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1.
Clin. transl. oncol. (Print) ; 26(1): 269-277, jan. 2024.
Artigo em Inglês | IBECS | ID: ibc-229165

RESUMO

Background This study aims to assess and compare the extent to which preoperative chemotherapy prior to CRS improves survival in patients diagnosed with CRCPM. Methods We included 251 patients from 2012 to 2019 in our center. Inverse probability of treatment weighting (IPTW) analysis was used to minimize the selection bias. Survival analysis was performed to compare the survival outcomes. Multivariate Cox regression analysis was conducted to identify prognostic factors. Result The baseline characteristics were well balanced using IPTW (standardized mean difference < 0.1). Preoperative chemotherapy cannot significantly improve overall survival (HR, 1.03; 95% CI 0.71–1.49; P = 0.88). In subgroup analysis, we found that intestinal obstruction after preoperative chemotherapy significantly reduced survival (HR, 2.25; 95% CI 1.01–5.03; P = 0.048), while in the upfront surgery group, intestinal obstruction had no impact on prognosis. Conclusion For CRCPM patients treated with CRS, preoperative chemotherapy does not seem to prolong overall survival. Furthermore, the emergence of intestinal obstruction after chemotherapy may compromise the effectiveness of treatment, resulting in a worse prognosis. This finding has important clinical implications for treatment decisions (AU)


Assuntos
Humanos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Colorretais/tratamento farmacológico , Hipertermia Induzida/métodos , Análise de Sobrevida , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Procedimentos Cirúrgicos de Citorredução , Estudos Retrospectivos , Prognóstico
2.
Clin. transl. oncol. (Print) ; 25(12): 3378-3394, dec. 2023.
Artigo em Inglês | IBECS | ID: ibc-227284

RESUMO

Peritoneal metastases (PM) occur when cancer cells spread inside the abdominal cavity and entail an advanced stage of colorectal cancer (CRC). Prognosis, which is poor, correlates highly with tumour burden, as measured by the peritoneal cancer index (PCI). Cytoreductive surgery (CRS) in specialized centres should be offered especially to patients with a low to moderate PCI when complete resection is expected. The presence of resectable metastatic disease in other organs is not a contraindication in well-selected patients. Although several retrospective and small prospective studies have suggested a survival benefit of adding hyperthermic intraperitoneal chemotherapy (HIPEC) to CRS, the recently published phase III studies PRODIGE-7 in CRC patients with PM, and COLOPEC and PROPHYLOCHIP in resected CRC with high-risk of PM, failed to show any survival advantage of this strategy using oxaliplatin in a 30-min perfusion. Final results from ongoing randomized phase III trials testing CRS plus HIPEC based on mitomycin C (MMC) are awaited with interest. In this article, a group of experts selected by the Spanish Group for the Treatment of Digestive Tumours (TTD) and the Spanish Group of Peritoneal Oncologic Surgery (GECOP), which is part of the Spanish Society of Surgical Oncology (SEOQ), reviewed the role of HIPEC plus CRS in CRC patients with PM. As a result, a series of recommendations to optimize the management of these patients is proposed (AU)


Assuntos
Humanos , Neoplasias Colorretais/patologia , Hipertermia Induzida/métodos , Neoplasias Peritoneais/secundário , Metástase Neoplásica , Modalidades de Fisioterapia , Estudos Retrospectivos , Estudos Prospectivos , Taxa de Sobrevida
3.
Clin. transl. oncol. (Print) ; 25(10): 2911-2921, oct. 2023. graf
Artigo em Inglês | IBECS | ID: ibc-225072

RESUMO

Purpose Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) treatment has classically presented a percentage of associated complications that have limited its expansion. The aim of this study is to describe the morbimortality results obtained from a referral center implemented with the support of a governmental health agency and directed by a surgical team experienced in CRS for Peritoneal Surface Malignancies (PSM). Methods Data from the Peritoneal Carcinomatosis Program of Catalonia (PCPC) prospective database, including patients who underwent CRS + HIPEC between September 2006 and January 2021, were analyzed. Results A total of 1151 consecutive patients underwent 1321 CRS + HIPEC procedures. Colonic origin of peritoneal metastasis was the most frequent (47.3%). Median PCI was 7 and most patients had CC0-1 (96.1%). Multivisceral resection was performed in 44% of all patients, 57% required digestive anastomosis. Median hospital stay was 11 days (range 6–144 days). High-grade complications occurred in 20% of all patient, most of them surgical complications. Anastomotic leak occurred in 0.6% of all cases. The overall in-stay and 30-day mortality rate was 0.4%. The low-rate of complications and the high rate of complete CRS were achieved from the beginning of the PCPC. Median overall survival was 54.7 months, with a 5-year survival rate of 47.5%. Conclusions Implementation of a CRS + HIPEC referral program for the treatment of PSM with preferably an experienced surgical team enables acceptable rates of severe morbidity (20%) and mortality (< 1%) (AU)


