Evaluation of pancreatic cyst prostaglandin E2 as a Marker for Differentiation between Mucinous and Non Mucinous Cysts and Prediction of Dysplasia in Mucinous Pancreatic Cysts

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Tarek Yousef ◽  
Hussein Okasha ◽  
Shereen Abo Bakr Saleh ◽  
Hagar Ahmed Ahmed Elessawy
Keyword(s):  
Prostaglandin E2 ◽  
University Hospital ◽  
Pancreatic Cysts ◽  
Cystic Lesions ◽  
Radiological Findings ◽  
Cystic Fluid ◽  
Treatment Plans ◽  
Group 2 ◽  
Control Study ◽  
Group 1

Abstract Background There are different types of pancreatic cysts.They can be classified by different ways. Each of them has different plan of management. that is why their differentiation became mandatory before setting their treatment plans. Aim of the study To Evaluate PGE2 as a marker of differentiation of mucin containing pancreatic cysts and prediction of dysplasia in these cyst. A Secondary aim is differentiation of mucin from non mucin containing pancreatic cystic lesions Patients and Methods 40 patients were recruited from the Department of Internal Medicine and the Outpatient Clinic of Cairo University hospital in the period between December 2018 and August 2019. A case control study design was adopted where the patients were grouped as follow : Group 1 - composed of 20 patients with pancreatic mucinous cystic lesions defined by EUS guided samples, Histopathology and Radiological findings. Group 2: - composed of 20 patients with pancreatic non mucinous cystic lesions defined by EUS guided samples, Histopathology and Radiological findings. Results In our study, there was a significant differences in PGE2 level between true and inflammatory pancreatic cysts (p = 0.001) .However, there is insignificant differences between mucinous, non mucinous (p = 0.406). There was insignificant differences between different grades of IPMN dysplasia (p = 0.615) Conclusion Prostaglandin E2 is pancreatic cystic fluid marker which can be used for differentiation between true pancreatic cysts from inflammatory pancreatic cysts which have different plans of management. Prostaglandin E2 is not good marker to be used for differentiation between different grades of IPMN dysplasia.

scholarly journals High-security closed devices are efficient and safe to protect human oocytes from potential risk of viral contamination during vitrification and storage especially in the COVID-19 pandemic

2021 ◽  
Author(s):  
Eleonora Porcu ◽  
Maria Lucrezia Tranquillo ◽  
Leonardo Notarangelo ◽  
Patrizia Maria Ciotti ◽  
Nilla Calza ◽  
...  
Keyword(s):  
Research Question ◽  
Randomized Study ◽  
Implantation Rate ◽  
University Hospital ◽  
Miscarriage Rate ◽  
Human Oocytes ◽  
High Security ◽  
Group 2 ◽  
And Storage ◽  
Group 1

Abstract Purpose The main purpose and research question of the study are to compare the efficacy of high-security closed versus open devices for human oocytes’ vitrification. Methods A prospective randomized study was conducted. A total of 737 patients attending the Infertility and IVF Unit at S.Orsola University Hospital (Italy) between October 2015 and April 2020 were randomly assigned to two groups. A total of 368 patients were assigned to group 1 (High-Security Vitrification™ - HSV) and 369 to group 2 (Cryotop® open system). Oocyte survival, fertilization, cleavage, pregnancy, implantation, and miscarriage rate were compared between the two groups. Results No statistically significant differences were observed on survival rate (70.3% vs. 73.3%), fertilization rate (70.8% vs. 74.9%), cleavage rate (90.6% vs. 90.3%), pregnancy/transfer ratio (32.0% vs. 31.8%), implantation rate (19.7% vs. 19.9%), nor miscarriage rates (22.1% vs. 21.5%) between the two groups. Women’s mean age in group 1 (36.18 ± 3.92) and group 2 (35.88 ± 3.88) was not significantly different (P = .297). A total of 4029 oocytes were vitrified (1980 and 2049 in groups 1 and 2 respectively). A total of 2564 were warmed (1469 and 1095 in groups 1 and 2 respectively). A total of 1386 morphologically eligible oocytes were inseminated by intracytoplasmic sperm injection (792 and 594 respectively, P = .304). Conclusions The present study shows that the replacement of the open vitrification system by a closed one has no impact on in vitro and in vivo survival, development, pregnancy and implantation rate. Furthermore, to ensure safety, especially during the current COVID-19 pandemic, the use of the closed device eliminates the potential samples’ contamination during vitrification and storage.

