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Ribera-Perianes J, Vega M, Cases Moreno X, Cordón J, Cortés Gracia J, Paredes P, Sánchez-Izquierdo N, Perissinotti A, Fuster Pelfort D, Vidal-Sicart S. Multidisciplinary radio-guided surgery team: Alternative to change the current paradigm. Rev Esp Med Nucl Imagen Mol 2024; 43:91-99. [PMID: 38387785 DOI: 10.1016/j.remnie.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 12/02/2023] [Indexed: 02/24/2024]
Abstract
INTRODUCTION Given the constant increase in the healthcare demand for examinations related to radio-guided surgery (RGS), our hospital adopted new professional profiles in the RGS team, in order to partially reduce the time spent by nuclear medicine physicians on this task. AIM To analyze the process of incorporating the profiles of Diagnostic Imaging Technician (DIT) and Sentinel Node Referent Nurse (SNRN), evaluating their deployment in the procedures linked to the technique. MATERIAL AND METHODS Analysis of RGS activity during the period 2018-2022, focusing on pre-surgical and surgical procedures related to breast cancer (BC) and malignant melanoma (MM), as they are those pathologies on which the transfer of care competencies was concentrated. Chronological evolution of the competencies assumed by the different profiles during their integration into the RGS team. RESULTS RGS's healthcare activity during the analyzed period experienced an increase of 109%. BC and MM were the pathologies that accounted for by far the greatest demand for care. The transfer of competencies in these two pathologies occurred in a progressive and staggered manner, with 74% (460/622) of the administration phase being carried out by the SNRN and 64% (333/519) of the surgeries by the DIT in 2022. CONCLUSIONS The creation of a multidisciplinary RGS team that includes different professional profiles (nuclear medicine physician [MN], ERGC and TSID) is an effective strategy to respond to the increase in the complexity and number of all procedures related to RGS.
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Affiliation(s)
| | - M Vega
- Nuclear Medicine Department, Clínic Barcelona, Barcelona, Spain
| | - X Cases Moreno
- Nuclear Medicine Department, Clínic Barcelona, Barcelona, Spain
| | - J Cordón
- Nuclear Medicine Department, Clínic Barcelona, Barcelona, Spain
| | - J Cortés Gracia
- Nuclear Medicine Department, Clínic Barcelona, Barcelona, Spain
| | - P Paredes
- Nuclear Medicine Department, Clínic Barcelona, Barcelona, Spain
| | | | - A Perissinotti
- Nuclear Medicine Department, Clínic Barcelona, Biomedical Research Networking Center of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
| | | | - S Vidal-Sicart
- Nuclear Medicine Department, Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Perissinotti A, Collantes M, Llopis J, Ecay M, Velloso MG, Moreno A, Peñuelas I, Fuster D, Miró J, Mària CGDL. Metabolismo de la fdg en Médula ósea y Bazo Como Signo Indirecto de Infección en un Modelo Experimental de Endocarditis. Cirugía Cardiovascular 2022. [DOI: 10.1016/j.circv.2022.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ribera-Perianes J, Buján Leiva D, Cases Moreno X, Sánchez-Izquierdo N, Perissinotti A, Fuster Pelfort D, Vidal-Sicart S. Sentinel node referent nurse: Description, validation and application in clinical practice. Rev Esp Med Nucl Imagen Mol 2022; 41:350-359. [DOI: 10.1016/j.remnie.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/30/2021] [Indexed: 11/30/2022]
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Cebrecos I, Sánchez-Izquierdo N, Ganau S, Mensión E, Perissinotti A, Úbeda B, Bargalló X, Alonso I, Vidal-Sicartb S. Radioactive and non-radioactive seeds as surgical localization method of non-palpable breast lesions. Rev Esp Med Nucl Imagen Mol 2022; 41:100-107. [DOI: 10.1016/j.remnie.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/21/2021] [Indexed: 11/28/2022]
