negative predictive value as 92.5 %, its positive predictive value as 100 %, and its diagnostic accuracy as 95.6 %. The highest rate was determined in the left lower paratracheal lymph node when they were examined in terms of malignancy detection rate in lymph node stations. CONCLUSION: EBUS-TBNA is a minimally invasive method with quite a low complication rate that does not require general anesthesia. It should be the first step method to be used in the diagnosis of mediastinal and hilar lymphadenopathies seen in extrathoracic malignancies since it has high diagnostic accuracy, sensitivity, and specificity. EBUS-TBNA significantly reduces the need for surgical intervention. Further surgical interventions can be planned in patients in whom diagnostic competence is not ensured.
[Mh] Termos MeSH primário: Broncoscopia/métodos
Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos
Neoplasias Pulmonares/diagnóstico por imagem
Neoplasias Pulmonares/secundário
Linfonodos/diagnóstico por imagem
Linfadenopatia/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Diagnóstico Diferencial
Feminino
Seguimentos
Seres Humanos
Neoplasias Pulmonares/patologia
Linfonodos/patologia
Linfadenopatia/patologia
Metástase Linfática
Masculino
Mediastino
Meia-Idade
Estudos Retrospectivos
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE
[do] DOI:10.1007/s00464-016-5293-z


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[PMID]:28455406
[Au] Autor:Petersen KB; Kjaergaard T
[Ad] Endereço:Department of ENT, Aarhus University Hospital, Aarhus C, Denmark.
[Ti] Título:Role of narrow band imaging in the diagnostics of sinonasal pathology.
[So] Source:BMJ Case Rep;2017, 2017 Apr 28.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Malignancies of the nasal cavity and paranasal sinuses are well known, but have uncommon presentations. Late diagnosis and local extension are significant prognostic factors associated with a poorer treatment outcome. Thus, refinements of the diagnostic procedures to enhance the sensitivity of the clinical evaluation are desirable. We here describe a case of endonasal lymphoma, in which the lesion was hardly visible and initially ignored at ordinary white light (WLI) nasoendoscopy, but easily recognisable, clearly pathogenic and well demarcated when illuminated with narrow band imaging (NBI) at a later session. In general, with regard to mucosal-derived pathology of the upper aerodigestive tract, the diagnostic gain of NBI-assisted endoscopy in comparison with that of WLI has been proved in several articles. The focus has however been on neoplasm in laryngopharynx and oesophagus. The authors recommend broadening the use of NBI to include all evaluations of nasal mucosa, when malignancy is suspected.
[Mh] Termos MeSH primário: Linfonodos/diagnóstico por imagem
Linfoma não Hodgkin/patologia
Membrana Mucosa/patologia
Imagem de Banda Estreita/métodos
Cavidade Nasal/diagnóstico por imagem
Invasividade Neoplásica/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Diagnóstico Diferencial
Endoscopia/métodos
Fluordesoxiglucose F18/metabolismo
Seres Humanos
Luz
Linfonodos/patologia
Linfoma não Hodgkin/complicações
Masculino
Mediastino/diagnóstico por imagem
Mediastino/patologia
Cavidade Nasal/patologia
Pescoço/diagnóstico por imagem
Pescoço/patologia
Invasividade Neoplásica/patologia
Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0Z5B2CJX4D (Fluorodeoxyglucose F18)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE


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[PMID]:29382030
[Au] Autor:Pan Y; Kong FW; Wang H; Wang X; Zhang H; Wu WB; Zhang M
[Ad] Endereço:Department of General Surgery, Xuzhou Infectious Disease Hospital, Xuzhou, China.
[Ti] Título:A recurrence-free survivor with chemotherapy-refractory small cell lung cancer after pneumonectomy: A case report and review of the literature.
[So] Source:Medicine (Baltimore);96(47):e8922, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: The optimal therapeutic regimen for chemotherapy-refractory and node-positive small-cell lung cancer (SCLC) is criticizable for the lack of evidence. PATIENT CONCERNS: A patient with locally advanced SCLC was insensitive to the first-line chemotherapy of etoposide, irinotecan, and cisplatin. DIAGNOSES: The patient was diagnosed as SCLC with mediastinal lymph node metastasis by pathological staining. INTERVENTIONS: Salvage pneumonectomy and systematic lymph node dissection combined with oral apatinib and mediastinal radiotherapy were performed for him. OUTCOMES: The patient survived for more than 2 years without recurrence after the operation and adjuvant therapy. LESSONS: For patients with chemotherapy-resistant but resectable SCLC, a timely resection combined with postoperative radiotherapy and apatinib might be effective.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica
Neoplasias Pulmonares/terapia
Excisão de Linfonodo/métodos
Pneumonectomia/métodos
Carcinoma de Pequenas Células do Pulmão/terapia
[Mh] Termos MeSH secundário: Quimioterapia Adjuvante
Seres Humanos
Neoplasias Pulmonares/patologia
Linfonodos/patologia
Linfonodos/cirurgia
Masculino
Mediastino
Meia-Idade
Recidiva Local de Neoplasia
Piridinas/uso terapêutico
Radioterapia Adjuvante
Terapia de Salvação/métodos
Carcinoma de Pequenas Células do Pulmão/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Pyridines); 5S371K6132 (apatinib)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008922


