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  1 / 13178 MEDLINE  
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[PMID]:29338059
[Au] Autor:Furukawa K; Ishida F; Tsuji M; Miura Y; Kishimoto T; Shiba M; Tanemura H; Umeda Y; Sano T; Yasuda R; Shimosaka S; Suzuki H
[Ad] Endereço:Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
[Ti] Título:Hemodynamic characteristics of hyperplastic remodeling lesions in cerebral aneurysms.
[So] Source:PLoS One;13(1):e0191287, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND & PURPOSE: Hyperplastic remodeling (HR) lesions are sometimes found on cerebral aneurysm walls. Atherosclerosis is the results of HR, which may cause an adverse effect on surgical treatment for cerebral aneurysms. Previous studies have demonstrated that atherosclerotic changes had a correlation with certain hemodynamic characteristics. Therefore, we investigated local hemodynamic characteristics of HR lesions of cerebral aneurysms using computational fluid dynamics (CFD). METHODS: Twenty-four cerebral aneurysms were investigated using CFD and intraoperative video recordings. HR lesions and red walls were confirmed on the intraoperative images, and the qualification points were determined on the center of the HR lesions and the red walls. The qualification points were set on the virtual operative images for evaluation of wall shear stress (WSS), normalized WSS (NWSS), oscillatory shear index (OSI), relative residence time (RRT), and aneurysm formation indicator (AFI). These hemodynamic parameters at the qualification points were compared between HR lesions and red walls. RESULTS: HR lesions had lower NWSS, lower AFI, higher OSI and prolonged RRT compared with red walls. From analysis of the receiver-operating characteristic curve for hemodynamic parameters, OSI was the most optimal hemodynamic parameter to predict HR lesions (area under the curve, 0.745; 95% confidence interval, 0.603-0.887; cutoff value, 0.00917; sensitivity, 0.643; specificity, 0.893; P<0.01). With multivariate logistic regression analyses using stepwise method, NWSS was significantly associated with the HR lesions. CONCLUSIONS: Although low NWSS was independently associated with HR lesions, OSI is the most valuable hemodynamic parameter to distinguish HR lesions from red walls.
[Mh] Termos MeSH primário: Hemodinâmica
Aneurisma Intracraniano/patologia
Aneurisma Intracraniano/fisiopatologia
Remodelação Vascular
[Mh] Termos MeSH secundário: Aneurisma Roto/patologia
Aneurisma Roto/fisiopatologia
Aneurisma Roto/cirurgia
Seres Humanos
Aneurisma Intracraniano/cirurgia
Período Intraoperatório
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180117
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191287


  2 / 13178 MEDLINE  
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[PMID]:28462719
[Au] Autor:Hung TJ; Burrage J; Bourke A; Taylor D
[Ad] Endereço:Department of Nuclear Medicine, Royal Perth Hospital, Perth. Australia.
[Ti] Título:Intraoperative Localisation of Impalpable Breast Lesions Utilising the ROLLIS Technique Following Peritumoral 99mTc-colloid Sentinel Node Lymphoscintigraphy.
[So] Source:Curr Radiopharm;10(2):111-114, 2017 Aug 24.
[Is] ISSN:1874-4729
[Cp] País de publicação:United Arab Emirates
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Ultrasound or stereotactic guided hook-wire localisation has been the standard-of-care for the pre-surgical localisation of impalpable breast lesions, which account for approximately a third of all breast cancer. Radioguided occult lesion localisation using I-125 seeds (ROLLIS) is a relatively new technique for guiding surgical excision of impalpable breast lesions, and is a promising alternative to the traditional hook-wire method. When combined with Tc-99m labelled colloid for sentinel node mapping in clinically indicated cases, there has been uncertainty regarding whether the downscatter of Tc-99m into the I-125 energy spectrum could adversely affect the intra-operative detection of the I-125 seed, especially pertaining to a peritumoral injection. OBJECTIVE: To evaluate the percentage contribution of downscattered activity from Tc-99m into the I-125 energy spectrum in simulated intra-operative resections of an I-125 seed following different sentinel node injection techniques. METHOD: Two scenarios were simulated using breast phantoms with lean chicken breast. The first scenario, with a 2cm distance between the Tc-99m injection site and the I-125 seed, simulated a periareolar ipsiquadrant injection with the subdermal or intradermal technique. The second scenario simulated a peritumoral injection technique with the Tc-99m bolus and an I-125 seed at the same site. Count rates were acquired with a hand-held gamma probe, and the percentage contribution of downscattered Tc-99m gamma photons to the I-125 energy window was calculated. RESULTS: In scenarios one and two, downscattered Tc-99m activity contributed 0.5% and 33% respectively to the detected count rate in the I-125 energy window. In both scenarios, the I-125 seed was successfully localised and removed using the gamma probe. CONCLUSION: There is no significant contribution of downscattered activity associated with a peritumoral injection of Tc-99m to adversely affect the accurate intra-operative localisation of an I- 125 seed.
