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Joseph S. Sav ino, MD
Faraji1 do antibiotics for acne work keflex 500mg otc, 1Shahrekord University antibiotics in animals buy keflex 250mg visa, Shahrekord antibiotics for dogs simplicef cheap keflex 250mg free shipping, Iran virus 20 orca generic keflex 250 mg amex, 2University of Arkansas, Fayetteville. Immunomodulatory effects of a commercially available probiotic on coccidiosis vaccination in broilers. Influence of probiotic administration, coccidiosis vaccination, Eimeria challenge, or ionophorous coccidiastat administration on gut morphology in broilers. Berghman1,3, 1Texas A&M University, Poultry Science Department, College Station, 2 Texas A&M University, Animal Science Department, College Station, 3Texas A&M University, Veterinary Pathobiology Department, College Station. Cole1, 1The Ohio State University, Columbus, 2University of Arkansas, Fayetteville. Zarkesh3, 1University of Tehran, College of Agriculture, Karaj, Iran, 2Islamic Azad University of Khorasgan, Isfahan, Iran, 3University of Isfahan, Isfahan, Iran. Effect of dietary cinnamomum cassia and curcuma longa on Eimeria tenella infection in broiler chickens. Lillehoj1, 1Animal and Natural Resources Institute, Agricultural Research Service-U. Use of the broiler (Gallus gallus) as an in vivo screening tool for Fe bioavailability. Effect of copper sulfate in the drinking water on egg production and other parameters in commercial laying hens. Effects of maternal age, sex and dietary phosphorus level on broiler performance and bone strength. Comparative effect of vitamin C and direct-fed microbial on the broiler performance, ileal microbial population profile, and gut morphology under heat stress condition. Kamyab4, 1 Ghent University, Melle, Belgium, 2Animal Science Research Institute, Karaj, Iran, 3Tarbiat Modaress University, Tehran, Iran, 4University of Missouri, Columbia, 5Jirof Higher Education Center for Agricultural Sciences, Jiroft, Iran. Effect of source and level of maternal vitamin D on carryover to newly hatched chicks. Effect of dietary vitamin U supplementation on the growth performance of young broiler chickens. Molecular characterization, tissue distribution and gene expression of reduced folate carrier in laying hens fed the folate supplemented diet. Germline replacement by transferring primordial germ cells into sterilized embryos in the chicken. Tagami2, 1Shinshu University, Minamiminowa, Nagano, Japan, 2National Institute of Livestock and Grassland Science, Tsukuba, Ibaraki, Japan. Comparison of Cobb and Ross strains in embryo physiology and chick juvenile growth. Decuypere3, 1University of Lome, Lome, Togo, 2University of Agriculture, Abeokuta, Nigeria, 3Catholic University of Leuven, Leuven, Belgium. Velleman, Ohio Agricultural Research and Development Center, the Ohio State University, Wooster. Mitochondrial proton leak kinetics and relationship to feed efficiency within a single genetic line of male broilers. A novel antibody for the detection of gonadotropin releasing hormone receptor-2 protein in chickens. Melanopsin in the premammillary nucleus of the avian hypothalamus may trigger seasonal reproduction. Evaluation of the minimum dose of dietary thyroxin sufficient to induce molt in turkey breeder hens. Influence of two different molting methods on productive performance and the immune response of two different strains of laying hens. Abdou, Animal Production Department, Faculty of Agriculture, Cairo University, Giza, Egypt. McElroy1, 1 Virginia Polytechnic Institute and State University, Blacksburg, 2 Ab Vista, Marlborough, Wiltshire, United Kingdom. Evaluation of length of finisher Maxiban withdrawal period on broiler performance. Effects of probiotic administration during coccidiosis vaccination on performance in broilers exposed to field strain Eimeria: Comparison to monensin administration. Effects of probiotic administration during coccidiosis vaccination on lesion development in broilers exposed to field strain Eimeria: Comparison to monensin administration. The influence of two essential oil blends on live performance after challenged with Eimeria spp. Immune response of broiler chickens fed different levels of arginine and vitamin E to a coccidiosis vaccine and Eimeria challenge. RuizFeria*1, 1Texas A&M University, College Station, 2Colegio de Postgraduados, Montecillos, Mexico, Mexico. Prophylactic and therapeutic supplementation with caprylic acid reduces enteric Campylobacter jejuni concentrations in young chickens. Siegel1, 1Virginia Polytechnic Institute and State University, Blacksburg, 2Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg. Effects