scholarly journals Tigilanol Tiglate-Mediated Margins: A Comparison With Surgical Margins in Successful Treatment of Canine Mast Cell Tumours

2021 ◽  
Vol 8 ◽  
Author(s):  
Thomas De Ridder ◽  
Paul Reddell ◽  
Pamela Jones ◽  
Graham Brown ◽  
Justine Campbell
Keyword(s):  
Mast Cell ◽  
Surgical Excision ◽  
Tumour Volume ◽  
Surgical Margins ◽  
Lower Limbs ◽  
Tissue Loss ◽  
Surgical Approaches ◽  
Controlled Clinical Trial ◽  
Novel Approach ◽  
The Usa

Tigilanol tiglate (TT) is a novel small molecule registered as a veterinary pharmaceutical for intratumoural treatment of canine mast cell tumours (MCTs). The drug has a multifactorial mode of action resulting in rapid destruction of the treated tumour by haemorrhagic necrosis and subsequent slough of the necrotic tumour to reveal a tissue deficit that is left to heal by second intention with minimal to no veterinary intervention. Here we introduce the concept of TT-mediated margins, the calculated margin of tissue loss analogous to surgically applied margins to help clinicians conceptualise tissue deficits formed following tumour destruction by TT relative to surgical excision. We used data from 51 dogs that were recurrence-free 12 months after a single administered TT dose into a single target MCT <10 cm3 in volume in a randomised, controlled clinical trial in the USA. We calculated TT-mediated margins based on length of the longest axis of (i) the tumour prior to treatment and (ii) the maximum tissue deficit formed 7–14 days after TT treatment. We compared these TT-mediated margins for each tumour to two surgical approaches to MCT excision in general practise: modified proportional margins (with 2 cm upper limit) and 3 cm fixed margins. For most dogs, TT-mediated margins were less than half the length of the margins calculated for the two surgical approaches in removing the same tumour. There was a trend for TT-mediated margins to increase with increasing tumour volume. Nonetheless, even for the larger tumours in this study (>2 cm3 volume), 50% of TT-mediated margins were less than half the length of the two surgical margins. Eighteen cases were lower limb MCTs, sites often surgically challenging in veterinary practise. On these lower limbs, TT-mediated margins were less than half the length of the corresponding proportional margins in 56% of cases and larger than proportional margins in only two cases. This study suggests that, in many cases, smaller and more targeted margins could be expected when treating MCTs <10 cm3 volume with TT compared with surgical excision. TT-mediated margins are a novel approach to conceptualise tissue deficits after intratumoural TT treatment.

scholarly journals Intratumoural Treatment of 18 Cytologically Diagnosed Canine High-Grade Mast Cell Tumours With Tigilanol Tiglate

2021 ◽  
Vol 8 ◽  
Author(s):  
Graham K. Brown ◽  
Justine E. Campbell ◽  
Pamela D. Jones ◽  
Thomas R. De Ridder ◽  
Paul Reddell ◽  
...  
Keyword(s):  
Mast Cell ◽  
Local Treatment ◽  
Evaluation Criteria ◽  
Surgical Excision ◽  
Complete Response ◽  
Tumour Volume ◽  
Additional Treatment ◽  
Tumour Mass ◽  
High Grade ◽  
Tumour Location

Canine high-grade mast cell tumours (HGMCT) are associated with a poor prognosis, are inherently more invasive, and have higher rates of local recurrence. The primary aim of this retrospective study was to assess the efficacy of intratumoural tigilanol tiglate (TT) as a local treatment option. Eighteen dogs with mast cell tumours (MCT) cytologically diagnosed by veterinary pathologists as either high-grade or suspected high-grade MCT were treated with TT. The TT dose was based on tumour volume (0.5 mg TT/cm3 tumour volume) and delivered intratumourally using a Luer lock syringe and a fanning technique to maximise distribution throughout the tumour mass. Efficacy was assessed on the presence/absence of a complete response (CR) to therapy at days 28 and 84 using response evaluation criteria in solid tumours (RECIST). For dogs not achieving a CR after 28 days, the protocol was repeated with a second intratumoural TT injection. Ten out of 18 dogs (56%) in this study achieved and maintained a CR to at least 84 days after their first or second treatment. Six patients were alive and available for evaluation at 2 years, three of those were recurrence free, and a further three patients were recurrence free following a second treatment cycle. Tigilanol tiglate shows efficacy for local treatment of HGMCT, with higher efficacy noted with a second injection if a CR was not achieved following the first treatment. In the event of treatment site recurrence (TSR), the tumour may be controlled with additional treatment cycles. Tigilanol tiglate provides an alternative local treatment approach to dogs with HGMCT that would either pose an unacceptable anaesthetic risk or the tumour location provides a challenge when attempting surgical excision.

