ABSTRACT
La electroporación irreversible o IRE (irreversible electroporation) es una técnica de ablación tumoral no térmica basada en la aplicación de pulsos eléctricos de alto voltaje entre pares de agujas insertadas alrededor de un tumor. La corriente generada favorece la creación de nanoporos en la membrana plasmática, desencadenando la apoptosis. Por ello, la IRE puede utilizarse de manera segura en localizaciones cercanas a estructuras vasculares delicadas, contraindicadas para el resto de técnicas termoablativas. Actualmente la IRE se emplea con éxito para la ablación de tumores en páncreas, riñón e hígado y, de manera muy extendida, como opción terapéutica focal para el cáncer de próstata. La necesidad de un manejo anestésico específico y la colocación precisa y en paralelo de múltiples agujas implican un alto nivel de complejidad, siendo necesaria una gran experiencia del equipo intervencionista. No obstante, se trata de una técnica muy prometedora con una gran capacidad inmunológica sistémica que puede provocar un efecto a distancia del tumor tratado (efecto abscopal).(AU)
Irreversible electroporation (IRE) is a non-thermal tumor ablation technique. High-voltage electrical pulses are applied between pairs of electrodes inserted around and/or inside a tumor. The generated electric current induces the creation of nanopores in the cell membrane, triggering apoptosis. As a result, IRE can be safely used in areas near delicate vascular structures where other thermal ablation methods are contraindicated. Currently, IRE has demonstrated to be a successful ablation technique for pancreatic, renal, and liver tumors and is widely used as a focal therapeutic option for prostate cancer. The need for specific anesthetic management and accurate parallel placement of multiple electrodes entails a high level of complexity and great expertise from the interventional team is required. Nevertheless, IRE is a very promising technique with a remarkable systemic immunological capability and may impact on distant metastases (abscopal effect).(AU)
Subject(s)
Humans , Male , Female , Electroporation/methods , Liver Neoplasms/diagnostic imaging , Kidney Neoplasms/diagnostic imaging , Pancreatic Neoplasms/diagnostic imaging , Immunotherapy , Radiology, Interventional , Radiology , Diagnostic Imaging , Medical Oncology , Ablation Techniques , Anesthesia/methodsABSTRACT
Irreversible Electroporation (IRE) is a non-thermal tumor ablation technique. High-voltage electrical pulses are applied between pairs of electrodes inserted around and/or inside a tumor. The generated electric current induces the creation of nanopores in the cell membrane, triggering apoptosis. As a result, IRE can be safely used in areas near delicate vascular structures where other thermal ablation methods are contraindicated. Currently, IRE has demonstrated to be a successful ablation technique for pancreatic, renal, and liver tumors and is widely used as a focal therapeutic option for prostate cancer. The need for specific anesthetic management and accurate parallel placement of multiple electrodes entails a high level of complexity and great expertise from the interventional team is required. Nevertheless, IRE is a very promising technique with a remarkable systemic immunological capability and may impact on distant metastases (abscopal effect).
Subject(s)
Ablation Techniques , Liver Neoplasms , Prostatic Neoplasms , Male , Humans , Ablation Techniques/methods , Electroporation/methods , PancreasABSTRACT
Introducción. El dolor de espalda durante el embarazo es una entidad de indudable relevancia, y la disfunción sacroilíaca (DASI) una de sus causas más frecuentes. El objetivo del estudio es presentar una serie de casos con DASI y su evolución tras el tratamiento médico-manual. Material y métodos. Serie de 15 pacientes embarazadas, diagnosticadas de DASI mediante la prueba de flexión de cadera en bipedestación (Kirkaldy-Gillet) y prueba en sedestación (Piedallu), que se trataron con una técnica adaptada de medicina manual. Para su seguimiento se aplicaron el test de discapacidad en dolor lumbar de Oswestry y la escala visual analógica (EVA). Resultados. Se observó una mejoría de 2 puntos en la escala EVA y un descenso de 10 puntos en el test de Oswestry. A los 40 días posparto ninguna de las pacientes refería persistencia de los síntomas. Conclusiones. La DASI es una entidad importante en la embarazada con dolor lumbar irradiado, y su manejo difiere de la clásica lumbalgia inespecífica. Las técnicas de medicina manual han demostrado beneficios en esta enfermedad en términos de dolor y discapacidad, pero son necesarios más ensayos clínicos que avalen su eficacia (AU)
Introduction. Back pain during pregnancy is a condition having unquestionable importance, sacroiliac malfunction being one of the most common causes. This study has aimed to analyze the efficiency of medical manual treatment for pregnant women with irradiated lumbar pain and symptoms consistent with sacroiliac malfunction. Material and methods. A study was conducted on 15 pregnant women with sacroiliac malfunction, diagnosed with the standing hip flexion test (Kirkaldy-Gillet) and the sitting test (Piedallu), who were treated with a technique adapted from manual medicine. For monitoring results, lumbar pain disability Oswestry test and visual analog numerical scale (VAS) were used. Results. A 2-point improvement was observed on the VAS scale and a decrease of 10 points on the Oswestry test. At 40 days after giving birth, none of the women reported sacroliac malfunction symptoms. Conclusions. Sacroiliac malfunction is an important condition in pregnant women with irradiated lumbar pain, and its treatment differs from the classic unspecific lower back pain. Medical manual techniques have demonstrated significant benefits in this condition in terms of pain and disability. However, further clinical trials are required to support its efficiency (AU)