scholarly journals Clinical Utilization of Point-of-care Ultrasound After Training: A Prospective Study

2021 ◽  
Author(s):  
Wan-Ching Lien ◽  
Chih-Heng Chang ◽  
Kah-Meng Chong ◽  
Meng-Che Wu ◽  
Cheng-Yi Wu ◽  
...  
Keyword(s):  
Image Quality ◽  
Positive Impact ◽  
University Hospital ◽  
Point Of Care Ultrasound ◽  
Global Rating ◽  
Clinical Trial Registration ◽  
Clinical Utilization ◽  
Global Ratings ◽  
Group 2 ◽  
Group 1

Abstract Background: This study aimed to investigate the clinical utilization of PoCUS of the first post-graduate year residents after a PoCUS curriculum. Methods: It was conducted at the emergency department of the National Taiwan University Hospital between July 2015 and October 2017. Every resident had one-month ED training and a curriculum was implemented during the first week. The post-training objective structured clinical examination (OSCE) global ratings were obtained, as well as the sonographic examinations by the residents. The participants were categorized into 4 groups: group 1 performed PoCUS before and after the curriculum; group 2 performed only after the curriculum; group 3 performed only before the curriculum; the last did not perform any examinations. Results: Two hundred and thirty-nine residents participated. The median global rating was 4 (interquartile ranges, 4-5). A significantly increasing number of residents integrated PoCUS into patient care (64 vs. 170, p=0.037) with acceptable image quality after the curriculum. Nearly 30% of residents did not use PoCUS although no differences existed in the OSCE global ratings. Group 1 performed more cases with better image quality and using ≥2 ultrasound applications (8/100 vs. 82/359, p=0.0009) after the curriculum. Group 1 performed more cases with better image quality than group 2 after the curriculum. In groups 3 and 4, “no suitable cases” (25/69), and “choosing other imaging priorities” (43/69) were the main feedbacks for not performing PoCUS. Conclusions: A focused training had a substantial positive impact on the utilization of PoCUS of the residents. The global ratings could not predict whether to integrate PoCUS into clinical practice. Further studies would be needed for the sustained effects of the curriculum and how to encourage these residents in groups 3 and 4 to use PoCUS.Clinical trial registration: NCT03738033.

scholarly journals Is low antiepileptic drug dose effective in long-term seizure-free patients?

2003 ◽  
Vol 61 (3A) ◽  
pp. 566-573 ◽  
Author(s):  
Tânia A.M.O. Cardoso ◽  
Fernando Cendes ◽  
Carlos A.M. Guerreiro
Keyword(s):  
Risk Factors ◽  
Antiepileptic Drug ◽  
Randomized Study ◽  
Drug Dose ◽  
University Hospital ◽  
Seizure Recurrence ◽  
Partial Group ◽  
Group 2 ◽  
Group 1