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[PMID]:29173765
[Au] Autor:Kuijvenhoven JC; Crombag L; Breen DP; van den Berk I; Versteegh MIM; Braun J; Winkelman TA; van Boven W; Bonta PI; Rabe KF; Annema JT
[Ad] Endereço:Department of Respiratory Medicine, Academic Medical Center (AMC), Amsterdam, The Netherlands.
[Ti] Título:Esophageal ultrasound (EUS) assessment of T4 status in NSCLC patients.
[So] Source:Lung Cancer;114:50-55, 2017 Dec.
[Is] ISSN:1872-8332
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Mediastinal and central large vessels (T4) invasion by lung cancer is often difficult to assess preoperatively due to the limited accuracy of computed tomography (CT) scan of the chest. Esophageal ultrasound (EUS) can visualize the relationship of para-esophageally located lung tumors to surrounding mediastinal structures. AIM: To assess the value of EUS for detecting mediastinal invasion (T4) of centrally located lung tumors. METHODS: Patients who underwent EUS for the diagnosis and staging of lung cancer and in whom the primary tumor was detected by EUS and who subsequently underwent surgical- pathological staging (2000-2016) were retrospectively selected from two university hospitals in The Netherlands. T status of the lung tumor was reviewed based on EUS, CT and thoracotomy findings. Surgical- pathological staging was the reference standard. RESULTS: In 426 patients, a lung malignancy was detected by EUS of which 74 subjects subsequently underwent surgical- pathological staging. 19 patients (26%) were diagnosed with stage T4 based on vascular (n=8, 42%) or mediastinal (n=8, 42%) invasion or both (n=2, 11%), one patient (5%) had vertebral involvement. Sensitivity, specificity, PPV and NPV for assessing T4 status were: for EUS (n=74); 42%, 95%, 73%, 83%, for chest CT (n=66); 76%, 61%, 41%, 88% and the combination of EUS and chest CT (both positive or negative for T4, (n=34); 83%, 100%, 100% 97%. CONCLUSION: EUS has a high specificity and NPV for the T4 assessment of lung tumors located para-esophageally and offers further value to chest CT scan.
[Mh] Termos MeSH primário: Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem
Esôfago/diagnóstico por imagem
Neoplasias Pulmonares/diagnóstico por imagem
Invasividade Neoplásica/diagnóstico por imagem
Estadiamento de Neoplasias/métodos
Ultrassonografia/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Carcinoma Pulmonar de Células não Pequenas/patologia
Carcinoma Pulmonar de Células não Pequenas/cirurgia
Endossonografia/métodos
Feminino
Seres Humanos
Neoplasias Pulmonares/patologia
Neoplasias Pulmonares/cirurgia
Masculino
Neoplasias do Mediastino/diagnóstico por imagem
Neoplasias do Mediastino/patologia
Neoplasias do Mediastino/secundário
Mediastino/diagnóstico por imagem
Mediastino/patologia
Meia-Idade
Invasividade Neoplásica/patologia
Países Baixos/epidemiologia
Estudos Retrospectivos
Toracotomia/métodos
Toracotomia/estatística & dados numéricos
Tomografia Computadorizada por Raios X/métodos
Neoplasias Vasculares/diagnóstico por imagem
Neoplasias Vasculares/patologia
Neoplasias Vasculares/secundário
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180131
[Lr] Data última revisão:
180131
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


