scholarly journals Arterial Calcium Stimulation with Hepatic Venous Sampling in the Localization Diagnosis of Endogenous Hyperinsulinism

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Paloma Moreno-Moreno ◽  
María Rosa Alhambra-Expósito ◽  
Aura Dulcinea Herrera-Martínez ◽  
Rafel Palomares-Ortega ◽  
Luis Zurera-Tendero ◽  
...  
Keyword(s):  
Positive Result ◽  
Surgical Management ◽  
Surgical Procedure ◽  
Statistical Study ◽  
Descriptive Study ◽  
Histopathological Diagnosis ◽  
Imaging Diagnosis ◽  
Venous Sampling ◽  
Histopathologic Diagnosis ◽  
Calcium Stimulation

Objective. The aim of this study was to assess the utility of arterial calcium stimulation with hepatic venous sampling (ASVS) in the localization diagnosis of endogenous hyperinsulinism.Patients and Methods. A retrospective descriptive study was performed including patients with endogenous hyperinsulinism who underwent ASVS. The histopathological diagnosis in patients who underwent a surgical procedure was used as the reference for the statistical study of the accuracy of this technique.Results. 30 patients were included with endogenous hyperinsulinism and nonconclusive imaging diagnosis was included. ASVS was performed in all cases. Surgery was performed in 20 cases. Insulinoma was removed in 19 patients; the location of all cases was detected in the ASVS. All cases of endogenous hyperinsulinism had a positive result for the ASVS, with this association being statistically significant (χ2=15.771;p<0.001). A good and statistically significant agreement was obtained between histopathologic diagnosis and ASVS results (K=0.518,p<0.001).Conclusions. ASVS is a useful procedure in the localization diagnosis of endogenous hyperinsulinism undetected by other imaging tests. This technique allows the localization of intrapancreatic insulinomas and represents useful tool for the diagnosis and surgical management of these tumors.

Which Indexes Are Appropriate Among Those Derived From Selective Arterial Calcium Stimulation and Venous Sampling (ASVS) for Diagnosing Pancreatic Insulinomas?

Pancreas ◽  
2011 ◽  
Vol 40 (2) ◽  
pp. 308-310 ◽  
Author(s):  
Yasutaka Baba ◽  
Sadao Hayashi ◽  
Terutoshi Senokuchi ◽  
Masayuki Nakajo
Keyword(s):  
Venous Sampling ◽  
Calcium Stimulation

scholarly journals Clinicopathological study of thyroid swelling and its management

2020 ◽  
Vol 6 (4) ◽  
pp. 727
Author(s):  
Seema Patel ◽  
Varsha J. Gattani ◽  
Ashok Z. Nitnaware
Keyword(s):  
Papillary Carcinoma ◽  
Surgical Management ◽  
False Negative ◽  
Malignant Lesion ◽  
Nodular Goiter ◽  
Follicular Neoplasm ◽  
Histopathological Diagnosis ◽  
Predictive Values ◽  
Neoplastic Lesion ◽  
Thyroid Swelling

<p class="abstract"><strong>Background:</strong> There is high prevalence of thyroid lesions in India. In this study, an attempt is made to find out the clinical spectrum of thyroid swellings in central India, diagnostic accuracy of fine needle aspiration cytology (FNAC), appropriate surgical management and to compare it with postoperative histopathological diagnosis so as to determine its role in surgical management.</p><p class="abstract"><strong>Methods:</strong> In this prospective study, 100 subjects presenting to ENT OPD of GMC, Nagpur during the period from September 2017 to August 2019 with thyroid swelling who were fit to undergo surgery and willing to participate in the study were selected. After detailed evaluation and routine investigations, thyroid function test (TFT), FNAC, ultrasonography (USG) neck, all the subjects underwent required thyroidectomy. The postoperative histopathological examination (HPE) report was correlated with cytological report.  </p><p class="abstract"><strong>Results:</strong> In 100 subjects, majority of subjects were from 4th decade (32%) with female: male ratio=6.14:1. FNAC findings were colloid goiter (61%), nodular goiter (19%), follicular neoplasm (10%), and papillary carcinoma (9%). On HPE, colloid goitre (57%) was most common non-neoplastic lesion and papillary carcinoma (65.21 %) was most common malignant lesion. Hemithyroidectomy (70%) was most common procedure done. Transient hypocalcemia (5%), recurrent laryngeal nerve (RLN) paresis (2%) were the postoperative complications encountered. Sensitivity, specificity, accuracy, positive and negative predictive values of FNAC to diagnose malignancy were 55.6%, 100%, 91%, 100% and 90% respectively.</p><p class="abstract"><strong>Conclusions:</strong> FNAC is an easy, rapid, reliable, cost-effective, minimally invasive and readily repeatable technique for diagnosis of thyroid swellings. The common false negative diagnosis is seen in follicular pattern cases, cystic papillary thyroid carcinoma (PTC) and papillary microcarcinoma.  </p>

