Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 13.737
Filtrar
1.
Radiologia (Engl Ed) ; 64 Suppl 1: 49-53, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35428468

RESUMO

Cryoablation is a therapeutic technique that uses very low temperatures to destroy cells; transcutaneous cryoablation can be performed under imaging guidance. This simple procedure is done on an outpatient basis with local anesthesia. Cryoablation has proven effective in the treatment of benign breast lesions, such as fibroadenomas. Nowadays, its main use in malignant breast lesions is to reduce the size of the mass in cases where surgery is contraindicated. Nevertheless, other uses in malignant breast disease are being investigated. Cryoablation can strengthen the tumor response to immunotherapy. Likewise, in the near future, it may become an alternative to surgery for the local control of early-stage neoplasms. This article aims to describe our experience using cryoablation with liquid nitrogen to treat benign and malignant breast lesions and to review the fundamentals of the technique and its indications. Since 2019 we have used cryoablation to treat 7 benign and 9 malignant lesions without significant complications, achieving excellent esthetic outcomes. Cryoablation has been incorporated into our institution's breast unit's protocol.


Assuntos
Criocirurgia , Fibroadenoma , Mama , Criocirurgia/métodos , Fibroadenoma/diagnóstico por imagem , Fibroadenoma/cirurgia , Humanos
2.
J Cancer Res Ther ; 18(1): 257-259, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35381794

RESUMO

Oral and maxillofacial anatomy and function are important and complex. They are involved in facial expressions, chewing, language, breathing, and other functions. It is therefore important to choose the optimal treatment plan for oral and maxillofacial tumors. For patients with who cannot tolerate surgery or who refuse surgery or radiotherapy can be treated with cryoablation. Cryoablation can maintain local tissue integrity and organ function and protect facial integrity. It is a repeatable treatment that, if necessary, can be followed by traditional antineoplastic therapies. This study introduces five cases with severe basic diseases who cannot tolerate or have refused surgery or radiotherapy. The patients were diagnosed as having oral and maxillofacial tumors. These patients experienced painful local swelling or breaking of the tumor. All patients received cryoablation combined with other treatments. Local control of the tumors and improved function and quality of life were achieved. In clinical work, for patients with severe basic diseases who cannot tolerate or refuse surgery or radiotherapy, cryoablation has unique advantages, and this approach is expected to become a widely used treatment for oral and maxillofacial tumors.


Assuntos
Ablação por Cateter , Criocirurgia , Neoplasias , Humanos , Neoplasias/etiologia , Qualidade de Vida , Resultado do Tratamento
3.
Urol Oncol ; 40(5): 199.e9-199.e14, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35379535

RESUMO

INTRODUCTION AND OBJECTIVES: Cryoablation offers a treatment option for small renal masses ideally suited ≤3 cm. In well-selected candidates, it is associated with less perioperative morbidity compared to more invasive options, such as partial or radical nephrectomy. However, little is known regarding device-related complications associated with the procedure. We provide an analysis of reports on renal cryoablation from the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database. METHODS: Reports on renal cryoablation submitted to the MAUDE database from 2015 through 6/2021 were analyzed. Cases not pertaining to renal cryoablation were excluded (n = 33). Reports were examined to identify patient morbidity related to a potential device malfunction, as well as manufacturer assessment. Complications were graded based on an established MAUDE complication-reporting stratification. Fisher's Exact test was utilized to analyze for associations between device-related adverse events and severity of post-treatment sequelae. RESULTS: Two hundred and thirty-nine unique cases were identified. Adverse events were related to issues with the needles or system (212 cases), technical error (12 cases), or complication related to patient or tumor complexity (14 cases). There were 187 (78.6%) minor complications (MAUDE 1-2) and 52 (21.4%) major complications (MAUDE 3-4). The manufacturer performed formal device review in 164 (68.6%) cases, accepting responsibility for malfunction in 41. Notable MAUDE 3 complications included 29 (12.1%) cases aborted due to instrument/system malfunction and 14 (5.9%) cases of hemorrhage requiring a subsequent procedure. All 3 reported patient deaths (MAUDE 4) appeared to be a consequence of poor baseline health. On statistical analysis, major complications were seen in a significantly higher proportion of non-device related adverse events compared to device related events (85.2% vs. 13.7%, P < .001). CONCLUSION: While renal cryoablation is associated with low overall perioperative morbidity, there is a diverse set of device-related and procedural complications reported in recent years. Device-related adverse events were often associated with minor complications, and major complications were often seen in higher risk patients with comorbidities, more complex tumors, and after technical error. These findings highlight the need for standardized reporting of complications, optimized patient selection and counseling to ensure the best outcomes.


