Society Consensus Research Articles

Collective memory of student youth in the post-modern era

The lack of consensus in society on the most important problems of history negatively affects the formation of the collective memory of the younger generation. The socialization of millennials (in the terms of N. Howe and W. Strauss) has specific features that become the main tool for the formation of a new collective identity. In the postmodern era, society faces a number of risks and needs recommendations to mitigate them. The purpose of this article is to reveal the features of the collective memory of student youth on the example of the perception of the events of the Great Patriotic War (WWII) in the conditions of a super-tolerant postmodern society. The following concepts were chosen as the methodological basis of the research: social construction (P. Berger, T. Luckmann), the concept of collective memory (M. Halbwachs, P. Nora, A. Assmann), as well as the post-structuralist direction of postmodernism (Z. Bauman, J. Baudrillard). The empirical base of the study was formed by the results of a large-scale research project of the Russian Society of Sociologists “Russian Students on the Great Patriotic War”, which has a fifteen-year history. Processing the data obtained has required using the software product Vortex 10. To study the peculiarities of young people’s perception of the events of the war years, the authors have chosen problematic issues, actualized by modern socio-political processes. The results have revealed the prerequisites for the alienation of generations (lack of discussion of events with relatives), as well as some inconsistencies in the perceptions of young people about the role of the countries participating in the Second World War to the real historical reality. The novelty of the results was predetermined by the identification of features in the views of civilian and military youth concerning controversial issues of history, explained by differences in the educational environment. In addition, the differences in ideas about patriotism in the two youth groups are shown and attributive markers of the concept of “patriotism” are proposed. The results obtained may be of interest to researchers studying youth problems.

Highly Skilled Migrants from Post-Soviet States: Labor Mobility

The Russian labor market is experiencing a shortage of highly skilled workers, and there is a consensus in Russian society that it is necessary to attract and utilize the labor of highly qualified foreign specialists. The key question of the article is: how much demand is there on the Russian labor market for the knowledge and experience of highly qualified migrants? What types of economic activities and occupations are typical for highly skilled migrants? What is their horizontal and vertical mobility on the Russian labor market? The article shows that highly skilled workers who come from post-Soviet states to Russia take jobs which are not in demand among Russian workers; the main types of their economic activities are trade, construction, utilities, social and personal services, and household assistance. Neither specific skills and knowledge nor qualifications of foreign workers are demanded on the Russian labor market: over 80% of highly skilled migrants work at jobs which do not require their education or qualification. Vertical labor mobility is predominantly downward, and upward mobility is quite rare (downward mobility is less typical for highly skilled migrants who have received education in Russia, Ukraine, and Belarus). The empirical basis of the study was the results of sociological surveys of 1,450 highly qualified migrants from the CIS and Georgia in 2017 and 1,050 in 2011.

Efficacy and safety of platelet-rich plasma for the treatment of thin endometrium

Background:Endometrial thickness has been identified as a prognostic factor for pregnancy rate for patients with female infertility. Thin endometrium is defined as <7 mm on the day of ovulation, or on the day of human chorionic gonadotrophin (HCG) injection in fresh in vitro fertilization (IVF) cycles, or the day to start progesterone in frozen-thaw embryo transfer cycles, as stated in the guideline of thin endometrium from the Canadin Fertility and Andrology Society and Chinese expert consensus from the Society of Reproductive Medicine, Chinese Medical Association. Many medicines are used for improving the endometrial thickness and embryo implantation rate of the patients with thin endometirum, but thin endometrium remains a major troublesome clinical problem with limited efficacy.Platelet-rich plasma (PRP), as a growing and robust therapeutic option in musculoskeletal medicine, is a preparation of autologous plasma with a high concentration of platelets, and the therapeutic mechanism is based on the capacity to supply supra physiologic amounts of essential growth factors to provide a regenerative stimulus for promoting repair in tissues with low healing potential. Some randomized controlled trials have reported the application of PRP for patients with thin endometrium with satisfactory effect. However, there is no systematic review on efficacy and safety of PRP as a treatment of thin endometrium.Methods:The data and information will be retrieved from the databases of MEDLINE, Embase, Web of Science, Clinicaltrials.org., Cochrane Library, China Biology Medicine Database, Wan Fang Database, China National Knowledge Infrastructure Database, VIP Science Technology Periodical Database, and OpenGrey for gray literature. The randomized controlled clinical trials are going to be selected before December 20, 2019, in English or Chinese language, with the search terms including “thin endometrium,”“platelet-rich plasma,” “endometrial thickness,” “hemorheology of endometrium,” “pregnancy rate,” and “adverse reactions.” RevMan 5.3 will be used for systematic review and meta-analysis. This protocol will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and the systematic review will be reported with the PRISMA statement.Results and conclusion:The efficacy and safety of PRP for the treatment of thin endometrium will be evaluated, and the conclusion will be published to provide medical evidence for a better clinical decision of patients with thin endometirum.

