106,523 research outputs found
Post-operative outcomes and quality of life assessment after thoracoscopic lobectomy for Non-small-cell lung cancer in octogenarians: Analysis from a national database
No full textBackground: Thoracoscopic lobectomy (VATS-L) for non-small-cell lung cancer (NSCLC) is a well-established
option for early stage NSCLC, but the evidences are limited for octogenarians.
Objective: The objectives of this multi-institutional study were to evaluate the post-operative outcomes of VATS-L
in octogenarians and to estimate the post-operative quality of life (QoL) using a validated questionnaire
(EuroQoL5D).
Methods: Data from patients underwent VATS-L between 2014 and 2019 were analysed and divided into two
groups: Group A (younger patients) and Group B (octogenarians). To define predictors for complications, univariate
and multivariable logistic regression analysis were performed.
Results: 7023 patients underwent VATS-L and 329 (4.6%) were octogenarians. 30-day and 90-day post-operative
mortality were similar (0.95% vs 0.91%, p = 0.84 and 1.3% vs 1.2%, p = 0.58), whereas the percentage of
patients who suffered from any complication (25.5% vs 31.9%, p = 0.012) and the complication rate (31.6% vs
45.2%, p=<0.01) were higher for octogenarians. At discharge, the values of EuroQoL5D were worse in group B,
but after one month these levels became similar. Age >80 years had a significant influence on morbidity on both
univariate and multivariable analyses (p = 0.025).
Conclusions: VATS-L for NSCLC can be performed in selected octogenarians without increased risk of postoperative
death, acceptable not-life-threatening complications and a moderate impact on QoL
Il pieno,
No full textRiflessione sugli effetti dell'11 settembre, in particolare sulle credenze e gli schemi mentali che regolano la produzione e la circolazione della cultura
Video-assisted mediastinoscopic resection of two bronchogenic cysts: a novel approach
No full textThe treatment of bronchogenic cysts (BCs) is still controversial. Many authors advocate the complete surgical excision of cysts [by video-assisted thoracoscopic surgery (VATS) or thoracotomy] to prevent their high rate of recurrence. Nevertheless, some recent works have attracted attention to a less invasive endoscopic management of benign mediastinal cysts. Here, we report a novel, safe, effective and minimally invasive mediastinoscopic technique used in the complete resection of two mediastinal BCs. We believe that this approach can be applied, with some restrictions: lesions located in the superior mediastinum, absence of severe adhesions, absence of infection, no previous mediastinal surgery. More experience of mediastinoscopic treatment of BCs is needed in order to better define its indications, contraindications, risks and complications. (C) 2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved
Synchrotron X-ray computed microtomography investigation of a mortar affected by alkali silica reaction: a quantitative characterization of its microstructural features
No full textAlkali-silica reaction (ASR) is one of the most important weathering processes in cement-based materials. The damages caused by ASR have been qualitatively investigated with a number of different techniques. In this study, we present a procedure to obtain quantitative morphological parameters of the ASR reaction effects using synchrotron X-ray microtomography data. We found three different kinds of voids due to the effect of three different mechanisms: (i) cracks from ASR expansion, (ii) irregularshaped voids due to the aggregate particles dissolution, and (iii) bubbles due to the cement paste preparation. We were able to separate them using morphological parameters (such as surface/volume ratio and aspect-ratio) calculated for each object, thus obtaining, e.g., volume fractions for each kind of voids. From the orientation data, we also studied if any shape preferred orientation was present in the sample, concerning the fractures network, and we found no appreciable preferred orientation. The new analysis procedure we applied in this study proved to be an effective approach for the quantitative characterization of the effects (cracks and porosity development by aggregate weathering) of the ASR reaction in mortars
Impact of interstitial lung disease on short-term and long-term survival of patients undergoing surgery for non-small-cell lung cancer: analysis of risk factors
No full textThe study aimed to determine the impact of interstitial lung disease (ILD) on postoperative morbidity, mortality and long-term survival of patients with non-small-cell lung cancer (NSCLC) undergoing pulmonary resection. We performed a retrospective chart review of 775 consecutive patients who had undergone lung resection for NSCLC between 2000 and 2009. ILD, defined by medical history, physical examination and abnormalities compatible with bilateral lung fibrosis on high-resolution computed tomography, was diagnosed in 37 (4.8%) patients (ILD group). The remaining 738 patients were classified as non-ILD (control group). We also attempted to identify the predictive factors for early and late survival in patients with ILD following pulmonary resection. There was no significant difference between the two groups in terms of age (69 vs 66 years), sex (79 vs 72% male), smoking history (93 vs 90% smokers), forced expiratory volume in 1 s % of predicted (89 vs 84%), predicted values of forced vital capacity (FVC)% (92 vs 94%), types of surgical resection and histology. Patients with ILD had a higher incidence of postoperative acute respiratory distress syndrome (ARDS; 13 vs 1.8%, P < 0.01) and higher postoperative mortality (8 vs 1.4%, P < 0.01). The overall 5-year survival rate was 52% in the ILD and 