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[PMID]:28470104
[Au] Autor:Belanger AR; Akulian JA
[Ad] Endereço:Division of Pulmonary and Critical Care, Section of Interventional Pulmonology, University of North Carolina at Chapel Hill, NC, USA.
[Ti] Título:An update on the role of advanced diagnostic bronchoscopy in the evaluation and staging of lung cancer.
[So] Source:Ther Adv Respir Dis;11(5):211-221, 2017 05.
[Is] ISSN:1753-4666
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Lung cancer remains a common and deadly disease. Many modalities are available to the bronchoscopist to evaluate and stage lung cancer. We review the role of bronchoscopy in the staging of the mediastinum with convex endobronchial ultrasound (EBUS) and discuss emerging role of esophageal ultrasonography as a complementary modality. In addition, we discuss advances in scope technology and elastography. We review the bronchoscopic methods available for the diagnosis of peripheral lung nodules including radial EBUS and navigational bronchoscopy (NB) with a consideration of the basic methodologies and diagnostic accuracies. We conclude with a discussion of the comparison of the various methodologies.
[Mh] Termos MeSH primário: Broncoscopia/métodos
Endossonografia/métodos
Neoplasias Pulmonares/diagnóstico
[Mh] Termos MeSH secundário: Técnicas de Imagem por Elasticidade/métodos
Seres Humanos
Neoplasias Pulmonares/patologia
Mediastino
Estadiamento de Neoplasias
Nódulo Pulmonar Solitário/diagnóstico
Nódulo Pulmonar Solitário/patologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180110
[Lr] Data última revisão:
180110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1177/1753465817695981


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[PMID]:29174782
[Au] Autor:St-Onge S; Perrault LP; Demers P; Boyle EM; Gillinov AM; Cox J; Melby S
[Ad] Endereço:Department of Cardiac Surgery, Montreal Heart Institute, Université de Montréal, Quebec, Canada.
[Ti] Título:Pericardial Blood as a Trigger for Postoperative Atrial Fibrillation After Cardiac Surgery.
[So] Source:Ann Thorac Surg;105(1):321-328, 2018 Jan.
[Is] ISSN:1552-6259
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Prevention strategies have long been sought to reduce the incidence and burden of postoperative atrial fibrillation (POAF) after heart surgery. However, none has emerged as a dominant and widely applicable prophylactic measure. The purpose of this review is to consider the biological mechanisms by which shed mediastinal blood leads to oxidation and inflammation within the postoperative pericardial environment and how this might trigger POAF in susceptible persons, as well as how it could represent a new target for prevention of POAF. METHODS: We conducted a structured research of literature using PubMed and MEDLINE databases to May 2016. Biomolecular and clinical articles focused on assessing the contribution of pericardial blood, or the resulting inflammation within the pericardial space and its potential role in triggering POAF, were included in this review. RESULTS: Evidence suggests that shed mediastinal blood through breakdown products, activation of coagulation cascade, and oxidative burst contributes to a highly pro-oxidant and proinflammatory milieu found within the pericardial space that can trigger postoperative atrial fibrillation in susceptible persons. The extent of this reaction could be blunted by reducing the exposition of pericardium to blood either through posterior pericardiotomy or improved chest drainage. CONCLUSIONS: Shed mediastinal blood undergoing transformation within the pericardium appears to be an important contributing factor to POAF. Strategies to prevent shed mediastinal blood from pooling around the heart might be considered in developing future paradigms for prevention of POAF.
[Mh] Termos MeSH primário: Fibrilação Atrial/etiologia
Sangue
Procedimentos Cirúrgicos Cardíacos
Pericárdio
Complicações Pós-Operatórias/etiologia
[Mh] Termos MeSH secundário: Fibrilação Atrial/prevenção & controle
Fenômenos Fisiológicos Sanguíneos
Seres Humanos
Mediastino
Complicações Pós-Operatórias/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171228
[Lr] Data última revisão:
171228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