Assuntos
Humanos , Hipertermia Induzida/métodos , Neoplasias Peritoneais/terapia , Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias Peritoneais/mortalidade , Quimioterapia Adjuvante , Terapia Combinada , Procedimentos Cirúrgicos de Citorredução/métodos , Estudos Retrospectivos , Taxa de Sobrevida
4.
Clin. transl. oncol. (Print) ; 24(8): 1542–1548, agosto 2022.
Artigo em Inglês | IBECS | ID: ibc-206242

RESUMO

Introduction: Small-bowel involvement in patients with ovarian cancer has been strongly correlated with the possibility of cytoreduction and thus with survival. The main objective of this study was to evaluate the prognostic significance of small-bowel involvement in patients undergoing optimal-complete interval cytoreductive surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC).Methods: We included a series of patients diagnosed with stage IIIC-IVA (pleural effusion) high-grade serous epithelial ovarian cancer and in whom CRS + HIPEC was indicated after neoadjuvant systemic chemotherapy (NACT). The study period extended from January 2008 to January 2020, with a minimum follow-up of 12 months from the inclusion of the last patient. A multivariate analysis using Cox regression allowed us to identify the variables that were independently related to disease-free survival.Results: A total of 144 patients were selected, 13 (9%) of whom were excluded from the analysis, because their disease was considered unresectable. The study included a series of 131 patients with a median age of 62 years (34-79 years) and a median Peritoneal Cancer Index (PCI) calculated during surgery of 9 (1-35). The median PCI of bowel areas 9-12 (SB-PCI) was 3 (1-10). Performance of a CC-1 cytoreduction (HR: 1.93, 95% CI: 1.02-3.64, p = 0.042) and SB-PCI greater than 3 (HR: 2.25, 95%CI: 1.13-4.48, p = 0.21) were independent factors associated with shorter disease-free survival.Conclusion: Small-bowel involvement, even in patients with a macroscopically complete resection, showed a correlation with worse prognostic outcomes and could be considered as a variable in the postoperative management of these patients. (AU)


Assuntos
Humanos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Epitelial do Ovário/terapia , Hipertermia Induzida , Neoplasias Ovarianas/terapia , Neoplasias Peritoneais/terapia , Estudos Retrospectivos , Taxa de Sobrevida
5.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 49(3): 100757, Jul - Sep 2022. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-205916

RESUMO

El objetivo en este estudio es evaluar la eficacia de las diferentes modalidades de fisioterapia para el tratamiento de la dismenorrea primaria. Métodos: Se ha llevado a cabo una revisión de la literatura científica actual mediante una búsqueda durante enero y febrero de 2021 en las bases de datos: PubMed, SPORTDiscus, Medline, CINAHL y Web of Science. Los descriptores MeSH utilizados fueron: «Dysmenorrhea», «Exercise Therapy» y «Physical Therapy Modalities». Resultados: Se han incluido y analizado 13 estudios, que fueron agrupados para un mejor análisis según el tipo de intervención: ejercicio terapéutico, electroestimulación transcutánea y termoterapia, kinesiotape, masaje de tejido conectivo, punción seca y acupuntura. La variable común en todos los estudios fue la evaluación de la intensidad del dolor menstrual, el cual se redujo al aplicar las distintas modalidades de fisioterapia. Conclusión: Las técnicas de fisioterapia planteadas en la revisión parecen ser una herramienta efectiva en el tratamiento de mujeres con dismenorrea primaria. Sin embargo, se necesitan más estudios que analicen los efectos a largo plazo.(AU)


The aim of this study is to evaluate the efficacy of different physical therapy modalities for the treatment of primary dysmenorrhoea. Methods: A review of the current scientific literature was conducted by searching during January and February 2021 the databases: PubMed, SPORTDiscus, Medline, CINAHL, and Web of Science. The MeSH descriptors used were: “Dysmenorrhea”, “Exercise Therapy” and “Physical Therapy Modalities”. Results: Thirteen studies were included and analysed, and were grouped for better analysis according to the type of intervention: therapeutic exercise, transcutaneous electrostimulation and thermotherapy, kinesiotape, connective tissue massage, dry needling, and acupuncture. The common variable in all the studies was the evaluation of the intensity of menstrual pain, which reduced when the different physical therapy modalities were applied. Conclusion: The physical therapy techniques proposed in the review seem to be an effective tool in the treatment of women with primary dysmenorrhoea. However, more studies are needed to analyse the long-term effects.(AU)