of mycotoxin contaminated diets and Mycofix Select on Leghorn performance characteristics. Comparing post-molt body weight and egg weight with two protein and five energy levels. The efficacy of Optiphos in pre-molt and post-molt diets fed to Hyline W-36 laying hens from 32-117 weeks of age. Effects of cinnamon, garlic and yucca extracts on growth performance and serum biochemical parameters in broilers. Effect of using zeolite in the broiler diet on reducing Salmonella and on production performance. Ragheb1, 1 Kuwait Institute for Scientific Research, Safat, Kuwait, 2 Pennsylvania State University, University Park. Broiler responses to low protein corn-soybean meal diets supplemented with valine, isoleucine, glycine and glutamic acid. Impact of dietary crude protein and nonessential amino acids (glycine and glutamic acid) with analogous essential amino acid levels and pattern on hormonal function of thyroid gland and fat deposition in chickens. Effects of reduced crude protein, amino acid balanced diets on performance and economics in a large-scale commercial laying hen flock. Atteh2, 1Federal College of Animal Health & Production Technology, Institute of Agricultural Research & Training, Ibadan, Oyo, Nigeria, 2University of Ilorin, Ilorin, Kwara, Nigeria. Predicting variations in amino acid digestibility of major coproducts of the bioethanol industry. Production performance of two strains of laying hens fed different levels of camelina meal and flaxseed. Lбzaro1, 1Universidad Politйcnica de Madrid, Spain, 2Laboratorio de Mouriscade, Pontevedra, Spain. Effects of the addition of whole sorghum on the productive and digestive responses of broiler chickens. Occurrence of white striping in chicken breast fillets in relation to broiler size. Studies on sensory evaluation and consumer acceptance of omega-3 enriched designer eggs. Jabbar2, 1University College of Agriculture, University of Sargodha, Sargodha, Pakistan, 2University of Veterinary & Animal Sciences, Lahore, Pakistan, 3Oregon State University, Department of Animal Science, Corvallis. Validation of a simple screening procedure to estimate contaminant concentration in processed poultry. Evaluation of recombinant Salmonella expressing the flagellar protein FliC for enhanced immune responses in commercial turkeys. Big bird programs: Impact of strain, gender, and debone time on meat quality of broilers. Effect of dietary balanced protein and metabolizable energy level, age and sex effects on broiler breast meat quality. Improvement of muscle oxidative stability and processing yield in relation with dietary methionine sources. Plant-derived essential oils influence intestinal morphology during a coccidial vaccine challenge. Micro encapsulation increases carvacrol stability during pelleting and premix and feed storage.
Syndromes
F addit~on antibiotic hip spacer buy keflex 250mg, disn as cussed above antibiotics for acne minocycline cheap keflex 750mg mastercard, v~ral proteins that are insertcd 111to the plasma ~ncmbrane may cause cell fusion bacteria 3 buy cheap keflex 500 mg on line, as well as providing a target for the immune response I ~ F 7)izvo bacteria never have safe keflex 250 mg. Insertinn of viral proteins into t h c plasma mernbrantx can also change membrane permeability, leading directly tr) loss of osrnubc integrily, cell swelling, and dealh. Mechanisms of Cell Damage Sn many biochemical changes occur In cells infected with cytocidal viruses that the death of the cell cannot readily be ascribed to one particular event; rather it may be the final result of the cumulative action o l several biochemical i11sult. Cell damage can occur even wjthnul replication of the virus, for example, when late stages of the expression of the viral genome are blocked exyerimontally, or in rerta~nabortive infections. Noncytocidal Infections N(lncytocida1 viruses usually do not kill the cells in which they replicate. I-Iits lype of to ccll-vtrus intctsaction i s l c ~ ~ In icclls infcctcd wit11 s ~ v e r a lkinds of I i N A ~ d viruses- arrntivir~iscs, rplrcrviruses, and solnc paramyxovlruses, lor example, In all ol which vlrlons arc relccised by budding from the plasma membrane. Althnugli such v~rus-y~elditlg may grow and divlde in cultrrrc for lor~g rclls pcriiods, there are slow, progressive changes that with some cxceplions (c. In khe body, cell r t p lacement ul occurs s o rapidly in ~ntlst organs and lissues that Lhe slow fall-out of cells due t o persistent infecl~on, Eeast In Llie short term, rnay have no cffecl on overall at ftrnclion Mnwevcr, persistently infrcted differentiated cells may lose their capacity to