OBJECTIVE: To investigate the value of leaving seizure-free patients on low-dose medication. METHOD: This was an exploratory prospective randomized study conducted at our University Hospital. We evaluated the frequency of seizure recurrence and its risk factors following complete or partial antiepileptic drug (AED) withdrawal in seizure free patients for at least two years with focal, secondarily generalized and undetermined generalized epilepsies. For this reason, patients were divided into two groups: Group 1 (complete AED withdrawal), and Group 2 (partial AED withdrawal). Partial AED withdrawal was established as a reduction of 50% of the initial dose. Medication was tapered off slowly on both groups. Follow-up period was 24 months. RESULTS: Ninety-four patients were followed up: 45 were assigned to complete (Group 1) AED withdrawal and 49 to partial (Group 2) AED withdrawal. Seizure recurrence frequency after two years follow-up were 34.04% in group 1 and 32.69% in Group 2. Survival analysis showed that the probability of remaining seizure free at 6, 12, 18 and 24 months after randomization did not differ between the two groups (p = 0.8). Group 1: 0.89, 0.80, 0.71 and 0.69; group 2: 0.86, 0.82, 0.75 and 0.71. The analysis of risk factors for seizure recurrence showed that more than 10 seizures prior to seizure control was a significant predictive factor for recurrence after AED withdrawal (hazard ratio = 2.73). CONCLUSION: Leaving seizure free patients on low AED dose did not reduce the risk for seizure recurrence. That is, once the decision of AED withdrawal has been established, it should be complete.

scholarly journals 353. A Comparison Study of Prevalence and Risk Factors for Nonalcoholic Fatty Liver Disease (NAFLD) and Nonalcoholic Steatohepatitis (NASH) by Transient Elastography (TE) in HIV-Infected Patients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S186-S186
Author(s):  
Sunny Choe ◽  
Hend Al-Saleh ◽  
James Fallon ◽  
Herbert Galang ◽  
Justin Mathew ◽  
...  
Keyword(s):  
Risk Factors ◽  
Transient Elastography ◽  
Medical Center ◽  
University Hospital ◽  
Lower Percentage ◽  
Strand Transfer ◽  
Nonalcoholic Fatty Liver ◽  
Virus Load ◽  
Group 2 ◽  
Group 1

Abstract Background There are limited data on the prevalence and risk factors of NAFLD and NASH in HIV-infected individuals receiving ART. A large study on this subject was presented at Glasgow 2018, from the University Hospital of Palermo (UHP). Methods We prospectively collected data on epidemiology, comorbidities, CD4, HIV virus load and ART from November 2017 to September 2018 in patients undergoing TE examination with Controlled Attenuation Parameter (CAP) in our HIV clinic at Saint Michael’s Medical Center in Newark, NJ. We used the same parameters to define NAFLD and fibrosis severity that were used for the UHP (CAP >248 dB/m and TE > 7.1 Kpa). We present comparative data between those 2 cohorts. Results We enrolled 624 consecutive HIV-infected individuals (group 1) their baseline epidemiologic characteristics were not significantly different from the UHP cohort (group 2) for age and sex. Prevalence of NAFLD was 51.6% in group 1compared with 42.7% in group 2, and the prevalence of significant fibrosis in those with NAFLD was 31% in group 1, and 23% in group 2. The main differences we found between those 2 cohorts were race: group 1, 68% black and group 2, 87% White, incidence of Diabetes mellitus was 20% in group 1, and 6% in group 2, despite the fact that BMI was not significantly higher in group 1. Other important differences were the mean time on ART, it was 5 years longer for group 1. Finally, there was a trend for a higher incidence of hypertension, a lower percentage of patients with Virus load < 20 c/mL, a lower mean CD4 count, and a higher percentage of integrase strand transfer inhibitors current users in group1. Conclusion NAFLD prevalence is alarming high in patients with HIV disease, it is of utmost importance to understand its natural history, in order to prevent the potentially severe consequences of NASH. Our study suggests that a longer duration on ART might correlate with higher incidence of NAFLD, which would suggest better monitoring of liver health with new ART. Disclosures All authors: No reported disclosures.

scholarly journals Impact of neoadjuvant therapy in downstaging of lower rectal adenocarcinoma and the role of pelvic magnetic resonance in staging

