Wider implications of video-assisted thoracic surgery versus open approach for lung metastasectomy

Lung metastasectomy is considered a safe and potentially curative procedure despite there is not a strong evidence that metastasectomy prolongs long-term survival in patients with lung metastases. Moreover, the debate is open regarding the best approach for lung metastasectomy, video-assisted thoracic surgery versus open approach. A systematic review of literature to clarify what is the best approach to prolong survival in patients with lung metastases was performed. Our study confirms that overall survival is equivalent for video-assisted thoracic surgery and thoracotomy, therefore the ‘gold standard’ surgical treatment for lung metastases remains a point of debate. The choice of the surgical approach still depends more on the single center or surgeon practice than on strong scientific evidence. A prospective randomized trial could clarify the question

Structured reporting for fibrosing lung disease: a model shared by radiologist and pulmonologist

Objectives: To apply the Delphi exercise with iterative involvement of radiologists and pulmonologists with the aim of defining a structured reporting template for high-resolution computed tomography (HRCT) of patients with fibrosing lung disease (FLD). Methods: The writing committee selected the HRCT criteria\ue2\u80\u94the Delphi items\ue2\u80\u94for rating from both radiology panelists (RP) and pulmonology panelists (PP). The Delphi items were first rated by RPs as \ue2\u80\u9cessential\ue2\u80\u9d, \ue2\u80\u9coptional\ue2\u80\u9d, or \ue2\u80\u9cnot relevant\ue2\u80\u9d. The items rated \ue2\u80\u9cessential\ue2\u80\u9d by < 80% of the RP were selected for the PP rating. The format of reporting was rated by both RP and PP. Results: A total of 42 RPs and 12 PPs participated to the survey. In both Delphi round 1 and 2, 10/27 (37.7%) items were rated \ue2\u80\u9cessential\ue2\u80\u9d by more than 80% of RP. The remaining 17/27 (63.3%) items were rated by the PP in round 3, with 2/17 items (11.7%) rated \ue2\u80\u9cessential\ue2\u80\u9d by the PP. PP proposed additional items for conclusion domain, which were rated by RPs in the fourth round. Poor consensus was observed for the format of reporting. Conclusions: This study provides a template for structured report of FLD that features essential items as agreed by expert thoracic radiologists and pulmonologists

Implication of Laboratory Findings in Clinical Protocols for CAD-CAM Blocks Adhesion

Avaliação biomecânica do pé em pacientes pediátricos após intervenção com técnica artroscópica AMIC para lesão osteocondral Em clínicas de podologia pediátrica pode acontecer que uma criança tenha dor no tornozelo não identificada, às vezes pós-trauma, outras vezes idiopática. A suspeita diagnóstica de lesão osteocondral do tálus deve ser levada em consideração nesses casos, às vezes o diagnóstico para esses pacientes vem após meses e meses. O protocolo terapêutico prevê o tratamento cirúrgico após um tratamento conservador inicial de cerca de 6 meses, em caso de insucesso. Esta população amostral foi submetida à intervenção de reconstrução biológica da lesão osteocondral com a técnica AMIC em artroscopia, técnica muito utilizada em adultos e menos utilizada na população pediátrica. Este projeto tem como objetivo estudar a estrutura biomecânica destes pés, pois é essencial tanto para fins puramente científicos mas acima de tudo para reduzir as recorrências, desconforto no tornozelo, razão pela qual esta amostra foi avaliada através de um exame clínico biomecânico, formas de avaliação como o Índice de Postura do Pé, AOFAS - escore do retropé, Índice de Função do Pé após a cirurgia para avaliar o estado de saúde e biomecânica destes pés. Os resultados são A amostra, apesar de pequena, reflete o nicho desta patologia, e os dados são tranquilizadores, pois os pacientes estão se saindo melhor, todos têm biomecânica compatível com um pé moderadamente pronado, exceto alguns casos em que a pronação excessiva é notável