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101.
102.
Sentinel lymph node biopsy versus observation in thick melanoma: A multicenter propensity score matching study
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Antonio Tejera‐Vaquerizo Simone Ribero Susana Puig David Moreno‐Ramírez Miguel A. Descalzo‐Gallego María T. Fierro Pietro Quaglino Cristina Carrera Josep Malvehy Sergi Vidal‐Sicart Antoni Bennássar Ramón Rull Llucìa Alos Celia Requena Isidro Bolumar Víctor Traves Ángel Pla María T. Fernández‐Figueras Carlos Ferrándiz Iciar Pascual José L. Manzano Marina Sánchez‐Lucas Pol Giménez‐Xavier Lara Ferrandiz Eduardo Nagore 《International journal of cancer. Journal international du cancer》2018,142(3):641-648
The clinical value of sentinel lymph node (SLN) biopsy in thick melanoma patients (Breslow >4 mm) has not been sufficiently studied. The aim of the study is to evaluate whether SLN biopsy increases survival in patients with thick cutaneous melanoma, and, as a secondary objective, to investigate correlations between survival and lymph node status. We included 1,211 consecutive patients with thick melanomas (>4 mm) registered in the participating hospitals' melanoma databases between 1997 and 2015. Median follow‐up was 40 months. Of these patients, 752 were matched into pairs by propensity scores based on sex, age, tumor location, histologic features of melanoma, year of diagnosis, hospital and adjuvant interferon therapy. The SLN biopsy vs. observation was associated with better DFS [adjusted hazard ratio (AHR), 0.74; 95% confidence interval (CI) 0.61–0.90); p = 0.002] and OS (AHR, 0.75; 95% CI, 0.60–0.94; p = 0.013) but not MSS (AHR, 0.84; 95% CI, 0.65–1.08; p = 0.165). SLN‐negative patients had better 5‐ and 10‐year MSS compared with SLN‐positive patients (65.4 vs. 51.9% and 48.3 vs. 38.8%; p = 0.01, respectively). As a conclusion, SLN biopsy was associated with better DFS but not MSS in thick melanoma patients after adjustment for classic prognostic factors. SLN biopsy is useful for stratifying these patients into different prognostic groups. 相似文献
103.
Boada S Solsona B Papaceit J Saludes J Rull M 《Revista espa?ola de anestesiología y reanimación》1999,46(8):364-366
A 61-year-old woman in chronic treatment with 25 mg of amitriptyline underwent ovarian cancer resection under combined general and epidural lumbar anesthesia. After administration of local anesthetic she presented signs of severe arterial hypotension that was refractory to high doses of ephedrine and administration of dopamine alpha-adrenergic substances. Control was achieved with 200 micrograms of noradrenaline. We review the anesthetic implications of chronic use of tricyclic antidepressives as they affect choice of vasopressin for treating hypotensive events during anesthesia. 相似文献
104.
Herrara MF Lozano-Salazar RR González-Barranco J Rull JA 《European journal of gastroenterology & hepatology》1999,11(2):63-67
Morbid obesity is a health hazard. It carries several health risks and decreases life expectancy. Individuals with morbid obesity may develop one or more complications. These are mainly cardiovascular, metabolic, respiratory, gastrointestinal, renal, genitourinary and gynaecological. Patients with morbid obesity also have a high surgical risk. This review analyses the most common complications of morbidly obese patients and their changes after surgically induced weight loss. 相似文献
105.
106.
