Cardiac tumors: review

Cardiac tumors are rare and encompass a variety of presentations. Clinica symptoms are usually nonspecific, but they can present as obstructive, embolic, or constitutional symptoms. Treatment options and prognosis vary highly depending on the subtype, tumor size, and location. Surgical resection is usually the first-line therapy, except for cardiac lymphomas, and provides favorable long-term prognosis in most benign tumors. Cardiac sarcomas, however, are usually diagnosed in advanced stages, and the treatment relies on a multimodal approach with chemotherapy and radiotherapy. Metastatic cardiac tumors are usually related to advanced disease and carry an overall poor prognosis.

Cardiac Tumors: Review.

Cardiac tumors are rare and encompass a variety of presentations. Clinica symptoms are usually nonspecific, but they can present as obstructive, embolic, or constitutional symptoms. Treatment options and prognosis vary highly depending on the subtype, tumor size, and location. Surgical resection is usually the first-line therapy, except for cardiac lymphomas, and provides favorable long-term prognosis in most benign tumors. Cardiac sarcomas, however, are usually diagnosed in advanced stages, and the treatment relies on a multimodal approach with chemotherapy and radiotherapy. Metastatic cardiac tumors are usually related to advanced disease and carry an overall poor prognosis.

Artificial intelligence for triaging of breast cancer screening mammograms and workload reduction: A meta-analysis of a deep learning software.

OBJECTIVE: Deep learning (DL) has shown promising results for improving mammographic breast cancer diagnosis. However, the impact of artificial intelligence (AI) on the breast cancer screening process has not yet been fully elucidated in terms of potential workload reduction. We aim to assess if AI-based triaging of breast cancer screening mammograms could reduce the radiologist's workload with non-inferior sensitivity. METHODS: PubMed, EMBASE, Cochrane Central, and Web of Science databases were systematically searched for studies that evaluated AI algorithms on computer-aided triage of breast cancer screening mammograms. We extracted data from homogenous studies and performed a proportion meta-analysis with a random-effects model to examine the radiologist's workload reduction (proportion of low-risk mammograms that could be theoretically ruled out from human's assessment) and the software's sensitivity to breast cancer detection. RESULTS: Thirteen studies were selected for full review, and three studies that used the same commercially available DL algorithm were included in the meta-analysis. In the 156,852 examinations included, the threshold of 7 was identified as optimal. With these parameters, radiologist workload decreased by 68.3% (95%CI 0.655-0.711, I² = 98.76%, p < 0.001), while achieving a sensitivity of 93.1% (95%CI 0.882-0.979, I² = 83.86%, p = 0.002) and a specificity of 68.7% (95% CI 0.684-0.723, I² = 97.5%, p < 0.01). CONCLUSIONS: The deployment of DL computer-aided triage of breast cancer screening mammograms reduces the radiology workload while maintaining high sensitivity. Although the implementation of AI remains complex and heterogeneous, it is a promising tool to optimize healthcare resources.

An overview of artificial intelligence in oncology.

Cancer is associated with significant morbimortality globally. Advances in screening, diagnosis, management and survivorship were substantial in the last decades, however, challenges in providing personalized and data-oriented care remain. Artificial intelligence (AI), a branch of computer science used for predictions and automation, has emerged as potential solution to improve the healthcare journey and to promote precision in healthcare. AI applications in oncology include, but are not limited to, optimization of cancer research, improvement of clinical practice (eg., prediction of the association of multiple parameters and outcomes - prognosis and response) and better understanding of tumor molecular biology. In this review, we examine the current state of AI in oncology, including fundamentals, current applications, limitations and future perspectives.

Cancer complaints: The profile of patients from the emergency department of a Brazilian oncology teaching hospital.

Background: With the increase in prevalence of cancer in our society, we aim to clarify through primary data use what drives emergency department (ED) utilization among patients with cancer. Methods: This is a cross-sectional study. A direct survey was applied to cancer patients over 277 visits in 2015. Variables including chief complaint for current and last visit, frequency of visits, primary tumor site, and demographics were collected. Results: Pain was the most common complaint, responsible for 40% of visits, followed by constitutional symptoms (17%), and gastrointestinal complaints (11%). Abdominal pain was the single most noted pain type, with 18.4%, and had the highest rate of recurrence. It was followed by back pain, dyspnea, asthenia and fever, accounting for 8.5%, 8.5%, 8.1% and 7%, respectively. Cervical cancer represented 14.8% of patients, followed by breast (11.6%) and lung (7.6%) cancers. The majority of patients visited the emergency department less than once a month. Conclusion: The drivers of emergency department utilization among patients with cancer found through primary use data mostly confirm findings from larger studies with secondary use data. Our research underscores the burden of pain to patients with cancer, as it is the most common complaint leading to ED visits, and generally requires multiple visits. Abdominal pain was more likely to recur than other complaints. Patients could benefit from focused outpatient pain management, and from more research and education targeting cancer-related pain.

