scholarly journals Preoperative Localization in Colonic Surgery (PLoCoS Study): a multicentric experience on behalf of the Italian Society of Colorectal Surgery (SICCR)

2021 ◽  
Author(s):  
Michele Manigrasso ◽  
Marco Milone ◽  
Mario Musella ◽  
Pietro Venetucci ◽  
Francesco Maione ◽  
...  
Keyword(s):  
Conventional Colonoscopy ◽  
Colonic Surgery ◽  
Multicentric Study ◽  
Colonic Lesion ◽  
Significant Difference ◽  
Visible Lesion ◽  
Descending Colon ◽  
Intraoperative Localization ◽  
Lesion Localization ◽  
Colonic Tumours

AbstractThe aim of this prospective multicentric study was to compare the accurate colonic lesion localization ratio between CT and colonoscopy in comparison with surgery. All consecutive patients from 1st January to 31st December 2019 with a histologically confirmed diagnosis of dysplastic adenoma or adenocarcinoma with planned elective, curative colonic resection who underwent both colonoscopy and CT scans were included. Each patient underwent conventional colonoscopy and CT to stage the tumour, and the localization results of each procedure were registered. CT and colonoscopic localization were compared with surgical localization, adopted as the reference. Our analysis included 745 patients from 23 centres. After comparing the accuracy of colonoscopy and CT (for visible lesions) in localizing colonic lesions, no significant differences were found between the two preoperative tools (510/661 vs 499/661 correctly localized lesions, p = 0.518). Furthermore, after analysing only the patients who underwent complete colonoscopy and had a visible lesion on CT, no significant difference was observed between conventional colonoscopy and CT (331/427 vs 340/427, p = 0.505). Considering the intraoperative localization results as a reference, a comparison between colonoscopy and CT showed that colonoscopy significantly failed to correctly locate the lesions localized in the descending colon (17/32 vs 26/32, p = 0.031). We did not identify an advantage in using CT to localize colonic tumours. In this setting, colonoscopy should be considered the reference to properly localize lesions; however, to better identify lesions in the descending colon, CT could be considered a valuable tool to improve the accuracy of lesion localization.

scholarly journals Clinically applicable artificial intelligence system for dental diagnosis with CBCT

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Matvey Ezhov ◽  
Maxim Gusarev ◽  
Maria Golitsyna ◽  
Julian M. Yates ◽  
Evgeny Kushnerev ◽  
...  
Keyword(s):  
State Of The Art ◽  
Model Development ◽  
Clinical Effectiveness ◽  
Anatomical Landmarks ◽  
Periapical Lesion ◽  
Artificial Intelligence System ◽  
Intelligence System ◽  
Significant Difference ◽  
Diagnostic Capabilities ◽  
Lesion Localization

AbstractIn this study, a novel AI system based on deep learning methods was evaluated to determine its real-time performance of CBCT imaging diagnosis of anatomical landmarks, pathologies, clinical effectiveness, and safety when used by dentists in a clinical setting. The system consists of 5 modules: ROI-localization-module (segmentation of teeth and jaws), tooth-localization and numeration-module, periodontitis-module, caries-localization-module, and periapical-lesion-localization-module. These modules use CNN based on state-of-the-art architectures. In total, 1346 CBCT scans were used to train the modules. After annotation and model development, the AI system was tested for diagnostic capabilities of the Diagnocat AI system. 24 dentists participated in the clinical evaluation of the system. 30 CBCT scans were examined by two groups of dentists, where one group was aided by Diagnocat and the other was unaided. The results for the overall sensitivity and specificity for aided and unaided groups were calculated as an aggregate of all conditions. The sensitivity values for aided and unaided groups were 0.8537 and 0.7672 while specificity was 0.9672 and 0.9616 respectively. There was a statistically significant difference between the groups (p = 0.032). This study showed that the proposed AI system significantly improved the diagnostic capabilities of dentists.

