scholarly journals Spontaneous and Traumatic Splenic Rupture: Retrospective Clinical, B-Mode and CEUS Analysis in 62 Patients

2018 ◽  
Vol 04 (01) ◽  
pp. E30-E34 ◽  
Author(s):  
M. Rosling ◽  
C. Trenker ◽  
A. Neesse ◽  
C. Görg
Keyword(s):  
Clinical Data ◽  
Clinical Characteristics ◽  
Splenic Rupture ◽  
Tertiary Referral ◽  
Course Of Disease ◽  
Tertiary Referral Center ◽  
Contrast Enhanced ◽  
Patients At Risk ◽  
Traumatic Splenic Rupture ◽  
Sonographic Pattern

Abstract Introduction Both B-mode ultrasound and contrast-enhanced ultrasound (CEUS) are well established procedures when diagnosing traumatic splenic ruptures (TSR). To date, there are no data about CEUS patterns in spontaneous splenic ruptures (SSR). It remains unknown whether TSR and SSR differ with respect to clinical characteristics, B-mode and CEUS characteristics. Patients and Methods Between 12/2003 and 2/2010, n=33 SSRs and n=29 TSRs were diagnosed in a tertiary referral center. All patients were examined with B-mode and CEUS, and clinical data and the outcome were retrospectively analyzed. Results Patients with SSR were significantly older than patients with TSR (62 years vs. 44 years; p=0.01). The 4-week mortality was significantly higher in SSR than in TSR (36% vs. 0%; p=0.001). No differences between the grading of TSR and SSR could be shown in B-mode or in CEUS. Notably, CEUS was significantly superior to B-mode with respect to the grading of splenic ruptures (p=0.01). Therefore, therapeutic management was influenced by CEUS. Conclusion There are differences between SSR and TSR, especially concerning clinical data (age, course of disease and mortality). Regarding the sonographic pattern, SSR and TSR show identical grading. When splenic rupture is suspected, CEUS should always be performed to identify patients at risk who require interventional procedures.

scholarly journals Higher Risk of Aggressive Pancreatic Neuroendocrine Tumors in MEN1 Patients With MEN1 Mutations Affecting the CHES1 Interacting MENIN Domain

2014 ◽  
Vol 99 (11) ◽  
pp. E2387-E2391 ◽  
Author(s):  
Detlef K. Bartsch ◽  
Emily P. Slater ◽  
Max Albers ◽  
Richard Knoop ◽  
Brunhilde Chaloupka ◽  
...  
Keyword(s):  
Multiple Endocrine Neoplasia ◽  
Multiple Endocrine Neoplasia Type ◽  
Clinical Phenotype ◽  
Tertiary Referral ◽  
Course Of Disease ◽  
Tertiary Referral Center ◽  
Checkpoint Kinase 1 ◽  
Related Mortality

Context: Sixty to 80% of multiple endocrine neoplasia type 1 (MEN1) patients develop pancreatic neuroendocrine neoplasias (pNENs), which reveal an aggressive behavior in 10%-20% of patients. Causative MEN1 mutations in the interacting domains of the encoded Menin protein directly alter its regulation abilities and may influence the phenotype. Objective: The objective of the study was the evaluation of an association between MEN1 mutations in different interacting domains of Menin and the phenotype of pNENs. Design: This was a retrospective analysis of a prospectively collected cohort of 71 genetically confirmed MEN1 patients at a tertiary referral center. Main Outcome Measures: Analysis of patients' characteristics and clinical phenotype of pNENs regarding the mutation type and its location in Menin interacting domains was measured. Results: Sixty-seven patients (93%) developed pNENs after a median follow-up of 134 months. Patients with mutations leading to loss of interaction (LOI) with the checkpoint kinase 1 (CHES1) interacting domain codons (428–610) compared with patients with mutations resulting in LOI with other domains (eg, JunD, Smad3) had significantly higher rates of functioning pNENs (70% vs 34%), malignant pNENs (59% vs 16%), and aggressive pNENs (37% vs 9%), respectively. Patients with CHES1-LOI also had an increased pNEN-related mortality (20% vs 4.5%). Neither gender, age, nor the ABO blood types were associated with the phenotype of pNENs. Conclusions: MEN1 patients with MEN1 mutations leading to CHES1-LOI have a higher risk of malignant pNENs with an aggressive course of disease and disease-related death.