Assuntos
Criocirurgia , Criocirurgia/efeitos adversos , Bases de Dados Factuais , Humanos , Estados Unidos , United States Food and Drug Administration
4.
J Card Surg ; 37(6): 1716-1717, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35353382

RESUMO

Residual tumor mass after large cardiac fibroma resection carries long-term risk, but cryoablation is useful during surgery to remove such tissue. Here, we present a case of a large cardiac fibroma of the posterior wall of the left ventricle, discovered during long-term, episodic ventricular tachycardia. Resection with cryoablation completely removed the tumor, eliminating postoperative, distant ventricular arrhythmias.


Assuntos
Criocirurgia , Fibroma , Neoplasias Cardíacas , Taquicardia Ventricular , Fibroma/diagnóstico por imagem , Fibroma/patologia , Fibroma/cirurgia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Ventrículos do Coração/patologia , Ventrículos do Coração/cirurgia , Humanos , Taquicardia Ventricular/etiologia , Taquicardia Ventricular/cirurgia
6.
J Am Coll Surg ; 234(4): 484-492, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35290267

RESUMO

BACKGROUND: Minimally invasive repair of pectus excavatum (MIRPE) involves placement of a transthoracic, retrosternal support bar under thoracoscopic guidance. Despite its minimally invasive technical approach, postoperative pain is a significant morbidity that often results in increased length of stay. Multi-modal pain control strategies have been used in the past with limited success. Recently, the use of intraoperative intercostal nerve cryoablation (CA) has been added. In the present study, we aim to evaluate the effects of CA on postoperative pain control, opioid requirements, and perioperative outcomes. STUDY DESIGN: A single-center, retrospective chart review of all patients (less than 18 years old) who underwent MIRPE from 2009 to 2020 was performed. CA was started in June 2018. Data collection included demographics, preoperative characteristics, intraoperative findings, and postoperative outcomes. We hypothesized that CA would be associated with improved pain scores, lower doses of total inpatient opioid requirement, and shorter length of stay (LOS). RESULTS: One hundred sixty-one patients met inclusion criteria: 75 underwent intraoperative CA and 86 underwent MIRPE without CA (NCA group). CA significantly decreased median LOS from 4 days in NCA to 2 days; the use of CA was the only significant predictor of LOS on linear regression. CA was also associated with decreased total PCA, intravenous opioid, and oral opioid dosages. There was no difference in inpatient pain scores and a slight increase in mean procedure time. However, CA was associated with significantly decreased postoperative complications. CONCLUSIONS: The use of cryoablation during MIRPE significantly decreases LOS, perioperative opioid requirements, and postoperative complications, with a minimal increase in operative time. Cryoablation is an effective pain control modality in the surgical management of chest wall deformities in children.