scholarly journals Computed tomography-guided preoperative localization of musculoskeletal lesions using the ROLL technique

2018 ◽  
Vol 51 (3) ◽  
pp. 147-150 ◽  
Author(s):  
Chiang Jeng Tyng ◽  
Paula Nicole Vieira Pinto Barbosa ◽  
Almir Galvão Vieira Bitencourt ◽  
Maurício Kauark Amoedo ◽  
Maria Fernanda Arruda Almeida ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Gamma Probe ◽  
Preoperative Localization ◽  
Bone Lesions ◽  
Radioguided Surgery ◽  
Previous Diagnosis ◽  
Occult Lesion ◽  
Intraoperative Localization ◽  
Lesion Localization ◽  
Musculoskeletal Lesions

Abstract Objective: To describe the preoperative localization of musculoskeletal lesions with the radioguided occult lesion localization (ROLL) technique. Materials and Methods: In all cases, computed tomography-guided injection of technetium-99m sulfur colloid was performed, directly into or near the suspicious lesion, up to 36 hours before the surgical procedure. Lesions were detected intraoperatively with a gamma probe. Results: We report the cases of six patients submitted to radioguided surgery, including three patients with bone lesions suspicious for metastasis, two patients suspected of recurrent sarcoma, and one patient with no previous diagnosis who had a nodular lesion on the left leg. Patients tolerated the procedure well, and no complications were associated with the puncture. All marked lesions were easily identified intraoperatively and were excised with clear margins. Conclusion: The ROLL technique was effective in the intraoperative localization of occult musculoskeletal lesions, demonstrating that it is a feasible and promising technique for the surgical exploration of selected cases.

Efficacy of weekly paclitaxel-bevacizumab combination in advanced nonsquamous non-small cell lung cancer (NSCLC): AVATAX, a retrospective multicentric study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21086-e21086
Author(s):  
Geoffroy Bilger ◽  
Anne-Claire Toffart ◽  
Marie Darasson ◽  
Michaël Duruisseaux ◽  
Lucie Ulmer ◽  
...  
Keyword(s):  
Performance Status ◽  
Objective Response ◽  
Progression Free Survival ◽  
Line Treatment ◽  
Second Line ◽  
Multicentric Study ◽  
Significant Difference ◽  
Third Line ◽  
And Performance ◽  
Line Setting

e21086 Background: With the growing role of immunotherapy (ICI) as first-line setting for advanced NSCLC, strategies must be redefined after failure. The combination paclitaxel-bevacizumab showed in the ULTIMATE trial a significant superiority versus docetaxel as second or third-line treatment. Limited restropective studies has demonstrated unexpected efficacy of chemotherapy after prior progression on ICI. This combination could be use as salvage treatment following ICI. Methods: This multi-centric retrospective study identifies patients treated with the combination paclitaxel-bevacizumab in metastatic non-squamous NSCLC as second-line therapy or beyond. Main objectives were to describe safety and efficacy of this combination, with a special attention to the sub-group treated just after ICI. Results: From January 2010 to February 2020, 314 patients started the paclitaxel-bevacizumab combination : 55% male, with a median age of 60 years, 27% with a performance status ≥2, 45% with brain metastases. A majority of patients were treated in second (20%) and third-line (39%), and 28% were treated just after ICI failure (88/314). Objective response rate (ORR) was 40% and disease control rate was 77 %. Median progression-free survival (PFS) and overall survival (OS) were 5,7 months [IQ,3,2–9,6] and 10,8 months [IQ,5,3–19,6] respectively. All grades adverse events concerned 82% of patients, including 53% asthenia and 39% neurotoxicity, and 25% of patients continued a monotherapy alone due to toxicity. Median PFS for patients treated after ICI failure (ICI+) was significantly superior compare to those not previously treated with ICI (ICI-) : 7,0 months [IQ,4,2–11,0] vs 5,2 months [IQ,2,9–8,8] p (log-rank) = 0,01. There was not statistically significant difference in term of OS between this two groups. In multivariate analysis, factors associated with superior PFS were previous ICI treatment (ICI+) and performance status. Conclusions: This study confirms an acceptable toxicity profile associated with interesting efficacy of the combination paclitaxel-bevacizumab as second-line treatment or beyond for non–squamous NSCLC patients, particularly after progression with ICI.