carry out specializccl functions, and neurons, once destroyed, are not replaced. Also, antigenic clianges produced in tlw plasma membrane may provoke irrimunc responses which can rapidly ltad to destruction o! Interferons 83 Effects on Functions of Specialized Cells Although they d o not immediately kill cells, infections with noncytocidal virr~sesoften intcrfcre with the spec~alrzcdfunctions of different~atedcells. Similarly, I C M virus replicating in p cells o f the ~sletso Langerhans in the pancreas can f induce hyperglycemia in the rnorrse, not dissimilar to insulin-dependent diahctcs in humans. Rhinovirus infecri(117 of the nasal e p ~ t h c l ~ results In cilia1 stasis and later in the destruction t~~u nf cilia, although thp cells are often not killcd. This discovery ralsed hnpcs thdt such interferons could be used as safe, nontoxic broad-spectrum antiv~raI chemotherapeutic agents. We nr,w know that these are about 20 human intcrferclns, falling into three chemically distinct types, known as interleron n (which occurs as over a dozen s u b types), interferon P and interteron y (Table 5-2). Each suhurtit has an M,of abclut 20,1100; interferon a Interferons Viral ir~tcrfert. The interfering virus does not necessarily have to replicntc to induce interference, and the ab~lity ~ ft l ~ c c challenge virus to replicate may bc completely or only partially inhibited. Some interferons, espec~ally and y, /3 display a certain degree of hcwt species specif~city; instance, mouse interfor ferons arc ineffective in humans, and vice versa. The lnl gene product of tht liu~nanininiunodefic~ens cy virus down-regrrlakes the synthesis uf i71/e1F-2tu k l n a s ~~rliereas, pc~l~ovirus infection appears to degrade the enzymcJ. Influenza virus infection activates a cellular regulator that inhibits induction r l f the kinase. There appears to be one receptor for interferon cu (which can also be utilized by interferon p) and another for interferon y. Binding of interferon y lo its receptor triggers the phosphorylation clC a different transcription factor which recognizes a dilferent regulatory sequence controlling a different set of genes. It has recently become apparent that, although the interferon-treated cell becomes resistant to most viruses, individual interferon-induced protuns are eflectxve only against a limited range of viruses. Interferon itself, in Ihe absence of virus infection, similarly induced prcduction of the Mx protein, in r~itm iii slizlo Transor fect~on cultured Mx- cell lines with Ithe Mx gene converted them permaof nently to a state of resistance to influenza virus Finally, transgenic mlce produced by transfecting the Mx gene into Mx, influenza-suscept~blemlcc were shown to be resistant to chalIengc with influenza virus (but not other viruses} and to make the Mx protern following infection with influenza virus or the administration of interferon Thus it can be seen that the degree of sensitivity of any particular virus to interferon 1s influenced by a complex interplay o f factors determined by the type of interferon, virtls, and host cell. Implicit in this discussion is that inlerfcrc>ns play a significant role in recovery from viral infections. Interferons as Cytokines Interferons were discovered as ant~viral agents, defincd accordingly, and generally regarded as such by virolo)gists for many ycars. R, ctds (1984) V ~ r aCytopathology " C n ~ n p r e l ~ e n s i v c~ r r j l H l V rlgy," Vol 19. L (1901) A n t i v ~ r a lartirrns of ~ n l c r f e r r l n I ~ ~ ( c r f e r o n - r e g u l a l e d l, ccltular proteins a n d L l i c ~ 5urprlslngly s ~ l r c t ~ a n l ~ v i r a a c t i v ~ t ~ e s r vc l Vlrtrkt<y! I02 To cause infection, virilses, Jike other infectious agents, must gain entry to kile body, multiply, and spread, either locally or systemically, and in generalixcd infect~nns localize in the appropriate target organ. To be maintained in nat-urc, infectlous v ~ r i o n smust be shed into tlie environment, nr taken u p by an arthropod vector or a needle, or passed congenifally. Routes of Entry To infcct its host, a virus must first attach to and infcct cells of o n e of tile body surfaces, unless they are bypassed by parenteral inoculation via a wound, needle, or bite o f a n arthropod or vertebrate. The human body can bc rcprescnted diagrammatically a s a svt of surfaces, al each of which a shect of epithelial cells separates host tissue from the outside world (Fig. Particles of 5 Prn or less,ire usually Inhaled directly into the lungs, and some may reach the alveoli, alvcolar epithelial cells or be destroyed by alveolar where virions may ~nfect nincrophages Dr. A11 viruses