[Mh] Termos MeSH primário: Neoplasias da Mama/diagnóstico por imagem
Neoplasias da Mama/cirurgia
Linfocintigrafia
Cintilografia/métodos
[Mh] Termos MeSH secundário: Neoplasias da Mama/patologia
Marcadores Fiduciais
Período Intraoperatório
Radioisótopos do Iodo
Metástase Linfática/diagnóstico por imagem
Imagens de Fantasmas
Compostos Radiofarmacêuticos
Espalhamento de Radiação
Sensibilidade e Especificidade
Pertecnetato Tc 99m de Sódio
Agregado de Albumina Marcado com Tecnécio Tc 99m
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Iodine Radioisotopes); 0 (Iodine-125); 0 (Radiopharmaceuticals); 0 (Technetium Tc 99m Aggregated Albumin); 0 (technetium Tc 99m nanocolloid); A0730CX801 (Sodium Pertechnetate Tc 99m)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.2174/1874471010666170428113052


  3 / 13178 MEDLINE  
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[PMID]:28742617
[Au] Autor:Dimitry MES; Lewis AD; Zacharaki F; Chandran M; Robson D; Menon G; Poole TRG
[Ad] Endereço:The Eye Dept, Frimley Park Hospital, Frimley Health NHS Foundation Trust, Surrey, United Kingdom.
[Ti] Título:Simple Single-Pass Technique for Ultrathin Descemet Stripping Automated Endothelial Keratoplasty: A Pilot Study.
[So] Source:Cornea;36(10):1178-1183, 2017 Oct.
[Is] ISSN:1536-4798
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To assess intraoperative and postoperative graft thickness (GT) after donor deturgescence for ultrathin Descemet stripping automated endothelial keratoplasty and to evaluate visual outcomes, endothelial cell density, and patient satisfaction at 1 year. METHODS: Prospective interventional case series of patients with Fuchs endothelial dystrophy, Fuchs endothelial dystrophy and cataract, and pseudophakic bullous keratopathy (n = 12 grafts). The donor cornea was allowed to thin out by simple evaporation on an artificial anterior chamber, to the required precut thickness, before a single microkeratome pass. GT after microkeratome cut, at 1 week, 1, 3, 6, and 12, months was measured. Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity, Pelli-Robson contrast sensitivity, endothelial cell density, and score on the visual function questionnaire (VFQ-25) were assessed. RESULTS: Mean intraoperative postmicrokeratome cut GT was 78.9 ± 33.3 µm. Mean GT at 1 week, 1, 3, 6, and 12 months was 70.7, 70.9, 62.8, 66.5, and 58.9 µm, respectively. Mean initial donor corneal thickness was 647 ± 67 µm, and mean precut thickness was 526 ± 4.5 µm (mean thinning time: 17 min). Best-corrected visual acuity at 1 week, 1, 3, 6, and 12 months was 68.8, 76.9, 76.3, 76.9, and 78.6 letters with 9-letter gain at 12 months (P = 0.02). Mean endothelial cell loss at 3, 6, and 12 months was 36.8% ± 6.75%, 37.2% ± 8%, and 37.9% ± 9.75% loss, respectively. At 1 year, 83.3% of patients achieved ≥20/40 (6/12) and 66.7% of patients achieved ≥20/32 (6/9.5). VFQ-25 testing showed an improvement in the visual function. CONCLUSIONS: This pilot study demonstrates a simple graft deturgescence technique that reproducibly creates ultrathin grafts without donor wastage.
