TY - JOUR. T1 - Intraoperative radiation therapy for breast cancer patients. T2 - Current perspectives. AU - Dutta, Sunil W.. AU - Showalter, Shayna L.. AU - Showalter, Timothy N.. AU - Libby, Bruce. AU - Trifiletti, Daniel M.. PY - 2017/4/18. Y1 - 2017/4/18. N2 - Accelerated partial breast irradiation (APBI) provides an attractive alternative to whole breast irradiation (WBI) through normal tissue radiation exposure and reduced treatment duration. Intraoperative radiation therapy (IORT) is a form of APBI with the shortest time interval, as it delivers the entirety of a planned radiation course at the time of breast surgery. However, faster is not always better, and IORT has been met with healthy skepticism. Patients treated with IORT have an increased compliance and overall satisfaction when compared to patients treated with WBI. However, early randomized trial results demonstrated an increased rate of recurrence after IORT, slowing its widespread adoption. Despite these controversies, IORT ...

No significant difference was observed in the risk of recurrence, local recurrence, or death between patients with cervical cancer in whom a radical uterine procedure (mostly radical hysterectomy) was completed or abandoned upon intraoperative detection of positive pelvic lymph nodes. These findings from the retrospective, observational, international ABRAX study were presented by Cibula et al at the ESMO Virtual Congress 2020 (Abstract 806O).. Controversy Around Intraoperative Detection of Positive Lymph Nodes. Researchers discussed the controversy regarding the management of patients with cervical cancer who are diagnosed with positive pelvic lymph nodes intraoperatively. Current clinical practice is almost equally divided between two different types of managements. It was noted that extensive surgical dissection in the pelvis followed by pelvic radiotherapy has been linked to higher morbidity, since both treatment modalities are associated with different types of adverse events.. ABRAX ...

Intraoperative radiation therapy, or IORT, is the application of therapeutic levels of radiation to the tumor bed while the area is exposed during surgery. IORT is typically a component in the multidisciplinary treatment of locally advanced and recurrent cancer, in combination with external beam radiation, surgery and chemotherapy. As a growing trend in recent years, IORT can also be used in earlier stage cancers such as prostate and breast cancer. IORT was found to be useful and feasible in the multidisciplinary management of many solid tumors but further studies are needed to determine the benefit more precisely. Single-institution experiences have suggested a role of IORT e.g. in brain tumors and cerebral metastases, locally advanced and recurrent rectal cancer, skin cancer, retroperitoneal sarcoma, pancreatic cancer and selected gynaecologic and genitourinary malignancies. For local recurrences, irradiation with IORT is, besides brachytherapy, the only radiotherapeutic option if repeated ...

Results of intraoperative electron beam radiotherapy containing multimodality treatment for locally unresectable T4 rectal cancer: a pooled analysis of the Mayo Clinic Rochester and Catharina Hospital Eindhoven

Invisible NIR fluorescent light can provide high sensitivity, high-resolution, and real-time image-guidance during oncologic surgery, but imaging systems that are presently available do not display th

This is a pilot study to determine the ability of intraoperative PET probe to detect and localize recurrent disease. Patients with evidence for a first recurrence of ovarian, fallopian tube or primary peritoneal carcinoma, with evidence of 18F-FDG avid disease on 18F-FDG PET/CT and who are able to undergo secondary CRS are eligible. 20 patients will be studied. All patients will undergo secondary cytoreduction guided by intraoperative PET probe survey. Intraoperative count levels as well as exvivo counts of the resected specimens will be done. Specimens detected with probe only will be labeled so and will be submitted to pathology for histopathologic confirmation ...