Radioguided Occult Colonic Lesion Identification (Rocli) during Open and Laparoscopic Surgery

2002 ◽  
Vol 88 (3) ◽  
pp. S19-S22 ◽  
Author(s):  
R Rezzo ◽  
G Scopinaro ◽  
M Gambaro ◽  
P Michetti ◽  
G Anfossi
Keyword(s):  
Laparoscopic Surgery ◽  
Open Surgery ◽  
Gamma Probe ◽  
Colon Surgery ◽  
Colonic Lesion ◽  
Clinical Method ◽  
Intraoperative Detection ◽  
Inflammatory Bowel ◽  
Endoscopic Marking ◽  
Intraoperative Localization

Aims and Background Intraoperative localization, during open and laparoscopic surgery, of small, nonpalpable colonic lesions located at peculiar sites or with concurrent inflammatory bowel alterations (diverticulosis, perivisceritis) is often difficult. The aim of our work was to assess the validity of radioguided identification after preoperative labeling. Methods and Study Design Patients who were candidates for colon surgery for occult lesions that, because of their size and location, were assumed to be difficult to detect, underwent colonoscopy 1 to 2.5 hours before surgery. A small dose of labeled albumin macroaggregates was injected with a sclerotherapy needle into the subserosa underneath the lesion. Immediately following injection the lesion was identified with a transcutaneously placed gamma detecting probe. Intraoperative tracer detection was performed either during open surgery or by means of a laparoscopic probe (detection time 3-5 mins). The position of the lesion was marked with a suture or with a clip. Surgery was performed according to the type of lesion to be treated. Results In our initial clinical experience 15 colon lesions were preoperatively marked in 14 patients and were subsequently detected during surgery (four under laparoscopy) with a gamma detecting probe. This technique allows highly accurate, fast, and inexpensive surgical localization of lesions without irradiation and without complications. Conclusion Our experience shows that preoperative endoscopic marking of nonpalpable colon lesions with 99mTc-labeled albumin macroaggregates followed by intraoperative detection with a gamma probe is a useful clinical method that is highly accurate and without complications.

scholarly journals Incidence of nutritional support complications in patient hospitalized in wards. multicentric study

2012 ◽  
pp. 147-153 ◽  
Author(s):  
Gloria María Agudelo Ochoa ◽  
Nubia Amparo Giraldo Giraldo ◽  
Nora Luz Aguilar ◽  
Beatriz Elena Restrepo ◽  
Marcela Vanegas ◽  
...  
Keyword(s):  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
General Hospital ◽  
Medical Diagnosis ◽  
Nutritional Support ◽  
Nutritional Condition ◽  
High Complexity ◽  
Multicentric Study ◽  
Significant Difference ◽  
Hospital Wards