[Mh] Termos MeSH primário: Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/métodos
Distrofia Endotelial de Fuchs/cirurgia
[Mh] Termos MeSH secundário: Idoso
Sensibilidades de Contraste/fisiologia
Paquimetria Corneana
Epitélio Posterior/patologia
Epitélio Posterior/transplante
Feminino
Seres Humanos
Período Intraoperatório
Masculino
Meia-Idade
Projetos Piloto
Período Pós-Operatório
Estudos Prospectivos
Doadores de Tecidos
Tomografia de Coerência Óptica
Acuidade Visual/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1097/ICO.0000000000001273


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[PMID]:29382028
[Au] Autor:Wang BY; Wu TK; Liu H; Deng YX; Ding C
[Ad] Endereço:Department of Orthopaedic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
[Ti] Título:Intraoperative conversion of artificial cervical disc replacement to anterior cervical discectomy and fusion for iatrogenic fracture: A rare case report.
[So] Source:Medicine (Baltimore);96(47):e8917, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Artificial cervical disc replacement (ACDR) has been reported to be an effective and safe surgical treatment for cervical spondylosis. However, iatrogenic fracture during ACDR surgery has rarely been reported. Considering its infrequency, we report a rare clinical case, with the aim of sharing our experience and exploring when to convert ACDR to fusion intraoperatively. PATIENTS CONCERNS: A 47-year-old woman felt neck pain with weakness and numbness in both upper limbs for 5 months. DIAGNOSES: The patient had received discectomy and fusion procedure on C3/4 and C5/6 to relieve her radicular pain nearly 4 years prior. Neurologic examination revealed a diminished sensation at the C6-C8 skin areas and level Grade-4 power in the left wrist extensor and grip muscle strength. Magnetic resonance imaging (MRI) showed disc herniation compressing the spinal cord at C6/7. Computed tomography (CT) scans showed intervertebral fusion in both the C3/4 and C5/6 segments. INTERVENTIONS: Surgery was performed to remove the plate and replace C6/7 with an artificial disc, but a transverse cleavage endplate cortical fracture was detected after cutting the blades. Thus, we terminated artificial cervical disc replacement intraoperatively and changed to discectomy and fusion in C6/7. OUTCOMES: The patient's symptoms were remarkably relieved. Postoperative CT scans showed a transverse cleavage fracture in the backside of the C6 caudal endplate. Good fusion was achieved after 6 months. LESSONS: Iatrogenic fracture during ACDR is rare but does occur in clinic practice. Complete examination and an alternative approach determined before surgery are important for operative safety. Anterior cervical discectomy and fusion (ACDF) is recommended as a feasible remedial surgical strategy if ACDR fails intraoperatively.
[Mh] Termos MeSH primário: Vértebras Cervicais/cirurgia
Discotomia/métodos
Fraturas da Coluna Vertebral/cirurgia
Fusão Vertebral/métodos
Substituição Total de Disco/efeitos adversos
[Mh] Termos MeSH secundário: Vértebras Cervicais/lesões
Feminino
Seres Humanos
Doença Iatrogênica
Período Intraoperatório
Meia-Idade
Reoperação/métodos
Fraturas da Coluna Vertebral/etiologia
Espondilose/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[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.0000000000008917


  5 / 13178 MEDLINE  
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[PMID]:29369184
[Au] Autor:Ozkunt O; Sariyilmaz K; Gemalmaz HC; Dikici F
[Ti] Título:The effect of tourniquet usage on cement penetration in total knee arthroplasty: A prospective randomized study of 3 methods.