65% in the non-ILD patients, respectively (P = 0.019). In the ILD group, at the median follow-up of 26 months (range 4-119), 19 (51%) patients were still alive and 18 (49%) had died in the ILD group. The major cause of late death was respiratory failure due to the progression of fibrosis (n = 7, 39%). In the ILD group, lower preoperative FVC% (mean 77 vs 93%, P < 0.01) and lower diffusing capacity of the lung for carbon monoxide (DLCO%; 47 vs 62%; P < 0.01) were significantly associated with postoperative ARDS. In conclusion, major lung resection in patients with NSCLC and ILD is associated with an increased postoperative morbidity and mortality. Patients with a low preoperative FVC% should be carefully assessed prior to undergoing surgery, particularly in the presence of a lower DLCO%. Long-term survival is significantly lower when compared with patients without ILD, but still achievable in a substantial subgroup. Thus, surgery can be offered to properly selected patients with lung cancer and ILD, keeping in mind the risk of respiratory failure during the evaluation of such patientsThe study aimed to determine the impact of interstitial lung disease (ILD) on postoperative morbidity, mortality and long-term survival of patients with non-small-cell lung cancer (NSCLC) undergoing pulmonary resection.We performed a retrospective chart review of 775 consecutive patients who had undergone lung resection for NSCLC between 2000 and 2009. ILD, defined by medical history, physical examination and abnormalities compatible with bilateral lung fibrosis on high-resolution computed tomography, was diagnosed in 37 (4.8%) patients (ILD group). The remaining 738 patients were classified as non-ILD (control group). We also attempted to identify the predictive factors for early and late survival in patients with ILD following pulmonary resection.There was no significant difference between the two groups in terms of age (69 vs 66 years), sex (79 vs 72% male), smoking history (93 vs 90% smokers), forced expiratory volume in 1 s % of predicted (89 vs 84%), predicted values of forced vital capacity (FVC)% (92 vs 94%), types of surgical resection and histology. Patients with ILD had a higher incidence of postoperative acute respiratory distress syndrome (ARDS; 13 vs 1.8%, P < 0.01) and higher postoperative mortality (8 vs 1.4%, P < 0.01). The overall 5-year survival rate was 52% in the ILD and 65% in the non-ILD patients, respectively (P = 0.019). In the ILD group, at the median follow-up of 26 months (range 4-119), 19 (51%) patients were still alive and 18 (49%) had died in the ILD group. The major cause of late death was respiratory failure due to the progression of fibrosis (n = 7, 39%). In the ILD group, lower preoperative FVC% (mean 77 vs 93%, P < 0.01) and lower diffusing capacity of the lung for carbon monoxide (DLCO%; 47 vs 62%; P < 0.01) were significantly associated with postoperative ARDS.In conclusion, major lung resection in patients with NSCLC and ILD is associated with an increased postoperative morbidity and mortality. Patients with a low preoperative FVC% should be carefully assessed prior to undergoing surgery, particularly in the presence of a lower DLCO%. Long-term survival is significantly lower when compared with patients without ILD, but still achievable in a substantial subgroup. Thus, surgery can be offered to properly selected patients with lung cancer and ILD, keeping in mind the risk of respiratory failure during the evaluation of such patients
Predicare bene, razzolare bene! Ovvero: dove può portare la ricerca di buone pratiche psicologiche nei servizi sanitari.
No full textAn investigations of mortars affected by alkali-silica reaction by X-ray synchrotron microtomography: a preliminary study
No full textA first attempt to investigate samples affected by alkali-silica reaction (ASR) by synchrotron X-ray microtomography has been made. The setup available at the SYRMEP beamline, at the third generation synchrotron Elettra (Trieste, Italy), allowed collecting phase-contrast enhanced images, with a detectability approaching that of optical microscopy (a few microns). In this study, mortar cylinders were prepared and immersed in a 1-M NaOH solution at 80 °C for 14 days to enhance the ASR. The weathered samples were studied using the traditional 2D techniques such as optical microscopy and scanning electron microscopy as well as using the 3D micro-CT. Over the aged samples, the 3D imaging allows the ASR weathering to be studied, showing the reactive aggregate progressive dissolution with subsequent deposition of gel and microcracks development. This technique has proven to be a valuable, non-destructive, method which allows the rendering of the microstructural features in specimen affected by ASR
Computed tomography imaging of a fistulating right pleural empyema in the inguinoscrotal region through the retroperitoneal space
No full textAccuracy of multislice CT in restaging patients with non-small cell lung carcinoma after neoadjuvant chemotherapy using a multiparametric approach.
No full textThe aim of this study was to assess diagnostic
accuracy of multislice CT in restaging patients with N2 nonsmall
cell lung carcinoma after neoadjuvant chemotherapy,
using a multiparametric approach as compared with traditional
size-based radiological criteria.
All patients staged as N2 at histologic examination after
neoadjuvant chemotherapy were correctly staged with multislice
CT (sensitivity, specificity, positive and negative predictive
value, and accuracy were 100%, 80%, 85%, 100% and
93,7% respectively, vs 34%, 60%, 34%, 60% and 50% using
size-based criteria), suggesting that a multiparametric approach
results in improved diagnostic accuracy
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