Aims. To retrieve and critique recent randomised trials of cutaneous warming systems used to prevent hypothermia in surgical patients during the intraoperative period and to identify gaps in current evidence and make recommendations for future trials.. Background. Hypothermia affects up to 70% of anaesthetised surgical patients and is associated with several significant negative health outcomes.. Design. Systematic review using integrative methods.. Methods. We searched CINAHL, EMBASE, Cochrane Register of Controlled Trials and Medline databases (January 2000-April 2007) for recent reports on randomised controlled trials of cutaneous warming systems used with elective patients during the intraoperative period.. Inclusion criteria. We included randomised control trials examining the effects of cutaneous warming systems used intraoperatively on patients aged 18 years or older undergoing non-emergency surgery. Studies published in English, Spanish or Portuguese with a comparison group that ...

Objectives The therapeutic relevance of enhanced sensitivity in detection of lymph node metastases has to be considered in the light of increased morbidity versus eventual prognostic improvements by modification of therapy. An interesting concept which might improve diagnostic accuracy while reducing operative morbidity is the sentinel node technique. The sentinel lymph node is the first lymph node to receive the lymphatic drainage from a primary tumour. Conducted using vital dye or visualisation would indicate that this concept can be successfully applied to the management of mammary tumours. (1) The immunohistochemical detection of cytokeratin positive disseminated tumour cells in lymph nodes can help to obtain a more exact identification of patients with an unfavourable prognosis. The use of immunohistochemistry can change the status of a negative node to a positive node in 5-20% of the sample tested, and thus inclusion of an immunohistochemical evaluation may reduce the false-negative rate ...

Breast IORT is radiation treatment delivered as a single radiation dose at the time of breast conserving surgery (lumpectomy). IORT is a form of brachytherapy, where radiation is delivered within the surgical cavity.

Lifetime cost-effectiveness analysis reveals $630 million annual cost savings, less radiation exposure and better quality of life for patients.

The goal of this study is to evaluate if a single dose of electron radiation therapy delivered during breast conserving surgery is safe and effective for...

Over the last 2 centuries, surgeons have depended on 2 tools in the operating room to detect disease-their eyes to look for suspicious masses and their hands to feel for abnormal tissue (23). Surgeons make subjective decisions based on experience of anatomical tissue planes and tumor spread in deciding where to excise tumors to obtain disease-free margins. However, this is historically inaccurate, especially in complex fields including those with prior radiation, infection, or trauma. For example, at University of Miami, one experienced urologist carried out 100 consecutive radical prostatectomies and recorded intraoperatively if he suspected the tumor margins were positive or negative based on visual clues and palpation (24). Despite his intraoperative decision that the surgical margins were negative in all 100 patients, the true pathologic margins were positive in 39% of cases. The intraoperative assessment of the margin status had a high false-negative rate and a sensitivity of only 7%. The ...

Obesity is considered a global epidemic. Its continuous increase in prevalence places the anesthestist in conflict with consequences of this condition. The most prominent alteration in the respiratory system is the reduction of the residual functional capacity, which occurs mainly due to the reduction of the chest and lung complacence. This impacts on the mechanic respiratory and on gas exchange. There are several strategies to minimize this impact on general anesthesia. Proclive position increases the apnea time during induction. One should avoid to the maximum the Trendelenburg and lithotomy positions, since they worsen the respiratory function. Maximum caution should be taken in airway management due to the increased risk of difficulties of ventilation and intubation in the obese. Before intubation, the patient should be positioned properly. Another strategy is the use of CPAP during the pre-oxigenation phase and the application of alveolar recruitment maneuver in intraoperative period, ...

NASHUA, N.H.--(BUSINESS WIRE)--Feb 19, 2013--iCAD (Nasdaq: ICAD), an industry-leading provider of advanced image analysis, workflow solutions and radiation therapy for the early identification and treatment of cancer, today reported financial results for the three and twelve months ended December 31, 2012.. During the fourth quarter we posted strong revenue growth, maintained adjusted EBITDA profitability and generated positive cash flow, said Ken Ferry, President and CEO of iCAD. This considerable progress can be attributed to continued strong growth of our therapy solutions, a much stronger quarter in cancer detection coupled with on-going disciplined expense management. For the full year, therapy revenue was particularly strong as we more than doubled new systems and applicator sales compared with 2011. We were pleased that the U.S. Centers for Medicare & Medicaid Services (CMS) issued an improved payment policy for the delivery of Intraoperative Radiation Therapy (IORT). The payment ...