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Falgàs N, Tort-Merino A, Balasa M, Borrego-Écija S, Castellví M, Olives J, Bosch B, Férnandez-Villullas G, Antonell A, Augé JM, Lomeña F, Perissinotti A, Bargalló N, Sánchez-Valle R, Lladó A. Clinical applicability of diagnostic biomarkers in early-onset cognitive impairment. Eur J Neurol 2019; 26:1098-1104. [PMID: 30793432 DOI: 10.1111/ene.13945] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/19/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Several diagnostic biomarkers are currently available for clinical use in early-onset cognitive impairment. The decision on which biomarker is used in each patient depends on several factors such as its predictive value or tolerability. METHODS There were a total of 40 subjects with early-onset cognitive complaints (<65 years of age): 26 with Alzheimer's disease (AD), five with frontotemporal dementia and nine with diagnostic suspicion of non-neurodegenerative disorder. Clinical and neuropsychological evaluation, lumbar puncture for cerebrospinal fluid (CSF) AD core biochemical marker determination, medial temporal atrophy evaluation on magnetic resonance imaging, amyloid-positron emission tomography (PET) and 18 F-fluorodeoxyglucose-PET were performed. Neurologists provided pre- and post-biomarker diagnosis, together with diagnostic confidence and clinical/therapeutic management. Patients scored the tolerability of each procedure. RESULTS Cerebrospinal fluid biomarkers and amyloid-PET increased diagnostic confidence in AD (77.4%-86.2% after CSF, 92.4% after amyloid-PET, P < 0.01) and non-neurodegenerative conditions (53.6%-75% after CSF, 95% after amyloid-PET, P < 0.05). Biomarker results led to diagnostic (32.5%) and treatment (32.5%) changes. All tests were well tolerated. CONCLUSIONS Biomarker procedures are well tolerated and have an important diagnostic/therapeutic impact on early-onset cognitive impairment.
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Affiliation(s)
- N Falgàs
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Tort-Merino
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - M Balasa
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain.,Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - S Borrego-Écija
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - M Castellví
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - J Olives
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - B Bosch
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - G Férnandez-Villullas
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Antonell
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - J M Augé
- Biochemistry and Molecular Genetics Department, Hospital Clínic de Barcelona, Barcelona
| | - F Lomeña
- Nuclear Medicine Department, Hospital Clínic de Barcelona, Barcelona
| | - A Perissinotti
- Nuclear Medicine Department, Hospital Clínic de Barcelona, Barcelona
| | - N Bargalló
- Image Diagnostic Centre, IDIBAPS, Hospital Clínic de Barcelona, Barcelona, Spain
| | - R Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
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Sánchez-Izquierdo N, Perissinotti A, Donaire A, Niñerola-Baizán A, Mayoral M, Setoain X. Detection of epileptogenic focus with two new methods of processing of SPECT and PET cerebral images: PET-Analysis and PISCOM. Rev Esp Med Nucl Imagen Mol 2019; 38:312-315. [PMID: 30827940 DOI: 10.1016/j.remn.2019.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 01/13/2019] [Accepted: 01/15/2019] [Indexed: 11/25/2022]
Abstract
Functional neuroimaging with positron emission tomography with 18F-fluorodeoxyglucose (PET-18F-FDG) and perfusion single photon emission computerized tomography (SPECT) are increasingly more essential for presurgically locating the epileptogenic focus. We present the case of an 18-year-old male with epileptic seizures refractory to antiepileptic treatment. Magnetic resonance (MR) showed dysplasia in the posterior right insular cortex. Subtraction of ictal SPECT co-registered to MR (SICOM) detected a focal increase of uptake in the left fronto-parietal cingulate and PET-FDG showed normal distribution of the radiotracer. The posterior right insula was resected with histopathological results of grade I ganglioglioma according to the World Health Organization classification. The patient made favourable post-surgical progress, and remains seizure-free after 5 years (Engel I). Retrospective analysis of this case with two new image processing methods (PET analysis and PET interictal subtracted ictal SPECT coregistered with MR [PISCOM]) correctly localized the epileptogenic focus in the posterior right insular cortex.