Assuntos
Humanos , Feminino , Especialidade de Fisioterapia , Dismenorreia , Dor , Eficácia , Dismenorreia/tratamento farmacológico , Hipertermia Induzida , Estimulação Elétrica Nervosa Transcutânea , Terapia por Exercício , Saúde da Mulher , Ginecologia , Medicina Física e Reabilitação
6.
Cir. Esp. (Ed. impr.) ; 100(4): 209-214, abril 2022. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-203243

RESUMO

BackgroundPleurodesis is a common technique for treating the accumulation of air or liquid in the pleural space caused by pneumothorax or pleural effusion, it is based on the bounding of pleural layers through induced inflammatory lesions. There are several pleurodesis procedures.ObjectivesTo test and describe the inflammatory effect of hyperthermia on the pleural and peritoneal mesothelia of rats, with the aim of testing the effectiveness of this process for inducing pleurodesis.Methods35 Sprague-Dawley (male/female) rats were randomized into four treatment groups: Group A (Talc, 10 individuals); group B (control, 5 individuals); group C (hyperthermic isotonic saline, 10 individuals); and group D (filtrate air at 50°, 10 individuals). Inflammatory effect of hyperthermia was the primary outcome parameter.ResultsIn the talc group, minimal adhesions between both pleural and peritoneal layers were observed in seven rats. Talc produced peritoneal mesothelium inflammation and fibrosis associated to foreign body giant cells in 80% (8/10) of the sample. Furthermore, clear evidence of a granulomatous foreign-body reaction was detected. No macroscopic and/or microscopic damage was registered in the remaining three groups (control, hyperthermic, and filtrate air).ConclusionsTalc is an excellent method for producing pleuro-peritoneal inflammatory lesions. On the contrary, hyperthermia apparently does not induce the macroscopic and microscopic damage that is required for efficient pleurodesis. Therefore, hyperthermia should not be used for pleurodesis procedures.


ObjetivoEstudiar y describir el efecto inflamatorio de la hipertermia sobre el mesotelio pleural y peritoneal de ratas con el objetivo de valorar si presenta un efecto sinfisiante y por tanto útil para conseguir la pleurodesis.MétodosTreinta y cinco ratas Sprague-Dawley (hembras/machos) fueron aleatorizadas en 4 grupos de tratamiento: grupoA (talco, 10 animales); grupoB (control, 5 animales); grupoC (suero salino hipertérmico: 10 animales), y grupoD (aire filtrado a 50°, 10 animales).ResultadosEn el grupo de talco se evidenciaron adherencias entre las dos membranas pleurales y peritoneales en 7 animales. Se observó inflamación, fibrosis asociada a células gigantes de cuerpos extraño en el 80% (8/10) del mesotelio peritoneal. Paralelamente, se observó reacción granulomatosa a cuerpo extraño. No se registraron lesiones macroscópicas ni microscópicas en el resto de grupos estudiados (control, hipertermia y aire filtrado).ConclusiónEl talco es un excelente método para producir inflamación a nivel del mesotelio pleural y peritoneal. Por el contrario, la hipertermia no parece inducir lesiones macroscópicas ni microscópicas requeridas para conseguir una pleurodesis eficaz.


Assuntos
Animais , Masculino , Feminino , Ratos , Hipertermia Induzida , Pleurodese/métodos , Pleura/patologia , Ratos Sprague-Dawley , Modelos Animais , Talco/administração & dosagem
8.
Cir. Esp. (Ed. impr.) ; 99(5): 354-360, may. 2021. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-218146

