Emergency Live’s Post

Anatomic hepatectomy based on portal vein region (PT) and edge priority (MPT-AR) maximizes the removal of PT liver tissue while providing sufficient surgical margin to enable rapid treatment and perioperative recovery of hepatocellular carcinoma. https://ja.ma/3yXcjqZ

Today’s cardiovascular case study is a case of PCI treatment for a kidney cancer patient with frequent chest pain. The patient is a 59-year-old male who was hospitalized for the discovery of lung cancer and kidney cancer accompanied by chest pain for half a month. A primary lung malignant tumor was found after a chest CT scan, and a urological examination diagnosed clear cell renal cell carcinoma (grade II). Due to repeated episodes of chest pain, a coronary CTA examination was also performed and revealed severe stenosis in multiple blood vessels. The patient was transferred to the cardiology department for further diagnosis and treatment. Active cancer and planned major surgery on DAPT are both major criteria according to the the ARC-HBR criteria, thus categorizing this patient to be a HBR (high bleeding risk) patient. PCI procedure was performed to treat the severe stenosis of LCX and LAD. BA9 drug-coated stent BioFreedom™ were implanted. BioFreedom™ stent allows for ultra-short (one-month) DAPT after the procedure for patients at high risk of bleeding or requiring near-future surgery. A total of 240 cancer patients and 400 recently-scheduled-for-surgery patients were enrolled in the LEADERS FREE study. The conclusion of these subgroup analysis confirmed the safety and effectiveness of the regimen of BioFreedom™ stent combined with one-month DAPT in patients, compared to the control group. The BioFreedom™ drug coated stent has been the recommended treatment stent in the ESC guidelines for patients with high bleeding risk. It is a suitable choice for short DAPT scenarios, including patients with active cancer. #healthcare #medical #cardiovascular #heartstent #PCI #interventionalcardiology #biofreedom

Does #PatientBloodManagement add value to Kidney Transplantation? A team of health professionals from Barcelona, Spain, made up of Diana Rodríguez Espinosa, José J. Broseta, Anney Rosario, Judit Cacho, Beatriz Tena, Elena Cuadrado Payan, Ramsés Marrero, Beatriu Bayés, Nuria Esfuerza, Mireia Musquera, Fritz Diekmann, Aleix Cases and Misericordia Basora, have collected and analyzed the data needed to answer this question conclusively. And they have done so when investigating the effects of perioperative blood transfusions on kidney transplant surgery (KTx). Transfusions present in most of these procedures as a result of anaemia occurs with a very high prevalence in patients with end-stage chronic kidney disease. The study consisted of observing all adult patients who received a KTx within a specified period of 2 years, patients who were included and followed up for up to six months after transplantation. They recorded donor and recipient characteristics, cold ischemia time, preoperative haemoglobin concentration, biomarkers of iron deficiency, the incidence of delayed graft function and biopsy-verified graft rejections, and graft function at discharge and 6 months after transplantation. 39% of KTx recipients required at least one blood transfusion during the perioperative period. 85.4% of these patients had anaemia at the time of transplantation. Iron level at admission was associated with transfusion of more units of blood. Surgical reoperation and deceased donor donation were associated with an increased risk of transfusion, and finally, there was an association between a greater number of blood units transfused and impaired renal graft function six months after hospital discharge. Evidence showed that a PBM program should be applied to patients on the waiting list for deceased donor kidneys and especially to those patients scheduled to receive a living-donor kidney transplant. Correcting anaemia across the universe of patients who will receive a kidney potentially increases the efficient use of blood products, thereby avoiding serious adverse effects related to transfusions and also decreasing the likelihood of rejection and deterioration of renal graft function six months after hospital discharge. https://lnkd.in/d42myFPf #bloodtransfusion #anemia #KTx #kidneytransplant #IFPBM

📃Scientific paper: Multifocal Fibrosing Thyroiditis: an Under-recognized Mimicker of Papillary Thyroid Carcinoma Abstract: Multifocal fibrosing thyroiditis (MFT) is an enigmatic entity, characterized by multiple fibrotic scar-like lesions with a paucicellular fibrotic center surrounded by a cellular peripheral area with reactive-appearing follicular cell atypia and variable chronic inflammation. Although poorly recognized and likely underreported in surgical pathology, the entity is considered rare with only 65 cases to date–including the current one reported to expand on the preoperative findings of this under-recognized entity. The average age of the patients is 46.8 years (range 15–71 years), 94% are female, with female to male ratio of 15:1. Individual MFT lesions typically have a superficial location. The average number of fibrotic lesions is 15.4 (range 2–51 per MFT case). Their average size is 3.1 mm (range 0.4–15.1). MFT is a disorder of diseased thyroids, typically found postoperatively in glands removed for other reasons, such as chronic lymphocytic/Hashimoto thyroiditis (32.3%), follicular nodular disease (nodular hyperplasia) (30.1%), hyperthyroidism/diffuse hyperplasia (Graves disease) (9.2%). Intriguing is the association with papillary thyroid carcinoma–present in 38.5% of MFT cases, and particularly with sub-centimetric and multifocal papillary thyroid carcinoma, with which MFT can be confused. Cases where MFT is the only thyroid pathology (7.7%) can be preoperatively mistaken for papillary thyroid carcinoma, due to worrisome ultrasound (US) and cytologic features, both ... Continued on ES/IODE ➡️ https://etcse.fr/KtL2 ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you.