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Affiliation(s)
| | - A Perissinotti
- Departamento de Medicina Nuclear, Hospital Clínic, Barcelona, España.
| | - A Donaire
- Departamento de Neurología, Hospital Clínic, Barcelona, España
| | - A Niñerola-Baizán
- Departamento de Medicina Nuclear, Hospital Clínic, Barcelona, España; Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Universidad de Barcelona, Barcelona, España
| | - M Mayoral
- Departamento de Medicina Nuclear, Hospital Clínic, Barcelona, España
| | - X Setoain
- Departamento de Medicina Nuclear, Hospital Clínic, Barcelona, España; Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Universidad de Barcelona, Barcelona, España
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Moreno-Ramírez D, Pérez-Anker J, Perissinotti A, Pigem R, Podlipnik S, Fragakis I, Toledo Pastrana T. Inguinal Sentinel Lymph Node Biopsy: Surgical Technique. Actas Dermo-Sifiliográficas (English Edition) 2018. [DOI: 10.1016/j.adengl.2018.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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Moreno-Ramírez D, Pérez-Anker J, Perissinotti A, Pigem R, Podlipnik S, Fragakis I, Toledo Pastrana T. Inguinal Sentinel Lymph Node Biopsy: Surgical Technique. Actas Dermosifiliogr (Engl Ed) 2018; 109:553-554. [PMID: 29571522 DOI: 10.1016/j.ad.2017.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 12/30/2017] [Indexed: 11/24/2022] Open
Affiliation(s)
| | - J Pérez-Anker
- Servicio de Dermatología, Hospital Clínic, Barcelona, España
| | - A Perissinotti
- Servicio de Medicina Nuclear, Hospital Clínic, Barcelona, España
| | - R Pigem
- Servicio de Dermatología, Hospital Clínic, Barcelona, España
| | - S Podlipnik
- Servicio de Dermatología, Hospital Clínic, Barcelona, España
| | - I Fragakis
- Servicio de Dermatología, Hospital Clínic, Barcelona, España
| | - T Toledo Pastrana
- Servicio de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España
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Boyd AM, Perissinotti AJ, Nagel JL, Frame DG, Marini BL. Risk factors for cefepime nonsusceptible Gram-negative infections in allogeneic hematopoietic cell transplant recipients. J Oncol Pharm Pract 2017; 25:279-288. [DOI: 10.1177/1078155217731507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Purpose Allogeneic hematopoietic cell transplant recipients undergo myelosuppressive chemotherapy to allow engraftment of stem cells and are at particularly high risk for bacterial infections and adverse outcomes. Patients undergoing hematopoietic cell transplant are at increased risk for healthcare-associated infections, including infections with multidrug-resistant pathogens. Cefepime is a commonly prescribed antibiotic for empiric therapy in hematopoietic cell transplant patients, but there is minimal data describing cefepime resistance rates, risk factors for resistance, and clinical outcomes associated with cefepime-resistant infections. Methods Adult (≥18 years old) allogeneic hematopoietic cell transplant recipients with a culture positive for a gram-negative rod between January 2010 and January 2016 were spilt into two groups: cefepime susceptible and cefepime nonsusceptible . The primary objective of this study was to identify risk factors for cefepime nonsusceptible through multivariable logistic regression. Results A total of 107 patients were included (27 cefepime nonsusceptible, 80 cefepime-susceptible), yielding a 25.2% nonsusceptibility rate. Multivariable analysis yielded age >60 years old, Klebsiella spp. infection, Acinetobacter spp. infection, healthcare exposures within 90 days, acute gastrointestinal graft-vs-host-disease, and chronic graft-vs-host-disease at multiple locations as significant risk factors for cefepime nonsusceptible. The receiver operating characteristic area under the curve of the model was 0.851. Thirty-day all-cause mortality (29.6% versus 16.3%, p = 0.13) and length of hospitalization (19 versus 12.5 days, p = 0.0650) were numerically higher in the cefepime nonsusceptible group. Conclusions Hematopoietic cell transplant patients with acute gastrointestinal graft versus host disease, extensive chronic graft-vs-host-disease, advanced age, previous healthcare exposures, or infections with Klebsiella and Acinetobacter are at increased risk for cefepime nonsusceptible. Patients infected with cefepime nonsusceptible pathogens may have higher rates of mortality and length of hospitalization.