Assuntos
Criocirurgia , Tórax em Funil , Adolescente , Analgésicos Opioides/uso terapêutico , Criança , Criocirurgia/efeitos adversos , Criocirurgia/métodos , Tórax em Funil/complicações , Tórax em Funil/tratamento farmacológico , Tórax em Funil/cirurgia , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos
7.
Cardiovasc Intervent Radiol ; 45(5): 613-621, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35237861

RESUMO

Desmoid tumours (DT) are rare locally infiltrative soft-tissue tumours which do not metastasise. DT arise sporadically or are associated with familial syndromes, with different clinical and genetic patterns. In recent years there has been an increasing therapeutic role of cryoablation for the treatment of sporadic DT. Therefore, in this present review, we: (a) summarize all the main epidemiological, clinical, and therapeutic aspects of sporadic DT that are relevant to an interventional radiologists' practice; (b) present the results of a systematic review that has been conducted with the intent of highlighting the main clinical outcomes available thus far with cryoablation; and (c) discuss the current and future potential applications of cryoablation in this field. Five studies were included in the systematic review accounting for 146 patients. Only 18.5% patients received cryoablation as a first-line treatment. Overall, the volume of the DT undergoing cryoablation was very large (mean total DT volume of 237 cm3). Major complications were noted for 13.3-30% patients and following 2.4-6.7% interventional sessions. The rates of complete tumour response ranged between 0 and 43.3%. 1- and 3-year local progression-free survival rates were 85.1-85.8%, and 77.3-82.9%, respectively. Complete pain relief was reported in 40-66.7% symptomatic patients. In conclusion, cryoablation is currently proposed as a therapeutic strategy to very large DT, which is recognized to be associated with an increased procedure-related morbidity and reduced rates of complete tumour response. Proposing cryoablation as the first-line treatment may improve these clinical outcomes.


Assuntos
Ablação por Cateter , Criocirurgia , Fibromatose Agressiva , Neoplasias de Tecidos Moles , Criocirurgia/métodos , Fibromatose Agressiva/diagnóstico por imagem , Fibromatose Agressiva/cirurgia , Humanos , Intervalo Livre de Progressão , Estudos Retrospectivos , Neoplasias de Tecidos Moles/cirurgia , Resultado do Tratamento
8.
Theranostics ; 12(5): 2175-2204, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35265206

RESUMO

With rapid advances in modern imaging, minimally invasive ablative procedures have emerged as popular alternatives to surgical removal of tumors. Tumor ablation modalities currently offered in clinical practice include microwave ablation, radiofrequency ablation, cryoablation, high-intensity focused ultrasound, and irreversible electroporation. Cryoablation, a non-heat-based method of ablation, is increasingly being used for treating various solid tumors. Accumulated comparative data of cryoablation versus heat-based ablation techniques (e.g., radiofrequency and microwave ablation) shows superior tumor response and quicker recovery time. Evolving research has demonstrated that nanocarriers may serves as excellent catalysts for the cryoablation therapy, imaging guidance, and the co-delivery of therapeutics for minimally invasive, precise, and complete treatment of cancer with immune modulation. This review article focuses on the current status of cryoablation in clinical practice, considers opportunities for enhancing therapeutic outcomes from cryoablation, and discusses new research in the field, including theranostic nanoparticles-mediated cryotherapy and combinational cryo-based immunotherapies.


Assuntos
Técnicas de Ablação , Ablação por Cateter , Criocirurgia , Nanopartículas , Neoplasias , Técnicas de Ablação/métodos , Ablação por Cateter/métodos , Criocirurgia/métodos , Humanos , Neoplasias/cirurgia
9.
Cardiovasc Intervent Radiol ; 45(5): 656-664, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35274173