RESUMO

Introducción: La carcinomatosis peritoneal se asocia a un mal pronóstico y las opciones terapéuticas son limitadas. El desarrollo de la quimioterapia intraperitoneal presurizada en aerosol (PIPAC) ofrece una alternativa de tratamiento paliativo para estos pacientes con una baja tasa de morbimortalidad. Nuestro objetivo es evaluar la implantación y la experiencia inicial de PIPAC para el tratamiento de la carcinomatosis peritoneal irresecable en nuestro centro. Material y métodos: Realizamos un estudio prospectivo incluyendo todos los pacientes a los que se les realizó PIPAC entre enero de 2019 y febrero de 2020 en nuestro hospital. Se recogieron: el origen del tumor primario, el volumen de ascitis, la extensión de la carcinomatosis peritoneal, el régimen de quimioterapia aplicada, el tiempo quirúrgico, las complicaciones postoperatorias, la estancia hospitalaria y la mortalidad. Resultados: Analizamos 9 PIPAC realizadas en 5pacientes con carcinomatosis peritoneal de origen gástrico, ovárico y neoplasia mucinosa apendicular. La tasa de acceso a la cavidad peritoneal fue del 100%. El PCI medio fue 27,6 (24-35). El tiempo quirúrgico medio fue de 93min (70-125). En nuestra serie solo hubo una complicación Clavien-DindoII (1/9 procedimientos). La estancia hospitalaria media fue de 2días (1-4). La mortalidad fue del 0%. Conclusión: La implantación de PIPAC en nuestro centro se ha llevado a cabo con seguridad, pudiendo afirmar que es una técnica reproducible y con una baja tasa de morbimortalidad en nuestra experiencia inicial. (AU)


Introduction: Peritoneal carcinomatosis remains a condition with poor prognosis and limited therapeutic options. Pressurized Intrapertioneal Aerosol Chemotherapy (PIPAC) has been developed as a new tool for delivering intraperitoneal chemotherapy with low morbidity. The aim of this study was to evaluate the initial experience of PIPAC in patients with peritoneal carcinomatosis at our hospital. Methods: A prospective study between January 2019 and February 2020 was carried at a tertiary public hospital. Primary tumor, ascites volume, PCI, chemotherapy regimen, operative time, morbidity, length of hospital stay and mortality were recorded for analysis. Results: We analyzed 9 PIPAC procedures performed in 5patients. Median PCI was 27.6 (24-35). Median surgical time was 93minutes (70-125). Only one adverse event occurred out of 9 procedures (Clavien-DindoII). Median length of hospital stay was 2days (1-4). Mortality was 0%. Conclusion: PIPAC seems to be a feasible and safe procedure to treat peritoneal carcinomatosis, with low morbidity and short hospital stay. (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/cirurgia , Neoplasias Peritoneais/terapia , Estudos Prospectivos , Espanha , Laparoscopia , Hipertermia Induzida
9.
Fisioterapia (Madr., Ed. impr.) ; 43(1): 5-11, ene.-feb. 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-202433

RESUMO

La dismenorrea es el conjunto de síntomas que se pueden padecer durante la menstruación, siendo el más característico un dolor intenso. El síndrome de dolor miofascial es el conjunto de signos y síntomas que producen los puntos gatillo miofasciales (PGM) tanto en su localización como a distancia, entre otros el dolor. Por lo tanto, el objetivo del estudio es estudiar la eficacia del tratamiento fisioterápico de los PGM en musculatura abdominal, aductora y del suelo pélvico para con la afectación de las variables de dolor, función sexual, calidad de vida, fuerza y movimiento en pacientes con dismenorrea. MATERIAL Y MÉTODOS: Estudio piloto aleatorizado. Se dividió a las participantes entre un grupo A (n = 6) donde se aplicó punción seca y terapia manual en musculatura abdominal, aductora de la cadera y suelo pélvico y grupo B (n = 7) donde se aplicó termoterapia y estiramientos en la misma musculatura. Las variables estudiadas fueron: dolor menstrual, función sexual, calidad de vida, rango de abducción de cadera, fuerza muscular, resistencia del suelo pélvico y existencia de puntos gatillo miofasciales. Una fisioterapeuta realizó los tratamientos y otra las valoraciones, estando cegada la segunda. RESULTADOS: el grupo A obtuvo una diferencia clínica (1,6 puntos menos en EVA) y estadísticamente significativa del dolor (p = 0,018), frente al otro grupo (0,4 puntos, p > 0,05), así como una mejora en la calidad de vida (p < 0,05) del grupo A. No se hallaron cambios significativos en el resto de las variables. CONCLUSIÓN: existe un alivio significativo del dolor y mejora de la calidad de vida del grupo A. Se considera así que el tratamiento específico del síndrome de dolor miofascial puede presentar mayor eficacia clínica. Se concluye la necesidad de continuar esta investigación con una mayor muestra de participantes, con el fin de esclarecer la eficacia del tratamiento de fisioterapia para el resto de las variables estudiadas