[So] Source:Medicine (Baltimore);97(4):e9668, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: It is a randomized study to compare cement penetration on x-rays after total knee arthroplasty (TKA) among 3 different ways to use tourniquets; application during the surgery, application only with implantation prosthesis and with no tourniquet use. METHODS: A total 69 knees of 59 patients were included in the study in a quasirandom manner. Each patient had physical exams and standard radiographic evaluations at 6 weeks after the TKA procedure. Outcome evaluations included visual analog scale (VAS) scores, Knee Society Scores (KSS), blood transfusion, and drainage status after surgery for all groups. For radiographic review, the tibial plateau was divided into zones in the anterior-posterior and lateral views, according to the Knee Society Scoring System. RESULTS: The average age of the patients who were eligible for the study was 65.05 (range 46-81) years. All 59 patients included in the study were female patients. Group 1 consisted of 24 patients who had TKA with use of a tourniquet during the entire operation. Group 2 consisted of 20 patients who had TKA with use of tourniquet only at the time of cementing and group 3 consisted of 25 patients with no use tourniquet. There is no significant difference in early cement penetration among the groups (group 1 2.50 mm, group 2 2.28 mm, group 3 2.27 mm; group 1 vs 2 P = .083, group 1 vs 3 P = .091, group 2 vs 3 P = .073). There is no significant difference for postoperative drainage among the 3 groups (group 1 245 mL, group 2 258.76 mL, group 3 175.88 mL; group 1 vs 2 P = .081, group 1 vs 3 P = .072, group 2 vs 3 P = .054). There was no need to transfuse more than 1 unit in any patient. The VAS score was significantly higher (group 1 3.58, group 2 1.55, group 3 1.52; group 1 vs 2 P = .022, group 1 vs 3 P = .018, group 2 vs 3 P = .062) and KSS was significantly lower in the tourniquet group (group 1 63, group 2 79, group 3 82; group 1 vs 2 P = .017, group 1 vs 3 P = .02, group 2 vs 3 P = .082). CONCLUSION: We do not suggest long-duration tourniquet use, which can lead higher pain scores and reduce functional recovery after total knee arthroplasty.
[Mh] Termos MeSH primário: Artroplastia do Joelho/instrumentação
Cimentos para Ossos/uso terapêutico
Dor Pós-Operatória/etiologia
Torniquetes/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Artroplastia do Joelho/métodos
Feminino
Seres Humanos
Período Intraoperatório
Joelho/fisiopatologia
Joelho/cirurgia
Masculino
Meia-Idade
Dor Pós-Operatória/fisiopatologia
Estudos Prospectivos
Recuperação de Função Fisiológica
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Bone Cements)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009668


  6 / 13178 MEDLINE  
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[PMID]:29254588
[Au] Autor:Petoukhova A; Rüssel I; Nijst-Brouwers J; van Wingerden K; van Egmond J; Jacobs D; Marinelli A; van der Sijp J; Koper P; Struikmans H
[Ad] Endereço:Haaglanden Medical Center, Department of Medical Physics, Leidschendam, The Netherlands. Electronic address: a.petoukhova@haaglandenmc.nl.
[Ti] Título:In vivo dosimetry with MOSFETs and GAFCHROMIC films during electron IORT for Accelerated Partial Breast Irradiation.
[So] Source:Phys Med;44:26-33, 2017 Dec.
[Is] ISSN:1724-191X
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The purpose of this study was to compare the delivered dose to the expected intraoperative radiation therapy (IORT) dose with in vivo dosimetry. For IORT using electrons in accelerated partial breast irradiation, this is especially relevant since a high dose is delivered in a single fraction. METHODS: For 47 of breast cancer patients, in vivo dosimetry was performed with MOSFETs and/or GAFCHROMIC EBT2 films. A total dose of 23.33 Gy at d was given directly after completing the lumpectomy procedure with electron beams generated with an IORT dedicated mobile accelerator. A protection disk was used to shield the thoracic wall. RESULTS: The results of in vivo MOSFET dosimetry for 27 patients and GAFROMIC film dosimetry for 20 patients were analysed. The entry dose for the breast tissue, measured with MOSFETs, (mean value 22.3 Gy, SD 3.4%) agreed within 1.7% with the expected dose (mean value 21.9 Gy). The dose in breast tissue, measured with GAFCHROMIC films (mean value 23.50 Gy) was on average within 0.7% (SD = 3.7%, range -5.5% to 5.6%) of the prescribed dose of 23.33 Gy. CONCLUSIONS: The dose measured with MOSFETs and GAFROMIC EBT2 films agreed well with the expected dose. For both methods, the dose to the thoracic wall, lungs and heart for left sided patents was lower than 2.5 Gy even when 12 MeV was applied. The positioning time of GAFCHROMIC films is negligible and based on our results we recommend its use as a standard tool for patient quality assurance during breast cancer IORT.