Epidemiology, clinical characteristics, and outcome of candidemia in a tertiary referral center in Italy from 2010 to 2014

Infection ◽  
2015 ◽  
Vol 44 (2) ◽  
pp. 205-213 ◽  
Author(s):  
Francesco Barchiesi ◽  
◽  
Elena Orsetti ◽  
Rosaria Gesuita ◽  
Edlira Skrami ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Referral Center

The willingness of patients to participate in an eye donation registry for research

2020 ◽  
Author(s):  
Muriel B. Huss ◽  
Steffen Schmitz-Valckenberg ◽  
Robert P. Finger ◽  
Karin U. Löffler ◽  
Monika Fleckenstein ◽  
...  
Keyword(s):  
Clinical Data ◽  
Positive Attitude ◽  
Great Benefit ◽  
Tissue Donation ◽  
Post Mortem ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Referral Center ◽  
Eye Donation

Introduction: For ophthalmologic research, the systematic correlation of clinical data with data obtained from postmortem tissue donation is of great benefit. In this respect, the establishment of an eye donation registry represents a prerequisite for the acquisition of such data. Methods: A total of 300 patients were interviewed at a tertiary referral center in Germany by means of a standardized questionnaire. Binary questions were evaluated by percentage; Likert-scaled questions (1= does apply; 5 = does not apply) were analyzed by median and 25th (Q25) and 75th (Q75) percentile. Results: The majority of patients (77.0%) would agree to donate their eyes for research purposes. When asked about reasons against an eye donation, 60.9% of all patients did only state reasons of the category “addressable” (e.g. not enough awareness of the topic). The vast majority of patients considered it appropriate for an ophthalmologist to approach them on the issue of postmortem eye donation (1[1;1]). Conclusion: Overall, patients had a positive attitude towards postmortem eye donation for research purposes. Importantly, reasons given against post-mortem eye donation were often related to misconceptions and were potentially addressable. These results underline the fundamental willingness of patients in Germany to donate their eyes post-mortem for research purposes.

Long-Term Outcomes and Clinical Characteristics of Hypnic Headache Syndrome: 40 Patients Series From a Tertiary Referral Center

2016 ◽  
Vol 56 (4) ◽  
pp. 717-724 ◽  
Author(s):  
Nauman Tariq ◽  
Emad Estemalik ◽  
Brinder Vij ◽  
Jennifer S. Kriegler ◽  
Stewart J. Tepper ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Long Term Outcomes ◽  
Tertiary Referral ◽  
Hypnic Headache ◽  
Tertiary Referral Center ◽  
Referral Center ◽  
Headache Syndrome

Clinical characteristics of microscopic Colitis in a single tertiary referral center

2015 ◽  
Vol 53 (05) ◽  
Author(s):  
VÁ Patai ◽  
C Csóka ◽  
Á Csontos ◽  
T Micsik ◽  
M Juhász ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Microscopic Colitis ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Referral Center

scholarly journals Diagnosis and Treatment of Atraumatic Splenic Rupture: Experience of 8 Cases

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Jian Liu ◽  
Yanyu Feng ◽  
Ang Li ◽  
Chunqing Liu ◽  
Fei Li
Keyword(s):  
Splenic Rupture ◽  
Diagnosis And Treatment ◽  
Etiological Factors ◽  
Contrast Enhanced ◽  
Life Threatening ◽  
Grade Ii ◽  
Atraumatic Splenic Rupture ◽  
Total Splenectomy ◽  
Traumatic Splenic Rupture ◽  
Enhanced Computed Tomography

Atraumatic splenic rupture (ASR) is rare but life threatening. In this study, we retrospectively described our experience on the diagnosis and treatment of 8 patients (male: 6; female: 2; mean age: 49.6) with ASR. ASR accounted for 3.2% (8/251) of the splenic ruptures. The clinical presentation of ASR was similar to traumatic splenic rupture (TSR). The sensitivity of ultrasound and contrast-enhanced computed tomography (CECT) in ASR diagnosis was 57.1% and 85.7%, respectively. According to the classification of the American Association for the Surgery of Trauma (AAST), 2 cases were classified as grade II splenic ruptures, 4 cases were classified as grade III ruptures, 1 case was classified as grade IV rupture, and 1 case was not classified. All the spleens became swollen, and hematomas were observed in 6 patients. Total splenectomy was recommended in most cases. At least 62.5% (5/8) of the patients with 7 etiological factors belonged to “atraumatic-pathological splenic rupture.” Local inflammation and cancer were the most common etiological factors.

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