The term dysmenorrhoea defines different symptoms that women can feel during menstruation, the most common being intense pain. Myofascial pain syndrome (MPS) is the combination of signs and symptoms caused by myofascial trigger points (MTP), at their site or at a distance. Therefore, the objective of this study is to evaluate the efficacy of a treatment for MTP in the abdominal, hip adductor and pelvic floor muscles, from a physiotherapeutic approach, regarding the following outcome measures: pain, sexual function, quality of life, strength and mobility in patients suffering from dysmenorrhoea. MATERIALS AND METHODS: Randomized pilot study. Participants were divided into two groups: A (n = 6), where dry needling and manual therapy was applied to the abdominal, hip adductor and pelvic floor muscles; and B (n = 7), where the participants received thermotherapy and stretching of these muscles. The outcome measures studied were menstrual pain, sexual function, quality of life, hip abduction range of motion, strength of the affected muscles, pelvic floor muscle endurance and finding myofascial trigger points. All the treatments were provided by the same physiotherapist, while a different physiotherapist carried out the evaluations blinded to each patient's group. RESULTS: in group A, a clinically (1.6 less in VAS) and statistically significant reduction (p = 0.018) in pain was observed in comparison with group B (.4 in VAS, p > 0.05). Quality of life also improved in the first group (p< 0.05). No further significant differences were found in the remaining outcome measures. CONCLUSIONS: a significant improvement was observed with regards to pain and quality of life in group A. Thus, we consider that specific treatment for MPS could be more clinically effective. We conclude that this research should be continued with a larger sample of participants, in order to clarify the efficacy of the physiotherapy treatment suggested for the remaining outcome measures


Assuntos
Humanos , Feminino , Adulto , Dismenorreia/terapia , Síndromes da Dor Miofascial/terapia , Pontos-Gatilho , Modalidades de Fisioterapia , Dismenorreia/epidemiologia , Síndromes da Dor Miofascial/epidemiologia , Analgesia por Acupuntura/métodos , Exercícios de Alongamento Muscular/métodos , Hipertermia Induzida/métodos
10.
Clin. transl. oncol. (Print) ; 23(1): 190-194, ene. 2021.
Artigo em Inglês | IBECS | ID: ibc-220466

RESUMO

Purpose The aim of this study is to assess for the first time, the role of regional deep hyperthermia in combination with radiotherapy and systemic therapy in patients with poor prognosis of brain metastases (GPI ≤ 2.5). Methods Patients with confirmed cerebral metastases and classified as GPI score ≤ 2.5 were included in this prospective study. Pretreatment stratification was defined as patients with 0–1 GPI score (Group A) and patients with 1.5–2.5 GPI score (Group B). HT was applied twice a week, 60 min per session, during RT by regional capacitive device (HY-DEEP 600WM system) at 13.56 MHz radiofrequency. Results Between June 2015 and June 2017, 15 patients and a total of 49 brain metastases were included in the protocol. All patients received all HT sessions as planned. RT and systemic therapy were also completed as prescribed. Tolerance to treatment was excellent and no toxicity was registered. Patients with HT effective treatment time longer than the median (W90time > 88%) showed better actuarial PFS at 6 and 12 months (100% and 66.7%, respectively) compared to those with less HT effective treatment time (50% and 0%, respectively) (p < 0.031). Median OS was 6 months (range 1–36 months). Stratification by GPI score showed a median OS of 3 months (CI 95% 2.49–3.51) in Group A and 8.0 months (CI 95% 5.15–10.41) in Group B (p = 0.035). Conclusions Regional hyperthermia is a feasible and safe technique to be used in combination with RT in brain metastases patients, improving PFS and survival in poor prognostic brain metastasis patients (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/mortalidade , Irradiação Craniana/métodos , Hipertermia Induzida/métodos , Antineoplásicos/uso terapêutico , Neoplasias Encefálicas/secundário , Terapia Combinada , Irradiação Craniana/mortalidade , Progressão da Doença , Estudos de Viabilidade , Hipertermia Induzida/mortalidade , Prognóstico , Intervalo Livre de Progressão , Dosagem Radioterapêutica , Estudos Prospectivos
11.
Enferm. glob ; 20(61): 464-475, ene. 2021. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-201470

RESUMO

OBJETIVOS: El objetivo es describir los métodos de calentamiento y su aplicación para el mantenimiento de la temperatura corporal en el paciente gran quemado. METODOLOGÍA: Revisión bibliográfica realizada entre septiembre de 2019 y febrero de 2020 acerca de la termorregulación y calentamiento del paciente quemado en las bases de datos CINAHL, CUIDEN, PUBMED, MEDES y WOS en español e inglés, de los últimos 10 años, de los cuales fueron analizados 24 documentos. RESULTADOS: La respuesta hipermetabólica y la reprogramación hipotalámica provocan un aumento de la temperatura basal en los pacientes quemados, entre 37 y 38,5ºC sin origen infeccioso. Para disminuir el gasto energético en reposo y la repuesta hipermetabólica se puede aplicar una temperatura ambiental elevada, como calentamiento externo pasivo, entre 28 y 32ºC. DISCUSIÓN: Existen otros métodos de calentamiento externo activo que pueden conseguir el mismo objetivo como las mantas de aire convectivo, placas térmicas o sistemas de superficie. CONCLUSIÓN: Debe revisarse la recomendación de calentamiento mediante temperatura ambiental elevada, que crea ambientes hostiles para los trabajadores y los pacientes, a través del estudio de la inclusión de métodos de calentamiento externo activo


