No-touch Radical Nephrectomy Technique Reduces Circulating Tumor Cell Release in Renal Cell Carcinoma Patients - a Randomized Controlled Trial
This study will study circulating tumor cell (CTC) release during laparoscopic radical nephrectomy (LRN) for RCC. The main objective is to determine if CTC release can be reduced during RN by using a no-touch technique, with an early renal pedicle ligation. The investigators also aim to describe the CTC profile in terms of CTC count (CTCn), epithelial/mesenchymal status, and CTC cellular features in renal cell carcinoma (RCC) patients, stratified by "primary tumor, regional nodes, metastasis" (TNM) staging, histological subtype, and other clinical and radiological features. Patients undergoing RN will enter a two-arm prospective single-center randomized controlled trial (RCT), comparing a no-touch RN technique, with direct pedicle ligation (Group A) vs. the more conventional approach of kidney traction and manipulation to reach the renal pedicle before its ligation (Group B). A microfluidic size-based CTC isolation device will be used to capture and count CTCs from peripheral blood samples of these patients. CTCs will be identified by staining with antibodies to cytokeratin 8/18, vimentin, 4',6-diamidino-2-phenylindole (DAPI), and cluster of differentiation antigen 45 (CD45). CTC release will be correlated with the disease-free survival (DFS), and overall survival (OS). The investigators will determine if CTC reducing no-touch radical nephrectomy technique improves these hard outcomes.
MILES STUDY - Mesotherapy In Lateral Epicondylitis, a Prospective Randomized Controlled Study
Investigate the short- and long-term efficacy and safety of intradermal NSAIDs and lidocaine (delivered through mesotherapy) for the treatment of LE comparing it with empty intradermal injections.
Ripple Mapping Guided Ablation of Ischaemic Ventricular Tachycardia: A Multi-centre Prospective Clinical Trial.
The Ripple VT-1 Study is a prospective clinical trial that aims to investigate if catheter ablation of ventricular tachycardia in patients with ischaemic heart disease can be effectively performed using Ripple Mapping.
Choristoma: a very rare cause of thyroid nodule. Case report and literature review
Review
作者: da Cruz, Rafael Moiteiro ; Bugalho, Maria João ; Alexandre, Maria Inês ; Gomes, Ana Raquel ; Rocha, José Vicente ; López-Presa, Dolores
BACKGROUNDChoristoma is a well-defined benign lesion formed by histologically normal tissue in an unusual location. Diagnosis is confirmed after surgical removal of the mass. To our knowledge, to date there has been only one case of thyroid choristoma described in the literature.PATIENT FINDINGSA 70-year-old man with a history of non-Hodgkin lymphoma presented with sudden cervical enlargement. Cervical CT scan showed a 47mm hypodense nodule on the right thyroid lobe. Fine-needle aspiration revealed follicular lesion of undetermined significance. During the following weeks there was noticeable thyroid enlargement. Reassessment with thyroid ultrasound showed a 73mm nodule. The patient underwent total thyroidectomy. Histopathological examination revealed a choristoma composed of squamous epithelium lined cysts, smooth muscle, adipose tissue, connective tissue, foci of ossification and extramedullary hematopoiesis. No cytological atypia or tumoral necrosis were found. Thyroid choristomas are an exceedingly rare cause of a thyroid nodule.
2024-12-01·Heart Rhythm
RIPPLE-VT study: Multicenter prospective evaluation of ventricular tachycardia substrate ablation by targeting scar channels to eliminate latest scar potentials without direct ablation
Article
作者: Luther, Vishal ; Chow, Anthony W ; Jamil-Copley, Shahnaz ; Das, Moloy ; Ng, Fu S ; Carpinteiro, Luis ; Lim, Phang Boon ; Koa-Wing, Michael ; Katritsis, George ; Linton, Nick W F ; Cortez-Dias, Nuno ; Kanagaratnam, Prapa ; Murray, Stephen ; de Sousa, Joao ; Kailey, Balrik ; Whinnett, Zachary ; Peters, Nicholas S ; Martin, Ruairidh
BACKGROUNDRecurrent ventricular tachycardia (VT) can be treated by substrate modification of the myocardial scar by catheter ablation during sinus rhythm without VT induction. Better defining this arrhythmic substrate could help improve outcome and reduce ablation burden.OBJECTIVEThe study aimed to limit ablation within postinfarction scar to conduction channels within the scar to reduce VT recurrence.METHODSPatients undergoing catheter ablation for recurrent implantable cardioverter-defibrillator therapy for postinfarction VT were recruited at 5 centers. Left ventricular maps were collected on CARTO using a Pentaray catheter. Ripple mapping was used to categorize infarct scar potentials (SPs) by timing. Earliest SPs were ablated sequentially until there was loss of the terminal SPs without their direct ablation. The primary outcome measure was sustained VT episodes as documented by device interrogations at 1 year, which was compared with VT episodes in the year before ablation.RESULTSThe study recruited 50 patients (mean left ventricular ejection fraction, 33% ± 9%), and 37 patients (74%) met the channel ablation end point with successful loss of latest SPs without direct ablation. There were 16 recurrences during 1-year follow-up. There was a 90% reduction in VT burden from 30.2 ± 53.9 to 3.1 ± 7.5 (P < .01) per patient, with a concomitant 88% reduction in appropriate shocks from 2.1 ± 2.7 to 0.2 ± 0.9 (P < .01). There were 8 deaths during follow-up. Those who met the channel ablation end point had no significant difference in mortality, recurrence, or VT burden but had a significantly lower ablation burden of 25.7 ± 4.2 minutes vs 39.9 ± 6.1 minutes (P = .001).CONCLUSIONScar channel ablation is feasible by ripple mapping and can be an alternative to more extensive substrate modification techniques.
2024-08-01·Radiotherapy and Oncology
Response to Tugcu et al
Letter
作者: Bulgarelli, Giorgia ; Perini, Zeno ; Pinzi, Valentina ; Nozzoli, Filippo ; Caini, Saverio ; Visani, Luca ; Zivelonghi, Emanuele ; Desideri, Isacco ; Navarria, Pierina ; Scartoni, Daniele ; Scorsetti, Marta ; Amelio, Dante ; Greto, Daniela ; Livi, Lorenzo ; Banini, Marco ; Della Puppa, Alessandro ; Clerici, Elena ; Osti, Mattia Falchetto ; Anselmo, Paola ; Morelli, Ilaria ; Minniti, Giuseppe ; Ascolese, Anna Maria