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- Anesthesia for Vascular Surgery(2022) SIMõES, C. M.Anesthesia for vascular procedures in cancer patients can be challenging. In this chapter, we discuss some important aspects in preoperative evaluation and anesthesia planning, including risk stratification, medications, and also other patient potential risks. Onco-anesthesia has some specific aspects and should be considered an emerging subspecialty with critical competencies to be developed. Venous access, hemodynamic monitoring, blood and fluid management, analgesia, and also enhanced recovery bundles must be considered for all patients. Also, anesthesia technique may be an important factor to be studied. Postoperative care is also specific, and we must consider some situations more frequent in cancer patients-that will be discussed as analgesia and its adverse effects-that may be present and should be prevented. © Springer Nature Switzerland AG 2022.
- Vascular Surgery in Oncology(2022)Circulatory conditions are involved both in the oncologic disease itself and in its treatment, with a direct impact on therapeutic planning for patients. At the same time, it goes without saying that cancer and its treatment affect the circulatory system, be it arterial, venous or lymphatic. This book explores the interface between vascular surgery and the various clinical and surgical oncological specialties, highlighting which types of neoplasm are most common and focusing on those that more frequently cause or are influenced by vascular diseases. The diagnostic procedures for these tumors and the most suitable types of treatment are also discussed. The content is divided into three sections: I - Surgical Oncology, II - Clinical Oncology and Oncohematology, and III - Vascular and Endovascular Surgery. The first section presents the most common types of tumor in each surgical oncology specialty, and the most frequent tumors associated with vascular complications. The diagnosis, staging, prognosis and oncological treatments are discussed, while associated vascular complications, such as vascular invasion, venous thrombosis, and arterial thrombosis, are described. The second section focuses on general aspects of Clinical Oncology and Oncohematology in addition to the most frequent vascular complications related to solid and hematological cancers and its treatment (chemotherapy, radiotherapy, bone marrow transplantation). The third section includes a more detailed approach to vascular events and diseases commonly found in cancer patients, in addition to technical discussions regarding vascular reconstructions associated with tumor resection, vascular access, among other topics. At the end of each chapter, the editors comment and highlight the most important challenges for vascular surgeons who dedicate their lives to treating cancer patients. Given its scope, the book offers a valuable resource for medical specialists and professionals in training in the fields of vascular surgery and angiology, clinical oncology, oncohematology and surgical oncology. © Springer Nature Switzerland AG 2022.
- Nuclear Medicine in Endocrine Disorders: Diagnosis and Therapy(2022)This book presents up-to-date information on the general principles of diagnostic and therapeutic nuclear medicine in the context of endocrinology. The content is divided into six parts. Section I examines general aspects of radiopharmaceuticals, scintigraphy, single-photon emission computed tomography (SPECT), positron emission tomography (PET), radionuclide therapies and radioguided surgery. Section II discusses diagnostic applications in benign thyroid diseases and evaluation of thyroid nodules. Section III gives an overview of the management of parathyroid diseases. Section IV presents diagnostic techniques in well-differentiated thyroid cancer. Section V addresses procedures and therapy in adrenal benign and malignant disorders (phaechromocytomas and paragangliomas). Lastly, the diagnosis and treatment of neuroendocrine tumors are featured in Section VI. Nuclear Medicine in Endocrine Disorders: Diagnosis and Therapy is intended for non-specialists in nuclear medicine working in the field of endocrinology, and is also a valuable resource for researchers and students. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
- Older Adult Patients(2022) DESIDERI, I.; KARNAKIS, T.; BRAIN, E.Ageing is the most important risk factor for developing cancer. Breast cancer is not an exception to the rule, with a median age of 62 years at diagnosis, depending on the age distribution of the population at risk. In western countries, 40–50% of patients are being diagnosed at age 70 or older. Given the competing risks on mortality with multi-morbidities, a screening tool for frailty is recognized as the gateway to any treatment decision-making in patients aged 70 and older, for personalizing treatment. Indeed, treatment choice requires careful assessment of the benefit–risk ratio and guidance according to a general health status assessment, to avoid jeopardizing functional status and quality of life. This concept applies to any specific local or systemic treatment, showing the need for constant adjustment according to the degree of frailty reversibility. Hypofractionated schedules and partial breast irradiation are approaches increasing attractivity of radiation therapy strategies for older patients to avoid multiple burdensome transportations, while improving selection of cases for which chemotherapy is required, both in adjuvant and metastatic settings, is the main challenge for systemic treatments.