Can Serum Fibrinogen Predict ARDS?

Acute respiratory distress syndrome (ARDS) has a worldwide mortality of 10% to 30% with severe pneumonia being the primary cause. Diagnosis relies on clinical criteria which may lead to under-recognition and delayed evidence-based interventions. In previous studies, plasma fibrinogen was associated with progression to ARDS among patients with severe pneumonia. This is a prospective cohort study wherein we hypothesized that levels of plasma fibrinogen and change in levels of fibrinogen can predict development of ARDS among a cohort of patients with severe pneumonia based on the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) consensus criteria. After acquiring consent, plasma fibrinogen levels were extracted upon enrollment and after 48 hours. These extraction times were arbitrarily chosen to determine whether levels rise or decline in relation to the course of disease. A total of 47 patients were prospectively followed within 7 days of enrollment, then divided into 2 groups, which included those who developed ARDS (n = 12, 25%) and those who did not (n = 35, 75%). Fibrinogen levels at baseline had sensitivity and specificity of 41.7% and 57.1%, respectively (P = .932) with an area under the curve (AUC) of 0.492; levels after 48 hours had sensitivity and specificity of 55.6% and 65.6%, respectively (P = .729) with an AUC of 0.538; and delta fibrinogen levels had sensitivity and specificity of 55.6% and 62.5%, respectively (P = 0.581) with an AUC of 0.561. Based on this study, plasma fibrinogen is an unreliable biomarker for predicting ARDS development in patients with severe pneumonia. In setting up this study, we experienced limitations which we had to accept but realizations of these led to the discovery of potential research areas. To our knowledge, this is the first Philippine study attempting to discover a biomarker for ARDS progression. It is recommended that further investigation on local incidence and other biomarkers for ARDS should be done.

Моральные основания и намерение участвовать в голосовании на выборах президента России

Objectives. The aim was to study the relationship between moral foundations and intention of voting on the presidential elections in Russia. Background. Voting in political elections is important for consensus of society but a large proportion of voters don’t vote that may depend on psychological characteristics among other factors. There is a growing interest in the world in the moral factors of political preferences and voter turnout due to the elaboration of moral foundations theory. However, the relation between moral sphere and intention to vote as well as possible mediators of this relation remains understudied. Study design. The correlational design with subsequent structural equation modeling was used. The survey was conducted in 2018, 2—6 weeks before the Russian presidential elections. Participants. 126 university students at the age from 18 to 50 years old (80% are women). Measurements. To test these hypotheses we used the Moral foundations questionnaire (by J. Graham et al.), the questionnaire of political engagement elaborated for this research and the questionnaire about intention to vote and some socio-demographic variables. Results. The structural equation modeling showed that binding moral foundations were associated with interest to politics which in turn predicted the intention to vote. We also confirmed the known from the previous researches trend to less intention of voting in youth. Using path analysis we found out that less intention of voting in younger voters was due to their less loyalty and weak interest to politics. Conclusions. The intention of voting on the presidential elections depends on the political engagement related with the binding moral foundations.

The North American Neuroendocrine Tumor Society Consensus Paper on the Surgical Management of Pancreatic Neuroendocrine Tumors.

This manuscript is the result of the North American Neuroendocrine Tumor Society consensus conference on the surgical management of pancreatic neuroendocrine tumors from July 19 to 20, 2018. The group reviewed a series of questions of specific interest to surgeons taking care of patients with pancreatic neuroendocrine tumors, and for each, the available literature was reviewed. What follows are these reviews for each question followed by recommendations of the panel.