that Infect the hust via the respiratory tract probably do so by attaching to specific rcrcptors on epithelial cells. Infr*ctionof Clumans vla the Resp~ratory Trart W~th production n f local respiratory symptoms P c r ~ r r i t Cor cr~mrrrrrrfu~* Morl r y r i Rf~l~ioviruscs,1 ~ 1~~I I ~ C ~ I I ~ I I I I S C S 40 lypcs Paralnflr~r~nza vlruhc-? Ir~fluenfavlrrls Ad~trc*a~rfrlnt~ Most typcs Produclr~g gencrali-ird dlseahc, usually withnut inmtral rcslxratory syrnl3lrrms M a n y viruses are accpired by ingcsiion. In general, viruses that cause intestinal ~nfcction, such as enteroviruses, rotavlruses, and calicivjruses (Table 6-2), are acid- and bile-resistant. However, after entry through minor abrasions or by artificial puncture, solme viruses replicate rn the skin to produce local lesions, for ~ x a m p l e,pa pi llomaviruses and poxviruses (Table 6-3). The most efficient way by wliich viruses are introduced through the skin is via the bite of an arthropod vector, such as a mosquito, tick, or sandfIy Suc11 insects niay be mechanical vc>ctrrrs. Viruses that are tsansniittcd by and replicate in arthropod vectc~rs called t1rl~o7~rrrrses are Infection can be acquired through the bite of an animal, as in rables. Generalized infection of the skin, producing a n exanthem such as is found in mcasIes, chicke~ipox, rubella, and several arbovirus diseases, is due to viral disscmi~lationvia the bloodstream. Infection by Other Routes the genital tract is the route of entry of scveral tmportant pathogens. Herpvs simplex viruses and papillomaviruses produce lcs~ons the genitalia and on perineum. Alternatively, they may cause generalized infcuctions, whicli are usually assrjciated with visemia and subsequent localizatioll in particular organs. Macrophage lymphatic Local Spread on Epithelial Surfaces Many viruses replicate in epithelial cells at [he site of entry, produce a localized or spreading infection in the epithelium, and are then shed directly intn the environment. Papillomaviruses initiate iitllection in the basal layer of the epidermis, but n~aturationof virions occurs only it1 cells that have become keratinized as they move toward the skin surface Slnce this is a slorv process, taking several weeks, warts have a long incubation period. Many poxviruses produce infection via the skin, but in addition to spreading from cell to cell, Ehpre is usually also local sub~pilhelialand lymphatic spread. In infection with vaccinia virus a few epidermal cells are infected by scarification and virus spreads IocaIly from cell to ceI1, primarily in the epidermis, before spreading to the local lymph nodes. The poxviruses that cause mollusc~rm contagiusum, orf, and tanapox remain localized in t11e skin and produce lumps. Viruses that enter the body via the intestinal or respiratory tract can spread readily in the layer nf fluid that can transport vir~ons over the moist epithelial surfaces; consequently, such intect~ons usually have a short incubation penod, Atter infections o l the respiratory tract by pararnyxoviruses and influenza virus, or the intestinal tract by rotavin~ses,there is little or n o invasion bryond the epithelium Although these viruses usiially enter lyniphaiics and thus have the potential to spread, they d o not appear to replicate in the dceper tissues, possibly because the appropriate virus receptors or other permissive cellular factors, such as cleavage-activating proteases, are restricted to epithelial cells, or because the lemperature of deeper tissues 3 higher than the optimal temperature for viral replication. The severity of by I(rcal~zedinfections of the respiratory tract depends on their location; infections trC the upper respiratory tract may produce rhinitis but few other signs; infectlor1 of the bronchioles nr alveoli produces more severe respiratory disIrtss and may predispose to secondary bacterial invasion. Virions may he inactivated and processed and tlie~r component antigens presented by macrophages and dendritic cells to adjacent lymphocytes in such a way that a n immune response is initiated (see Chapter 8). Some viruses, however, replicale in cells of the rnonncyte/macrophage lineage; others infect lyrnphncytes. Monocytes and lymphocytes circulate through the body, and there is also a constant movement nf lymphocytes directly from the blood into the lymph nodes, and in thc opposite direction. Local blood vessels arc dilated and rendered more permeable, so that monocytes and lymphocytes, lymphnkines, irnmnnoglobolins, and co~nplernent componenla can be delivered directly to [he site of infection, wilh a consequen! As tifiey enter, they are exposed to macrophages linlng margin- 