- Management of Oral Lesions in COVID-19 Patients(2023) GUERRA, E. N. S.; SANTOS-SILVA, A. R.; NORMANDO, A. G. C.; SCARINI, J. F.; SANTOS, J. A. Dos; BRANDãO, T. B.In COVID-19 patients, the infection can lead to taste disturbances, xerostomia, halitosis, parotitis, and oral mucosal lesions. Usually, the lesions are symptomatic and have no sex predilection. Patients with older age and greater severity of the disease present more disseminated and severe lesions. This chapter sought to describe the clinical presentation and specificities of managing orofacial lesions in patients with COVID-19, based on the best evidence of clinical effectiveness. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.
- Oncology and Hematology in the ICU(2022) NASCIMENTO, R. G. Do; PAULA, N. A. B. Garrido de; CONCEIçãO, M. Ferreira; BASTOS, D. R. De; CERQUEIRA, D. De OliveiraIn the coming years, accelerated progress against oncologic and hematologic diseases will be associated with a greater number of patients requiring life support therapies. In this chapter, we seek to highlight recent changes in the use and outcomes of intensive care in onco-hematologic patients. In recent decades, we have shown a substantial increase in our understanding of organ dysfunctions in the population of patients with solid and hematological malignancies, in the more appropriate use of life support therapies and in the selection of new and better therapeutic approaches that have been increasing survival of these patients. While reading this chapter, the reader is expected to reflect on the daily management of critically ill onco-hematological patients, from the management of toxicity to palliative care, and to understand the role and importance of the pharmacist within the field of oncology among critically ill patients. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
- Vascular Access(2022) SAES, G. F.; ZERATI, A. E.; WOLOSKER, M. B.; BARBOSA, J. A. S.; SILVA, T. C. do CampoIn this chapter, we deal with vascular accesses in cancer patients, complications associated with those devices, and nursery care. Long-term venous catheters, especially tunneled catheters, are essential for cancer treatment, with wide applicability in various stages of treatment. In addition to enabling the infusion of drugs and blood products, they also allow the collection of blood samples for laboratory analysis, the monitoring of hemodynamic parameters, parenteral nutrition, and the performance of essential procedures for maintaining life, such as hemodialysis sessions.The indications and types of catheters are discussed, taking into account the time of use, the compatibility of the drug with the peripheral venous system, and the risk of infection. Most frequent complications and how to avoid them are also a subject in this chapter. © Springer Nature Switzerland AG 2022.
- Retroperitoneal Tumors(2022) FERREIRA, F. de OliveiraRetroperitoneal tumors are a topic of interest to different specialties. Due to the variety of diagnoses, there are few references that contemplate the theme all together. In this chapter, we chose to analyze the different tumors that may present as retroperitoneal mass, including primary tumors of the retroperitoneal space, primary tumors of retroperitoneal organs that may occupy the retroperitoneal space, intraperitoneal tumors that simulate retroperitoneal lesions, and retroperitoneal lymph node masses. In clinical practice, diagnostic uncertainty regarding the finding of a retroperitoneal mass can lead to misconceptions and be harmful to the patient. Our goal is to address the clinical, radiological, and therapeutic aspects of the different diagnoses. We present a suggestion of the “step by step” to be followed for the diagnostic clarification and also discuss vascular problems related to each diagnosis. The idea is that specialists from different areas can take advantage of the list of diagnoses discussed and keep in mind the diversity of situations associated with the theme. © Springer Nature Switzerland AG 2022.
- FDG PET/CT in bone sarcomas(2022) CAMACHO, M.; CARVALHO, M.; MUNHOZ, R.; ETCHEBEHERE, M.; ETCHEBEHERE, E.Bone sarcomas are a rare and diverse group of malignant neoplasms composed by entities with distinct presentations, clinical courses and therapeutic approaches. Although bone sarcomas may affect all age groups, these tumors exhibit a bimodal distribution, with higher incidences in children and in the elderly. Imaging exams are a crucial step for an adequate evaluation of bone sarcomas and mandatory for treatment planning, and provide invaluable information regarding disease extent, prognostic information, treatment response, and disease relapse.Whole-body FDG PET/CT imaging may be a part of the diagnostic work-up of bone sarcomas. FDG PET/CT combines, in a single study, morphologic and metabolic information that may alter treatment strategies, help guide or avoid unnecessary biopsies, stage patients, determine the degree of tumor necrosis following neoadjuvant chemotherapy, detect local recurrence, and provide important prognostic information. This article will discuss the current and potential roles of FDG PET/CT in osteosarcoma, Ewing's sarcoma, chondrosarcoma, giant cell bone tumor, and chordoma. © 2022 Elsevier Inc. All rights reserved.