OBJECTIVES: To describe the heating methods and their application to maintain body temperature in majors burn patients. METHODOLOGY: Bibliographic review carried out between September 2019 and February 2020 about the thermoregulation and heating of the burn patient in the CINHAL, CUIDEN, PUBMED, MEDES and WOS databases in Spanish and English, documents from the last 10 years, from which 26 were analyzed. RESULTS: Hypermetabolic response and hypothalamic reprogramming cause an increase in basal temperature in burn patients between 37 and 38.5ºC without infectious origin. To decrease the energy expenditure at rest and the hypermetabolic response, it is possible to act through a high ambient temperature between 28 and 32ºC as passive external heating. DISCUSSION: Other external heating methods can achieve this goal such as convective air blankets, heating plates, or surface systems. CONCLUSIONS: The recommendation of warming by means of high ambient temperature, which creates hostile environments for workers and patients, should be reviewed through the study of the inclusion of active external warming methods


Assuntos
Humanos , Queimaduras/terapia , Temperatura Corporal/fisiologia , Regulação da Temperatura Corporal/fisiologia , Metabolismo Energético/fisiologia , Queimaduras/enfermagem , Hipertermia Induzida/enfermagem
14.
Rev. esp. anestesiol. reanim ; 67(1): 15-19, ene. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-197125

RESUMO

INTRODUCCIÓN: La cirugía citorreductora asociada a quimioterapia hipertérmica intraoperatoria (HITHOC) es una alternativa terapéutica del mesotelioma maligno pleural. Su manejo supone un reto para el anestesiólogo. MATERIAL Y MÉTODOS: Se elabora un análisis descriptivo de una serie de casos de pacientes con diagnóstico de mesotelioma maligno pleural intervenidos de HITHOC. El manejo anestésico se realizó con anestesia general asociada a epidural y una extensa monitorización hemodinámica. Se analizaron datos del periodo perioperatorio. RESULTADOS: Siete pacientes fueron intervenidos entre mayo de 2015 y octubre de 2018. Durante el intraoperatorio, todos requirieron transfusión de hemoderivados y, 5 de ellos, perfusión de fármacos vasoactivos. En 6 pacientes se logró la extubación al finalizar la intervención. La mediana de estancia en cuidados intensivos y hospitalaria fueron 4 y 29 días, respectivamente. No se observó dolor postoperatorio significativo. CONCLUSIÓN: La cirugía HITHOC es un procedimiento agresivo con importantes cambios hemodinámicos. Una monitorización intensiva fue útil para tratar las complicaciones


INTRODUCTION: Cytoreductive surgery with hyperthermic intraoperative chemotherapy (HITHOC) is a therapeutic option for treatment of malignant pleural mesothelioma. Anesthetic management might be challenging. PATIENTS AND METHODS: A descriptive analysis of a case series is presented. Seven patients with malignant pleural mesothelioma diagnostic undergoing HITHOC surgery were studied. Combined general and epidural anesthesia were administered. An intensive hemodynamic monitorization was implemented. Data regarding perioperative course was analyzed. RESULTS: Between May 2015 and October 2018 7 patients underwent HITHOC procedure. Blood transfusions were administered in all patients, and 5 of the 7 patients required vasoactive drug administration. Extubation at the end of the procedure was able in 6 of the 7patients. The median length of stay in ICU was 4 days, and 29 days for the whole hospitalary stay. No significant postoperative pain was observed. CONCLUSIONS: HITHOC surgery is a complex procedure in which several hemodynamic changes occur. An intensive intraoperative monitorization was useful for controlling complications


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Mesotelioma/cirurgia , Neoplasias Pulmonares/cirurgia , Anestesia Epidural , Anestesia Geral , Procedimentos Cirúrgicos de Citorredução , Mesotelioma/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Hipertermia Induzida , Terapia Combinada , Citostáticos/uso terapêutico , Epidemiologia Descritiva
16.
Fisioterapia (Madr., Ed. impr.) ; 41(6): 322-328, nov.-dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-187805