94 Chapler 6 Mechanisms of Infection c~rlrlnryuirclvin (Fig. Viruses carr~cdIn leukocytes, generally lympliocytes or monnc-ytrs, arc not cleareci as readily or 111 the same way as viruscs c~rculatingfrcc 111 tho plasma; being protected frotn a n tibodies and other p l a s m ccnmponen~sthey can bc carrietf to rhstant lissues Monocytcassocialed v~reniiais a ieaturc of nieaslcs and many herpesvirus infect~ons, for example. Rarely, as in Rift Valley fever and Colorado tick fever, virions may be assoc~atcdwith crylhrncytes. Certain mouse leuken~iaviruses infect megakaryocytes; tlie c~rculating platelets derived from them are infected but d o not appear to be important in the patliogenes~sof viral infecl~ons. NeuIrc~pliilsIiavr a very short life span and powerful antimicrnbial mechanisms; they are rarely infected, altliough they may contain phagocytosed virions. Flepadnaviruses, logaviruses, flaviviruses, and the entcrovfruses [hat cause vire~nia circulate Iree in the plasma.
Purchase keflex 750mg online. Rational Anti-Microbial Chemotherapy and Antibiotic Resistance pt1 Dr. John Heritage.
Pituitary Adenoma Surgical removal is the treatment of choice infection 6 months after surgery 250mg keflex visa, with radiation therapy indicated for medically inoperable cases antibiotics for dogs with swollen glands discount 750mg keflex overnight delivery, recurrence after surgery virus - f order keflex 250mg with mastercard, incomplete resection different antibiotics for sinus infection discount keflex 750 mg otc, or persistence of elevated hormones after resection of functional adenomas. Plantar fasciitis Recent publications, mainly originating in Europe, support the use of radiation therapy to treat plantar fasciitis if conservative measures fail. The typical dose of 1 Gy per week for six weeks was associated with a response rate approaching 80% and durable at 48 weeks. Plasma cell granuloma (benign) Treatment of a true benign plasma cell granuloma is surgical resection. About one third of these will transform into the malignant version if left untreated. Radiation therapy is indicated for those which recur or for more extensive lesions. Radiation therapy has been used in the past for both an attempt at improving fertility (see anovulation) and for the termination of intrauterine or tubal pregnancy (see abortion). Generally radiation is a treatment of last resort and is reserved for inaccessible locations such as the nail beds. Typical radiation treatment utilizes superficial x-ray, electron beam, or complex photon beam therapy in four or fewer fractions. Pterygium the use of radiation to treat a pterygium is supported in the clinical references reviewed. Pyogenic granuloma Despite one case report in the literature of successful treatment of a pyogenic granuloma of the middle ear with radiation, treatment of a pyogenic granuloma is surgical. Rheumatoid arthritis Attempts at treating rheumatoid arthritis with radiation have included single joint external beam radiation, intra-articular infusions of radioactive isotopes, and total lymphoid irradiation for immunosuppression. Rosai-Dorfman Disease Rosai-Dorfman Disease is a rare disorder characterized by a benign histiocyte proliferation. In lesions involving the airway not responding to more conservative measures, radiation therapy has been used with success. When utilized, radiation planning using complex or three-dimensional technique and delivered in up to twenty-two sessions is typical. Policy: cases will require medical review and documentation that non-radiation alternatives have been exhausted. Sarcoidosis If primary medical management fails to control those lesions in need of treatment, the use of radiation therapy is appropriate. Sinusitis Sinusitis caused by infection does not have literature support for treatment by radiation therapy. Splenomegaly Splenomegaly treated by radiation therapy is most commonly caused by leukemic or myeloproliferative diseases, and to a lesser extent by metastases from solid tumors. The policy for the use of radiation therapy in these malignant conditions is not covered in this Guideline for the treatment of non-malignant disorders. However, the use of radiation therapy for the treatment of hypersplenism or splenomegaly caused by a "benign" or pre-malignant myelodysplastic syndrome © 2019 eviCore healthcare. Typically radiation is delivered in ten or fewer sessions, planned using complex or three-dimensional technique. While once common, this procedure has been less frequently performed with the availability of drug eluting stents. Support for this has not continued into newer references other than Pigmented