G Sugra?es S Vidal-Sicart J Piulachs E Bombuy F Pons T Castel R Rull R Herranz J Visa 《Acta chirurgica》2001,167(8):581-586
OBJECTIVE: To assess the usefulness of lymphoscintigraphy and intraoperative gamma probe in the detection of sentinel lymph nodes. DESIGN: Prospective open study. SETTING: University hospital, Spain. SUBJECTS: 40 patients with malignant melanoma (24 stage I/II, 16 stage III). INTERVENTION: The day before operation a lymphoscintigram with 99mTc-nanocolloid was taken and the first lymph node identified was considered to be the sentinel node. A hand-held gamma probe was used for intraoperative mapping. MAIN OUTCOME MEASURE: Identification of the sentinel node. RESULTS: Sentinel nodes were identified in 39/40 patients (98%). In 24 patients with stage I/II disease, 34 sentinel nodes were found (6 invaded and 28 clear of melanoma). A total number of 161 regional lymph nodes were harvested, none of them invaded by melanoma. In 16 patients with stage III disease, 22 sentinel nodes were located (14 invaded and 8 clear of melanoma). A total of 89 regional lymph nodes were excised in patients with invaded sentinel nodes (44 of which were invaded and 45 clear of disease). 41 lymph nodes were excised from patients with clear sentinel nodes, and all were also clear of melanoma. CONCLUSIONS: We conclude that this is a useful technique for the selection of patients with melanoma who may require lymphadenectomy. 相似文献
107.
Ramon Rull Juan Carlos Garcia Valdecasas L. Grande Jose Fuster Antonio Maria Lacy Francisco Xavier González Antonio Rimola Miguel Navasa Carmen Iglesias Jose Visa 《Transplant international》2001,14(3):129-134
Intrahepatic biliary lesions (IBL) are rare (2–9 %) after orthotopic liver transplantation (OLT). The aim was to evaluate
the incidence, etiology and outcome. In nine years, a total 532 OLTs were performed in 481 patients. Twenty-four patients
developed IBL. Eight were due to HAT, seven to ABOI, three to CDR and six to PI. The time until diagnosis of HAT is longest
in patients (14 ± 6) with IBL. ABOI is another cause of IBL. CDR is a rare cause of IBL, however when it takes place, patients
must undergo Rtx. Finally, PI is a relevant cause of IBL. In order to suppress the incidence of IBL we should consider 1)
the systematic use of Doppler-Ultrasound; 2) emergency reoperation of patients with HAT, 3) avoid ABOI in OLT; 4) Rtx in cases
of CDR, and 5) OLT should still be performed as an emergency procedure.
Received: 25 October 1999 Revised: 17 January 2001 Accepted: 12 April 2001 相似文献
108.
109.
Gerard Aragonès Carlos Alonso-Villaverde Cristina Oliveras-Ferraros Raúl Beltrán-Debón Anna Rull Fernando Rodríguez-Sanabria Jordi Camps Alejandro Vázquez Martín Javier A Menéndez Jorge Joven 《BMC gastroenterology》2010,10(1):92
Background
Fatty acid synthase (FASN) is an enzyme synthesized by the liver and plays an important role in lipogenesis. The present study aimed to investigate whether serum FASN concentration may provide a direct link between HIV and/or HCV viral infections and lipid metabolic disorders commonly observed in HIV/HCV-infected patients. 相似文献110.
This study compared the efficacy of 2 psychological treatments for fibromyalgia with each other and with standard care. Ninety-three patients with fibromyalgia (FM) were randomly assigned to 1 of the 3 experimental conditions: 1) multicomponent cognitive-behavioral therapy (CBT); 2) multicomponent CBT with hypnosis; and 3) pharmacological treatment (standard care control group). The outcome measures of pain intensity, catastrophizing, psychological distress, functionality, and sleep disturbances were assessed before treatment, immediately after treatment, and at 3- and 6-month follow-up visits. CBT and CBT with hypnosis participants received the standard pharmacological management plus 14 weekly, 120-minute-long sessions of psychological treatment. All but 1 session followed a group format; the remaining session was individual. The analyses indicated that: 1) patients with FM who received multicomponent CBT alone or multicomponent CBT with hypnosis showed greater improvements than patients who received only standard care; and 2) adding hypnosis enhanced the effectiveness of multicomponent CBT. This study presents new evidence about the efficacy of multicomponent CBT for FM and about the additional effects of hypnosis as a complement to CBT. The relevance and implications of the obtained results are discussed. PERSPECTIVE: This article highlights the beneficial effects of adding hypnosis in a multicomponent cognitive-behavioral group treatment of fibromyalgia patients. Also, this research showed that by adding hypnosis the length of treatment did not increase. 相似文献