RESUMO

Antecedentes: En las últimas décadas varios estudios han mostrado resultados beneficiosos con el uso de realidad virtual en pacientes con diversas enfermedades de origen neurológico y musculoesquelético. El objetivo del presente estudio fue describir los cambios en la funcionalidad posterior a la aplicación de un entrenamiento fisioterapéutico que incluye el uso de realidad virtual en pacientes postoperados de artroplastia total de rodilla (ATR). Materiales y métodos: El presente estudio cuasiexperimental prueba-posprueba fue realizado en el Hospital Clínico San Borja Arriarán en Santiago de Chile. Mediante un muestreo no probabilístico, se reclutó a 25 a pacientes postoperados de ATR, con un promedio de edad de 69,83 años (desviación estándar de 8,15). Se les realizó entrenamiento fisioterapéutico que incluye el uso de realidad virtual durante 6 semanas. Las medidas de resultado fueron: el cuestionario de funcionalidad WOMAC; la escala Berg Balance; dolor con escala visual analógica (EVA); distancia recorrida con el test de marcha 6 min; el tiempo de traslado con test Time Up and Go (TUG) y la diferencia de la carga de peso en las extremidades inferiores. Resultados: Al finalizar el tratamiento, el WOMAC total mostró una disminución de 17,2 puntos (p = 0,00), la EVA 2,2cm (p = 0,00), el TUG 3 s (p = 0,00) y la diferencia de carga de 11,9kg (p = 0,00). Por el contrario, el Berg Balance mostró un incremento de 9,8 puntos (p = 0,00) y el test de marcha 6 min de 105,7 m (p = 0,00). Conclusiones: Un entrenamiento fisioterapéutico que adiciona realidad virtual, a corto plazo, mejora la funcionalidad en pacientes mayores de 50 años postoperados de ATR unilateral


Background: In recent decades several studies have showed beneficial results with the use of virtual reality in patients with various pathologies of neurological and musculoskeletal origin. The aim of the present study was to describe the changes in functionality after physiotherapy training that included the use of virtual reality in patients undergoing Total Knee Arthroplasty (TKA). Materials and methods: The present quasi-experimental trial-post-test study was performed at the San Borja Arriaran Clinical Hospital in Santiago, Chile. Through non- probabilistic sampling, 25 post-operative TKA patients were recruited, with an average age of 69.83 years (standard deviation of 8.15). Physiotherapy training was provided, including the use of virtual reality for 6 weeks. The outcome measures were the WOMAC functionality questionnaire; Berg Balance scale; pain with visual analogue scale (VAS); Distance travelled with the 6-minute walk test; the transfer time with the Time Up and Go test (TUG) and the difference of weight bearing on the lower extremities. Results: At the end of the treatment, the total WOMAC showed a decrease of 17.2 points (P=.00), the VAS 2.2cm (P=.00), the TUG of 3seconds (P=.00) and the load difference was 11.9kg (P=.00). In contrast, the Berg Balance showed an increase of 9.8 points (P=.00) and the 6-minute walk test of 105.7 meters (P=.00). Conclusions: To add virtual reality to a physiotherapeutic training, in the short term, to improve functionality in post-operative patients older than 50 years following unilateral TKA


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Realidade Virtual , Exercício Físico , Modalidades de Fisioterapia , Artroplastia do Joelho/reabilitação , Hipertermia Induzida/métodos , Frequência Cardíaca
18.
Clin. transl. oncol. (Print) ; 20(12): 1502-1521, dic. 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-173757

RESUMO

Cancer stem cells (CSCs) have been identified as the main center of tumor therapeutic resistance. They are highly resistant against current cancer therapy approaches particularly radiation therapy (RT). Recently, a wide spectrum of physical methods has been proposed to treat CSCs, including high energetic particles, hyperthermia (HT), nanoparticles (NPs) and combination of these approaches. In this review article, the importance and benefits of the physical CSCs therapy methods such as nanomaterial-based heat treatments and particle therapy will be highlighted


No disponible


Assuntos
Humanos , Células-Tronco Neoplásicas/patologia , Resistencia a Medicamentos Antineoplásicos , Radioterapia/métodos , Nanomedicina/métodos , Células-Tronco Neoplásicas , Nanopartículas/uso terapêutico , Hipertermia Induzida
19.
Clin. transl. oncol. (Print) ; 20(10): 1268-1273, oct. 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-173714