Introduction: Nutritional support generates complications that must be detected and treated on time. Objective: To estimate the incidence of some complications of nutritional support in patients admitted to general hospital wards who received nutritional support in six high-complexity institutions. Methods: Prospective, descriptive and multicentric study in patients with nutritional support; the variables studied were medical diagnosis, nutritional condition, nutritional support duration, approach, kind of formula, and eight complications. Results: A total of 277 patients were evaluated; 83% received enteral nutrition and 17% received parenteral nutrition. Some 69.3% presented risk of malnourishment or severe malnourishment at admittance. About 35.4% of those receiving enteral nutrition and 39.6% of the ones who received parenteral nutrition had complications; no significant difference per support was found (p = 0.363). For the enteral nutrition, the most significant complication was the removal of the catheter (14%), followed by diarrhea (8.3%); an association between the duration of the enteral support with diarrhea, constipation and removal of the catheter was found (p < 0.05). For parenteral nutrition, hyperglycemia was the complication of highest inci­dence (22.9%), followed by hypophosphatemia (12.5%); all complications were associated with the duration of the support (p < 0.05). Nutritional support was suspended in 24.2% of the patients. Conclusions: Complications with nutritional support in hospital-ward patients were frequent, with the removal of the catheter and hyperglycemia showing the highest incidence. Duration of the support was the variable that revealed an asso­ciation with complications. Strict application of protocols could decrease the risk for complications and boost nutritional support benefits.

Adjuvant Chemotherapy with Fluorouracil and ccnu in Colon Cancer. Results of a Multicentric Randomized Study

1989 ◽  
Vol 75 (3) ◽  
pp. 269-276 ◽  
Author(s):  
Maurizio Marangolo ◽  
Giuseppe Pezzuoli ◽  
Ettore Marubini ◽  
Dino Amadori ◽  
Patrizia Boracchi ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Randomized Study ◽  
Cure Rate ◽  
Relapse Free Survival ◽  
Multicentric Study ◽  
Free Survival ◽  
Treatment Groups ◽  
Intention To Treat ◽  
Significant Difference

To establish the effectiveness of adjuvant chemotherapy in patients with colon cancer after radical surgery, from 1980 to December 1983, 263 patients were randomized in a multicentric study to no further treatment (131 patients) or to a combination of fluorouracil (5-FU) (400 mg/m2 i.v., days 1–5) and lomustine (CCNU) (100 mg/m2 per os on day 5) every 6 weeks for 9 cycles (132 patients). The two groups were well balanced for age, sex, histology, tumor and nodal extent. Chemotherapy was not given to 30 of the 132 randomized patients, and of 98 treated patients only 38 completed the entire protocol. Analysis, as intention to treat, at 54 months did not show any significant difference between the two treatment groups in terms of relapse-free survival (surgery alone, 74.5%; surgery+adjuvant chemotherapy, 70.9%; p = 0.91). In contrast, a significant difference was observed in overall survival (surgery alone, 78.8%; surgery+adjuvant chemotherapy, 60.8%; p = 0.04). The sites of relapse were identical in the two treatment arms. In conclusion, from this study it appears that adjuvant chemotherapy with 5-FU and CCNU seems to have no efficacy in the cure rate of colon cancer patients.

Vitamin E in the neuroprotection of cisplatin induced peripheral neurotoxicity and ototoxicity

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9114-9114 ◽  
Author(s):  
A. Pace ◽  
S. Carpano ◽  
E. Galiè ◽  
A. Savarese ◽  
M. Della Giulia ◽  
...  
Keyword(s):  
Placebo Group ◽  
Vitamin E ◽  
Peripheral Neurotoxicity ◽  
Double Blind ◽  
Multicentric Study ◽  
Phase Ii Studies ◽  
Significant Difference ◽  
Before And After ◽  
Vitamin E Supplementation