Treatment Options for Pilonidal Disease

2017 ◽  
Vol 83 (5) ◽  
pp. 453-457 ◽  
Author(s):  
Denis Ehrl ◽  
Cornelia Choplain ◽  
Paul Heidekrueger ◽  
Holger C. Erne ◽  
Horst-Guenter Rau ◽  
...  
Keyword(s):  
Pilonidal Disease ◽  
Treatment Options ◽  
Surgical Excision ◽  
Minimal Invasive ◽  
Tissue Loss ◽  
Surgical Approaches ◽  
Complication Rates ◽  
Short Recovery Time ◽  
Flap Closure

Pilonidal disease can be treated medically; however, surgical excision remains the gold standard. Nonetheless, all current surgical approaches are still associated with potential for tissue loss, wound healing disorders, and high rates of recurrence. Aim of this study is to assess the long-term outcomes of the minimal-invasive pit-picking operation in comparison to the well-established technique of Karydakis flap-closure. Medical records of all patients undergoing either Karydakis flap-closure or the pit-picking operation for pilonidal disease at our department were reviewed retrospectively. A total of 101 patients were treated either by excision and Karydakis flap-closure (n = 62) or by the pit-picking operation (n = 39). Mean follow-up time was 65.5 (range: 38–101) months, including data collection using a standardized questionnaire. Analysis of the outcomes revealed no significant differences between the Karydakis flap-closure- and the pit-picking groups; however, the latter was associated with faster recovery, no need for hospitalization and overall low complication rates. In summary, the main advantages of the pit-picking operation lie in its’ outpatient character, the simplicity of the procedure, low complication rates, short recovery time, and predictably good results.

scholarly journals One-Stage Soft Tissue Reconstruction Following Sarcoma Excision: A Personalized Multidisciplinary Approach Called “Orthoplasty”

2020 ◽  
Vol 10 (4) ◽  
pp. 278
Author(s):  
Andrea Angelini ◽  
Cesare Tiengo ◽  
Regina Sonda ◽  
Antonio Berizzi ◽  
Franco Bassetto ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Lower Limbs ◽  
Surgical Approaches ◽  
Soft Tissue Reconstruction ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
One Stage ◽  
Unplanned Excision ◽  
Increased Risk ◽  
Toronto Extremity Salvage Score

Background and Objectives. Wide surgical resection is a relevant factor for local control in sarcomas. Plastic surgery is mandatory in demanding reconstructions. We analyzed patients treated by a multidisciplinary team to evaluate indications and surgical approaches, complications and therapeutic/functional outcomes. Methods. We analyzed 161 patients (86 males (53%), mean age 56 years) from 2006 to 2017. Patients were treated for their primary tumor (120, 75.5%) or after unplanned excision/recurrence (41, 25.5%). Sites included lower limbs (36.6%), upper limbs (19.2%), head/neck (21.1%), trunk (14.9%) and pelvis (8.1%). Orthoplasty has been considered for flaps (54), skin grafts (42), wide excisions (40) and other procedures (25). Results. At a mean follow-up of 5.3 years (range 2–10.5), patients continuously showed no evidence of disease (NED) in 130 cases (80.7%), were alive with disease (AWD) in 10 cases (6.2%) and were dead with disease (DWD) in 21 cases (13.0%). Overall, 62 patients (38.5%) developed a complication (56 minor (90.3%) and 6 major (9.7%)). Flap loss occurred in 5/48 patients (10.4%). The mean Musculoskeletal Tumor Society (MSTS) and Toronto Extremity Salvage Score (TESS) was 74.8 ± 14 and 79.1 ± 13, respectively. Conclusions. Orthoplasty is a combined approach effective in management of sarcoma patients, maximizing adequate surgical resection, limb salvaging and functional recovery. One-stage reconstructions are technically feasible and are not associated with increased risk of complications.