scholarly journals Positive patient experience of wide awake local anaesthesia no tourniquet (WALANT) hand surgery in the government setting: a prospective descriptive study

2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Jaco J Naude ◽  
Odette Koch ◽  
Ludwig W Schmidt ◽  
Theo LB le Roux
Keyword(s):  
Patient Experience ◽  
Carpal Tunnel ◽  
Local Anaesthesia ◽  
Surgical Procedure ◽  
Hand Surgery ◽  
Descriptive Study ◽  
Trigger Finger ◽  
The Mean ◽  
Wide Awake ◽  
No Tourniquet

ABSTRACT BACKGROUND: The purpose of this study was to establish a subjective patient experience with wide awake local anaesthesia no tourniquet (WALANT) procedures performed in the institution from May 2019 to March 2020. WALANT surgery was initiated to improve standard operating procedure and to decrease theatre burden METHODS: This prospective, descriptive study included 100 patients with a mean age of 59 years who required either a carpal tunnel or trigger finger release. The patients' pain experience was documented on the visual analogue scale (VAS) for the local anaesthetic injection and the surgical procedure. Overall experience was assessed on the patient's preference to have the procedure performed by the WALANT method or the conventional method RESULTS: One hundred patients were included, of which 67 had medical comorbidities. The mean VAS score was 1.5 (SD±1.6) with pain on injection. The mean VAS pain score during the surgical procedure was 0.2 (SD±0.7). One hundred per cent of patients (100/100) felt they would do the WALANT outpatient procedure again instead of admission to hospital and surgery in the theatre. Two complications occurred related to wound care problems, and were successfully managed. None of the patients required reoperations for incomplete release of the carpal tunnel or trigger finger surgery CONCLUSION: The results of this study suggest that minor hand surgery using the WALANT protocol can be performed effectively and with high patient satisfaction rates in the orthopaedic outpatient clinic, and is a useful tool in the skillset of a hand surgeon Level of evidence: Level 4 Keywords: WALANT, hand surgery, trigger finger, carpal tunnel release

scholarly journals AGREEMENT BETWEEN DIFFERENT PATHOLOGISTS IN HISTOPATHOLOGIC DIAGNOSIS OF 128 GASTRIC POLYPS

2017 ◽  
Vol 54 (3) ◽  
pp. 263-266 ◽  
Author(s):  
Sérgio Henrique Brito BARBOSA ◽  
Geraldo Cezário de LÁZARO FILHO ◽  
Luciano Monteiro FRANCO ◽  
José Telmo VALENÇA JUNIOR ◽  
Miguel Ângelo NOBRE E SOUZA ◽  
...  
Keyword(s):  
University Hospital ◽  
Histopathological Diagnosis ◽  
Fundic Gland ◽  
Digestive Endoscopy ◽  
Hyperplastic Polyps ◽  
Kappa Index ◽  
Substantial Agreement ◽  
Gastric Polyps ◽  
Fundic Gland Polyps ◽  
Histopathologic Diagnosis

ABSTRACT BACKGROUND - Gastric polyps are elevated mucosal lesions. Most of them are less than 1 cm and when larger than 2 cm, has a high malignancy probability. The histopathological types are mainly fundic gland polyps, hyperplastic polyps and adenomatous polyps. OBJECTIVE - To evaluate the agreement between three different pathologists in the histopathological diagnosis of 128 biopsied gastric polyps in Digestive Endoscopy Unit from Walter Cantídeo University Hospital, between May 2010 to May 2012. METHODS - To describe the intensity of agreement between observers, we use kappa index that is based on the number of concordant measures between them. RESULTS - There was substantial agreement in the diagnosis of adenoma (kappa=0.799, CI: 0.899-0.698) and fundic glands (kappa=0.655, CI: 0.755-0.555). Regarding to hyperplastic polyps (kappa=0.415, CI: 0.515-0.315) and inflammatory (kappa=0.401, CI: 0.501-0.301), we obtained a moderate agreement. Regarding the presence of Helicobacter pylori in biopsy of the polyp, there was a low agreement (kappa=0.219, CI: 0.319-0.119). CONCLUSION - It is clear that the agreement between pathologists depends on the histological type of the biopsied polyp and this agreement is more substantial in adenoma, or fundic gland polyps.