2016 ◽  
Vol 43 (2) ◽  
pp. 102-109 ◽  
Author(s):  
Karina Dagre Magri ◽  
Fang Chia Bin ◽  
Fernanda Bellotti Formiga ◽  
Thiago da Silveira Manzione ◽  
Caroline Merci Caliari de Neves Gomes ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Neoadjuvant Therapy ◽  
Rectal Adenocarcinoma ◽  
Resonance Imaging ◽  
Radiological Findings ◽  
Pelvic Magnetic Resonance Imaging ◽  
Group 2 ◽  
Locoregional Staging ◽  
Group 1

ABSTRACT Objective: to evaluate the effect of neoadjuvant therapy on the stage (TNM) of patients with rectal adenocarcinoma and validate the use of MRI as a method of determining locoregional stage. Methods: we conducted a retrospective study of 157 patients with lower rectum adenocarcinoma, whom we divided into two groups: Group 1, 81 patients (52%) who had undergone surgical treatment initially, with the purpose to analyze the accuracy of locoregional staging by pelvic magnetic resonance imaging throug the comparison of radiological findings with pathological ones; Group 2, 76 patients (48%), who had been submitted to neoadjuvant therapy (chemotherapy and radiation) prior to definitive surgical treatment, so as to evaluate its effects on the stage by comparing clinical and radiological findings with pathology. Results: In group 1, the accuracy of determining tumor depth (T) and lymph node involvement (N) was 91.4% and 82.7%, respectively. In group 2, neoadjuvant therapy decreased the T stage, N stage and TNM stage in 51.3%, 21% and 48.4% of cases, respectively. Conclusion: neoadjuvant therapy in patients with rectal adenocarcinoma is effective in decreasing disease stage, and pelvic magnetic resonance imaging is effective for locoregional staging.

scholarly journals Zinc supplementation in preterm neonates with jaundice: is it beneficial?

2020 ◽  
Vol 21 ◽  
Author(s):  
Mohamed Shawky Elfarargy ◽  
Ghada M Al-Ashmawy ◽  
Sally Abu-Risha
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Zinc Supplementation ◽  
University Hospital ◽  
Preterm Neonates ◽  
P Value ◽  
Indirect Bilirubin ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Background: Neonatal jaundice is a common neonatal disease which had adverse effect in the neonates especially preterm neonates when the level of indirect bilirubin is high enough to pass the blood brain barrier causing bilirubin encephalopathy or kernicterus. Aim: The aim of this study is to investigate the value of zinc (Zn) supplementation in preterm neonates with jaundice and if it will be beneficial or not. Patients and methods: A prospective randomized clinical trial (RCT) study, identification number is TCTR20200504007, which was done at Tanta University Hospital (TUH) from July 2016 to March 2018 on 200 preterm neonates suffering from neonatal jaundice. The studied neonates were divided into 2 groups: group 1, which received Zn and phototherapy, and group 2, which received phototherapy only and did not take Zn. In the group 1, 100 preterm neonates with jaundice received Zn as 0.6 ml(cm3 ) of zinc origin/kg/day orally through oro/nasogastric tube divided into 2 doses (/12 hours) which is equal 1.2 mg elemental zinc/kg/day orally for 10 day. Results: There was no significant difference in serum bilirubin between the 2 groups in the 2nd, 4th and 6th day of admission while the serum bilirubin was significantly decreased in neonates who were treated by Zn and phototherapy in group 1, compared with neonates of group 2 who were treated with phototherapy only in the 8th , 9th and 10th day of admission where the p value was 0.045* ,0.027* and 0.004* respectively. Conclusion: Zn administration in jaundiced preterm neonates is beneficial in decreasing serum bilirubin. Recommendation: Zn supplementation for jaundiced preterm neonates.

scholarly journals Prevalence of HPV in Adolescents Virgins and Sexually Active at a University Hospital in the City of Rio de Janeiro, Brazil