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Affiliation(s)
- AM Boyd
- Department of Pharmacy Services, Michigan Medicine and University of Michigan College of Pharmacy, Ann Arbor, USA
- Department of Pharmacy, Cleveland Clinic, Cleveland, USA
| | - AJ Perissinotti
- Department of Pharmacy Services, Michigan Medicine and University of Michigan College of Pharmacy, Ann Arbor, USA
| | - JL Nagel
- Department of Pharmacy Services, Michigan Medicine and University of Michigan College of Pharmacy, Ann Arbor, USA
| | - DG Frame
- Department of Pharmacy Services, Michigan Medicine and University of Michigan College of Pharmacy, Ann Arbor, USA
| | - BL Marini
- Department of Pharmacy Services, Michigan Medicine and University of Michigan College of Pharmacy, Ann Arbor, USA
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Navales I, Paredes P, Cols M, Perissinotti A, Vancells M, Pons F. Utility of positron emission tomography with 18F-FDG in a case of juvenile recurrent respiratory papillomatosis. Rev Esp Med Nucl Imagen Mol 2013. [DOI: 10.1016/j.remnie.2013.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Fuster D, Lafuente S, Setoain X, Navales I, Perissinotti A, Pavia J, Paredes P, Lomeña F, Pons F. [Dual-time point images of the liver with (18)F-FDG PET/CT in suspected recurrence from colorectal cancer]. Rev Esp Med Nucl Imagen Mol 2011; 31:111-6. [PMID: 22154291 DOI: 10.1016/j.remn.2011.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 10/23/2011] [Accepted: 10/25/2011] [Indexed: 10/14/2022]
Abstract
AIM To analyze the potential improvement of (18)F-fluorodeoxyglucose (FDG) PET/CT using additional delayed images of the liver in operated colorectal cancer. MATERIAL AND METHODS The study prospectively included 71 patients (22 women, 49 men) with mean age of 65 ± 11 years with clinical, analytic or radiological suspicion of current disease. A whole body PET/CT scan was performed at 60 min. (standard images) and after 2 hr (delayed images) post-injection of 4.07 MBq/Kg of (18)F-FDG. Visual and quantitative SUV analysis of PET/CT findings was done. All findings were confirmed by histopathology and/or at least 6 months follow-up. RESULTS Thirty-seven out of 71 patients were diagnosed of liver metastases (79 metastases). In 38/71 cases there was extra-hepatic disease in the form of local recurrence (10), abdominopelvic (3) or mediastinal (3) lymph nodes, bone (1) or lung metastases (16) and carcinomatosis (10). Sensitivity and specificity in the diagnosis of liver metastases in a patient-by-patient basis in standard (81% and 91%) and in delayed images (95% y 97%) was calculated. The number of lesions detected in delayed images was significantly higher (66/79) than in standard images (57/79). Sensitivity and specificity for PET/CT in the diagnosis of extra-hepatic disease was 84% and 70%, contributing to the detection of synchronous tumors in 5 patients. CONCLUSIONS PET/CT may be useful in the diagnosis of extra-hepatic disease in suspected recurrence of colorectal cancer. Delayed images on PET/CT may increase the sensitivity to identify liver metastases.
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Affiliation(s)
- D Fuster
- Servicio de Medicina Nuclear, Hospital Clínic, Barcelona, España.
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