- PET/CT in soft tissue sarcomas(2022) ETCHEBEHERE, E.; MUNHOZ, R. R.; CASALI, A.; ETCHEBEHERE, M.Soft tissue sarcomas are a diverse group of rare malignant tumors of mesenchymal origin. Clinical diagnosis of soft tissue sarcoma poses a dilemma since the differentiation of a benign from a malignant lesion might be challenging. In addition to the risk of local relapse, these tumors may metastasize, mainly to the lungs, but also to other tissues, and evaluation of the extent of disease and subsequent response to therapy may be difficult. Following local or systemic therapies, tumor fibrosis might occur and can be confounded with viable tumor tissue. FDG PET/CT is a molecular imaging modality that uses the tumor metabolism to evaluate aggressiveness, the extent of disease, treatment response, and differentiation of benign from malignant lesions. This chapter will discuss the potential added value of FDG PET/CT in soft tissue sarcomas. © 2022 Elsevier Inc. All rights reserved.
- Lymphadenectomy in Prostate Cancer: Technique and Outcomes(2022) LESTINGI, J. F. P.; SALAS, R. S.; YOSHIOKA, K.; COELHO, R. F.Despite recent advances in imaging, pelvic lymph node dissection (PLND) remains the gold standard modality for nodal staging in prostate cancer (PCa) patients. There remains significant debate about PLND: the odds of finding positive pelvic lymph nodes are proportional to the extent of the PLND; however, the therapeutic benefits of more extensive PLND remain an area of controversy, besides the increasing number of surgical risks. This chapter will review indications, techniques, and results of extended pelvic lymphadenectomy (ePLND) in the surgical treatment of PCa patients. Two recent randomized controlled trials comparing extended to limited PLND have not demonstrated differences in early biochemical recurrence. Limited lymphadenectomy significantly underestimates the actual incidence of lymph node metastasis and should no longer be performed for staging. EPLND is currently the gold standard in lymph node staging. It should be reserved for patients at higher risk of lymph node invasion. The oncological role of ePLND is not defined. It can help patients directly (up to two positive lymph nodes), indirectly (select for adjuvant treatments), or may benefit patients with ISUP Gleason Grade in biopsy 3-5. EPLND is also associated with significantly worse intra- and postoperative non-oncological outcomes, such as bleeding, lymphocele, and increased surgical time. The oncological role of salvage lymphadenectomy also is not clear. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
- Oral Management of Cancer Patients After Multimodality Therapy(2023) PRADO-RIBEIRO, A. C.; SANTOS-SILVA, A. R.; FONSECA, F. P.; SCARINI, J. F.; INNOCENTINI, L. M. A. R.; BRANDãO, T. B.No currently available anticancer treatment, whether radiotherapy or chemotherapy, can kill neoplastic cells without affecting normal cells. In this context, the oral mucosa epithelium is susceptible to acute and chronic toxicities of antineoplastic treatment. This chapter offers an update on the main oral toxic effects of radiotherapy and chemotherapy and how to adequate individualize treatment based on the recommendations of preventative and interventional treatments for these patients. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.
- Nonviral Infections(2011) ALVES, V. A. F.; ABDALLA, E.
- Hepatic Granulomas: Differential Diagnosis. Differential Diagnosis.(2011) MELLO, E. S. de; ALVES, V. A. F.
- Orthopedics: Musculoskeletal Tumors(2022) BAPTISTA, A. M.; REBOLLEDO, D. C. S.; JUNIOR, M. C. M. T.; CORREIA, L. F. M.; CAIERO, M. T.; TEIXEIRA, W. J.; NARAZAKI, D. K.; CAMARGO, A. F. de França; CAMARGO, O. P. deAmputation has historically been the first choice of treatment for patients with bone or soft tissue sarcomas of the extremities involving major blood vessels. However, recent advances in surgical technique have allowed limb-salvage surgery in a significant number of cases. Nowadays, most patients with malignant bone tumors can be treated with limb-salvage procedures whenever wide margins are possible. Surgical resection of bone and soft tissue tumors, with or without adjuvant radiation therapy, is effective in achieving local control, and limb-salvage procedures have been accepted because they achieve survival rates comparable to those of amputation allowing better quality of life. Along with other reconstructive techniques, vascular reconstruction might allow limb-sparing surgery and avoid amputation in patients with malignant tumors involving major vessels. Intraarterial embolization may as well serve as adjuvant therapy for major resection surgeries or therapeutic in some types of irresectable tumors. © Springer Nature Switzerland AG 2022.