Impact of an external ventricular drain bundle and limited duration antibiotic prophylaxis on drain-related infections and antibiotic resistance

Background/ObjectiveSystemic prophylactic antibiotics have been used to reduce the rate of neurosurgical drain-related infections (DRIs) but the optimal duration is unknown. The Neurocritical Care Society Consensus Statement for External Ventricular Drain (EVD) management recommends a single antibiotic dose preoperatively. Data regarding antibiotic management for other neurosurgical drains (e.g. subgaleal and subdural drains) are lacking. Previously at our institution antibiotics were continued for the duration of drain placement. In 2016 an EVD bundle was implemented to standardize nursing care, and antibiotic duration was changed to one preoperative dose for all neurosurgical drains. The objective of this study was to compare the incidence of DRI, non-DRI, and antibiotic resistance before and after the implementation of an EVD bundle and limited duration antibiotics. Patients and methodsThis was a single center, quasi-experimental study that included patients status post EVD or craniotomy/craniectomy with subgaleal or subdural drain placement. The pre-intervention period was June 2014 through May 2015 and the post-intervention period was January 2017 through December 2017. ResultsNinety-one patients were included in the pre-intervention group and 54 in the post-intervention group. The use of limited duration antibiotics (< 48 h) was 14.3 % in the pre-intervention group and 96.3 % in the post-intervention group (p < 0.001). Five DRIs were identified in the pre-intervention group and 3 in the post-intervention group (5.5 % vs 5.6 %, p = 1.00). Of patients who developed a non-DRI, 77.5 % had a resistant non-DRI in the pre-intervention group compared to 48 % in the post-intervention group (p = 0.01). The rates of resistant DRI (80 % vs 66.7 %, p = 1.00) and Clostridium difficile infection (1.1 % vs 3.7 %, p = 0.56) were similar between groups. ConclusionsImplementation of an EVD bundle and limited duration antibiotics reduced antibiotic exposure with no associated increase in risk of DRI. Rates of resistant non-DRI were significantly lower in the post-intervention group.

The development of high quality training program for real tine trans rectal ultrasound low dose rate (LDR) prostate brachytherapy

Although ultrasound forms a critical component of transrectal ultrasound image guided brachytherapy for prostate cancer, ultrasound training is not required as part of radiation oncology training programs, nor does any objective competency measure exist to independently assess clinical performance [ [1] Davis B.J. et al. American Brachytherapy Society consensus guidelines for transrectal ultrasound-guided permanent prostate brachytherapy. Brachytherapy. 2012; Abstract Full Text Full Text PDF Scopus (360) Google Scholar ]. Physical simulation training and objective clinical competency testing can provide a structured approach to training [ [2] McGaghie W.C. et al. A critical review of simulation-based medical education research: 2003–2009. Med. Educ. 2010; Google Scholar ], but only if suitably challenging training devices are available which replicate the complex anatomy of the male pelvis and prostate. This study describes the iterative process in the development of a range of training devices which simulate both the anthropomorphic and sonographic characteristics of the different presentations of patient specific prostate cancer. The design of the clinical features involved selection of patient cases and then rapid prototyping the different anatomical features and inverse casting these features in tissue mimicking materials (TMM). Novel TMMs were developed that had the sonographic appearance of the prostate and overlying tissues, as well as having the relevant mechanical compliance to give the training devices required haptic feedback. These devices will be used in the development of a training programme and will complement the learner’s development of the specific skills required for the procedure. The use of training strategies such as gamification allows trainees to track their own performance over time as well as relative to their peers; thereby, providing a structured and competitive approach to learning. The 3D prototyped clinical features in these devices provided a more clinically-relevant representation of the procedure, thus providing a more efficacious training opportunity.

Economic impact of severe asthma exacerbations in Spain: multicentre observational study

Objective: To describe resource use and costs of severe exacerbations in patients with severe asthma.Method: Secondary analysis of an observational, longitudinal, retrospective study that estimated the economic impact of severe asthma. The study was carried out in severe asthma units of the pulmonology and allergy services of 20 public hospitals (inclusion period: June to November 2016). The study included adult patients diagnosed with severe asthma according to the European Respiratory Society/American Thoracic Society consensus in the stable phase (no exacerbation during the last 2 months), and with at least one severe exacerbation during the study period (12 months). Healthcare resource use due to severe exacerbations (emergency visits, hospitalizations and pharmacological treatment) was recorded. The direct health costs associated with severe exacerbations were calculated by multiplying the resources used by the corresponding unit cost (in 2018 euros).Results: 134 patients with ≥1 severe exacerbation were included: 63% were female and the mean age was 54 years. 249 severe exacerbations were registered. There were 1.5 physician visits at primary care, hospital care and/or emergency room per episode, 13% of episodes required hospitalization, with a mean hospital stay of 7.2 days. Systemic corticosteroids were prescribed in 92% of exacerbations. The mean direct cost was €758.7/exacerbation (95% confidence interval: 556.8–1,011.1), of which 82% was due to hospitalizations (€623.3/episode). Considering only episodes requiring hospital admission, the mean cost increased by €4,997/exacerbation.Conclusions: It was estimated that the economic impact of a severe exacerbation in Spanish patients with severe asthma was €758.7/exacerbation.