9114 Background: Peripheral neurotoxicity is a well recognized effect of cisplatin chemotherapy that can result in severe disability and represents a major dose-limiting factor. Several phase II studies have recently investigated the role of vitamin E as neuroprotectant in the prevention of cisplatin induced peripheral neurotoxicity and ototoxicity. Methods: An Italian randomized, placebo controlled, double blind multicentric study is ongoing to confirm the role of vitamin E supplementation in the prevention of neurotoxicity and ototoxicity induced by cisplatin Patients candidates to cisplatin chemotherapy were randomised to either vitamin E supplementation (a-tocopherol 400 mg/day) or to placebo. Patients were evaluated with neurological and neurophysiological examination before and after treatment. Neurotoxicity was measured using the comprehensive clinical and neurophysiological Total Neuropathy Score (TNS). Ototoxicity was evaluated with audiometric test and acoustic evoked potential before and after treatment. Results: 81 patients have been enrolled in 3 italian oncologic centers. An interim analysis on the first 50 patients was carried out. 25 patients (11 in the vit E group and 14 in the placebo group) received a cumulative dose higher than 300 mg/mq and were evaluable for neurotoxicity. Statistical analysis showed a significant difference (p < 0.05) in median neurotoxicity score observed in vit E group (TNS=1) respect to the placebo group (TNS=5). Conclusions: This is the first randomised, placebo controlled, double blind trial exploring the efficacy of vitamin E in the neuroprotection of cisplatin neurotoxicity. The results of this study confirm the neuroprotective effect of vitamin E supplementation against cisplatin-induced neurotoxicity. No significant financial relationships to disclose.

Mid-stream vs. first-voided urine collection by using automated analyzers for particle examination in healthy subjects: an Italian multicenter study

2012 ◽  
Vol 50 (4) ◽  
Author(s):  
Fabio Manoni ◽  
Gianluca Gessoni ◽  
Maria Grazia Alessio ◽  
Alberta Caleffi ◽  
Graziella Saccani ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Vacuum System ◽  
Laboratory Diagnostics ◽  
Chemical Examination ◽  
Multicentric Study ◽  
Laboratory Staff ◽  
Significant Difference ◽  
Reference Limits ◽  
Health Related ◽  
Analytical Phase

AbstractIn analogy with other areas of laboratory diagnostics, the pre-analytical phase is the leading source of variability also in urinalysis. We carried out a multicentric study for comparing results obtained from first-voided and mid-stream urine samples.Each of the six hospital-based clinical laboratories participating to this study recruited 50 healthy subjects among laboratory staff and/or their relatives. Two consecutive samples of the first morning micturition were collected by vacuum system, the first from the first-void and the second from the mid-stream. Routine urinalysis was performed using dip-stick automated analyzers for chemical examination and automated analyzers for formed particle examination (Sysmex UF-100, Sysmex UF-1000i and Iris iQ-200).Counts of epithelial cells (EC), erythrocytes (ERY) and leukocytes (LEU) but not for cylinders (CAS) were significantly higher in the first-voided samples. A significantly higher count of EC, ERY and LEU was also observed between females and males in first-voided samples, whereas no significant difference could be found in mid-stream samples. Health related analyzer specific upper reference limits (URL) were CAS≤1, EC≤5, ERY≤19, Leu≤13 for UF-100; CAS≤1, EC≤4, ERY≤15, Leu≤11 for UF-1000i; CAS≤1, EC≤4, ERY≤18, Leu≤10 for iQ200. The overall prevalence of subjects with cellular elements count exceeding URL was also higher in first-voided than in mid-stream samples.Mid-stream urine was confirmed as the most appropriate sample, since the presence of contaminating elements, such as bacteria, analytes and formed particles are minimized.

scholarly journals 512 - The impact of the Health Crisis on the psychological feeling of patients during the second wave of Covid-19 in Geriatric wards.

2021 ◽  
Vol 33 (S1) ◽  
pp. 63-63
Author(s):  
S. Higuet ◽  
L. Berte ◽  
F. Kromar ◽  
C. Lelubre ◽  
JP. Praet ◽  
...  
Keyword(s):  
Nursing Home ◽  
Mental State ◽  
High Stress ◽  
Depression Scale ◽  
Psychological State ◽  
Multicentric Study ◽  
Health Crisis ◽  
Significant Difference ◽  
The Impact ◽  
At Home

