Search results for "Multimodal therapy"
showing 8 items of 18 documents
A fully automatic approach for multimodal PET and MR image segmentation in gamma knife treatment planning
2017
The aim of this study is to combine Biological Target Volume (BTV) segmentation and Gross Target Volume (GTV) segmentation in stereotactic neurosurgery.Our goal is to enhance Clinical Target Volume (CTV) definition, including metabolic and morphologic information, for treatment planning and patient follow-up.We propose a fully automatic approach for multimodal PET and MR image segmentation. This method is based on the Random Walker (RW) and Fuzzy C-Means clustering (FCM) algorithms. A total of 19 brain metastatic tumors, undergone stereotactic neuro-radiosurgery, were retrospectively analyzed. A framework for the evaluation of multimodal PET/MRI segmentation is presented, considering volume…
DEGENERATIVE CERVICAL MYELOPATHY: REVIEW OF SURGICAL OUTCOME PREDICTORS AND NEED FOR MULTIMODAL APPROACH
2020
Degenerative cervical myelopathy is the most common cause of spinal cord injury in the elderly population in the developed world, and it significantly affects the quality of life of patients and their caregivers. Surgery remains the only treatment option able to halt disease progression and provide neurological recovery for most patients. Although it has remained challenging to predict exactly who will experience improvement after surgery, increasingly it has been shown that clinical, imaging, and electrophysiological factors can predict, with relatively good capacity, those more likely to benefit. Clinically, the baseline neurological impairment appears to be strongly related to the outcom…
The multidisciplinary management of gastro-oesophageal junction tumours
2016
Abstract Background and scope The management of GOJ cancers remains controversial and may vary between countries. Evidence-based attitudes and guidelines are not easy to elaborate since most of the trials and studies reported mixed cases of oesophageal (both adenocarcinoma and squamous cell tumours), GOJ and gastric cancers. The aim of this expert discussion and position paper is to elaborate practical recommendations that integrate evidence-reported literature and experience-based attitude covering all clinical aspects of GOJ cancer across different specialities and countries in Europe. Methodology Opinion leaders, selected on scientific merit were asked to answer to a prepared set of ques…
Psychoanalytically-Oriented Inpatient Psychotherapy of Somatoform Disorders
2008
Somatoform disorders have been neglected in psychoanalytic publications. Unlike the descriptive approach of DSM-IV and ICD-10, sophisticated psychoanalytical models have been proposed for many years explaining the development of physical symptoms without definable medical cause. Based on a review of the psychoanalytic models of somatization and conversion, this article explores difficulties in the medical and psychotherapeutic treatments of somatoform disorders. The unique tradition of psychosomatic inpatient treatment in Germany is illustrated by the psychoanalytic treatment setting at the University of Mainz. A case report of a somatoform patient shows how childhood trauma is activated an…
Intensive Care Management of Head-Injured Patient
2019
Traumatic brain injury (TBI) plays an important role for the prognosis of multiple injured patients. Severely injured patients require intensive care treatment to support organ function and to maintain normal brain physiology. Optimal treatment is a cornerstone for good outcome. Therefore, in addition to general principles and concepts of modern intensive care medicine, special brain-specific aspects need to be addressed in these patients. Essential aspects of physiological regulation of cerebral perfusion and intracranial pressure as well as recent publications are reviewed as basis for current trends in the management of TBI patients. Focusing on single parameters such as intracranial pre…
Das Plattenepithelkarzinom des Ösophagus – Stellenwert der Chirurgie im therapeutischen Konzept
2010
Squamous cell carcinomas of the oesophagus are a completely different entity from adenocarcinomas in regard to their aetiopathology, tumour biology, co-morbidity, operative risk, and prognosis. For superficial squamous cell carcinomas, the risk of a relevant lymph node metastatisation already exists from the mucosal infiltration level m3 onward, and thus oncological resection is indicated. Neoadjuvant radiochemotherapy is the international standard for locally advanced squamous cell carcinoma. The early-response should be determined. Non-responders must be identified early, and a salvage operation with a justifiable operative risk should be carried out. Due to its high complete response rat…
Single-institution experience with primary tumours of the male urethra
2007
OBJECTIVE To assess primary tumours of the urethra in males. PATIENTS AND METHODS We retrospectively reviewed our database from 1986 to 2006 for primary tumours of the male urethra; nine patients with primary tumours of the urethra were analysed and follow-up information was obtained. RESULTS Three patients had tumours of the prostatic urethra, two of which had proliferating focal inflammation and one a low-grade, superficial urothelial cancer. All patients were treated successfully with transurethral resection. Six patients had carcinoma of the bulbar or penile urethra, including two with previous local percutaneous radiotherapy for prostate cancer. All had primary surgical excision that w…
Lidocaine versus ropivacaine for postoperative continuous paravertebral nerve blocks in patients undergoing laparoscopic bowel surgery: a randomized,…
2015
Daniela Ghisi,1,3 Andrea Fanelli,1,2 Julie Jouguelet-Lacoste,1 Luca La Colla,1,4 Anne-Sophie Auroux,1,5 Jacques E Chelly1 1Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; 2Anesthesia and Intensive Care Unit, Policlinico S.Orsola-Malpighi, Bologna, Italy; 3Department of Anesthesia and Postoperative Intensive Care, Istituto Ortopedico Rizzoli, Bologna, Italy; 4Department of Anesthesia, Intensive Care and Pain Therapy, Università degli Studi di Parma, Parma, Italy 5Institut des Sciences Pharmaceutiques et Biologiques-Faculté de Pharmacie de Lyon Université Claude Bernard Lyon, FranceBackground and objectives: Lidocain…