RESUMO

Purpose: Peritoneal carcinomatosis (PC) from colorectal cancer (CRC) has poor survival. Multi-modal treatment including systemic chemotherapy, cytoreductive surgery (CRS), and hyperthermic intraperitoneal chemotherapy (HIPEC) can be used in selected patients with curative intent. The majority published works consider PC of CRC origin as a homogenous disease. Aim of this study is to stress the different biological behaviors and survival of PC according to colonic or rectal origin. Methods: Data of CRS and HIPEC procedures for PC of CRC origin performed at MD Anderson Cancer Center-Madrid (Spain) have been collected, dividing patients into two groups according to colonic or rectal PC. Clinical, operatory, and postoperatory variables of the two groups have been analyzed to compare survival-related rates and PC origin. Results: In the years 2004-2015, 114 procedures of CRS followed by HIPEC for peritoneal metastasis of different origin have been performed; of these, 36 procedures were for colorectal PC (31 patients in colonic and 5 in rectal group). Two groups are homogenous after analysis of clinical, operatory, and follow-up data. Median survival (OS) is significantly higher in colonic compared to rectal group (47.83 vs. 22.0 months, p 0.008). 3- and 5-year survival rate is 74 and 50% in colonic group vs. 20 and 0% in rectal group. Conclusion: Rectal origin PC has a more aggressive behavior compared to colonic origin, reflecting in a worst prognosis of patients affected by rectal origin PC. According to our data and literature, indications of multi-modal treatment including CRS and HIPEC should be more restrictive for rectal cancer PC. Authors should differentiate colonic and rectal origin of PC when reporting cases in the literature


No disponible


Assuntos
Humanos , Neoplasias Retais/terapia , Neoplasias do Colo/terapia , Neoplasias Peritoneais/terapia , Neoplasias Retais/patologia , Neoplasias do Colo/patologia , Carcinoma/patologia , Neoplasias Peritoneais/patologia , Metástase Neoplásica/patologia , Procedimentos Cirúrgicos de Citorredução , Hipertermia Induzida
20.
Arch. Soc. Esp. Oftalmol ; 93(9): 439-443, sept. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-175008

RESUMO

OBJETIVOS: El número de enucleaciones y secuelas visuales por retinoblastoma es elevado. El objetivo del estudio fue evaluar diferentes aspectos diagnósticos y plantear estrategias que ayuden a mejorar el manejo clínico del retinoblastoma. Método: Estudio retrospectivo de 38 pacientes con retinoblastoma estudiados genéticamente (29 unilaterales, 9 bilaterales). Se evaluaron la edad de inicio, los signos clínicos y el tiempo de evolución, el número de enucleaciones, el momento de realización y la supervivencia a 5 años. Resultados: La leucocoria fue el signo clínico fundamental (presente en el 90% de los casos). El retraso diagnóstico medio fue de 3,2 meses. Entre los casos unilaterales se enuclearon el 76% de los ojos y en las formas bilaterales el 55%. Solo se encontró un fallecimiento entre los 25 pacientes seguidos durante al menos 5 años. Conclusiones: Las estrategias de diagnóstico y tratamiento del retinoblastoma necesitan ser actualizadas. Para ello, una buena coordinación entre pediatras y oftalmólogos es esencial. El manejo en centros de referencia, que dispongan de la tecnología y experiencia necesarias, debería contribuir a aumentar la tasa de preservación de órganos


OBJETIVOS: The number of enucleations and visual sequels due to retinoblastoma is high. The aim of this study was to evaluate the different diagnostic aspects and propose strategies that might improve the clinical management of this condition. Method: A retrospective study was conducted on 38 patients with retinoblastoma studied genetically (29 unilateral, 9 bilateral). The evaluation included: age of onset, clinical signs, and time since onset, number of enucleations, time to diagnosis, and survival at 5 years. Results: Leukocoria was the main clinical sign (present in 90% of cases). The mean diagnostic delay was 3.2 months. Among the unilateral cases, the eyes were enucleated in 76%, and 55% in the bilateral forms. Only one death was found among the 25 patients followed-up for at least 5 years. Conclusions: Retinoblastoma diagnostic and treatment strategies need to be updated. Good coordination between paediatricians and ophthalmologists is essential for this. Its management in reference centres, which have the necessary technology and experience, should contribute to increase the rate of organ preservation


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Retinoblastoma/diagnóstico , Diagnóstico Precoce , Estrabismo/diagnóstico , Retinoblastoma/tratamento farmacológico , Tratamento Farmacológico , Enucleação Ocular/métodos , Estudos Retrospectivos , Estadiamento de Neoplasias , Retinoblastoma/classificação , Crioterapia , Braquiterapia , Hipertermia Induzida
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