ObjectivesDuring the Covid Health crisis, Belgium is one of the countries that currently counts a very high rate mortality among the elderly population.With more than 24,000 deaths, including more than 10 000 nursing home patients (for a total population of 11 million); this vulnerable population paid a heavy price during this pandemic. During the 2nd wave, we wanted to focus on the level of stress, anxiety, depression and loneliness among the Geriatric hospitalized population.MethodsThis prospective observational and multicentric study (CHU St Pierre and Hospital of Nivelles-Tubize) evaluated the psychological state of our patients hospitalized in Geriatrics from 16/11/2020 to 16/03/2021 (with a Minimal Mental State > 20/30) according to the Hospital Anxiety and Depression Scale (HAD) and to the Perceived Stress Scale(PSS).We also estimated their feeling of loneliness. We analysed their biographical, social and medical data as well as their Global Geriatric Evaluation. We will also observe if there are difference between patient living in Nursing Home (NH) or at home.ResultsThe sample (n=81) has an average age of 85 years and is predominantly female. The majority were widows with an average of 2 children living at homeAmong the 81 geriatric inpatients, 30% scored positive for anxiety, rising to 57% with questionable cases. The depression scale was found to be certain for 17%, rising to 39% if doubtful cases are taken into account.We did not observe a significant difference between the two categories for the patients living at home or in Nursing Home. For the Perceived Stressed Scale, 65% had a high stress score, 15% a moderate score and 20% a low score. It can be noted that nursing home residents also suffer more from loneliness (56%) than people living at home (35%).ConclusionThis study confirms that the pandemic has had a deleterious effect on the mental state of our elderly during the 2nd wave despite some efforts to reduce isolation. The high mortality rate could be explained by government mismanagement, a delay in action in NH, but also by a latent ageism in Belgium which it would be good to analyze after the pandemic.

scholarly journals Results of a phase I, non-randomized study evaluating a Magnetic Occult Lesion Localization Instrument (MOLLI) for excision of non-palpable breast lesions

2019 ◽  
Vol 179 (3) ◽  
pp. 671-676 ◽  
Author(s):  
Nicole Look Hong ◽  
Frances C. Wright ◽  
Mark Semple ◽  
Alexandru M. Nicolae ◽  
Ananth Ravi
Keyword(s):  
User Satisfaction ◽  
Guidance System ◽  
Standards Of Care ◽  
Breast Lesions ◽  
Sonographic Guidance ◽  
Patient Reported ◽  
Occult Lesion ◽  
Palpable Breast ◽  
Intraoperative Localization ◽  
Lesion Localization

Abstract Purpose Magnetic Occult Lesion Localization Instrument (MOLLI) is a wireless, non-radioactive alternative for non-palpable breast lesion localization. The primary objective of this first-in-human study was to evaluate the clinical feasibility of using MOLLI for intraoperative localization of non-palpable breast lesions. Methods Twenty women with non-palpable breast lesions at a single institution received a lumpectomy using the MOLLI guidance system. Patients were co-localized with magnetic and radioactive markers up to 7 days before excision by a dedicated breast radiologist under sonographic guidance. Both markers were localized intraoperatively using dedicated hand-held probes. The primary outcome was successful excision of the magnetic marker, confirmed radiographically and pathologically. Demographic data, margin positivity, and re-excision rates were collected. Surgical oncologists, radiologists, and pathology staff were surveyed for user satisfaction. Results Post-radiological analysis: Post-implant mammograms verified that 17/20 markers were placed directly in the lesion center. Radiologists reported that all marker implantations procedures were “easy” or “very easy” following a single training session. Post-surgical analysis: All MOLLI markers were successfully removed with the specimen during surgical excision. In all cases, surgeons ranked the MOLLI guidance system as “very easy” for lesion localization. Pathologic analysis: All patients had negative margins. All anatomic pathology staff ranked the MOLLI system as “very easy” to localize markers. Conclusions The MOLLI guidance system is a reliable and accurate method for intraoperative localization of non-palpable breast lesions. Further evaluation of the MOLLI system in studies against current standards of care is required to demonstrate system cost-effectiveness and improved patient-reported outcomes.

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