Intraoperative Laparoscopic Fluorescence Guidance to the Sentinel Lymph Node in Prostate Cancer Patients: Clinical Proof of Concept of an Integrated Functional Imaging Approach Using a Multimodal Tracer

Purpose To perform a meta-analysis of all published studies of sentinel lymph node (SLN) biopsy for staging patients with melanoma. Methods Published literature in all languages between 1990 and 2009 was critically appraised. Primary outcomes evaluated included the proportion successfully mapped (PSM) and test performance including false-negative rate (FNR), post-test probability negative (PTPN), and positive predictive value in the same nodal basin recurrence. Results A total of 71 studies including 25,240 patients met full eligibility criteria. The average PSM was 98.1% (95% CI, 97.3% to 98.6%) and increased with the year of publication, female sex, ulceration, age, and the quality score of the studies. The FNR ranged from 0.0% to 34.0%, averaging 12.5% overall (95% CI, 11% to 14.2%). FNR increased with the length of follow-up (P .002) but decreased with greater PSM (P .001). PTPN averaged 3.4% (95% CI, 3.0% to 3.8%), which also increased in studies with longer follow-up, younger age, female sex, deeper Breslow thickness, and with tumor ulceration while decreasing with greater PSM (P .001). Approximately 20% of the patients with a positive SLN had additional lymph nodes in the complete lymph node dissection and 7.5% of the patients with positive SLN developed recurrence in the same nodal basin which was greater in studies that also reported higher FNR (P .01).

Lymphatic Mapping and Sentinel Lymph Node Biopsy in Patients With Melanoma: A Meta-Analysis

Objetivo: Verificar a variação da pressão intraocular decorrente do uso de óculos de natação. Métodos: Nove nadadores (5 homens e 4 mulheres), com idade entre 18 e 25 anos tiveram sua PIO medida em seis diferentes momentos. Momento 1): pré teste, momento 2): após 10 minutos sentados vestindo óculos de natação, momento 3): quinze minutos após o momento 2, momento 4): após 10 minutos dentro da piscina sem usar óculos de natação, momento 5): imediatamente após nadar 400 metros usando o óculos de natação, momento 6): doze minutos após o termino do nado. Foi utilizado como procedimento estatístico o teste ANOVA e o pós teste de Bonferonni. Resultados: Não houve alteração significativa após 10 minutos de uso do óculos de natação (p˃0.05); não houve alteração significativa da PIO após 10 minutos de permanência dentro da piscina sem usar óculos de natação (p˃0.05); houve redução significativo da PIO (p˂0.01) imediatamente após os 400 metros de nado, retornando próximo aos valores iniciais 12 minutos após o termino do teste. Conclusão: houve redução significativa da PIO após 400 metros de nado, retornando aos valores iniciais 12 minutos após o término do teste.

Revista Brasileira de Prescrição e Fisiologia do Exercício

Clinical significance of lympho vascular space involvement and lymph node micrometastases in early-stage cervical cancer: a retrospective case-control surgico-pathological study.

Congenital vascular lesions: Clinical application of a new classification

O presente estudo de revisao visa uniformizar a nomenclatura e os conceitos classificatorios existentes na literatura, relativos aos desenhos ou modelos de estudo cientifico mais comumente utilizados em pesquisas na area clinico-cirurgica geral. Procurou-se facilitar a elaboracao do delineamento de um projeto de pesquisa cientifica, visando sua aplicabilidade. Esta revisao tambem tem o intuito de auxiliar o cirurgiao-pesquisador a identificar qual foi o delineamento proposto em um artigo, assim como desenvolver um senso de critica metodologica mais apurada sobre o mesmo, alem de desmistificar a miscelânea conceitual existente na literatura.