Purpose This study was designed to evaluate the effect of preoperative pregabalin on intraoperative neurophysiological monitoring in adolescents undergoing surgery for spinal deformities.

Scientists say new technique may help improving decision-making during surgery and provide expert-level assessment in the absence of trained neuropathologists

Typically, when treating breast cancer, some type of surgery is performed to remove the tumor. After breast-preserving surgery, external beam radiatio...

Sentinel lymph node (SLN) biopsy is the standard of care for the surgical assessment of the axilla during breast cancer surgery. However, the diagnostic accuracy of intraoperative frozen section analysis for confirming metastatic involvement of SLNs in cases of invasive lobular carcinoma (ILC) versus that of invasive ductal carcinoma (IDC) has generated controversy secondary to a frequently low-grade cytologic appearance and an often discohesive pattern displayed by metastatic lymph nodes in ILC. In the current report, we present a comparison of intraoperative frozen section analysis for confirming the presence of metastatic disease within SLNs during breast cancer surgery for ILC and IDC. We evaluated the results of 131 consecutive cases of ILC from 1997 to 2008 and 133 cases of IDC (selected by a random sequence generator program) from amongst 1163 consecutive cases of IDC from the same time period. All cases had at least one SLN that had both intraoperative frozen section analysis and confirmatory

TY - JOUR. T1 - Feasibility of intraoperative detection of sentinel lymph nodes with 89-zirconium-labelled nanocolloidal albumin PET-CT and a handheld high-energy gamma probe. AU - Heuveling, Derrek A.. AU - Karagozoglu, K. Hakki. AU - Van Lingen, Arthur. AU - Hoekstra, Otto S.. AU - Van Dongen, Guus A. M. S.. AU - De Bree, Remco. PY - 2018/2/14. Y1 - 2018/2/14. N2 - Background: PET/CT lymphoscintigraphy using 89Zr-nanocolloidal albumin has the potential to improve the preoperative identification of sentinel lymph nodes (SLNs), especially if located in the near proximity of the primary tumour. This study aims to demonstrate the feasibility of PET/CT lymphoscintigraphy followed by intraoperative detection of 89Zr-nanocolloidal albumin containing SLNs with the use of a handheld high-energy gamma probe. Methods: PET/CT lymphoscintigraphy was performed after peritumoural injection of 89Zr-nanocolloidal albumin in five patients with oral cavity carcinoma planned for surgical resection. SLN biopsy ...

Intraoperative radiation therapy (IORT) has been customarily performed either in a shielded operating suite located in the operating room (OR) or in a shielded treatment room located within the Department of Radiation Oncology. In both cases, this cancer treatment modality uses stationary linear accelerators. With the development of new technology, mobile linear accelerators have recently become available for IORT. Mobility offers flexibility in treatment location and is leading to a renewed interest in IORT. These mobile accelerator units, which can be transported any day of use to almost any location within a hospital setting, are assembled in a nondedicated environment and used to deliver IORT. Numerous aspects of the design of these new units differ from that of conventional linear accelerators. The scope of this Task Group (TG-72) will focus on items that particularly apply to mobile IORT electron systems. More specifically, the charges to this Task Group are to: i) identify the key ...

New York-Presbyterian/Columbia University Medical Center is one of the first institutions in the New York metropolitan area to offer intraoperative radiation therapy (IORT), which entails a single dose of radiation therapy that is administered immediately after lumpectomy. This innovative breast cancer therapy became available at the BreastCenter during the summer of 2013.