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Renata Mírian Nunes Eleutério ◽  
Marco Aurélio Pinho de Oliveira ◽  
Cláudia Márcia de Azevedo Jacyntho ◽  
Josele de Freitas Rodrigues ◽  
Diane Isabelle Magno Cavalcante ◽  
...  
Keyword(s):  
Sexual Activity ◽  
Sexual Intercourse ◽  
Rio De Janeiro ◽  
Hpv Infection ◽  
University Hospital ◽  
Hpv Dna ◽  
Sexually Transmitted ◽  
History Of ◽  
Group 2 ◽  
Group 1

Sexually transmitted diseases (STDs) are common worldwide, with especially alarming numbers in Brazil. Among the most common infections is human papillomavirus (HPV). The possibility of the nonsexual transmission of HPV is not well defined and is the subject of debate. This study aimed to identify the prevalence of HPV in adolescents with no history of sexual intercourse compared with a group of similar age with sexual activity. 100 adolescents were evaluated with at least two years after menarche, who attended from January 2007 to January 2009 at the University Hospital Pedro Ernesto, Rio de Janeiro, Brazil. Among the adolescents, 50 had intact hymen and 50 reported regular sexual activity. For patients without sexual intercourse (group 1) we collected material from vestibule and for patients with sexual activity (group 2) we collected material from vagina and endocervix. The search for HPV-DNA 2nd generation hybrid capture (hC2) was performed. In group 1 the test was positive in 3 cases (6%). In the second group, 33 cases (66%) were positive for at least one site. The positivity in girls with sexual activity is high. On the other hand, the HPV infection, although rare, may occur in girls without sexual intercourse.

scholarly journals PREGNANCY INDUCED HYPERTENSION;

2014 ◽  
Vol 21 (03) ◽  
Author(s):  
Asghar Khan ◽  
Amin Fahim ◽  
Aneela Qureshi ◽  
Ghulam Shah Nizamani ◽  
Mohammad Ahmed Azmi
Keyword(s):  
University Hospital ◽  
Control Group ◽  
P Value ◽  
Pregnancy Induced Hypertension ◽  
Severity Of Disease ◽  
Induced Hypertension ◽  
Mild Preeclampsia ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objective: To assess the early detection of thrombocytopenia in womenpresenting with varying degree of pregnancy induced hypertension (PIH). Study Design: A casecontrol study. Place of Study: Hematology laboratory Isra University Hospital Hyderabad.Duration of Study: From July 2009 to December 2010. Materials and Methods: Total 130pregnant women were included in this study. The subjects were divided into three groups asGroup 1 with pre-eclampsia, Group 2 with eclampsia and Group 3 with normotensive pregnantwomen as control group. The Group 1 was further divided into two sub groups such as Subgroup1a with mild preeclampsia and Sub-group 2b with severe pre-eclampsia. Results:Anticoagulated whole blood samples (5cc) from all subjects were analyzed for the detection ofthrombocytopenia for the possible involvement of pregnancy induced hypertension. It was notedthat out of total subjects, 33(25.39%) had mild pre-eclampsia, 17(13.07%) had severe preeclampsia,15(11.54%) had eclampsia and 65 (50.0%) were normotensive pregnant women.Based on the comparative findings, the results showed significant differences between group 3and group 1a (p-value 0.001), group 3 and group 1b (p-value 0.001), group 2 and group 3 alsoshowed same results (p-value 0.001) but the subjects of group 1a and 1b when compared,showed non-significant findings (p value 0.955). Conclusion: The results suggested that earlydetection of platelet count provide significant role for the assessment of severity of disease inwomen with pregnancy induced hypertension when compared with normotensive pregnantwomen.

scholarly journals Clinical Priority Setting and Decision-Making in Sweden: A Cross-sectional Survey Among Physicians