scholarly journals Epidemiology of burn injury in older adults: An Australian and New Zealand perspective

2020 ◽  
Vol 6 ◽  
pp. 205951312095233
Author(s):  
Lincoln M Tracy ◽  
Yvonne Singer ◽  
Rebecca Schrale ◽  
Jennifer Gong ◽  
Anne Darton ◽  
...  
Keyword(s):  
Older Adults ◽  
New Zealand ◽  
Older Adult ◽  
Surgical Management ◽  
Surgical Procedure ◽  
Burn Injury ◽  
Burn Injuries ◽  
Younger Patients ◽  
Care Community ◽  
Burn Care

Introduction: The ageing global population presents a novel set of challenges for trauma systems. Less research has focused on the older adult population with burns and how they differ compared to younger patients. This study aimed to describe, and compare with younger peers, the number, causes and surgical management of older adults with burn injuries in Australia and New Zealand. Methods: The Burns Registry of Australia and New Zealand was used to identify patients with burn injuries between 1 July 2009 and 31 December 2018. Temporal trends in incidence rates were evaluated and categorised by age at injury. Patient demographics, injury severity and event characteristics, surgical intervention and in-hospital outcomes were investigated. Results: There were 2394 burn-injured older adults admitted during the study period, accounting for 13.4% of adult admissions. Scalds were the most common cause of burn injury in older adults. The incidence of older adult burns increased by 2.96% each year (incidence rate ratio = 1.030, 95% confidence interval = 1.013–1.046, P < 0.001). Compared to their younger peers, a smaller proportion of older adult patients were taken to theatre for a surgical procedure, though a larger proportion of older adults received a skin graft. Discussion: Differences in patient and injury characteristics, surgical management and in-hospital outcomes were observed for older adults. These findings provide the Australian and New Zealand burn care community with a greater understanding of burn injury and their treatments in a unique group of patients who are at risk of poorer outcomes than younger people. Lay Summary The number and proportion of older persons in every country of the world is growing. This may create challenges for healthcare systems. While burn injuries are a unique subset of trauma that affect individuals of all ages, less is known about burns in older adults and how they differ from younger patients. We wanted to look at the number, type, management, and outcomes of burns in older adults in Australia and New Zealand. To do this, we used data from the Burns Registry of Australia and New Zealand, or BRANZ. The BRANZ is a database that collects information on patients that present to Australian and New Zealand hospitals that have a specialist burns unit. Our research found that one in eight adult burns patients was over the age of 65, and that the rate of burn injuries in older adults has increased over the last decade. Older adult burns patients were most commonly affected by scalds after coming in contact with wet heat such as boiling liquids or steam. Fewer older adults went to theatre for an operation or surgical procedure compared to their younger counterparts. However, a larger proportion of older adults that went to theatre had a skin graft (where skin is removed from an uninjured part of the body and placed over the injured part). This research provides important information about a unique and growing group of patients to the local burn care community. It also highlights potential avenues for injury prevention initiatives.

scholarly journals Tangential Biopsy Thickness versus Lesion Depth in Longitudinal Melanonychia: A Pilot Study

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Nilton Di Chiacchio ◽  
Walter Refkalefsky Loureiro ◽  
Nilceo Schwery Michalany ◽  
Felipe Veiga Kezam Gabriel
Keyword(s):  
Nail Plate ◽  
Histopathological Diagnosis ◽  
Total Thickness ◽  
Thickness Measure ◽  
Histopathologic Diagnosis ◽  
The Matrix ◽  
General Average ◽  
The Mean ◽  
Longitudinal Melanonychia ◽  
Hematoxylin Eosin