In a randomized noninferiority trial (TARGIT-A) reported in The Lancet, Jayant S. Vaidya, PhD, and Michael Baum, MD, of University College London, and colleagues compared risk-adapted radiotherapy using single-dose targeted intraoperative radiotherapy vs fractionated external-beam radiotherapy in women with breast cancer. Targeted intraoperative radiotherapy met the noninferiority margin for 5-year local recurrence among all patients and when given concurrently with lumpectomy but not when delayed until after lumpectomy (postpathology). Breast cancer mortality did not differ significantly between the two groups, but targeted intraoperative radiotherapy was associated with reduced non-breast cancer mortality.. Study Details. In this open-label, randomized trial, 3,451 women aged ≥ 45 years with invasive ductal carcinoma were randomly assigned to receive single-dose targeted intraoperative radiotherapy (n = 1,721) or whole-breast external-beam radiotherapy according to standard schedules over ...

TY - JOUR. T1 - Haemostatic derangement in patients with intracranial tumours. AU - Manjunath Prasad, K. S.. AU - Sharma, B. S.. AU - Marwaha, Neelam. AU - Sarode, Ravindra S.. AU - Kak, V. K.. PY - 1994/1/1. Y1 - 1994/1/1. N2 - Forty-five patients with brain tumours were studied for evidence of any haemostatic abnormalities in the preoperative and intraoperative period. An abnormality was found in 44 of the patients in the preoperative period and in all the patients during the operation. One patient developed acute disseminated intravascular coagulation. A change in the haemostatic abnormality from the preoperative to the intraoperative period was demonstrated in 9 of the patients. The histological nature of the tumour did not influence the haemostatic derangement. A shortened euglobulin lysis time, prolonged thrombin time, increased fibrin degradation products and abnormal fibrinogen levels were the common isolated abnormalities. When considered together, chronic disseminated intravascular ...

Intraoperative Radiotherapy (IORT) involves treatment with radiation therapy during surgery. The benefit of this method is that less tissue is exposed to radiation. The target area can be directly viewed by your team of oncologists and surgeons, and a more effective dose of radiation may be delivered directly to the tumor. Intraoperative irradiation can be used with many types of tumors, including breast cancer, colorectal cancers, and sarcomas, in order to improve the outcome of cancer treatment. ROA physicians use the Zeiss Intrabeam system to deliver intraoperative radiation treatments. Learn more about the Zeiss Intrabeam System. ...

Relapses of epithelial ovarian carcinoma (EOC) have a poor prognosis and are almost always fatal. The aim of this study was to evaluate the clinical outcome and toxicity of intraoperative electron beam radiation therapy (IOERT) in advanced and recurrent EOC. Forty-five women with EOC were treated with IOERT. Twenty-five patients had primary disease (PD) without distant metastasis at IOERT, and 20 patients had an isolated local recurrence (ILR) after surgery. All 45 patients in this series underwent optimal cytoreductive (≤ 1 cm) surgery. The whole pelvic (WP) radiotherapy was intraoperatively delivered using 12 Mev electron beam; 43 patients received 18-20 Gy and two patients received 10 Gy. Thirty-three patients received postoperateive intraperitoneal (IP) chemotherapy, while seven patients received intravenous (IV) chemotherapy. Five patients refused concurrent chemotherapy. Overall survival (OS) rates were analyzed using the Kaplan-Meier method. Tumor recurrence and metastasis were observed in 16

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A national survey has revealed that 80% of patients experienced pain after surgery and 86% of these patients had moderate, severe or extreme pain (1).Postoperative pain can extend recovery room stay after surgery and it is also a common cause of unanticipated admissions which have important economic implications(2).More importantly, postoperative pain can lead to a poor quality of recovery in ambulatory patients. The Intraoperative use of medications that might decrease postoperative pain is therefore highly desirable.. Some medications such as lidocaine and ketamine have been proved to decrease postoperative pain when given during the Intraoperative period in ambulatory patients(3,4) but it is still unknown if those medications can in fact lead to a better quality of recovery .. Magnesium sulfate is a non-competitive calcium antagonist at the N-methyl-D- aspartate (NMDA) receptor(5). NMDA receptors have an important role on pain modulation (6). The use of Intraoperative magnesium in order to ...