RESUMO

PURPOSE: To retrospectively investigate the safety and oncological outcomes of cryoablation performed on residual/recurring renal cell carcinoma (RCC) in the ipsilateral kidney following partial nephrectomy (PN). MATERIALS AND METHODS: Data dealing with patients', RCC, procedure (including the length of the hospital stay), and follow-up (technical efficacy [TE], local tumor progression-free survival [LTPFS], disease-free survival [DFS], metastasis-free survival [MFS], cancer-specific survival (CSS), and overall survival [OS]) were retrospectively collected and analyzed. RESULTS: Between January 2008 and November 2020, 21 consecutive patients (17 [81%] men; 4 [19%] women; median age 68 years; range 43-82) underwent cryoablation due to residual/recurring RCC in the PN site (15 patients) or de-novo RCC (6 patients) in the ipsilateral kidney. Median tumor size was 2.2 cm (mean 2.3 cm; range 0.8-4; interquartile range [IQR] 1.9-3). There were two (2/21; 10%) minor self-limiting hemorrhagic complications, both occurring in the group of patients with RCC in the PN site. Median hospital stay was 2 days (mean 2.1; range 1-5; IQR 2-2). TE was 100% (21/21 patients), and 10-year estimates of LTPFS, MFS and DFS were 74.1% (95% confidence intervals [CI] 56.8-96.7%), 36.4% (95% CI 14.2-93.8%), and 43.5% (95% CI 21.9-86.4%), respectively. CSS and OS were 100% at the last available follow-up (median 56 months; mean 67.4; range: 12-147; IQR:34-95). CONCLUSION: Cryoablation in patients with residual/recurring RCC following PN is safe and results in high 10-year estimates of LTPFS.


Assuntos
Carcinoma de Células Renais , Criocirurgia , Neoplasias Renais , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Renais/diagnóstico por imagem , Carcinoma de Células Renais/cirurgia , Doença Crônica , Criocirurgia/métodos , Feminino , Humanos , Rim/patologia , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Nefrectomia/métodos , Estudos Retrospectivos , Resultado do Tratamento
10.
Future Oncol ; 18(14): 1705-1716, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35255716

RESUMO

Aim: To share our experience after 28 cryoablation treatments for prostate cancer (PCa) with histopathology, clinical data and MRI as the follow-up methods. Methods: Clinical follow-up comprised prostate-specific antigen (PSA)-measurements, PSA-density and quality of life-parameters. multi-parametric (mp)MRI pre- and post-cryoablation were retrospectively re-analyzed in 23 cases using Likert scores. Follow-up-histopathology was performed via MRI/ultrasound fusion-guided and/or systematic biopsy. Receiver operating characteristic curve analysis was performed. Results: 17 PCa (61%) were diagnosed within 12-month post-cryotherapy (infield and out-of-field disease). PSA levels and PSA density were not significantly different between patients with or without PCa recurrence. mpMRI can characterize the decrease in prostate volume and necrosis. Area under the curve for the detection of PCa was 81% (global Likert scores), 74-87% (T2), 78% (diffusion weighted imaging) and 57-78% (dynamic contrast enhanced imaging; Youden-selected cutoff ≥3). Conclusion: Besides histopathological evaluation and control biopsy, MRI might have the potential to accurately detect PCa after cryotherapy. Clinical data and interdisciplinary communication are required for efficient monitoring after cryoablation treatments for PCa.


Assuntos
Criocirurgia , Neoplasias da Próstata , Criocirurgia/efeitos adversos , Seguimentos , Humanos , Biópsia Guiada por Imagem/métodos , Imageamento por Ressonância Magnética/métodos , Masculino , Antígeno Prostático Específico , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Qualidade de Vida , Estudos Retrospectivos
11.
Cryo Letters ; 43(1): 25-31, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35315867

RESUMO

BACKGROUND: It is well established that in cryosurgery some cells can survive one freeze thaw cycle and that surviving cells are found at the margin of the frozen lesion. Numerous techniques are being developed to ensure the survival of frozen cells to the margin of the frozen region. OBJECTIVE: We thought that it would be of fundamental interest to observe the pattern of cell survival in a liver treated with one freeze-thaw cycle. MATERIALS AND METHODS: We performed six ultrasound-guided single freeze-thaw cryosurgery procedures on the liver of four Landrace pigs, using two cryosurgery probes separated by 25 mm inserted in parallel. Treated organs were removed 24 hours after the cryosurgery and processed for histology with hematoxylin and eosin. The tissues were analyzed with a digital slice scanner. RESULTS: We found an unexpected pattern of cell survival; sheets of live cells, about 200 µm in width, that follow the network of interlobular connective tissue septae to a distance of several millimeter from the outer edge of the one freeze-thaw cycle cryosurgery treated lesion. The sheets of live cells surround lobule cores that have undergone complete coagulative necrosis. In addition, larger blood vessels, as far as 5 mm from the outer rim of the treated lesion, have a major and complex effect on cell survival with large areas of completely necrotic and completely alive cells intermixed. CONCLUSION: This study may have value as a baseline for developing new cryosurgery protocols designed to ablate cells to the margin of the frozen lesion.


