scholarly journals New Targeted Therapies and Immunotherapies for Locally Advanced Periocular Malignant Tumours: Towards a New ‘Eye-Sparing’ Paradigm?

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2822
Author(s):  
Arnaud Martel ◽  
Sandra Lassalle ◽  
Alexandra Picard-Gauci ◽  
Lauris Gastaud ◽  
Henri Montaudie ◽  
...  
Keyword(s):  
Targeted Therapies ◽  
Paradigm Shift ◽  
Adjuvant Radiotherapy ◽  
Locally Advanced ◽  
Second Step ◽  
Malignant Tumours ◽  
New Paradigm ◽  
Eye Pain ◽  
Almost All ◽  
Orbital Lesions

The management of periocular skin malignant tumours is challenging. Surgery remains the mainstay of treatment for localised eyelid cancers. For more locally advanced cancers, especially those invading the orbit, orbital exenteration has long been considered the gold standard; however, it is a highly disfiguring and traumatic surgery. The last two decades have been marked by the emergence of a new paradigm shift towards the use of ‘eye-sparing’ strategies. In the early 2000s, the first step consisted of performing wide conservative eyelid and orbital excisions. Multiple flaps and grafts were needed, as well as adjuvant radiotherapy in selected cases. Although being incredibly attractive, several limitations such as the inability to treat the more posteriorly located orbital lesions, as well as unbearable diplopia, eye pain and even secondary eye loss were identified. Therefore, surgeons should distinguish ‘eye-sparing’ from ‘sight-sparing’ strategies. The second step emerged over the last decade and was based on the development of targeted therapies and immunotherapies. Their advantages include their potential ability to treat almost all tumours, regardless of their locations, without performing complex surgeries. However, several limitations have been reported, including their side effects, the appearance of primary or secondary resistances, their price and the lack of consensus on treatment regimen and exact duration. The aim of this article was to review the evolution of the management of locally advanced periocular malignant tumours over the last three decades and highlight the new paradigm shift towards the use of ‘eye-sparing’ strategies.

vNotes (Vaginal Natural Office Transluminal Endoscopic Surgery)

2021 ◽  
pp. 321-336
Author(s):  
Jan Baekelandt
Keyword(s):  
Endometrial Cancer ◽  
Laparoscopic Surgery ◽  
Endoscopic Surgery ◽  
Paradigm Shift ◽  
Clinical Approach ◽  
Natural Orifice ◽  
Gynaecological Surgery ◽  
New Paradigm ◽  
Conventional Surgery ◽  
Almost All

vNOTES or vaginal Natural Orifice Transluminal Endoscopic surgery is a new paradigm shift in gynaecological surgery. A first paradigm shift from conventional surgery into laparoscopic surgery was firstly observed in the 1980s and 1990s. vNOTES may represent a shift from 90° to parallel surgery. Almost all benign gynaecological operations can be performed via vNOTES. The chapter presents the technique of vNOTES along with results of various benign and mainly malignant cases. In parallel, the clinical approach of endometrial cancer is widely discussed.

scholarly journals Transoral laser surgery for laryngeal carcinoma: has Steiner achieved a genuine paradigm shift in oncological surgery?

2018 ◽  
Vol 100 (1) ◽  
pp. 2-5 ◽  
Author(s):  
AT Harris ◽  
A Tanyi ◽  
RD Hart ◽  
J Trites ◽  
MH Rigby ◽  
...  
Keyword(s):  
Paradigm Shift ◽  
Aerodigestive Tract ◽  
Malignant Tumours ◽  
Upper Aerodigestive Tract ◽  
Oncological Surgery ◽  
New Paradigm ◽  
Scientific Revolutions ◽  
Structure Of Scientific Revolutions ◽  
American Physicist ◽  
Single Modality