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[PMID]:29069017
[Au] Autor:Shen-Tu Y; Mao F; Pan Y; Wang W; Zhang L; Zhang H; Cheng B; Guo H; Wang Z
[Ad] Endereço:aDepartment of Thoracic Surgery bDepartment of Pharmacology, Shanghai Chest Hospital, Shanghai Jiao Tong University cDepartment of Thoracic Surgery, Tongji Hospital, Tongji University, Shanghai dDepartment of Thoracic Oncology Medicine, Jilin Tumor Hospital, Changchun, Jilin Province eDepartment of Thoracic Oncology Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China fCentre for Clinical Research, Faculty of Medicine, University of Queensland, Australia.
[Ti] Título:Lymph node dissection and survival in patients with early stage nonsmall cell lung cancer: A 10-year cohort study.
[So] Source:Medicine (Baltimore);96(43):e8356, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:It is still debatable whether complete mediastinal lymph node dissection (MLND) is associated with better survival than mediastinal lymph node sampling (MLNS) in surgical treatment of nonsmall cell lung cancer (NSCLC). We aimed to assess the impact of lymph node dissection on long-term survival among stage I NSCLC patients.In this cohort study, 317 stage I NSCLC Chinese patients in Shanghai Chest Hospital were followed up for at least 10 years to evaluate the impact of different lymph node dissection modes on their survival. Among them, 161 patients were in the MLND group and 156 in the MLNS group. Overall survival and median survival times were calculated for the 2 groups. The association between lymph node dissection and the survival of NSCLC patients was assessed using Cox proportional-hazard models.Patients in the MLND group presented better survival (median survival time = 154.67 months) than those in the MLNS group (median survival time = 124.67 months). The MLNS had higher mortality than the MLND group, with the crude hazard ratio of the MLNS group relative to the MLND group as 1.32 (95% confidence interval [CI] 0.97, 1.78). After adjusting for age and sex, the association between lymph node dissection and mortality (hazard ratio 1.36, 95% CI 1.00, 1.84) was statistically significant (P = .047). Further adjusting for baseline clinical characteristics, the association (hazard ratio 1.40, 95% CI 1.02, 1.92) remained statistically significant (P = .036). The association between lymph node dissection mode and mortality was strong among patients with tumor size between 2.0 and 3.0 cm (hazard ratio 2.79, 95% CI 1.45, 5.37).We found that the MLND was associated with better survival for patients with early-stage NSCLC, compared with the MLNS. The effects of MLND on survival may depend on tumor size. Our findings have important implications in the treatment of early-stage NSCLC. Further prospective studies with a large sample size are needed to confirm our findings.
[Mh] Termos MeSH primário: Carcinoma Pulmonar de Células não Pequenas/cirurgia
Neoplasias Pulmonares/cirurgia
Excisão de Linfonodo/mortalidade
Linfonodos/cirurgia
[Mh] Termos MeSH secundário: Idoso
Carcinoma Pulmonar de Células não Pequenas/mortalidade
Carcinoma Pulmonar de Células não Pequenas/patologia
Intervalo Livre de Doença
Feminino
Seres Humanos
Estudos Longitudinais
Neoplasias Pulmonares/mortalidade
Neoplasias Pulmonares/patologia
Excisão de Linfonodo/métodos
Linfonodos/patologia
Metástase Linfática
Masculino
Mediastino
Estadiamento de Neoplasias
Modelos de Riscos Proporcionais
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171123
[Lr] Data última revisão:
171123
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008356


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[PMID]:28977194
[Au] Autor:Tchaick RM; Sá MPBO; Figueira FRM; Paz KC; Ferraz ÁAB; Moraes FR
[Ad] Endereço:Division of Cardiovascular Surgery, Hospital Dom Helder Câmara (HDH), Cabo de Santo Agostinho, PE, Brazil.
[Ti] Título:Cefazolin Concentration in the Mediastinal Adipose Tissue of Patients Undergoing Cardiac Surgery.
[So] Source:Braz J Cardiovasc Surg;32(4):239-244, 2017 Jul-Aug.
[Is] ISSN:1678-9741
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To measure the concentration of cefazolin in the anterior mediastinal adipose tissue of patients undergoing cardiac surgery, determining the variation of cefazolin concentration. METHODS: Two samples of approximately 1g of subcutaneous tissue were collected from 19 patients who underwent surgery in December 2015: the first sample was collected right after sternotomy and the second one, before sternal synthesis with steel wires. Antibiotic dosage was administered through high performance liquid chromatography. RESULTS: We observed a positive and statistically significant correlation between time 1 and cefazolin concentration (r=0.489 and P=0.039). For time 2 and cefazolin concentration, there was a negative and statistically significant correlation between both variables (r=-0.793 and P<0.001). A negative correlation was also observed between body mass index and cefazolin concentration at time 2 (r=-0.510 and P=0.031). The regression model showed that every 1-minute increase in time 1 corresponded to an increase of 0.240 µg/dL in cefazolin concentration, whereas every 1-minute increase in time 2 corresponded to a reduction of 0.046 µg/dL in cefazolin concentration. As for body mass index, every 1 kg/m2 increase corresponded to a reduction of about 0.510 µg/dL in cefazolin concentration. CONCLUSION: There was a positive and significant correlation between the initial time of surgery and cefazolin level in the first dosage. The evaluation of the second dosage showed a negative and significant correlation between cefazolin level and the second time of dosage. The concentration of cefazolin is under the influence of body mass index.
[Mh] Termos MeSH primário: Tecido Adiposo/química
Antibacterianos/análise
Cefazolina/análise
Mediastino
[Mh] Termos MeSH secundário: Adulto
Idoso
Antibacterianos/administração & dosagem
Índice de Massa Corporal
Procedimentos Cirúrgicos Cardíacos
Cefazolina/administração & dosagem
Cromatografia Líquida de Alta Pressão/métodos
Feminino
Seres Humanos
Período Intraoperatório
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); IHS69L0Y4T (Cefazolin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171005
[St] Status:MEDLINE