Assuntos
Criocirurgia , Animais , Sobrevivência Celular , Criopreservação , Criocirurgia/métodos , Congelamento , Fígado/cirurgia , Suínos
12.
Tech Vasc Interv Radiol ; 25(1): 100800, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35248324

RESUMO

Image guided percutaneous biopsy has become the initial procedure of choice in most cases for obtaining bone samples for histological and microbiological assessment. It is a minimally invasive procedure which offers multiple advantages over open surgical biopsy including maintenance of bone structure, minimal soft tissue injury, reduced need of general anesthesia, reduced hospital stay and a low rate of post-procedure complications. In some cases, it can be combined with therapeutic procedures such as cementoplasty and cryoablation via the same access route. For the radiologist, knowledge of the key principles is essential for a safe and effective procedure, particularly when a sarcoma of bone is in the differential diagnosis. In this article we cover the core concepts of percutaneous bone biopsy including indications and contraindications, essential planning steps, appropriate imaging modalities, equipment selection, common approaches, technique as well as avoiding, recognizing and treating complications. Recent technological advancements in this field are also discussed.


Assuntos
Neoplasias Ósseas , Criocirurgia , Neoplasias de Tecidos Moles , Biópsia , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/cirurgia , Criocirurgia/efeitos adversos , Humanos , Biópsia Guiada por Imagem/efeitos adversos , Biópsia Guiada por Imagem/métodos , Radiologistas , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/cirurgia
13.
Europace ; 24(2): 226-233, 2022 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-35134151

RESUMO

AIMS: Pulmonary vein isolation (PVI) is still regarded as a cornerstone for treatment of persistent atrial fibrillation (AF). This study evaluated the effectiveness of PVI performed with cryoballoon ablation (CBA) in comparison with radiofrequency ablation (RFA) in patients with persistent AF. METHODS AND RESULTS: A total of 101 patients with symptomatic persistent AF were enrolled and randomized (1:1) to CBA or RFA groups and followed up for 12 months. The primary endpoint was any documented recurrent atrial tachyarrhythmia (ATA) lasting longer than 30 s following a 3-month blanking period. Secondary endpoints were procedure-related complications, procedure and ablation duration, and fluoroscopy time. The ATA-free survival curves were estimated by Kaplan-Meier method and analysed by the log-rank test. According to intention-to-treat analysis, freedom from ATA was achieved in 36 out of 52 patients in the CBA group and 30 out of 49 patients in the RFA group (69.2% vs. 61.2%, P = 0.393). No difference in AF recurrence was found between the two groups (27.5% in CBA vs. 38.0% in RFA, P = 0.258), and less atrial flutter recurrence was documented in the CBA group compared with the RFA group (3.9% vs. 18.0%, P = 0.020). The procedure and ablation duration were significantly shorter in the CBA group (160 ± 31 vs. 197 ± 38 min, P < 0.0001; 36.7 ± 9.5 vs. 55.3 ± 16.7 min, P < 0.0001). There was no difference regarding fluoroscopy time (21.5 ± 7.8 vs. 23.4 ± 11.2 min, P > 0.05). CONCLUSION: Compared with RFA, PVI performed by CBA led to shorter procedure and ablation duration, with less atrial flutter recurrence and similar freedom from ATA at 12-month follow-up.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Criocirurgia , Veias Pulmonares , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/cirurgia , Ablação por Cateter/efeitos adversos , Ablação por Cateter/métodos , Criocirurgia/efeitos adversos , Criocirurgia/métodos , Humanos , Veias Pulmonares/cirurgia , Recidiva , Resultado do Tratamento
16.
Int Angiol ; 41(2): 128-135, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35112827