📃Scientific paper: Multifocal Fibrosing Thyroiditis: an Under-recognized Mimicker of Papillary Thyroid Carcinoma Abstract: Multifocal fibrosing thyroiditis (MFT) is an enigmatic entity, characterized by multiple fibrotic scar-like lesions with a paucicellular fibrotic center surrounded by a cellular peripheral area with reactive-appearing follicular cell atypia and variable chronic inflammation. Although poorly recognized and likely underreported in surgical pathology, the entity is considered rare with only 65 cases to date–including the current one reported to expand on the preoperative findings of this under-recognized entity. The average age of the patients is 46.8 years (range 15–71 years), 94% are female, with female to male ratio of 15:1. Individual MFT lesions typically have a superficial location. The average number of fibrotic lesions is 15.4 (range 2–51 per MFT case). Their average size is 3.1 mm (range 0.4–15.1). MFT is a disorder of diseased thyroids, typically found postoperatively in glands removed for other reasons, such as chronic lymphocytic/Hashimoto thyroiditis (32.3%), follicular nodular disease (nodular hyperplasia) (30.1%), hyperthyroidism/diffuse hyperplasia (Graves disease) (9.2%). Intriguing is the association with papillary thyroid carcinoma–present in 38.5% of MFT cases, and particularly with sub-centimetric and multifocal papillary thyroid carcinoma, with which MFT can be confused. Cases where MFT is the only thyroid pathology (7.7%) can be preoperatively mistaken for papillary thyroid carcinoma, due to worrisome ultrasound (US) and cytologic features, both ... Continued on ES/IODE ➡️ https://etcse.fr/KtL2 ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you.

SALVAGE MICROSURGERY Following FAILED PRIMARY SRS in Sporadic VESTIBULAR SCHWANNOMA John P Marinelli et al, JAMA Otolaryngol Head Neck Surg, 2024 Apr https://lnkd.in/d3TjxKcF 126 patients treated with salvage microsurgery (failed primary SRS treatment) - post-OP CEREBROSPINAL FLUID LEAK was seen in 12% of the patients - post-OP HYDROCEPHALUS developed in 6% of the patients - 6% of the patients delt with post-OP SYMPTOMATIC STROKE - MENINGITIS was seen in 2% of the patients post-OP - each 1-mm increase in cerebellopontine angle TUMOR SIZE was associated with a 13% increased likelihood of FOREGOING GROSS TOTAL RESECTION (63% of patients) or long-term post-OP HOUSE-BRACKMANN GRADE>I (47% of patients) - PFS rates were: * 1-yr PFS 97% * 3-yr PFS 93% * 5-yr PFS 91% CONCLUSIONS: In this cohort study, more than half of patients who received salvage microsurgery following primary SRS/FSRT underwent LESS THAN GROSS TOTAL RESECTION or experienced some degree of FACIAL PARESIS long term. These data suggest that the CUMULATIVE RISK of developing FACIAL PARESIS following primary SRS/FSRT by the end of the patient's journey with treatment approximates 2.5%-7.5% when using published primary SRS/FSRT long-term TUMOR CONTROL RATES. #SalvageMicrosurgery #SRS #radiosurgery #VestibularSchwannoma #neurinoma #acousticneurinoma

💫Highlights from the @hpbjournal: 📕Assessment by a multidisciplinary team conference affects treatment strategy and overall survival in patients with synchronous colorectal liver metastases. 🇸🇪 Retrospective observational study in patients with sCRLM (South-East Health Care Region of Sweden) 📕615 patients from Swedish Colorectal Cancer Registry (2009-2015) 📈 Investigating the geographical or sex differences, regarding overall survival and assessment by a MDT 💡 In overall survival no sex difference 🚨 Increased overall survival: Patients living near HBU Hospital and assessing by MDT with liver surgeon https://lnkd.in/dXNkaCXA Karin Almlöv IHPBA: International Hepato Pancreato Biliary Association

2024 • Colorectal Endoscopic Submucosal Dissection in the USA by Abdulrahman Qatomah and Hiroyuki Aihara Abstract Endoscopic submucosal dissection (ESD) is a transformative advancement in the endoscopic management of superficial gastrointestinal lesions. Initially conceived for the treatment of early gastric cancer, ESD has demonstrated proficiency in achieving en-bloc resection of superficial gastrointestinal lesions. ESD has experienced widespread acceptance in Japan and East Asia; however, its adoption in the USA remains delayed. This initial hesitancy could be attributed to procedural complexity and training demands; nonetheless, recently, ESD has been gaining popularity in the USA. This is due to the advancements in endoscopic technology, tailored training programs, and cumulative evidence regarding the efficacy and safety of ESDs. This review aimed to deliberate the historical progress, current implementation, and prospective trajectory of ESDs in the USA. With ongoing clinical research, technological integration, and educational efforts, ESD is likely to become the gold standard for managing large gastrointesitinal lesions. This progress marks an imperative step toward less invasive, more precise, and patient-centric approaches regarding advanced therapeutic endoscopy in the USA.

🎉 New Publication 🎉 We’re excited to share our latest manuscript published in Langenbeck's Archives of Surgery, showing that our in-development stage TriVerity Classifier (version IMX-BVN-3b) identified bacterial infections in liver transplant patients earlier than routine biomarkers.     We look forward to conducting more studies to demonstrate the ability of our host-response classifiers to rapidly and accurately identify infections in liver transplant and other immunocompromised patients as early as possible. If successful, this would provide medical professionals with important information to enhance treatment decision making. 📚 Read the full publication: [https://lnkd.in/ewe9J5bP] Follow us to stay updated on more innovative research! #HealthcareInnovation #Diagnostics #LiverTransplant #Immunocompromised #Inflammatix #MedicalResearch #PatientCare

How effective is #cryoabaltion for #KidneyCancer? ❄️ For #KidneyMonth, delve into our blog to learn how IceCure Medical’s minimally invasive procedure reduces pain, scarring, and recovery time for renal tumors: 🔗 https://lnkd.in/dHJ8khRU #KidneyHealthforAll #InterventionalRadiology #InterventionalOncology