Consensus of the German-Speaking Society for Microsurgery of Peripheral Nerves and Vessels (DAM) on minimum standards for microsurgical training courses and accreditation - Minimum Standards for Microsurgical Training Courses and Accreditation

Microsurgical training courses are an integral part of surgical education and training. Due to the changes in the surgical everyday routine, the competence and skills training outside the operating room has an increasingly important status. Multi-day, hands-on exercises with different models of increasing difficulty use artificial, avital and vital microsurgical models. The skills are evaluated with regard to fine motor skills as well as orientation in space and low-tremor motion sequences as well as bimanual manipulation exercises by means of "lobal rating scales". However, with numerous course offerings in German-speaking countries, there are no uniform and transparent contents and evaluation standards to reflect the quality of the courses. At a consensus meeting, minimum requirements for the contents of microsurgical training courses in the context of continuing medical education were defined and drafted as a German-language consensus in order to award a DAM quality seal. The parameters include the definition of targets, the existence of a scripts, the number of hours used, models used, practical exercise time on the microscope, trainer to participant ratio, types of anastomosis or coaptation (artery, vein, nerve, lymph vessel), application of a global rating scale , examination (grade/passed-failed), participant certificate and course evaluation. With the aim to meet the available courses/course concepts to maintain or improve the quality of education and training, the assignment of a "Basic" and an "Advanced" quality seal has been defined. The further stepwise development of the courses is necessary to sustain all skills and competencies for future microsurgeons. Integration of validated microsurgical simulators may reduce animal use and thus contribute to the ethical responsibility. The introduction of quality seals for microsurgical training courses should strengthen the transparency and commitment of participants and provide support to course providers with appropriately substantiated content through DAM.

Effect of Prior Sternotomy on Outcomes in Transvenous Lead Extraction.

A history of open-heart surgery has been a heavily debated topic in transvenous lead extraction. This study evaluates the impact of prior sternotomy on transvenous lead extraction outcomes. Data for all patients undergoing transvenous lead extraction at a tertiary referral center were prospectively gathered from 2004 to 2017. Relevant clinical information was compared between patients with a history of sternotomy before transvenous lead extraction and those without. After considering baseline differences, multivariate regression, and propensity-matched analysis were performed. Outcome variables included major and minor complication rates, clinical success, and in-hospital mortality as defined by the 2017 Heart Rhythm Society consensus statement. Of 1480 patients in the study period, 455 had a prior sternotomy. When compared with patients with no prior sternotomy, those with prior sternotomy were more likely to be older, male, and present with more comorbidities and leads targeted for extraction. No statistical differences were identified in major and minor complication rates (P=0.75, P=0.41), clinical success rate (P=0.26), and in-hospital mortality (P=0.08). In patients with prior sternotomy, there were no instances of pericardial effusion after extraction. Prior sternotomy was not an independent predictor of clinical or procedural outcomes. No associations were elucidated after propensity-matched analysis. In a large, single-center series, no differences in clinical or procedural outcomes were elucidated between patients with a history of sternotomy and those without. Patients with sternotomies before lead extraction who experienced vascular or cardiac perforations clinically presented with hemothoraces rather than pericardial effusions.

Why Spirituality Matters for Law: An Explanation

In this article, I explore potential connections between law and spirituality as well as some of the legal implications of these connections. After arguing that spirituality is conceptually autonomous from religion and morality, I explain why the spiritual triad of love, communion, and gift is deeply interconnected with the legal triad of justice, agreement, and right. I also make clear why individual and collective intentions and cultural values are the main channels of interaction between law and spirituality. In the second part of the article, I argue that legal systems evolve through spiritualization, among other ways, promoting the dematerialization of the legal system, encouraging the limitation of domination, inspiring the reduction of coercion, stimulating communion and consensus in society, or increasing respect for the law and the legal systems. Spiritualization demands a recognition of the higher dimension of the law and, therefore, helps rethink, reorient, renew, reform, and reimagine law and legal systems. Finally, I sketch a pattern of five levels to measure the degree of spiritualization of concrete legal systems. This pattern can be also applied to legal actors and institutions.

