Gestione chirurgica del paziente oncologico durante e dopo l’epidemia di COVID-19: raccomandazioni pratiche dalla società italiana di chirurgia oncologica
Il recente focolaio del COVID-19 in Italia ha determinato una limitazione delle risorse del sistema sanitario, che ha necessariamente portato alla loro razionalizzazione nella fase critica (fase 1) e ad una riorganizzazione del sistema nella fase successiva (fase 2). La Società Italiana di Chirurgia Oncologica-SICO ha redatto queste raccomandazioni pratiche, calibrate sulla più recente letteratura scientifica e tenendo conto delle normative sanitarie vigenti e del buon senso. L’attività chirurgica durante le fasi 1 e 2 dovrebbe seguire un modello dinamico, considerando le strutture architettoniche, la missione ospedaliera, i modelli organizzativi. Il ritardo chirurgico non dovrebbe influenzare la prognosi oncologica.
Tuttavia, i pazienti con cancro positivo per COVID-19 devono essere rimandati fino alla guarigione dell’infezione. I pazienti da considerare con maggiore attenzione prima di ritardare l’intervento sono quelli che hanno completato la terapia neoadiuvante, i pazienti con tumori ad alta aggressività biologica o senza alternative terapeutiche. Le discussioni multidisciplinari sono fondamentali per la condivisione delle decisioni cliniche; sono preferibili riunioni in videoconferenza e si raccomanda l’uso della telemedicina per il follow-up. Soprattutto nella fase 1, è necessario compiere il massimo sforzo per ridurre la diffusione della pandemia. Preferire l’anastomosi intra-corporea piuttosto che aperta durante la laparoscopia e l’anastomosi meccanica piuttosto che cucita a mano in chirurgia aperta. Considerare i DPI per gli operatori sanitari durante la gestione dello stoma. La chirurgia mininvasiva non è scoraggiata, perché ci sono poche prove per un aumento del rischio.
Devono essere seguite procedure specifiche e l’uso di dispositivi energetici deve essere limitato. I programmi di formazione con pazienti COVID-19 + non sono raccomandati. Tutto il personale in sala operatoria deve essere formato con corsi specifici sull’uso specifico dei DPI. Vengono presentate raccomandazioni differenziate per ogni tumore distrettuale. L’oncologia chirurgica durante la fase 2 dovrebbe essere garantita da protocolli e percorsi individuali e distinti tra pazienti oncologici e pazienti COVID-19 + con risorse specificatamente indirizzate alle due distinte tipologie di pazienti per limitare interferenze o rallentamenti diagnostico / terapeutici.
Una tecnica chirurgica modificata per semplificare la procedura di impianto dello stelo femorale per un angolo di antiversione appropriato durante la ricostruzione endoprotetica
Background: nei pazienti con tumori ossei del femore prossimale, la ricostruzione endoprotetica può fornire una ricostruzione biologica stabile e duratura. Tuttavia, è difficile e richiede tempo posizionare accuratamente la componente femorale per un angolo di antiversione appropriato dopo la resezione del tumore di grandi dimensioni. Proponiamo una tecnica chirurgica modificata per semplificare il processo di impianto e promuovere la stabilità dell’articolazione artificiale.
Metodi: abbiamo analizzato retrospettivamente i dati clinici di 28 pazienti sottoposti a ricostruzione endoprotetica presso il nostro centro tra il 2009 e il 2016. Abbiamo utilizzato un metodo tradizionale (gruppo A, n = 11) e una tecnica chirurgica modificata (gruppo B, n = 17) per determinare l’angolo di antiversione femorale durante l’impianto della componente femorale. La tecnica chirurgica modificata ha consentito un impianto più comodo e accurato delle componenti femorali ruotando esternamente lo stinco con un angolo di 15 °. Il tempo chirurgico e la perdita di sangue sono stati designati come esiti primari, degenze ospedaliere, complicanze postoperatorie e recupero funzionale [Harris Hip Score (HHS); Musculoskeletal Tumor Society Score (MSTS)] sono stati registrati come risultati secondari. I risultati dei due gruppi sono stati confrontati per verificare la sicurezza e l’efficacia della tecnica chirurgica modificata.