Residential segregation of same-sex partnered households in the US

2018 ◽  
Vol 38 (11/12) ◽  
pp. 973-981
Author(s):  
Danielle Xiaodan Morales
Keyword(s):  
Residential Segregation ◽  
Quantitative Research ◽  
Scale Effects ◽  
Sex Partners ◽  
Same Sex ◽  
Dissimilarity Index ◽  
Geographic Scale ◽  
Content Type ◽  
Novel Approach ◽  
The Usa

Purpose Quantitative research on the segregation of same-sex partners in the USA is new, and limited by challenges related to the accurate measurement of segregation and data errors. The purpose of this paper is to provide a novel approach to re-examine residential segregation between same-sex partners and different-sex partners in the USA. Design/methodology/approach Two versions of the dissimilarity index and corrected same-sex partners data from the 2010 decennial census were used. Effects of different geographic scales were examined. Findings Results reveal that the levels of segregation of both male and female same-sex partners were higher at metropolitan- vs state-levels; the levels of segregation was lower when measured using the unbiased as compared to the conventional version of the D-index; and male same-sex partnered households were more segregated from different-sex partnered households than were female same-sex partnered households. Research limitations/implications Future studies should be attuned to geographic scale effects and should not ignore the bias of the D-index. Originality/value This study provides a better test of the differences between the two versions of the D-index and contributes to the literature by examining the segregation of both male same-sex partners and female same-sex partners across different geographic scales.

scholarly journals Tuberculous brain abscess in a patient with AIDS: case report and literature review

2003 ◽  
Vol 45 (2) ◽  
pp. 111-114 ◽  
Author(s):  
José E. Vidal ◽  
Sérgio Cimerman ◽  
Paula R. Marques da Silva ◽  
Jaques Sztajnbok ◽  
João F.G.S. Coelho ◽  
...  
Keyword(s):  
Brain Abscess ◽  
Surgical Excision ◽  
Toxoplasmic Encephalitis ◽  
Surgical Approaches ◽  
Aids Patients ◽  
Stereotactic Aspiration ◽  
Antituberculous Treatment ◽  
Brain Abscesses ◽  
Tuberculous Brain Abscess ◽  
Tomography Scan

Tuberculous brain abscesses in AIDS patients are considered rare with only eight cases reported in the literature. We describe the case of a 34-year-old woman with AIDS and previous toxoplasmic encephalitis who was admitted due to headache and seizures. A brain computed tomography scan disclosed a frontal hypodense lesion with a contrast ring enhancement. Brain abscess was suspected and she underwent a lesion puncture through a trepanation. The material extracted was purulent and the acid-fast smear was markedly positive. Timely medical and surgical approaches allowed a good outcome. Tuberculous abscesses should be considered in the differential diagnosis of focal brain lesions in AIDS patients. Surgical excision or stereotactic aspiration, and antituberculous treatment are the mainstay in the management of these uncommon lesions.

scholarly journals Juvenile Nasopharyngeal Angiofibroma - Excision Through Lateral Rhinotomy and Sublabial Approach - A Case Report

1970 ◽  
Vol 20 (1) ◽  
pp. 78-81
Author(s):  
NK Sinha ◽  
MH Rashid ◽  
MM Shaheen ◽  
DC Talukder ◽  
MAY Fakir ◽  
...  
Keyword(s):  
Surgical Excision ◽  
Complete Removal ◽  
Definitive Treatment ◽  
Surgical Approaches ◽  
Complete Excision ◽  
Nasopharyngeal Angiofibroma ◽  
Male Adolescents ◽  
Large Size ◽  
Complete Surgical Excision ◽  
Sublabial Approach

Juvenile angiofibroma is a rare hypervascular, locally aggressive benign tumour which is exclusively found in the nose and paranasal sinuses of male adolescents. The definitive treatment for this tumour is complete surgical excision. Different surgical approaches are used for complete excision. Most recent development is excision of the tumour using endoscopes. But in certain cases with large size and different extensions, open transfacial approaches are the choice for complete removal and for less operative bleeding, which are the main challenges for surgical excision of this tumour. DOI: http://dx.doi.org/10.3329/jdmc.v20i1.8587 J Dhaka Med Coll. 2011; 20(1) :78-81

scholarly journals Aspirin Exacerbated Respiratory Disease: Epidemiology, Pathophysiology, and Management

2019 ◽  
Vol 7 (3) ◽  
pp. 45 ◽  
Author(s):  
Kevin Li ◽  
Andrew Lee ◽  
Waleed Abuzeid
Keyword(s):  
Respiratory Disease ◽  
Symptom Control ◽  
Significant Proportion ◽  
Disease Process ◽  
Surgical Approaches ◽  
Endoscopic Techniques ◽  
Disease Epidemiology ◽  
Asthmatic Patients ◽  
Aspirin Exacerbated Respiratory Disease ◽  
The Usa