Why Spirituality Matters for Law: An Explanation

Abstract In this article, I explore potential connections between law and spirituality as well as some of the legal implications of these connections. After arguing that spirituality is conceptually autonomous from religion and morality, I explain why the spiritual triad of love, communion, and gift is deeply interconnected with the legal triad of justice, agreement, and right. I also make clear why individual and collective intentions and cultural values are the main channels of interaction between law and spirituality. In the second part of the article, I argue that legal systems evolve through spiritualization, among other ways, promoting the dematerialization of the legal system, encouraging the limitation of domination, inspiring the reduction of coercion, stimulating communion and consensus in society, or increasing respect for the law and the legal systems. Spiritualization demands a recognition of the higher dimension of the law and, therefore, helps rethink, reorient, renew, reform, and reimagine law and legal systems. Finally, I sketch a pattern of five levels to measure the degree of spiritualization of concrete legal systems. This pattern can also be applied to legal actors and institutions.

Consensus of the Brazilian Headache Society on the treatment of chronic migraine.

Chronic migraine poses a significant personal, social and economic burden and is characterized by headache present on 15 or more days per month for at least three months, with at least eight days of migrainous headache per month. It is frequently associated with analgesic or acute migraine medication overuse and this should not be overlooked. The present consensus was elaborated upon by a group of members of the Brazilian Headache Society in order to describe current evidence and to provide recommendations related to chronic migraine pharmacological and nonpharmacological treatment. Withdrawal strategies in medication overuse headache are also described, as well as treatment risks during pregnancy and breastfeeding. Oral topiramate and onabotulinum toxin A injections are the only treatments granted Class A recommendation, while valproate, gabapentin, and tizanidine received Class B recommendation, along with acupuncture, biofeedback, and mindfulness. The anti-CGRP or anti-CGRPr monoclonal antibodies, still unavailable in Brazil, are promising new drugs already approved elsewhere for migraine prophylactic treatment, the efficacy of which in chronic migraine is still to be definitively proven.

Association of Child Neurology-Indian Epilepsy Society Consensus Document on Parental Counseling of Children with Epilepsy.

When a child is diagnosed with epilepsy, counseling regarding the same is done by the treating doctor. Most parents are frightened and have poor knowledge about epilepsy. Therapeutic advice including drug dosage, administration and side effects takes up the major part of physician's time, thereby neglecting important issues like home seizure management, follow up and others.These lacunae in knowledge require systematic patient and family education. To address these issues, an expert group meeting of pediatric neurologists and epileptologists in India along with social workers/epilepsy educators, legal experts, parents, and teachers was held. The various aspects regarding parental counseling in children with epilepsy were discussed and a consensus document was formulated. Here authors present the group consensus statement on counseling parents and caregivers of children with epilepsy. This document is intended to help physicians and pediatricians counsel the families when a child is diagnosed with epilepsy.

Some Barriers to Democratic Practical Process in the Provinces of Central Highlands of Vietnam

Implementing democracy in provinces of the Central Highlands with the guideline know, citizen discuss, citizen do, citizen check which was concerned by the Central Highlands authorities achieved many encouraging results. The implementation process has really promoted the democratic rights of local people classes, contributed positively to the construction of the government, promoted the role of the Fatherland Front and the mass organizations; built many self-management models in residential communities, created a positive change in the awareness and working style of civil servants towards being closer to citizen, respecting citizen and being more responsible to people. However, there are still many weaknesses arising due to many both objective and subjective obstacle. The ownership of the citizens in many places and localities is still violated, and citizens are not allowed to discuss and comment on issues related to national policies and social welfare. To find suitable solutions, promote the ownership role of the citizens in all activities, create consensus in society, equality between the Central Highlands ethnic groups, constantly strengthen the great unity of all ethnic groups in the area in the development process, it is necessary to examine to clarify some barriers to the quality and effectiveness of the grassroots democratic implementation in the provinces of the Central Highlands of Vietnam.

Lympho-reconstructive microsurgery for secondary lymphedema: Consensus of the German-Speaking Society for Microsurgery of Peripheral Nerves and Vessels (DAM) on indication, diagnostic and therapy by lymphovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT)