RESUMO

BACKGROUND: Postoperative pain after thoracoabdominal (TAAA) or thoracic (TAA) aortic aneurysm open surgical repair may be debilitating and induce limitations in mobilization resulting in a longer length of stay, higher rate of pulmonary adverse events, readmissions, and a higher risk of mortality. Commonly employed analgesic strategies do not completely solve this issue and have their own drawbacks. Cryoablation of intercostal nerves has been proposed as an appealing alternative to address the postoperative pain. METHODS: Between 2020 and 2021, data of all consecutive patients undergoing TAA or TAAA aortic aneurysms open repair with electroneurography-guided cryoablation of intercostal nerves were collected. Postoperative pain was recorded using patient-reported 0-10 numeric rating scale (NRS). Need for adjunctive opioid drugs and postoperative complications were also recorded. Narcotic usage was calculated as morphine milligram equivalents (MMEs) per day. RESULTS: A total of 15 patients (8 males, mean age 61.1-year-old) underwent open surgical repair for TAAA (13 cases) or TAA (2 cases) and received intercostal nerve cryoablation. There were no intraoperative deaths and cases of spinal cord ischemia. Overall, 70 intercostal nerves underwent electroneurography-guided cryoablation, with a mean of 4.6 nerves per patient. On the first day after extubating, mean NRS was 4.6 and the MMEs calculated was 6.7, decreasing over the days. There was one case of pneumonia and atelectasis requiring bronchoscopy. There were no reported bowel complications. The mean postoperative length of stay was 16 days and in the intensive care unit stay was 6.5 days. CONCLUSIONS: Electroneurography-guided cryoablation of intercostal nerves is a safe and reproducible technique which can be used in addition to systemic pain management for TAA and TAAA open repair.


Assuntos
Aneurisma da Aorta Torácica , Criocirurgia , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/cirurgia , Criocirurgia/efeitos adversos , Criocirurgia/métodos , Humanos , Nervos Intercostais/cirurgia , Masculino , Pessoa de Meia-Idade , Manejo da Dor/efeitos adversos , Manejo da Dor/métodos , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Estudos Retrospectivos , Resultado do Tratamento
17.
Prim Care ; 49(1): 47-62, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35125158

RESUMO

Clinicians in the primary care setting will encounter various different skin conditions requiring procedural intervention. There are many different procedural approaches to treatment. Knowing which modalities are available and best suited to handle a particular skin lesion allows for flexibility for patient and clinician. Although some treatment modalities may be used more than others, it is helpful to be at least familiar with basic in office skin procedures such as removal of foreign bodies, cryotherapy, electrosurgery, and treatment of keloids, as these procedures are helpful in addressing the wide variety of the most commonly encountered skin issues in primary care.


Assuntos
Criocirurgia , Corpos Estranhos , Queloide , Crioterapia , Eletrocirurgia , Humanos , Queloide/patologia , Queloide/cirurgia
18.
BMC Cardiovasc Disord ; 22(1): 45, 2022 02 13.
Artigo em Inglês | MEDLINE | ID: mdl-35152878