Longitudinal melanonychia can be caused by melanocyte activation (hypermelanosis) or proliferation (lentigo, nevus or melanoma). Histopathologic examination is mandatory for suspicious cases of melanomas. Tangential biopsy of the matrix is an elegant technique avoiding nail plate dystrophy, but it was unknown whether the depth of the sample obtained by this method is adequate for histopathologic diagnosis. Twenty-two patients with longitudinal melanonychia striata were submitted to tangential matrix biopsies described by Haneke. The tissue was stained with hematoxylin-eosin and the specimens were measured at 3 distinct points according to the total thickness: largest (A), intermediate (B) and narrowest (C) then divided into 4 groups according to the histopathologic diagnosis (G1: hypermelanosis; G2: lentigos; G3: nevus; G4: melanoma). The lesions were measured using the same method. The mean specimen/lesion thickness measure values for each group was: G1: 0,59/0,10 mm, G2: 0,67/0,08 mm, G3: 0,52/0,05 mm, G4: 0,58/0,10 mm. The general average thickness for all the specimens/lesions was 0,59/0,08 mm. We concluded that the tangential excision, for longitudinal melanonychia, provides an adequate material for histopathological diagnosis.

Selective Arterial Calcium Stimulation and Hepatic Venous Sampling in the Evaluation of Hyperinsulinemic Hypoglycemia: Potential and Limitations

2004 ◽  
Vol 15 (11) ◽  
pp. 1251-1256 ◽  
Author(s):  
Peter Wiesli ◽  
Michael Brändle ◽  
Christoph Schmid ◽  
Lukas Krähenbühl ◽  
Jürg Furrer ◽  
...  
Keyword(s):  
Hyperinsulinemic Hypoglycemia ◽  
Venous Sampling ◽  
Calcium Stimulation

scholarly journals Essentials of Insulinoma Localization with Selective Arterial Calcium Stimulation and Hepatic Venous Sampling

2020 ◽  
Vol 9 (10) ◽  
pp. 3091
Author(s):  
Ken Zhao ◽  
Nihal Patel ◽  
Kopal Kulkarni ◽  
Jonathan S. Gross ◽  
Bedros Taslakian
Keyword(s):  
Nuclear Imaging ◽  
Invasive Procedure ◽  
Pancreatic Neuroendocrine Tumor ◽  
Venous Sampling ◽  
Cross Sectional ◽  
Arterial Perfusion ◽  
Non Invasive ◽  
Calcium Stimulation ◽  
Invasive Techniques ◽  
Proper Interpretation

Insulinomas are the most common functional pancreatic neuroendocrine tumor. Most insulinomas can be localized non-invasively with cross-sectional and nuclear imaging. Selective arterial calcium stimulation and hepatic venous sampling is an effective and safe minimally-invasive procedure for insulinoma localization that may be utilized when non-invasive techniques are inconclusive. The procedure’s technical success and proper interpretation of its results is dependent on the interventional radiologist’s knowledge of normal and variant pancreatic arterial perfusion. Accurate pre-operative localization aids in successful surgical resection. Technical and anatomic considerations of insulinoma localization with selective arterial calcium stimulation and hepatic venous sampling are reviewed.

A Surgical Alternative to Internal Maxillary Artery Ligation for Posterior Epistaxis

1984 ◽  
Vol 92 (4) ◽  
pp. 427-433 ◽  
Author(s):  
Robert G. Anderson ◽  
Donelson N. Shannon ◽  
Steven D. Schaefer ◽  
Lewis A. Raney
Keyword(s):  
Nasal Cavity ◽  
Surgical Management ◽  
Surgical Procedure ◽  
Lateral Displacement ◽  
Maxillary Artery ◽  
Internal Maxillary Artery ◽  
Artery Ligation ◽  
Ethmoidal Arteries ◽  
Considerable Morbidity

Posterior epistaxis is a disease of varying magnitude and is associated with considerable morbidity. Surgical management often consists of transantral ligation of the internal maxillary artery and its branches, with or without ligation of the ethmoidal arteries. Ten patients underwent an alternative surgical procedure in which the nasopharynx and posterior nasal cavity were indirectly examined for bleeding sites with a large laryngeal mirror. Nasal septal reconstruction with mobilization of the anterior cartilaginous septum from the maxillary crest allowed lateral displacement of the septum with excellent visualization of the lateral nasal walls. Hemorrhage was controlled by electrocoagulation of bleeding sites with a disposable, malleable suction electrocautery. No complications occurred in this group of 10 patients and no further epistaxis has been reported during a follow-up of 17 to 35 months.

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