- Gastrointestinal Surgery(2022) TAKEDA, F. R.; JUNIOR, U. R.; MAKDISSI, F. F.; MACHADO, M. A.; MARQUES, C. F. S.; NAHAS, C. S. R.; PINTO, R. A.; NAHAS, S. C.Esophageal and gastric cancer surgical treatment still represents a challenge in the curative-intent treatment. The neoadjuvant treatment plays a vital role in downstaging tumors since most of them are advanced tumors, improving overall survival, disease-free survival, and outcomes. Vascular procedures are required in local-regional tumoral invasions, and most tumors are in palliative conditions. Pancreatic and liver tumors, even the small ones, can also affect vessels, requiring vascular reconstruction in selected patients. Colorectal neoplasms rarely cause direct invasion of trunk vessels. Vascular intraoperative complications are mostly related to advanced stages tumors - and not its histopathology. This chapter discusses the main types of cancer of the gastrointestinal tract and the most frequent complications associated with the vascular system. © Springer Nature Switzerland AG 2022.
- Dermatological Manifestations(2023) CURY-MARTINS, J.; SANCHES, J. A.Cutaneous involvement by amyloidosis is characterized by extracellular deposition of amyloid protein within the skin and appendages and can occur as a skin-limited disorder (localized cutaneous amyloidosis—LCA) or as a manifestation of systemic amyloidosis (SA). LCA can be divided into primary LCA—macular, lichen and nodular amyloidosis; or secondary LCA. The main subtypes of SA with cutaneous involvement include immunoglobulin light chain (AL) amyloidosis, secondary (AA) amyloidosis, dialysis-related amyloidosis, and heredofamilial amyloidosis. Skin involvement is present, for example, in approximately 40% of patients with AL amyloidosis, and might provide an early clue to the existence of an underlying plasma-cell dyscrasia. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.
- Thoracic Surgery(2022) TERRA, R. M.; JúNIOR, E. R.Neoplasms originating in chest organs are important not only for their incidence but also for the complexity of their treatment. Given the presence of vital structures such as heart, lung, and great vessels, multidisciplinary treatment is often necessary. Lung cancer is a major concern given its high incidence and lethality, besides being the neoplasm with the significant relation to thromboembolic events. Mediastinal tumors originating in the thymus gland and germinative cell tumors require special attention from the vascular surgeon since their treatment is sometimes composed of complex vascular reconstructions or endovascular therapy beyond the technical knowledge of the thoracic surgeon. Primary pulmonary artery sarcoma, although rare, is an important differential diagnosis for pulmonary thromboembolism and requires adequate surgical treatment for a better prognosis. In this chapter, we review these thoracic neoplasms and their vascular implications. © Springer Nature Switzerland AG 2022.
- Lymphedema in Cancer Patients(2022) ANDRADE, M. F. C. de; BERGMANN, A.; MONTAG, E.; MUNARETTO, J. B.; JACOMO, A.Metastasis to distant organs is the most important factor related to cancer survival. Tumor cells spread via blood and lymphatic vessels, systems responsible for transporting fluid and cells. Besides its structural role in cancer metastasis, the lymphatic system displays a critical functional interaction with developing tumors. In clinical settings, full evaluation of the lymphatic system involvement is crucial for treatment and prognosis in cancer patients. Comprehension of physiological and pathological processes involving the lymphatic system is a continuously growing field of basic and clinical research due to recent advances in molecular Lymphology. However, the most interesting biological aspects of lymphatic metastasis of cancer are beyond our objective in this chapter. Here we will focus on the consequences of cancer spread and therapeutic approaches and their impact on the lymphatic system. The knowledge of basic function, structure and distribution of the lymphatic system is essential to diagnosis and treatment in Oncology. In this chapter we will highlight relevant aspects of lymphatic anatomy as well as current topics in conservative and surgical treatment of lymphedema. © Springer Nature Switzerland AG 2022.
- Head and Neck Surgery(2022) SANTOS, A. B. dos; KOWALSKI, L. P.; KöHLER, H. F.; GOLDENBERG, D. C.; TOLEDO, R. N. de; CARVALHO, A. Y. deHead and neck region is very rich in vascular structures and a site for every incident of malignant neoplasms with potential to nodal metastasis in the carotid sheath that, when operated, may require complex vascular reconstruction with potential morbid complications, especially in salvage surgery. But the region can also be affected by complex benignant neoplasms that may require concomitant endovascular and open approaches for proper treatment, besides the complexity of surrounding anatomical structures, and life-threatening bleeding events. © Springer Nature Switzerland AG 2022.