RESUMO

BACKGROUND AND AIMS: Inflammation plays a key role in the initiation and progression of atrial fibrillation (AF). The systemic inflammation indexes are easily evaluated and predict AF development. However, it's role in prediction of recurrence of AF is unknown. We aim to explore the association between the systemic inflammation indexes and recurrence of AF in patients underwent cryoablation (CryoMaze) concomitant with mitral valve surgery. METHODS: We examined systemic inflammation indexes during perioperative period in 122 patients between 2015 and 2018. Systemic inflammation indexes were developed by systemic immune-inflammation index (SII), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocytes to monocytes ratio. Univariate and multivariate analyses were performed to examine the association of each markers with recurrence of AF. RESULTS: Of the 122 patients included in this study, 22 patients (18%) experienced AF recurrence after CryoMaze concomitant with mitral valve surgery. There is no significant difference between each systemic inflammation indexes before surgery and recurrence of AF. In univariate analysis, MLR after surgery 3 days, PLR, MPLR, NLR, SII after surgery 7 days were able to predict recurrence of AF. In multivariate analyses, SII ≥ 1696 independently predicted recurrence (OR, 3.719; 95% CI, 1.417-9.760). Interestingly, baseline SII showed no significant in prediction of recurrence. It was sharply elevated after surgery and dropped slowly. In patients of recurrence, SII after 7 days of surgery increased again. CONCLUSIONS: The raised SII again was associated with an increased risk of the postoperative recurrence of AF and independently predicted the late recurrence of AF after CryoMaze concomitant with mitral valve surgery.


Assuntos
Fibrilação Atrial/cirurgia , Criocirurgia/efeitos adversos , Técnicas de Apoio para a Decisão , Doenças das Valvas Cardíacas/cirurgia , Inflamação/diagnóstico , Procedimento do Labirinto/efeitos adversos , Valva Mitral/cirurgia , Idoso , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/imunologia , Fibrilação Atrial/fisiopatologia , Plaquetas/imunologia , Feminino , Doenças das Valvas Cardíacas/diagnóstico , Doenças das Valvas Cardíacas/imunologia , Doenças das Valvas Cardíacas/fisiopatologia , Humanos , Inflamação/imunologia , Contagem de Linfócitos , Linfócitos/imunologia , Masculino , Pessoa de Meia-Idade , Valva Mitral/fisiopatologia , Monócitos/imunologia , Contagem de Plaquetas , Valor Preditivo dos Testes , Recidiva , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
19.
Plast Reconstr Surg ; 149(3): 424e-428e, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-35196676

RESUMO

BACKGROUND: Cryolipolysis is a noninvasive method that allows selective reduction of adipose tissue. The aim of the present study was to evaluate the efficacy of cryothermogenesis, the repetitive applications of cryotherapy, in body contouring of the abdomen and saddlebag areas. METHODS: Thirty participants were included in the study. Premenopausal women with an overload of subcutaneous abdominal and saddlebag adipose tissue were enrolled. For each participant, five cryothermogenesis sessions were carried out using a medical device equipped with two cooling probes. The primary endpoint was metric measurement. The secondary endpoints were the measurement of subcutaneous fat mass using a Lunar iDXA whole-body scanner (GE Healthcare, Madison, Wis.) and a metabolic assessment conducted before treatment and 15 days after treatment. RESULTS: The mean age of participants was 36.72 ± 7 years. Participants had different phototypes and an average body mass index of 23.0 ± 1.41 kg/m2. A decrease in body mass index was observed 3 months after the last session; the body mass index dropped to 20.5 ± 2.1 kg/m2 (p = 0.004 compared to baseline). Waist measurements showed a significant decrease, with an average loss of 4.1 cm after 15 days and 4.62 cm after 3 months. Concerning the circumference of saddlebags, a decrease was observed 3 months after treatment. These results were confirmed by iDXA computed tomographic measurements, showing a significant fat mass reduction in the treated areas. CONCLUSION: The results indicate that subcutaneous fat in the abdomen and saddlebags was reduced after five successive cryothermogenesis sessions, without any complications, in a cohort of participants with different phototypes. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.


Assuntos
Abdome/cirurgia , Contorno Corporal/métodos , Criocirurgia/métodos , Lipectomia/métodos , Gordura Subcutânea/cirurgia , Coxa da Perna/cirurgia , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Estudos Prospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...