Transoral laser microsurgery applies to the piecemeal removal of malignant tumours of the upper aerodigestive tract using the CO2 laser under the operating microscope. This method of surgery is being increasingly popularised as a single modality treatment of choice in early laryngeal cancers (T1 and T2) and occasionally in the more advanced forms of the disease (T3 and T4), predominantly within the supraglottis. Thomas Kuhn, the American physicist turned philosopher and historian of science, coined the phrase ‘paradigm shift’ in his groundbreaking book The Structure of Scientific Revolutions. He argued that the arrival of the new and often incompatible idea forms the core of a new paradigm, the birth of an entirely new way of thinking. This article discusses whether Steiner and colleagues truly brought about a paradigm shift in oncological surgery. By rejecting the principle of en block resection and by replacing it with the belief that not only is it oncologically safe to cut through the substance of the tumour but in doing so one can actually achieve better results, Steiner was able to truly revolutionise the management of laryngeal cancer. Even though within this article the repercussions of his insight are limited to the upper aerodigestive tract oncological surgery, his willingness to question other peoples’ dogma makes his contribution truly a genuine paradigm shift.

Sanitation game changing: paradigm shift from end-of-pipe to off-grid solutions

2019 ◽  
Vol 14 (3) ◽  
pp. 497-506 ◽  
Author(s):  
J. N. Bhagwan ◽  
S. Pillay ◽  
D. Koné
Keyword(s):  
Paradigm Shift ◽  
Developing World ◽  
Universal Access ◽  
Energy Requirement ◽  
Water Security ◽  
User Preferences ◽  
New Paradigm ◽  
Human Waste ◽  
Wastewater Pollution ◽  
Developed Nations

Abstract The toilet-wastewater-pollution nexus – the provision of safe, hygienic and appropriate sanitation solutions – is an emerging, priority issue world-wide. Developed nations have followed a linear design approach to achieve their sanitation needs, with conventional waterborne systems continuously improved to meet more stringent control and pollution regulations while minimising the load on the natural environment. Developing countries, on the other hand, continue to struggle to implement such systems, due to a myriad of factors associated with financing, affordability and revenue, and thus rely heavily on on-site systems. On-site systems pose a different set of technical challenges related to their management, which is often overlooked in the developing world. Whereas, while technology strides increase in conventional sanitation processes towards zero-effluent, these come at a significant cost and energy requirement. Further, climate variability and water security put added pressure on the resources available for flushing and transporting human waste. A new paradigm for sanitation, proposed in this paper, introduces and is based on technology disrupters that can safely treat human excreta, and matches user preferences without the need for sewers, or reliance on large quantities of water and/or energy supplies. Through innovation and smart-chain supply, universal access can be achieved sustainably, and linked to water security and business opportunities. The opportunity arises for leapfrogging these solutions in growing cities in the developing world, reducing water consumption and eliminating pollutant pathways.

The Question of the Future of Indian Muslims in Malaysia: The Post-Mahathir Legacy Era

2012 ◽  
Vol 11 (1-2) ◽  
pp. 219-246 ◽  
Author(s):  
Ahmad Noor Sulastry Yurni
Keyword(s):  
Paradigm Shift ◽  
Social Economic ◽  
Ethnic Politics ◽  
Muslim Community ◽  
British Colonialism ◽  
Way Of Life ◽  
New Paradigm ◽  
Economic Allocation ◽  
Islamic Resurgence ◽  
The Difference

Abstract Abstract The Malays, Chinese and Indian community in Malaysia have been homogenized since British colonialism. The existence of Indian Muslims’ identity caused a new paradigm shift in Malaysia involving the racial discussion. This paper traces the difference in Indian Muslims’ identities from Indian and the Hindus. I argued that Indian Muslims share Islam as their religion and faith, while maintaining a Malay way of life and custom in their daily practices. In Malaysia, the Indian Muslim community struggled to place their future in terms of social, economic allocation and political justification among the other communities. However, the strength of ethnic politics clearly charted out their involvement in the political base and moved them to fight for their cause and rights. Hence, today’s Indian Muslim community has caused an Islamic resurgence, which has brought a new Indian dimension as a whole.

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