Establishment of a desirable dose using neutral argon plasma to eradicate miliary peritoneal implants: A phase I/II controlled trial.

INTRODUCTION: Neutral argon plasma (NAP) system could meet the requirements to achieve oncological cytoreduction of peritoneal carcinomatosis with miliary lesions, minimizing the associated morbidity. This phase I/II trial aims to establish the desirable dose that is safe and effective in eliminating tumor cells with lower penetration. METHODS: Patients diagnosed with different origins for peritoneal carcinomatosis and miliary implants were selected for the study. The safe and potentially effective dose (desirability) of NAP was evaluated according to three factors: distance (mm), application time (s) and power (%), to evaluate the response variables such as the presence of tumor cells (Y/N) and the depth of penetration. RESULTS: Ten patients and 120 samples were evaluated and treated with NAP. There was no vascular or organ injury intraoperative using a pre-established dose of 100% (coagulation mode) at a distance of 2-3 cm. The distance was found to be correlated with the presence of the tumor cells in ex-vivo analysis, with an OR of 15.4 (4.0-111.4). The time and energy used were protective factors to eliminate tumor cells with an OR of 0.4 (0.1-0.9) and 0.8 (0.8-0.9), respectively. The safest and most effective desirability results were as follows i) energy 80% during 2-4 s with a distance of 2 cm (0.89), and ii) energy 100% during 2-4 s with a distance of 3 cm (0.90). CONCLUSIONS: The use of NAP during a CRS and HIPEC is safe and effective for eradicating tumor cells on the peritoneal surface at suggested doses of energy, distance and duration. TRIAL IDENTIFICATION: ClinicalTrials.gov Identifier: NCT04904042.

[Incidence of malnutrition in surgical departments of the Reina Sofía Hospital of Córdoba]. / Incidencia de la desnutrición en los servicios quirúrgicos del Hospital Reina Sofía de Córdoba.

We conducted a prospective study of the incidence of malnutrition in the surgical departments of the Reina Sofia University Hospital, on a total of 329 patients at the time of admittance (154 women and 175 men). As was denounced by Bristian more than 20 years ago, more than 50% of the patients presented some form of malnutrition. There are a series of factors, detected by the Chi2 test, which are as divers as sex, marital status, level of education, profession, smoker or chronic medication user, which are of influence on the nutritional status of the patients. The type of malnutrition is conditioned by the marital status, the job situation, the nature of the pathology, or the use of tobacco. Malnutrition still exists in developed countries, induced by many factors, and it is often found in the hospitals, which is even worse.