RESUMO
Radioactive seed localization (RSL) provides a precise and efficient method for removing non-palpable breast lesions. It has proven to be a valuable addition to breast surgery, improving perioperative logistics and patient satisfaction. This retrospective review examines the lessons learned from a high-volume cancer center's RSL program after 10 years of practice and over 25 000 cases. We provide an updated model for assessing the patient's radiation dose from RSL seed implantation and demonstrate the safety of RSL to staff members. Additionally, we emphasize the importance of various aspects of presurgical evaluation, surgical techniques, post-surgical management, and regulatory compliance for a successful RSL program. Notably, the program has reduced radiation exposure for patients and medical staff.
Assuntos
Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Mastectomia Segmentar/métodos , Radioisótopos do Iodo , Mama , Estudos RetrospectivosRESUMO
The goal of this study is to investigate the effect of the location and width of a single lead shield on the dose rate of staff and caregivers in a hospital room with an I-131 patient. The best orientation of the patient and caregiver relative to the shield was determined based on minimizing staff and caregiver radiation dose rates. Shielded and unshielded dose rates were simulated using a Monte Carlo computer simulation and validated using real-world ionisation chamber measurements. Based on a radiation transport analysis using an adult voxel phantom published by the International Commission on Radiological Protection, placing the shield near the caregiver yielded the lowest dose rates. However, this strategy reduced the dose rate in only a tiny area of the room. Furthermore, positioning the shield near the patient in the caudal direction provided a modest dose rate reduction while shielding a large room area. Finally, increased shield width was associated with decreasing dose rates, but only a four-fold dose-rate reduction was observed for standard width shields. The recommendations of this case study may be considered as potential candidate room configurations where radiation dose rates are minimized, however these findings must be weighed against additional clinical, safety, and comfort considerations.
Assuntos
Cuidadores , Compostos Radiofarmacêuticos , Adulto , Humanos , Doses de Radiação , Radioisótopos do Iodo/uso terapêutico , Simulação por Computador , Imagens de FantasmasRESUMO
INTRODUCTION: Robotics and ambulatory are modern applications of surgery. This case study proves the feasibility of robot-assisted radical prostatectomy as an outpatient procedure. METHOD: This report highlights the first, half-day, robotic prostatectomy performed on a 57-year-old man with localized prostate cancer. This operation was proposed to the subject because of his excellent physical condition and favorable environmental factors. He chose to undergo the surgery voluntarily. He underwent a nerve sparing radical prostatectomy. Target-controlled infusion propofol was used in perioperative sedation and analgesia. Postoperative evaluation criteria was made with the Visual Analog Scale of Pain Intensity (VASPI), Chung score and a patient satisfaction survey. RESULTS: No perioperative or postoperative complications were reported. Blood loss was low (75 mL). The patient stayed less than 12 hours in the ambulatory unit thanks to a rapid recovery. The patient returned home after reporting a Chung score of 10. No hospital readmission was necessary. Functional results were: a bowel movement on day 1, back to work on day 2, normal urinary continence on day 8, a correct erectile function on day 9. Oncological results revealed negative surgical margins for cancer and PSA postoperative<0.03 ng/mL. CONCLUSION: Ambulatory robotic radical prostatectomies can be performed on voluntarily-selected patients without affecting the high quality of urological surgery outcomes.
Assuntos
Procedimentos Cirúrgicos Ambulatórios , Biomarcadores Tumorais/sangue , Antígeno Prostático Específico/sangue , Prostatectomia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/cirurgia , Procedimentos Cirúrgicos Robóticos , Procedimentos Cirúrgicos Ambulatórios/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Prostatectomia/métodos , Prostatectomia/tendências , Neoplasias da Próstata/sangue , Resultado do TratamentoAssuntos
Neurossífilis , Feminino , Humanos , Pessoa de Meia-Idade , Neurossífilis/diagnóstico , Neurossífilis/terapiaRESUMO
The aim of the study was to clarify whether fear in children is related to a distorted cognitive processing of fear-related information. In anxious children, only a few studies of this bias were performed which yielded inconsistent results. Martin, Horder, and Jones (1992. Cognition and Emotion, 6(6), 479-486) found a bias for spider words in spider-fear children, using a card format of the Stroop task. However, by using a single-trial format of the Stroop task, we previously found that both anxious and control children favored the processing of threatening information (Kindt, Brosschot, & Everaerd, 1997. Journal of Experimental Child Psychology, 64, 79-97). In the present study, we administered both a card format and a single-trial format of the Stroop task to spider-fear and control children. In line with our previous results, a bias for spider words was observed in spider fear but also in control children, regardless of the format used. Furthermore, the processing biases assessed by the two formats did not correlate, which suggests that they measure different mechanisms and/or that one or both mechanisms are unstable. It is speculated that certain cognitive developmental deficits in regulating emotions may be a vulnerability factor in the etiology of anxiety disorders.