Intraoperative Ultrasound (IOUS) in Neurosurgery auf frohberg.de - This book is intended as a practical manual on the use of intraoperative ultrasound...

Receive peer-to-peer education on the use of intraoperative ultrasound in neurosurgery and learn the clinical benefits of intraoperative ultrasound.

Vol 5: Intraoperative use of remifentanil and opioid induced hyperalgesia-acute opioid tolerance: systematic review.. . Biblioteca virtual para leer y descargar libros, documentos, trabajos y tesis universitarias en PDF. Material universiario, documentación y tareas realizadas por universitarios en nuestra biblioteca. Para descargar gratis y para leer online.

A single dose of radiotherapy delivered at the time of surgery by way of targeted intraoperative radiotherapy should be considered as an alternative to external beam radiotherapy delivered over several weeks postsurgery for selected patients with early breast cancer, found a study published online June 5 in the Lancet.

Single-dose intraoperative radiotherapy for early stage breast cancer - Radiation delivered to the tumour site after the tumour is removed.. Choose Spire Parkway Hospital.

David Azria, Claire Lemanski. Intraoperative radiotherapy for breast cancer.. Lancet, Elsevier, 2013, epub ahead of print. ⟨10.1016/S0140-6736(13)62304-1⟩. ⟨inserm-00905297⟩ ...

The Pathology Institute diagnoses patients at the ukb using microscopic analysis of tissue samples, surgical specimens and aspirates. We use innovative histological, immunohisotological and molecular biological methods. The diagnoses we provide contributes to the successful treatment of patients in all disciplines. The services of the Institute encompasses almost the entire diagnostic spectrum of pathology. The pathologists are part of an interdisciplinary team of the tumour conference that determines the therapeutic approach to patients with malignant tumours. The tumour conference is led by the Director of the Pathology Institute. The Institute is an integral part of the Head Neck and Tumour Centre of the ukb. Among its other services, the Institute also provides intraoperative frozen section analyses which supply essential information to the surgeon. The Institute also performs autopsies to find underlying illness and cause of death. ...

There have been previous studies with similar hypotheses and methodology. Engoren et al. 12 studied 1,915 subjects undergoing first-time isolated coronary artery bypass at St. Vincent Mercy Medical Center, Toledo, Ohio. In a Cox regression model, they demonstrated that age, New York Heart Association functional class IV, chronic obstructive pulmonary disease, peripheral vascular disease, and perioperative blood transfusion were predictors of mortality occurring between 1 and 5 yr after surgery. Detailed information about the number of units transfused was not available; therefore, quantification of transfusion was done in a limited manner, subjects were grouped according to transfusions given during the intraoperative period, postoperative period, or both. Koch et al. 13 studied 10,289 subjects undergoing isolated coronary artery surgery at the Cleveland Clinic, follow-up was 10 yr, and transfusion was quantified by the number of units of red cells transfused to subjects in the perioperative ...

title:Perioperative Anaphylaxis - Our Experience of Two Cases. Author:Nikhil Mudgalkar, Nagpadma, Sharley. Keywords:Keywords: perioperative anaphylaxis, hydatid cyst, adrenaline. Type:Case report. Abstract:Anaphylactic reactions during intraoperative period are difficult to diagnose because of the anaesthetized state of the patient. During the perioperative period, any event relating to sudden-onset haemodynamic collapse or increased airway pressures during certain surgical procedures should raise suspicion of anaphylaxis. Though cited as rare in the western world, echinococcus infection is common in India, resulting in an increased ratio of cases, as and when compared to the western world. We report of two cases of perioperative anaphylaxis for hydatid disease surgery during 3 years period. Anaphylaxis is a medical emergency requiring prompt intervention. Although protocols vary in some of the details of management, adrenaline is the mainstay of treatment and early administration saves lives. ...