Secondary lymphedema is a complex and devastating disease including chronic inflammation and reduced immunofunction, lymphatic fluid and protein accumulation due to misdirected lymphatic transport, and secondary fat deposition followed by fibrosis. While the domain of treatment still is lifelong complex decongestive therapy, it is more and more widespread to treat the disease with a surgical focus on physiologic, reconstructive strategies or debulking surgery. Lymphovenous Anastomosis (LVA) and Vascularized lymph node transplantation (VLNT) are the mostly frequently applied, reconstructive techniques which address restoration or improvement of physiologic lymph clearance. The article summarizes and discusses the recommendations of an expert panel on the diagnostic, indication and therapy of LVA and VLNT in secondary lymphedema during the 40th Meeting of the Germanspeaking Society of Microsurgery in Lugano, Switzerland, 2018. The expert panel addressed the basic diagnostics prior to lymphoreconstructive surgery, including the inevitable application of Indocyanine Green (ICG) based fluorescence lymphangiography and navigation for both techniques including reverse mapping to reduce the rate of donor-site lymphedema for VLNT as well as the use of lymphedema-specific quality of life questionnaires. Both LVA and VLNT are elaborately described, including tips and tricks on identifying functional lymphatic collectors, equipment, types of anastomosis and documentation for LVA and choice of donor and recipient site, number of includable lymph nodes and management of specific donor sites, e. g. jejunal mesenteric for VLNT. The synchronous and sequential application of LVA, VLNT and/or ablative liposuction is discussed against the background of the effectivity and morbidity of both reconstructive, physiologic techniques. Finally, recommendations on post-operative treatment and diagnostics are discussed. The present consensus paper intends to improve the level of standardization for further multicenter studies in the germanspeaking countries in this aspiring field of lymphedema treatment.

Surveying the Landscape of Structural Heart Disease Coordination: An Exploratory Study of the Coordinator Role

ABSTRACT Background: In professional society consensus statements for structural heart disease (SHD), the Coordinator is identified as a key member of the Multidisciplinary Team (MDT). Minimal information is available to describe this role. The purpose of this exploratory survey is to describe the current landscape of SHD coordination and the Coordinator role on the MDT. Methods: A link to a 40-question web-based survey was distributed to 596 email addresses of nurses and allied health professionals involved in coordinating catheter-based therapies for SHD. Descriptive statistics were used to analyze survey data. Results: Respondents (N = 219) were predominantly registered nurse coordinators (82.2%); 43.9% held a bachelor’s degree and 43.4% a master’s or doctoral degree. Valve Clinic Coordinator was the most frequently held title (33.5%). A total of 23.3% of respondents coordinated patient care for TAVR, TMVr MitraClip, LAAO Watchman; 42.4% coordinated patient care for TAVR and TMVr MitraClip or LAAO Watchman; and 34.3% coordinated patient care solely for TAVR. Whereas 33.8% of respondents represented programs with more than one coordinator, 26% of respondents were hired to replace a coordinator and 9.6% of respondents reported more than one coordinator had resigned from the program. Common responsibilities were determined and areas for further study (skill-task alignment, retention, and impact of the Coordinator role) were identified. Conclusions: This study provides the first data-driven description of the SHD Coordinator on the MDT. These data on the scope of SHD coordination in the U.S. may assist with establishing a standardized definition and national parameters for the Coordinator role.

The American Brachytherapy Society consensus statement on intraoperative radiation therapy

PurposeAlthough radiation therapy has traditionally been delivered with external beam or brachytherapy, intraoperative radiation therapy (IORT) represents an alternative that may shorten the course of therapy, reduce toxicities, and improve patient satisfaction while potentially lowering the cost of care. At this time, there are limited evidence-based guidelines to assist clinicians with patient selection for IORT. As such, the American Brachytherapy Society presents a consensus statement on the use of IORT. MethodsPhysicians and physicists with expertise in intraoperative radiation created a site-directed guideline for appropriate patient selection and utilization of IORT. ResultsSeveral IORT techniques exist including radionuclide-based high-dose-rate, low-dose-rate, electron, and low-energy electronic. In breast cancer, IORT as monotherapy should only be used on prospective studies. IORT can be considered in the treatment of sarcomas with close/positive margins or recurrent sarcomas. IORT can be considered in conjunction with external beam radiotherapy for retroperitoneal sarcomas. IORT can be considered for colorectal malignancies with concern for positive margins and in the setting of recurrent gynecologic cancers. For thoracic, head and neck, and central nervous system malignancies, utilization of IORT should be evaluated on a case-by-case basis. ConclusionsThe present guidelines provide clinicians with a summary of current data regarding IORT by treatment site and guidelines for the appropriate patient selection and safe utilization of the technique. High-dose-rate, low-dose-rate brachytherapy methods are appropriate when IORT is to be delivered as are electron and low-energy based on the clinical scenario.

French and European Neuroendocrine Tumor Society consensus guidelines

French and European Neuroendocrine Tumor Society consensus guidelines