[Mh] Termos MeSH primário: Neoplasias da Mama/radioterapia
Elétrons/uso terapêutico
Dosimetria Fotográfica/instrumentação
Metais/química
Óxidos/química
Dosímetros de Radiação
Transistores Eletrônicos
[Mh] Termos MeSH secundário: Neoplasias da Mama/cirurgia
Calibragem
Seres Humanos
Período Intraoperatório
Meia-Idade
Aceleradores de Partículas
Dosagem Radioterapêutica
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Metals); 0 (Oxides)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180130
[Lr] Data última revisão:
180130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE


  7 / 13178 MEDLINE  
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[PMID]:29208831
[Au] Autor:Joshi RS; Hussain MS
[Ad] Endereço:Resident, Shri Vasantrao Naik Government Medical College, Yavatmal, Maharashtra, India.
[Ti] Título:Long-term results of trypan blue dye irrigation in the capsular bag to prevent posterior capsule opacification: A randomized trial.
[So] Source:Indian J Ophthalmol;65(12):1440-1444, 2017 Dec.
[Is] ISSN:1998-3689
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To study the effect of capsular bag irrigation of trypan blue dye (0.06%) on posterior capsular opacification (PCO) in eyes undergoing phacoemulsification. METHODS: This was a randomized, trial conducted at a tertiary eye care center in central India. The study included 50 patients (100 eyes) with senile cataracts who were scheduled for phacoemulsification and intraocular lens (IOL) implantation and were willing to undergo bilateral cataract surgery. One eye of each patient was randomized to one of two groups. The dye group received 0.2 ml of trypan blue injected in the capsular bag after cortical cleanup under air. The control group (other eye of the same patient) received 0.2 ml of balanced salt solution injected in a similar manner. PCO in the central 3 mm area of IOL optic was analyzed by a masked observer using an evaluation of PCO software computer analysis system at 6, 12, 24, and 36 months. RESULTS: The average age of patients was 62.05 ± 6.22 in the dye group and 64.92 ± 7.16 years in the control group. The mean PCO score at 6 months was significantly lower in the dye group (0.10 ± 0.15) than in the control group (0.22 ± 0.30). There were no significant differences in the PCO scores between the two groups from 12 to 36 months. At the end of 3 years, eight eyes in the dye group and seven in the control group required YAG capsulotomy (P = 0.21). CONCLUSION: Capsular bag irrigation of trypan blue dye decreased the PCO score at 6 months, but it had no effect at 36 months.
[Mh] Termos MeSH primário: Opacificação da Cápsula/prevenção & controle
Facoemulsificação/métodos
Cápsula Posterior do Cristalino/efeitos dos fármacos
Complicações Pós-Operatórias/prevenção & controle
Azul Tripano/administração & dosagem
[Mh] Termos MeSH secundário: Opacificação da Cápsula/etiologia
Corantes/administração & dosagem
Feminino
Seguimentos
Seres Humanos
Período Intraoperatório
Masculino
Meia-Idade
Complicações Pós-Operatórias/etiologia
Estudos Prospectivos
Irrigação Terapêutica
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; VIDEO-AUDIO MEDIA
[Nm] Nome de substância:
0 (Coloring Agents); I2ZWO3LS3M (Trypan Blue)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180103
[Lr] Data última revisão:
180103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.4103/ijo.IJO_454_17


  8 / 13178 MEDLINE  
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[PMID]:29016707
[Au] Autor:Shin ET; Joehlin-Price AS; Agnese DM; Zynger DL
[Ad] Endereço:Departments of Pathology.
[Ti] Título:Minimal Clinical Impact of Intraoperative Examination of Sentinel Lymph Nodes in Patients With Ductal Carcinoma In Situ: An Opportunity for Improved Resource Utilization.