Off-Pump Triple Coronary Artery Bypass Grafting in a Patient with Situs Inversus Totalis: Case Presentation and a Brief Review of the Brazilian and the International Experiences.

A 76-year-old man with situs inversus totalis underwent a successful off-pump three-vessel coronary artery bypass surgery. The postoperative course was uneventful, and the patient was discharged 8 days later. At 9-month follow-up a coronary computed tomography angiography confirmed the viability of all of the grafts, and one year after the operation the patient remained asymptomatic. It comprises the fifth Brazilian case of a coronary surgery in a patient with situs inversus totalis and the first one of the country of a coronary artery bypass surgery without the use of the cardiopulmonary bypass in this condition.

Off-pump triple coronary artery bypass grafting in a patient with situs inversus totalis: case presentation and a brief review of the brazilian and the international experiences

Abstract A 76-year-old man with situs inversus totalis underwent a successful off-pump three-vessel coronary artery bypass surgery. The postoperative course was uneventful, and the patient was discharged 8 days later. At 9-month follow-up a coronary computed tomography angiography confirmed the viability of all of the grafts, and one year after the operation the patient remained asymptomatic. It comprises the fifth Brazilian case of a coronary surgery in a patient with situs inversus totalis and the first one of the country of a coronary artery bypass surgery without the use of the cardiopulmonary bypass in this condition.

Neurosurgical Videos on YouTube / Vídeos Neurocirúrgicos no YouTube

Introduction Videos can become valuable teaching tools and YouTube is a useful tool to disseminate information. It was created in February, 2005; since then, there has been a rapid expansion of YouTube videos on several subjects. Neurosurgery is not an exception in this trend, and several channels on the topic are available at the YouTube website. Methods We analyzed many articles related to the theme in several medicine specialties. In this study, we balance the pros and cons of this new technology, to foster a discussion of these changes, as well as to explain how to create and get the most fromit. We also list some interesting channels and their features as examples and suggestions. Results YouTube should be the main platform for supporting instructional videos, although it is important to be cautious at this time, as the platform still lacks good quality videos. Conclusion This technology could turn into a very important tool for learning and teaching neurosurgery. Educational institutions should guide an effort for better quality videos and broader content coverage, which could also achieve superior training at no cost.

Introdução Vídeos podem tornar-se ferramentas de ensino valiosas e o YouTube é uma plataforma muito útil para a disseminação da informação. Desde sua criação em fevereiro de 2005, houve grande expansão na quantidade dos vídeos de vários conteúdos e a neurocirurgia não está fora dessa onda, muitos canais relacionados podem ser encontrados no YouTube. Métodos Analisamos artigos relacionados ao tema em várias especialidades médicas. Balanceamos prós e contras dessa nova tecnologia, estimulamos a discussão dessas mudanças e ainda explicamos como criar e ter máximo proveito. Alguns canais interessantes são também listas como exemplos e sugestões. Resultados O YouTube deve ser a principal plataforma para vídeos instrucionais, mas nesse momento o conteúdo deve ser tomado com cuidado, uma vez que há ainda escassez de vídeos de boa qualidade. Conclusão Essa tecnologia pode tornar-se importante ferramenta na aprendizagem e ensino da neurocirurgia. Um esforço para vídeos de boa qualidade e maior abrangência de conteúdo deveria ser guiado por instituições de ensino, que também podem conseguir treinamentos melhores e mais baratos.

E-learning for neurosurgeons: Getting the most from the new web tools.

As open access resource, the role of Internet has been increasing in our professional life. There are several emergent new tools that can facilitate and make it more efficient to get accurate and reliable information. In this article, we discuss how we can manage to get the most from these new instruments, like blogs, Facebook, Twitter, and LinkedIn, in order to improve clinical practice. With good sense and some caution, these can turn to be of valuable help in our careers.