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[PMID]:28942077
[Au] Autor:Yendamuri S; Battoo A; Dy G; Chen H; Gomez J; Singh AK; Hennon M; Nwogu CE; Dexter EU; Huang M; Picone A; Demmy TL
[Ad] Endereço:Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York; Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York. Electronic address: sai.yendamuri@roswellpark.org.
[Ti] Título:Transcervical Extended Mediastinal Lymphadenectomy: Experience From a North American Cancer Center.
[So] Source:Ann Thorac Surg;104(5):1644-1649, 2017 Nov.
[Is] ISSN:1552-6259
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Accurate staging of the mediastinum is a critical element of therapeutic decision making in non-small cell lung cancer. We sought to determine the utility of transcervical extended mediastinal lymphadenectomy (TEMLA) in staging non-small cell lung cancer for large central tumors and after induction therapy. METHODS: A retrospective record review was performed of all patients who underwent TEMLA at our institution from 2010 to 2015. Clinical stage as assessed by positron emission tomography integrated with computed tomography (PET-CT), stage as assessed by TEMLA, final pathologic stage, lymph node yield, and clinical characteristics of tumors were assessed along with TEMLA-related perioperative morbidity. Accuracy of staging by TEMLA for restaging the mediastinum after neoadjuvant therapy was compared with that of PET-CT. RESULTS: Of 164 patients who underwent TEMLA, 157 (95.7%) were completed successfully. Combined surgical resection along with TEMLA was performed in 138 of these patients, with 131 (94.2%) undergoing a video-assisted thoracoscopic resection. The recurrent laryngeal nerve injury rate was 6.7%. TEMLA was performed in 118 of 164 patients for restaging after neoadjuvant therapy, and 101 of these patients were also restaged by PET-CT. Based on TEMLA, 7 patients did not go on to have resection. Of the 101 patients who did have a resection, TEMLA was more accurate than PET-CT in staging the mediastinum (95% vs 73%, p < 0.0001). However, the pneumonia rate in this subgroup of patients was 13%. CONCLUSIONS: TEMLA is a safe procedure and superior to PET-CT for restaging of the mediastinum after neoadjuvant therapy for non-small cell lung cancer. However, this increased accuracy comes with a high postoperative pneumonia rate.
[Mh] Termos MeSH primário: Carcinoma Pulmonar de Células não Pequenas/patologia
Carcinoma Pulmonar de Células não Pequenas/cirurgia
Neoplasias Pulmonares/patologia
Neoplasias Pulmonares/cirurgia
Excisão de Linfonodo/métodos
Linfonodos/patologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Institutos de Câncer
Carcinoma Pulmonar de Células não Pequenas/mortalidade
Estudos de Coortes
Endossonografia/métodos
Feminino
Seres Humanos
Neoplasias Pulmonares/mortalidade
Metástase Linfática
Masculino
Mediastino/patologia
Mediastino/cirurgia
Meia-Idade
Invasividade Neoplásica/patologia
Estadiamento de Neoplasias
América do Norte
Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos
Prognóstico
Estudos Retrospectivos
Medição de Risco
Análise de Sobrevida
Cirurgia Torácica Vídeoassistida/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170925
[St] Status:MEDLINE



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