Desenhos de pesquisa

The main purpose of a study is its publication on a scientific journal. Research financing agencies are important institutions so that studies can be developed and published. The most important research financing agencies that are discussed in this article are: "Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior" (CAPES), "Conselho Nacional de Desenvolvimento Cientifico e Tecnologico" (CNPq) and "Fundacao de Amparo a Pesquisa do Estado de Sao Paulo" (FAPESP). CAPES' activities can be grouped in four different strategy lines: a) it evaluates the stricto sensu, at the post-graduation level; b) it provides access and development of scientific research; c) it provides investment on the development of high qualified human resources in Brazil and abroad, and d) it promotes international scientific cooperation. Although CAPES does not support directly scientific publications, almost all actions of this agency contribute to the development of scientific research and publication. CNPq has two main purposes: financing researches and development of human resources. It provides the researchers with financial aid to scientific publication. The grants for editing were specifically created for supporting the national scientific and technical publications edited by Brazilians institutions or societies. CNPq can also support Congresses, Symposiums and similar short-term courses. The Plataforma Lattes is also a branch of CNPq on which the Curriculum Lattes is available. This site has the curriculum vitae of the scientific community and is of great value for researchers. FAPESP also finances journal publications, articles and books that bring up original results of studies made by researchers from the state of Sao Paulo. It finances, partially, the travel expenses of innovative papers authors in meetings within the country or abroad. Brazilian authors are increasing the number of international publications. Universities, research institutes, financing agencies and private companies are more and more concerned with knowledge property. Researchers must understand the need of knowledge property and the financing agencies have to consider the patents achieved as a criteria of evaluation of scientific production.

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Fomento à publicação científica e proteção do conhecimento científico

Influence of colloid particle profile on sentinel lymph node uptake

The purpose of this study is to evaluate and compare the effect of the incision of the external oblique aponeurosis along the semilunaris in amount of tension present after the undermining of the anterior rectus sheaths. Forty fresh adult cadavers were studied and divided into two groups: group A (n=20) and group B (n=20). Traction indexes were compared in three situations: (1) before any aponeurotic undermining (similar on both groups); (2) after incision and undermining of the anterior rectus sheaths (similar on both groups) and (3) group A: after undermining of the external oblique muscles with the incision of their aponeurosis along the semilunaris and group B: undermining of a continuous layer of the anterior rectus sheaths and the external oblique aponeurosis, after release of the lateral aspect of the rectus sheaths. Significance of differences was assessed using non-parametric tests. There was a significant tension reduction after each stage of dissection in both supra- and infra-umbilical levels and on both groups. Comparisons between groups A and B did not show statistically significant differences in all sites and stages of the dissections. Therefore, both techniques showed similar aponeurotic tension reduction after each stage of the dissections in cadavers.

https://www.jprasurg.com/article/S1748-6815(08)01232-1/pdf

A variation in the component separation technique that preserves linea semilunaris: a study in cadavers and a clinical case

CONTEXT: Sentinel node (SN) biopsy has changed the surgical treatment of malignant melanoma. The literature has emphasized the importance of gamma probe detection (GPD) of the SN. OBJECTIVE: Our objective was to evaluate the efficacy of patent blue dye (PBD) and GPD for SN biopsy in different lymphatic basins. DESIGN: Patients with cutaneous malignant melanoma in stages I and II were submitted to biopsy of the SN, identified by PBD and GPD, as part of a research project. SETTING: Patients were seen at Hospital Sao Paulo by a multidisciplinary group (Plastic Surgery Tumor Branch, Nuclear Medicine and Pathology). PATIENTS: 64 patients with localized malignant melanoma were studied. The median age was 46.5 years. The primary tumor was located in the neck, trunk or extremities. INTERVENTIONS: Preoperative lymphoscintigraphy, lymphatic mapping with PBD and intraoperative GPD was performed on all patients. The SN was examined by conventional and immunohistochemical staining. If the SN was not found or contained micrometastases, only complete lymphadenectomy was performed. MAIN MEASUREMENTS: The SN was identified by PBD if it was blue-stained, and by GPD if demonstrated activity five times greater than the adipose tissue of the neighborhood. RESULTS: Seventy lymphatic basins were explored. Lymphoscintigraphy showed ambiguous drainage in 7 patients. GPD identified the SN in 68 basins (97%) and PBD in 53 (76%). PBD and GPD identified SN in 100% of the inguinal basins. For the remaining basins both techniques were complementary. A metastatic SN was found in 10 basins. Three patients with negative SN had recurrence (median follow-up = 11 months). CONCLUSION: Although both GPD and PBD are useful and complementary, PBD alone identified the SN in 100% of the inguinal lymphatic basins.

/pdf/is-intra-operative-gamma-probe-detection-really-necessary-rsxlk6obh9.pdf

Renato Santos de Oliveira Filho

Papers

Desenhos de pesquisa

Fomento à publicação científica e proteção do conhecimento científico

Influence of colloid particle profile on sentinel lymph node uptake

A variation in the component separation technique that preserves linea semilunaris: a study in cadavers and a clinical case

Is intra-operative gamma probe detection really necessary for inguinal sentinel lymph node biopsy?