Minerva chirurgica
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The aim of this study was to compare serum S100B levels and EEG findings as prognostic indexes in comatose (GCS<8) patients after cardiac arrest. ⋯ The association of serum S100B levels with EEG might be helpful when used together to formulate outcome in comatose patients within 24 h after cardiac arrest. However, increased levels of S100B 12 h after a cardiac arrest might be expression of a still amendable brain damage.
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Palliative care represents a new field among clinical approaches to patients with advanced or terminal cancer. The modern concept of palliative care can be considered in several ways: 1) the relationship between palliative care and primary treatments of cancer (surgery, radiotherapy or chemotherapy); 2) the treatment of symptoms and the relationship between symptom control and quality of life; 3) end-of-life care. ⋯ Moreover, support for the patient and his/her family during the terminal phase of the disease is one of the most important dimensions of palliative care. In addition, assistance provided during the last hours of life and support for the family after the patient's death represent the so-called global assistance, which is distinctive of palliative care.
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Review Comparative Study
Neoadjuvant treatment of oesophageal adenocarcinoma.
Oesophageal adenocarcinoma is an enigma. It has emerged, seemingly from nowhere, in the late 20th century to dominate the oesophageal oncological landscape. This review will examine whether the current outcome for adenocarcinoma is as good as it gets or whether additional treatment is necessary and if so whether neoadjuvant therapy is effective.
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Interventional magnetic resonance (IMR) machines have produced unique opportunity for image-guided surgery. The open configuration design and fast pulse sequence allow virtual real time intraoperative scanning to monitor the progress of a procedure, with new images produced every 1.5 sec. This may give greater appreciation of anatomy, especially deep to the 2-dimensional laparoscopic image, and hence increase safety, reduce procedure magnitude and increase confidence in tumour resection surgery. ⋯ Histological examination confirmed clear surgical margins of at least 1 cm in each case. Intraoperative MR scanning reliably identifies palpable breast tumours and skin sarcomas and is sufficiently accurate to guide their surgical excision. Further work may be done to develop laparoscopic and open abdominal surgery as well.
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Gastrointestinal stromal tumors (GIST) comprise a rare group of neoplasms of unpredictable malignant potential with an annual incidence of 4/million persons. The stomach is the most common site of occurrence in the gastrointestinal tract. A combination of prognostic factors (patient age, histologic grade, mitotic rate, tumor size, and DNA analysis) have been utilized to predict their biologic behavior. ⋯ Consequently, complete surgical resection of the primary tumor is the most definitive treatment. An increasing number of cases have been reported utilizing a combination of laparoscopic and endoscopic techniques to resect these tumors. The manuscript will characterize the biologic behavior of gastrointestinal stromal tumors of the stomach, discuss the preoperative evaluation and minimally invasive surgical management of these patients, and review recent, encouraging adjuvant treatment strategies.