1,721,102 research outputs found
Lympha technique for primary and early secondary prevention of lymphedema following cancer treatment
No full textLYMPHA proved to be an effective preventive procedure that contributes in giving our oncological patients a good quality of life. In this presentation, the author will report indications, technical aspects and benefits of LYMPHA technique
Intraoperative sentinel node detection by an innovative imaging probe.
No full textIntraoperative sentinel node detection by an innovative imaging probe.
Campisi C, Soluri A, Stella S, Valenti G, Scopinaro F.
SourceInstitute of Biomedical Technologies, National Research Council, Rome. [email protected]
Abstract
Intraoperative tumor detection has been used in many applications, and today the sentinel node technique is a widely employed surgical procedure in breast cancer. Different detector systems are employed but several problems have been reported in clinical practice, in particular the difficulty to accurately detect the sentinel node within the axillary soft tissue. The problem is even greater for abdominal and thoracic tumors. We propose an innovative Imaging Probe (IP) able to visualize on a monitor the primary tumor and secondary lesions if appropriately radiolabeled. The IP can be optimally applied for minimally invasive surgery in breast cancer treatment, and a preliminary experience related to 15 patients and 20 sentinel nodes is reported here. We compared the results obtained with the IP to those obtained with an Anger camera and a traditional scintillation detector, and found them to be very promising. In particular the surgeon's work is greatly facilitated by direct visual guidance instead of a generic acoustic signal.
PMID:12369557[PubMed - indexed for MEDLINE
Optimizing the staging of melanoma patients for their best surgical management
No full textInterval nodes (IN) are defined as lymph nodes that lie along the course of lymphatic collecting vessels between a primary tumor site and a draining node field. Sometimes INs contain metastases and a consensus on their surgical management is needed. Therefore, to optimize the surgical management of melanoma patients with metastatic lymphatic involvement, especially when the sentinel lymph node biopsy identifies an unusual drainage field, we identified patients treated at the Department of Plastic and Reconstruction Surgery of Bari between July 1994 and December 2012 identified with a primary-cutaneous melanoma who underwent lymphoscintigraphy and subsequent positive-IN the lymphadenectomy to evaluate the impact of this procedure on overall survival and disease-free-period. 51 patients presented INs, and lymphadenectomy (LA) of the subsequent lymphatic field was performed in 13 subjects with positive-IN. In 4 cases additional lymphatic metastases were detected in the usual basin beyond the IN+. Recurrence-free period and survival rate at 5 years were higher in patients with positive-IN who underwent LA than in subjects who underwent LA due to positive lymph nodes in the usual field. Immediate lymphadenectomy of the subsequent lymphatic field in patients with positive-INs may afford patients earlier stage treatment of their disease and improved prognosis
Optimizing the staging of melanoma patients for their best surgical management
No full textInterval nodes (IN) are defined as lymph nodes that lie along the course of lymphatic collecting vessels between a primary tumor site and a draining node field. Sometimes INs contain metastases and a consensus on their surgical management is needed. Therefore, to optimize the surgical management of melanoma patients with metastatic lymphatic involvement, especially when the sentinel lymph node biopsy identifies an unusual drainage field, we identified patients treated at the Department of Plastic and Reconstruction Surgery of Bari between July 1994 and December 2012 identified with a primary-cutaneous melanoma who underwent lymphoscintigraphy and subsequent positive-IN the lymphadenectomy to evaluate the impact of this procedure on overall survival and disease-free-period. 51 patients presented INs, and lymphadenectomy (LA) of the subsequent lymphatic field was performed in 13 subjects with positive-IN. In 4 cases additional lymphatic metastases were detected in the usual basin beyond the IN+. Recurrence-free period and survival rate at 5 years were higher in patients with positive-IN who underwent LA than in subjects who underwent LA due to positive lymph nodes in the usual field. Immediate lymphadenectomy of the subsequent lymphatic field in patients with positive-INs may afford patients earlier stage treatment of their disease and improved prognosis
Chyloperitoneum: Diagnostic and therapeutic options
No full textChyloperitoneum is not rare and is often associated with other chylous disorders particularly in more complex clinical conditions. An accurate diagnostic study is indispensable to plan the correct therapeutic approach, and we examined the long-term outcomes of our experience in the management of primary and secondary chyloperitoneum in fifty-eight patients (50 adults and 8 children; 34 primary and 24 secondary forms). Diagnostic assessment consisted of paracentesis, whole body lymphoscintigraphy, lymphangio-MR, and lymphangio-CT (LAG-CT). The management of chyloperitoneum consisted initially of non-operative procedures (MCT diet, TPN, octreotide). Surgical treatment was performed in patients not responsive to conservative methods and involved different options using surgical and microsurgical approaches. Microsurgical techniques included chylous-venous shunts connecting chyliferous vessels and mesenteric veins. Fibrin glue or platelet gel injection at the site of the chylous leakage was also used to treat one case of refractory secondary chyloperitoneum. Patients were followed clinically and instrumentally (echography and labs tests) for 6 months to over 5 years. We found that LAG-CT was the primary diagnostic modality to provide precise topographic information concerning the site, cause, and extension of chylous pathology, all of which allowed proper planning of therapeutic procedures. Thirty-four patients did not have a relapse of the chyloperitoneum and 22 patients had a persistence of a small quantity of ascites with no protein imbalance. We observed early relapse of chylous ascites in 2 cases that required a peritoneal-jugular shunt leading to good outcomes. An accurate diagnostic study (above all LAG-CT) and a microsurgical approach proved to represent an effective management of chyloperitoneum refractory to non-operative treatment
Diagnostic assessment and therapeutic approach for immunodeficiency due to chylous dysplasia: A case report.
No full textSistema d'accoglienza e fabbisogni formativi
No full textIl contributo contenuto in questo capitolo, vuole indagare il sistema di relazioni esistenti tra turista-imprese, turista-enti pubblici, turista-comunità locale, nei tre ambiti territoriali.
L’analisi accerta la presenza di relazionalità tra gli attori, verificandone l’intensità e la direzione, adottando una metodologia statistica, che fa uso di indicatori sintetici, sulla base dei dati raccolti in fase di rilevazione.
I paragrafi seguenti, riportano per ciascuna relazione (turista verso la comunità e viceversa; turista verso gli enti, e viceversa; turista verso imprese e viceversa), la misura della relazionalità. Ciò consente di tracciare la mappa delle relazioni presenti all’interno di ciascun sistema territoririale (Anapo, S. Vito e Halesa), evidenziazione le difformità e le principali somiglianze.
Dall’analisi del sistema relazionale interno ed esterno, si è provceduto all’analisi dei principali fabbisogni formativi presenti nei tre sistemi territoriali, evidenziandome, contestualmente i gaps esistenti e da colmare per il raggiungimento di su sistema d’offerta turistica locale particolarmente fondato sulla relazionalità degli attori locali
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