The correlation between aspirin sensitivity, asthma, and nasal polyposis was recognized in the early 20th century. Today, this classic triad of symptoms, eponymously named Samter’s Triad, is known as aspirin exacerbated respiratory disease (AERD). Aspirin exacerbated respiratory disease affects approximately 0.3–0.9% of the general population in the USA and approximately 7% of asthmatic patients. The management of AERD is challenging as no single modality has proven to have high rates of symptom control. Consequently, disease management typically involves a multimodality approach across both medical and surgical disciplines. This review describes the epidemiology of AERD and the current state-of-the-art as it relates to the underlying pathophysiologic mechanisms of this disease process. A significant proportion of the review is focused on the appropriate diagnostic workup for AERD patients including the utility of aspirin provocation testing. The spectrum of medical treatments, including aspirin desensitization and recently introduced immunotherapies, are discussed in detail. Furthermore, surgical approaches to disease control, including advanced endoscopic techniques, are reviewed and treatment outcomes presented.

scholarly journals The relationship between the deep fibular nerve and the dorsalis pedis artery and its surgical importance

2009 ◽  
Vol 42 (01) ◽  
pp. 018-021
Author(s):  
R. Chitra
Keyword(s):  
Vascular Supply ◽  
Lower Limbs ◽  
Surgical Approaches ◽  
Tarsal Tunnel ◽  
Detailed Knowledge ◽  
Dorsalis Pedis Artery ◽  
Extensor Hallucis Longus ◽  
Relationship Of ◽  
The Relationship ◽  
Fibular Nerve

ABSTRACTThe aim of this study was to demonstrate the relationship between the deep fibular nerve and the dorsalis pedis artery to provide useful anatomical knowledge for safe surgical approaches in plastic surgery. The dissection of 30 cadaver lower limbs was undertaken to describe the relationship of the deep fibular nerve to the dorsalis pedis artery in the anterior tarsal tunnel and on the dorsum of the foot. The anterior tarsal tunnel is a flattened space between the inferior extensor retinaculum and the fascia overlying the talus and navicular. The deep fibular nerve and its branches pass longitudinally through this fibro-osseous tunnel, deep to the tendons of the extensor hallucis longus and extensor digitorum longus. Four distinct relationships of the deep fibular nerve to the dorsalis pedis artery were determined. The dorsalis pedis neurovascular island flap contains both the dorsalis pedis artery and the deep fibular nerve. Because the design of a neurovascular free flap requires detailed knowledge of the nerve and vascular supply, the data presented here are intended to help surgeons during surgical approaches to the foot and ankle.

A novel approach to estimate methane oxidation in interim landfill covers across the USA

2015 ◽  
Vol 15 (4) ◽  
pp. 309 ◽  
Author(s):  
Tarek Abichou ◽  
Tarek Kormi ◽  
Cheng Wang ◽  
Jeffrey P. Chanton ◽  
Roger Green ◽  
...  
Keyword(s):  
Methane Oxidation ◽  
Novel Approach ◽  
The Usa ◽  
Landfill Covers

scholarly journals The World Bacterial Biogeography and Biodiversity through Databases: A Case Study of NCBI Nucleotide Database and GBIF Database

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Okba Selama ◽  
Phillip James ◽  
Farida Nateche ◽  
Elizabeth M. H. Wellington ◽  
Hocine Hacène
Keyword(s):  
Geographical Area ◽  
Geographic Area ◽  
Global Scale ◽  
Service Access ◽  
Novel Approach ◽  
Online Databases ◽  
The Usa ◽  
Nucleotide Database ◽  
Bacterial Biodiversity

Databases are an essential tool and resource within the field of bioinformatics. The primary aim of this study was to generate an overview of global bacterial biodiversity and biogeography using available data from the two largest public online databases, NCBI Nucleotide and GBIF. The secondary aim was to highlight the contribution each geographic area has to each database. The basis for data analysis of this study was the metadata provided by both databases, mainly, the taxonomy and the geographical area origin of isolation of the microorganism (record). These were directly obtained from GBIF through the online interface, whileE-utilitiesandPythonwere used in combination with a programmatic web service access to obtain data from the NCBI Nucleotide Database. Results indicate that the American continent, and more specifically the USA, is the top contributor, while Africa and Antarctica are less well represented. This highlights the imbalance of exploration within these areas rather than any reduction in biodiversity. This study describes a novel approach to generating global scale patterns of bacterial biodiversity and biogeography and indicates that theProteobacteriaare the most abundant and widely distributed phylum within both databases.

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