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Iskalni niz: "ključne besede" (surgery) .

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1.
Idiopathic pulmonary fibrosis in patients with early-stage non-small-cell lung cancer after surgical resection
Nežka Hribernik, Igor Požek, Izidor Kern, 2019

Povzetek: Background. The outcomes of patients with both lung cancer and idiopathic pulmonary fibrosis (IPF) are unfavorable. Therapeutic interventions for lung cancer such as surgery can cause acute exacerbation of IPF (aeIPF). This study aimed to assess the frequency of IPF in a group of patients with early-stage non-small-cell lung cancer (NSCLC) and to report clinical characteristics and outcomes of this cohort of patients. Patients and methods. This observational cohort retrospective study analyzed 641 pathological records of patients after surgical resection of early-stage non-small-cell lung cancer (NSCLC) at University Clinic Golnik from May 2010 to April 2017. Pathological records of NSCLC with coexisting IPF were reviewed. CT scans and biopsy specimens for this group of patients were analyzed by a thoracic radiologist and pathologist, independently. We searched radiological and pathological features of usual interstitial pneumonia (UIP) pattern in this group of patients. We report the clinical characteristics and outcome of this cohort of patients. Results. Out of 641 patients with early-stage NSCLC, only 13 (2.0%) had histologically and radiologically proven coexisting UIP/IPF. Squamous cell carcinoma was the most common type of lung cancer (7/13 patients). The majority of tumors were small size (all being pT1 or pT2), stage I–II (11/13 patients), located in the lower lung lobes (11/13 patients). Almost all patients were current or ex-smokers (11/13 patients). There were two pathologically confirmed fatal cases (15.4%) due to aeIPF in the first two months after radical treatment, one after adjuvant radiotherapy and the other after surgery. Out of 13 patients, one patient had a lung cancer relapse. Conclusions. Frequency of UIP/IPF in surgically treated early stage NSCLC is rather low. Our observational study shows that radical treatment of lung cancer can cause aeIPF with dismal outcome in this group of patients. The standard of care in these mostly elderly patients still remains unresolved.
Ključne besede: non-small-cell lung cancer, early-stage cancer, idiopathic pulmonary fibrosis, surgery, radiotherapy
DiRROS - Objavljeno: 07.10.2020; Ogledov: 529; Prenosov: 381
URL Celotno besedilo (0,00 KB)

2.
Consensus clinical scoring for suspected perioperative immediate hypersensitivity reactions
Philip M. Hopkins, Peter J. Cooke, Russel C. Clarke, Anne Berit Guttormsen, Peter R. Platt, Pascale Dewachter, Didier G. Ebo, Tomaz Garcez, Lene Heise Garvey, David L. Hepner, Peter Kopač, 2019

Povzetek: Background: Grading schemes for severity of suspected allergic reactions have been applied to the perioperative setting, but there is no scoring system that estimates the likelihood that the reaction is an immediate hypersensitivity reaction. Such a score would be useful in evaluating current and proposed tests for the diagnosis of suspected perioperative immediate hypersensitivity reactions and culprit agents. Methods: We conducted a Delphi consensus process involving a panel of 25 international multidisciplinary experts in suspected perioperative allergy. Items were ranked according to appropriateness (on a scale of 1-9) and consensus, which informed development of a clinical scoring system. The scoring system was assessed by comparing scores generated for a series of clinical scenarios against ratings of panel members. Supplementary scores for mast cell tryptase were generated. Results: Two rounds of the Delphi process achieved stopping criteria for all statements. From an initial 60 statements, 43 were rated appropriate (median score 7 or more) and met agreement criteria (disagreement index <0.5); these were used in the clinical scoring system. The rating of clinical scenarios supported the validity of the scoring system. Although there was variability in the interpretation of changes in mast cell tryptase by the panel, we were able to include supplementary scores for mast cell tryptase. Conclusion: We used a robust consensus development process to devise a clinical scoring system for suspected perioperative immediate hypersensitivity reactions. This will enable objectivity and uniformity in the assessment of the sensitivity of diagnostic tests.
Ključne besede: alergy and immunology, anesthesia, anaphylaxis, drug hypersensitivity, drug-related side effects and adverse reactions, perioperative period, surgery, operative surgical procedures
DiRROS - Objavljeno: 09.10.2020; Ogledov: 242; Prenosov: 95

3.
Management of a surgical patient with a label of penicillin allergy : narrative review and consensus recommendations
Louise C. Savic, David A. Khan, Peter Kopač, Russel C. Clarke, Peter J. Cooke, Pascale Dewachter, Didier G. Ebo, Tomaz Garcez, Lene Heise Garvey, Anne Berit Guttormsen, 2019

Povzetek: Unsubstantiated penicillin-allergy labels are common in surgical patients, and can lead to significant harm through avoidance of best first-line prophylaxis of surgical site infections and increased infection with resistant bacterial strains. Up to 98% of penicillin-allergy labels are incorrect when tested. Because of the scarcity of trained allergists in all healthcare systems, only a minority of surgical patients have the opportunity to undergo testing and de-labelling before surgery. Testing pathways can be modified and shortened in selected patients. A variety of healthcare professionals can, with appropriate training and in collaboration with allergists, provide testing for selected patients. We review how patients might be assessed, the appropriate testing strategies that can be used, and the minimum standards of safe testing.
Ključne besede: allergy and immunology, drug hypersensitivity, penicillins, antibiotic prophylaxis, surgery, operative surgical procedures, bacterial infections, surgical wound infection, drug provocation testing, surgical procedures
DiRROS - Objavljeno: 16.10.2020; Ogledov: 291; Prenosov: 75

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