Steroids sepsis nejm

Vogl et al (2007) evaluated the feasibility, safety and effectiveness of CT-guided and MR-thermometry-controlled LITT in adrenal metastases.  A total of 9 patients (7 males, 2 females; average age of years; range of to years) with 9 unilateral adrenal metastases (mean diameter cm) from primaries comprising colorectal carcinoma (n = 5), renal cell carcinoma (n = 1), esophageal carcinoma (n = 1), carcinoid (n = 1), and hepato-cellular carcinoma (n = 1) underwent CT-guided, MR-thermometry-controlled LITT using a T MR unit.  Laser interstitial thermo-therapy was performed with an internally irrigated power laser application system with an Nd:YAG laser.  A thermo-sensitive, fast low-angle shot 2D sequence was used for real-time monitoring.  Follow-up studies were performed at 24 hrs and 3 months and, thereafter, at 6-month intervals (median of 14 months).  All patients tolerated the procedure well under local anesthesia.  No complications occurred.  Average number of laser applicators per tumor: (range of 1 to 4); mean applied laser energy 33 kJ (range of to kJ), mean diameter of the laser-induced coagulation necrosis cm (range of to cm).  Complete ablation was achieved in 7 lesions, verified by MR imaging; progression was detected in 2 lesions in the follow-up.  The authors concluded that these preliminary results suggested that CT-guided, MR-thermometry-controlled LITT is a safe, minimally invasive and promising procedure for treating adrenal metastases.

Steroids sepsis nejm

steroids sepsis nejm

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