2021 ◽  
Author(s):  
Catharina Drees ◽  
Barbro Krevers ◽  
Niklas Ekerstad ◽  
Annette Rogge ◽  
Christoph Borzikowsky ◽  
...  
Keyword(s):  
Decision Making ◽  
Priority Setting ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
University Hospital ◽  
National Guidelines ◽  
Cross Sectional ◽  
Group 2 ◽  
Scarcity Of Resources ◽  
Group 1

Background: Priority setting in healthcare that aims to achieve a fair and efficient allocation of limited resources is a worldwide challenge. Sweden has developed a sophisticated approach. Still, there is a need for a more detailed insight on how measures permeate clinical life. This study aimed to assess physicians’ views regarding (1) impact of scarce resources on patient care, (2) clinical decision-making, and (3) the ethical platform and national guidelines for healthcare by the National Board of Health and Welfare (NBHW). Methods: An online cross-sectional questionnaire was sent to two groups in Sweden, 2016 and 2017. Group 1 represented 331 physicians from different departments at one University hospital and group 2 consisted of 923 members of the Society of Cardiology. Results: Overall, a 26% (328/1254) response rate was achieved, 49% in group 1 (162/331), 18% in group 2 (166/923). Scarcity of resources was perceived by 59% more often than ‘at least once per month,’ whilst 60% felt less than ‘well-prepared’ to address this issue. Guidelines in general had a lot of influence and 19% perceived them as limiting decision-making. 86% professed to be mostly independent in decision-making. 36% knew the ethical platform ‘well’ and ‘very well’ and 64% NBHW’s national guidelines. 57% expressed a wish for further knowledge and training regarding the ethical platform and 51% for support in applying NBHW’s national guidelines. Conclusion: There was a need for more support to deal with scarcity of resources and for increased knowledge about the ethical platform and NBHW’s national guidelines. Independence in clinical decision-making was perceived as high and guidelines in general as important. Priority setting as one potential pathway to fair and transparent decision-making should be highlighted more in Swedish clinical settings, with special emphasis on the ethical platform.

Role of intermittent pneumatic compression in the treatment of breast cancer–related lymphoedema: a randomized controlled trial

2019 ◽  
Vol 34 (2) ◽  
pp. 220-228 ◽  
Author(s):  
Engin Tastaban ◽  
Aykut Soyder ◽  
Elif Aydin ◽  
Omer Faruk Sendur ◽  
Yasemin Turan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Controlled Trial ◽  
Excess Volume ◽  
Controlled Trial ◽  
Intermittent Pneumatic Compression ◽  
University Hospital ◽  
Randomized Controlled ◽  
Group 2 ◽  
Group 1

Objective: To evaluate the role of intermittent pneumatic compression in the treatment of breast cancer–related lymphoedema. Design: Randomized controlled trial. Setting: Physical medicine and rehabilitation clinic at a university hospital. Subjects: Seventy-six patients with lymphoedema. Interventions: Patients were allocated into Group 1 (complex decongestive treatment, n = 38) and Group 2 (complex decongestive treatment + intermittent pneumatic compression, n = 38). The complex decongestive treatment involved skin care, manual lymphatic drainage, compression bandaging, and exercise for 20 sessions. Group 2 additionally received intermittent pneumatic compression. Main measures: Quantitative outcomes consisted of volumetric measures prior to and after the treatment. Clinical assessments included severity of pain, heaviness and tightness, disability, grip strength, and depression. Results: Lymphoedema was similar at baseline, but treatments significantly reduced the excess volume (from 373 mL to 203 mL in Group 1 and 379.5 mL to 189.5 mL in Group 2). Percentage excess volumes (PEVs) decreased in both groups. The percentage reduction of excess volume was better in Group 2 than Group 1, but the intergroup difference was not significant. The clinical scores reflected improvements, but the heaviness and tightness read significantly lower in Group 2 than Group 1. Conclusion: Intermittent pneumatic compression seems to add no benefit when combined with complex decongestive treatment of lymphoedema, but, may be functional in reducing the sensations of heaviness and tightness for the patients with pitting oedema.

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