[So] Source:Am J Clin Pathol;148(5):374-379, 2017 Nov 02.
[Is] ISSN:1943-7722
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: There is little information regarding sentinel lymph node (SLN) frozen-section examination in patients with a history of ductal carcinoma in situ (DCIS). We evaluated the usage, clinical impact, and pathology resources used for SLN cryosectioning in mastectomy cases with a DCIS history. Methods: Mastectomies with SLNs submitted from 2012 to 2013 at a tertiary care center were analyzed. Medicare reimbursement was used to estimate pathology health care expenditures of intraoperative frozen sections. Results: There was no difference in the rate of SLN frozen-section examination or parts submitted, total blocks frozen, total blocks submitted, or total SLNs identified per case between the DCIS (n = 139) and invasive (n = 369) groups. Nine patients with DCIS had SLN metastases (three macrometastases, two micrometastases, and four isolated tumor cells), all of which were examined by frozen section. Only the macrometastases were identified by cryosectioning, which led to two synchronous axillary lymph node dissections that did not yield any additional positive nodes. A total of $19,313 was spent for pathology per DCIS patient with surgical management affected, whereas only $1,019 was spent per invasive carcinoma patient affected. Conclusions: Decreasing SLN frozen-section use in patients with a history of DCIS represents an opportunity for pathology cost containment.
[Mh] Termos MeSH primário: Neoplasias da Mama/diagnóstico
Carcinoma Intraductal não Infiltrante/diagnóstico
Secções Congeladas/economia
Biópsia de Linfonodo Sentinela/economia
Biópsia de Linfonodo Sentinela/métodos
[Mh] Termos MeSH secundário: Feminino
Secções Congeladas/métodos
Seres Humanos
Período Intraoperatório
Metástase Linfática/diagnóstico
Linfonodo Sentinela
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE
[do] DOI:10.1093/ajcp/aqx089


  9 / 13178 MEDLINE  
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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]:28967955
[Au] Autor:Desouki MM; Li Z; Hameed O; Fadare O
[Ad] Endereço:Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN.
[Ti] Título:Intraoperative Pathologic Consultation on Hysterectomy Specimens for Endometrial Cancer: An Assessment of the Accuracy of Frozen Sections, "Gross-Only" Evaluations, and Obtaining Random Sections of a Grossly "Normal" Endometrium.
[So] Source:Am J Clin Pathol;148(4):345-353, 2017 Oct 01.
[Is] ISSN:1943-7722
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: Pathologic intraoperative consultation (IOC) is a common approach for segregating the subset of patients with endometrial cancer who likely require a lymphadenectomy. Methods: We evaluate factors related to the performance and value of IOC, including the accuracy of frozen sections, "gross-only examinations," and obtaining random sections when a gross lesion is not apparent. Results: IOC was performed by gross examination only in 17 (8%) of 250 cases, the specificity and negative predictive value of which in diagnosing cancer were 100% and 85%, respectively. Among the 64 cases wherein a gross lesion was not apparent and random sections were examined, a final diagnosis of carcinoma was rendered in 20, of which only three (15%) had a diagnosable malignancy on the random section. The frozen-section/final diagnosis concordance was 80% for tumor grade. Determining the depth of myometrial invasion was problematic, with 36% underestimation and 2.6% overestimation. Conclusions: Obtaining random sections in the absence of a gross lesion has no significant benefit, and a negative result is likely to provide inaccurate data to the surgeon. Frozen-section analyses are a generally reliable tool to determine "low-risk" pathologic parameters that were evaluated herein when a gross lesion is present.
[Mh] Termos MeSH primário: Neoplasias do Endométrio/diagnóstico
Secções Congeladas
Período Intraoperatório
Patologia Cirúrgica/métodos
Encaminhamento e Consulta
[Mh] Termos MeSH secundário: Neoplasias do Endométrio/patologia
Neoplasias do Endométrio/cirurgia
Feminino
Seres Humanos
Histerectomia
Valor Preditivo dos Testes
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171003
[St] Status:MEDLINE
[do] DOI:10.1093/ajcp/aqx076



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