Risultati: il tempo operatorio medio era più breve nel gruppo B (109 ± 10 minuti) rispetto al gruppo A (131 ± 6 minuti) (P <0,05). Sebbene la perdita di sangue intraoperatoria media stimata fosse inferiore nel gruppo B (814 ± 35 ml) rispetto a quella nel gruppo A (839 ± 30 ml), non vi era alcuna differenza significativa tra i due gruppi (P = 0,06). Non c’era alcuna differenza significativa tra i due gruppi in degenza ospedaliera, complicanze postoperatorie, HHS o MSTS.
Conclusioni: questa tecnica chirurgica modificata può semplificare il processo di impianto della componente femorale e ridurre significativamente il tempo operatorio senza aumentare le complicanze postoperatorie.
Gestione chirurgica del paziente oncologico durante e dopo l’epidemia di COVID-19: raccomandazioni pratiche dalla società italiana di chirurgia oncologica
Epidemie respiratorie e persone anziane
La malattia da coronavirus 2019 (COVID-19) è stata particolarmente grave nelle persone anziane. Anche le epidemie di coronavirus del passato, ovvero la sindrome respiratoria acuta grave e la sindrome respiratoria mediorientale, sono state gravi nelle persone anziane. Queste epidemie sono durate solo per un periodo limitato, tuttavia, e si sono dimostrate di breve durata nella memoria sia del sistema sanitario pubblico che di quello pubblico. Non è stata appresa alcuna lezione per mitigare l’impatto di future epidemie di tale natura sulle persone anziane. Questo compiacimento che riteniamo abbia causato la morte di molte persone anziane durante l’attuale epidemia globale di COVID-19. La natura dei rischi associati all’acquisizione di infezioni e alla mortalità associata tra gli anziani in situazioni di epidemia respiratoria è varia e desta seria preoccupazione.
Description: A competitive ELISA for quantitative measurement of Goat Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Goat Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Goat Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Goat Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Goat Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Rabbit Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Rabbit Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Rabbit Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Rabbit Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Rabbit Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Rabbit Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Mouse Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Mouse Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Mouse Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Mouse Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Mouse Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Mouse Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Monkey Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Monkey Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Monkey Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Monkey Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Monkey Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Monkey Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Rat Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Rat Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Rat Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Rat Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Rat Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Rat Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Pig Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Porcine Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Pig Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Porcine Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Pig Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Porcine Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Dog Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Canine Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Dog Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Canine Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Dog Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Canine Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Human Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Human Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Human Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Human Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Human Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Human Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Guinea pig Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Guinea pig Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Guinea pig Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Guinea pig Ovarian cancer marker/Carbohydrate antigen 125 ELISA kit
Description: A competitive ELISA for quantitative measurement of Guinea pig Ovarian cancer marker/Carbohydrate antigen 125 in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) Antibody
Description: Cancer Antigen 72-4 Antigen, Host/Source: Metastatic Liver. The purity is ~65% by SDS-PAGE. It is tested negative for HBsAg, antibodies to HCV and HIV 1/2.
Description: Ovarian cancer tissue array (2003 WHO classification), including pathology grade, TNM and clinical stage, 80 cases/80 cores, replacing OV803c
Description: Ovarian cancer with normal ovary tissue array, including pathology grade, TNM and clinical stage (AJCC 8.0), 2 serial sections, 6 cases/24 cores (core size 1.5mm), replacing T113b
Description: A sandwich quantitative ELISA assay kit for detection of Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) in samples from tissue homogenates, cell lysates or other biological fluids.
Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) ELISA Kit
Description: A sandwich quantitative ELISA assay kit for detection of Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) in samples from tissue homogenates, cell lysates or other biological fluids.
Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) Polyclonal Antibody (Human)
Description: This is Double-antibody Sandwich Enzyme-linked immunosorbent assay for detection of Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) in Tissue homogenates, cell lysates and other biological fluids.
Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) ELISA Kit
Description: This is Double-antibody Sandwich Enzyme-linked immunosorbent assay for detection of Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) in Tissue homogenates, cell lysates and other biological fluids.
Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) ELISA Kit
Description: This is Double-antibody Sandwich Enzyme-linked immunosorbent assay for detection of Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) in Tissue homogenates, cell lysates and other biological fluids.
Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) ELISA Kit
Description: This is Double-antibody Sandwich Enzyme-linked immunosorbent assay for detection of Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) in Tissue homogenates, cell lysates and other biological fluids.
Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) ELISA Kit
Description: Enzyme-linked immunosorbent assay based on the Double-antibody Sandwich method for detection of Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) in samples from Tissue homogenates, cell lysates and other biological fluids. with no significant corss-reactivity with analogues from other species.
Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) ELISA Kit
Description: Ovarian cancer tissue array with adjacent normal tissue, including pathology grade, TNM and stage, 100 cases/100 cores, replacing BC11115c
Ovarian cancer with adjacent normal ovary tissue array
Description: Ovarian cancer with adjacent normal ovary tissue array, including TNM, clinical stage and pathology grade, 200 cases/200 cores, replacing OV2001a
High-density ovarian cancer with ovary tissue array
Description: High-density ovarian cancer with ovary tissue array, including pathology grade, TNM and clinical stage, 208 cases/208 cores, replacing OV2084a
Description: Ovarian cancer with adjacent normal ovary tissue array, including pathology grade, TNM and clinical stage, 12 cases/24 cores, replacing OV241c
Ovarian cancer with adjacent normal ovary tissue array
Description: Ovarian cancer with adjacent normal ovary tissue array, including TNM and pathology grade, 12 cases/24 cores (core size 1.5mm), replacing OV242
Ovarian cancer with adjacent normal ovary tissue array
Description: Ovarian cancer with adjacent normal ovary tissue array, including pathology grade, TNM and clinical stage, 12 cases/24 cores, replacing OV242a
Ovarian cancer tissue array with normal ovary tissue
Description: Ovarian cancer tissue array with normal ovary tissue, including TNM, clinical stage and pathology grade, 48 cases/48 cores, replacing OV483
Ovarian cancer and normal adjacent ovary tissue array
Description: Ovarian cancer and normal adjacent ovary tissue array, including TNM, clinical stage and pathology grade, 70 cases/70 cores(1.5), replacing OV701
Ovarian cancer with adjacent normal ovary tissue array
Description: Ovarian cancer with adjacent normal ovary tissue array, including pathology grade, TNM and clinical stage, 77 cases/80 cores, replaced by OV801b
Description: A sandwich ELISA kit for detection of Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 from Human in samples from blood, serum, plasma, cell culture fluid and other biological fluids.
Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) Polyclonal Antibody (Human), APC
Description: A Rabbit polyclonal antibody against Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2). This antibody is labeled with APC.
Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) Polyclonal Antibody (Human), Biotinylated
Description: A Rabbit polyclonal antibody against Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2). This antibody is labeled with Biotin.
Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) Polyclonal Antibody (Human), Cy3
Description: A Rabbit polyclonal antibody against Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2). This antibody is labeled with Cy3.
Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) Polyclonal Antibody (Human), FITC
Description: A Rabbit polyclonal antibody against Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2). This antibody is labeled with FITC.
Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) Polyclonal Antibody (Human), HRP
Description: A Rabbit polyclonal antibody against Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2). This antibody is labeled with HRP.
Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2) Polyclonal Antibody (Human), PE
Description: A Rabbit polyclonal antibody against Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2). This antibody is labeled with PE.
Cancer Antigen 125 Antigen (Human Adenocarcinoma) (> 90%)
Description: Cancer Antigen 19-9 Antigen, Host/Source: Liver Carcinoma. The purity is detected by gel filtration and ion-exchange chromatography. It is tested negative for HBsAg, antibodies to HCV and HIV 1/2.
Description: A Rabbit polyclonal antibody against Human Ovarian Cancer Immuno Reactive Antigen Domain Containing Protein 2 (OCIAD2). This antibody is labeled with APC-Cy7.
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Il nostro commento identifica i determinanti demografici, biologici, comportamentali, sociali e sanitari, che aumentano la vulnerabilità delle persone anziane alle epidemie respiratorie. Riconosciamo che questi determinanti probabilmente varieranno tra le persone anziane nei paesi a reddito medio-alto. Nonostante queste variazioni, chiediamo un’azione urgente per mitigare l’impatto delle epidemie sulle persone anziane e preservarne la salute e la dignità. Devono essere sviluppati e attuati programmi intersettoriali che riconoscano i bisogni speciali delle persone anziane e in contesti unici come le case di cura, con la piena partecipazione e il consenso degli anziani. COVID-19 ha creato sconvolgimenti, sfidando l’umanità e minacciando la vita, i diritti e il benessere delle persone anziane. Dobbiamo garantire di rimanere una società a misura di anziano e rendere il mondo un posto migliore per tutti, compresi gli anziani.