Villonodular Synovitis. There is ample world literature that describes the successful use of radiation to treat insertion tendonitis, a practice that is more common in Europe than the Americas. The mainstay of treatment is conservative using a pharmacologic or physical therapy approach. Typical treatment is with photon beam therapy using, at most, complex treatment planning, and delivered in up to five sessions. Policy: Radiation therapy is medically necessary for those cases not responding to conservative measures and case will require medical review. There are several types of thymoma ranging from the benign medullary thymoma to true invasive thymic carcinomas. There is general agreement that thymomas respond to radiation therapy, but controversy exists on the value of using radiation in low and intermediate stages and grades, especially if encapsulated and fully resected. Radiation therapy is appropriate if unresectable or incompletely resected, particularly if causing a paraneoplastic syndrome. Thyroiditis Presently there is no indication for the use of radiation therapy for the treatment of thyroiditis. Tolosa-hunt syndrome (episodic orbital pain) this is caused by nonspecific inflammation of the cavernous sinus or superior orbital fissure. The successful use of low dose radiation has been reported and may be used as a last resort. Tonsillitis In the modern era of antibiotics, the use of radiation to treat inflamed or infected tonsils is obsolete. Total body irradiation For the preparation of patients for bone marrow or stem cell transplant for malignant disorders, see the Guideline for the primary disease. For non-malignant, pre-malignant and quasi-benign marrow disorders such as aplastic anemia or myelodysplastic disorders, total body irradiation prior to transplant may be appropriate if chemotherapeutic preparation is not possible. The use of total body irradiation for immunosuppression as treatment of totally non-malignant disorders, such as auto-immune diseases is not medically appropriate. Total lymphoid irradiation Total lymphoid irradiation has been used for the purpose of immunosuppression in the treatment of immune-mediated disorders. Further research is needed to establish its role, but it remains an option in situations of chronic rejection in which conventional antirejection treatment is no longer viable. Policy: Requests require medical review and confirmation that alternatives have been exhausted. Trigeminal neuralgia (tic douloureux) Radiation therapy is considered appropriate for cases not responding to conservative management if a surgical approach is not possible for technical or medical reasons. Tuberculosis lymphadenitis Prior to the availability of antibiotics for tuberculosis, lymphadenitis caused by this disease responded to therapeutic radiation. Vernal catarrh this disorder is characterized by inflammation of the conjunctiva associated with infiltration by eosinophils, lymphocytes, plasma cells and histiocytes. The resultant hyperplasia of the conjunctival epithelium may respond to ionizing radiation, but alternative therapy is readily available and the use of radiation is no longer supported in any literature. Warts Older literature describes an 80% response rate in treating warts with a relatively low dose of radiation and it is described in at least one modern text (Gunderson). With the availability of alternative therapy, the use of radiation should be reserved for those cases requiring treatment for which alternative, simpler therapy has been unsuccessful. Committee to Review the Use of Ionizing Radiation for the Treatment of Benign Diseases. Preventing Breast Cancer: the Story of a Major, Proven, Preventable Cause of this Disease. Beyond cancer treatment a review of total lymphoid irradiation for heart and lung transplant recipients. Consensus guidelines for radiation therapy of benign diseases: a multicenter approach in Germany. Radiotherapy for non-malignant disorders: state of the art and update of the evidencebased practice guidelines. Has had or who will undergo curative treatment of the primary tumor (based on T and N stage) and 2. Presents with 1 to 3 metastases in the lung or liver in the synchronous setting and 3. A clinical presentation of one 1 to 3 adrenal gland, lung, liver or bone metastases in the metachronous setting when all the following criteria are met: a. Histology is non-small cell lung, colon, breast, sarcoma, renal cell, or melanoma b. Oligometastatic disease found at the time of the diagnosis of the primary tumor C. Progression of a limited number of metastatic sites while other metastatic disease sites remain controlled.
Diseases