Health care stakeholders need to invest in value-based care, innovative care delivery models, advanced digital technologies. XploreMR will help you to know declarative, procedural, contextual, and somatic information about the Intraoperative Imaging Market. It also provides a critical assessment of the performance of emerging and mature markets in a new publication titled Global Market Study on Intraoperative Imaging: Systems Segment Projected to Grow at a Relatively High CAGR over the Forecast Period.. XploreMR examines the performance of the global intraoperative imaging market for a period of eight years in a new report titled Intraoperative Imaging Market: Global Industry Analysis and Forecast, 2016-2024. According to the report, companies operating in the global intraoperative imaging market are mainly focusing on geographic expansion, establishing facilities in proximity to target markets and consolidation of existing manufacturing capabilities to gain larger market share.. Click ...

The broad scope of the National Clinical Guidelines on Intraoperative Massive Haemorrhage project includes unanticipated massive haemorrhage events caused by the operating/surgical procedure itself. More ...

PubMed comprises more than 30 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

Some surgeons check PTH levels in the operating room just before and after removing a parathyroid gland. This technique is called intraoperative PTH.

Mediastinum aims to provide high level evidence and useful resources for all healthcare professionals engaged in delivering quality care to their mediastinal patients.

Intraoperative angiography was also found to be useful in the reassessment of residual lesions after the surgical approach had been modified. Our study revealed 43 cases in which repeat imaging was conducted. The results of these repeat studies confirmed complete eradication of the lesion in 19 (44%) and persistent lesion requiring additional surgical manipulation in 24 (56%) of the cases. Therefore, it is necessary to repeat the imaging technique at various stages during the operation to identify the anatomic changes as the operation progresses and to ensure total eradication of the lesion.. Analysis of the combined data showed that intraoperative angiography verified complete eradication in 158 procedures (84%). In a second group of 15 patients (8%) the lesion was thought to be completely treated on the basis of previous intraoperative angiograms and surgical inspection; however, repeat intraoperative angiograms were not obtained after minor surgical manipulations. This lack of consistency was ...

Intraoperative frozen section interpretation is the base for treatment for the patient within the operating room. It requires immediate answer for the surgeons specific question and the subsequent consequences are frequently irreversible. The pathologist should be very familiar with the related

[118 Pages Report] Check for Discount on Global Intraoperative Computed Tomography (CT) Sales Market Report 2017 report by QYResearch Group. In this report, the global Intraoperative Computed Tomography (CT) market...

Vaidya, J. S., Wenz, F., Bulsara, M., Tobias, J. S., Joseph, D., Keshtgar, M., Flyger, H., Massarut, S., Alvarado, M., Saunders, C., Eiermann, W., Metaxas, M., Sperk, E., Sutterlin, M., Brown, D., Esserman, L., Roncadin, M., Thompson, A., Dewar, J. A., Holtveg, H., Pigorsch, S., Falzon, M., Harris, E., Matthews, A., Brew-Graves, C., Potyka, I., Corica, T., Williams, N. R., & Baum, M. (2013). Updated results of local control and first analysis of survival from the randomised trial of risk-adapted TARGeted Intraoperative radioTherapy (TARGIT-A) for early breast cancer. Lancet, In press. ...

At Cole Eye Institute, surgeons and researchers are working to develop the next generation of intraoperative OCT devices and instrumentation to improve ophthalmic surgical outcomes in real time.

Intraoperative neurophysiological monitoring is a procedure to continuously monitor the nervous systems functional integrity during operations involving the brain and spinal cord. Electrodes or needles attached to the patients relevant anatomy continuously transmit information, which can be viewed on a monitor.

[161 Pages Report] Intraoperative Imaging Market categorizes the global market By Product (CT, MRI, Ultrasound), By Application (ENT, Gastro) & By Geography

A surgical stress to the body causes a series of metabolic changes that leads to a cascade of endocrine and inflammatory responses. The magnitude of the responses depends on the extent and nature of t... more

4.1. Excessive bleeding without surgical explanation according to the surgeons impression (Classification of bleeding as normal, moderate or excessive by the surgeon. Classification as excessive bleeding leads to recruitment to the study ...