scholarly journals Malignant insulinoma

2009 ◽  
Vol 55 (5) ◽  
pp. 10-14
Author(s):  
Ekaterina Anatol'evna Troshina ◽  
M Y Yukina ◽  
A V Egorov ◽  
I A Vasilyev ◽  
A A Krivko ◽  
...  

According to official statistics, malignant insulinomas account for a small fraction of gastroenteropathic endocrine neoplasms, the majority of insulinomas being essentially benign tumours. This paper reports a clinical case of malignant insulin-producing neuroendocrine tumour of the pancreas tail in a 28 year-old woman. She had multiple liver metastases and organic hyperinsulinism. Results of comprehensive examination of the patient at the Endocrinological Research Centre including laboratory diagnostic data and their evaluation are presented. Her surgical treatment was accomplished in N.N. Burdenko Facultative Surgery Clinic, I.M. Sechenov Moscow Medical Academy. Treatment strategy in the post-operative period and follow-up observations are described.

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Danielle Whiting ◽  
Ian Rudd ◽  
Amit Goel ◽  
Seshadri Sriprasad ◽  
Sanjeev Madaan

Abstract Background Angiomyolipomas are rare mesenchymal tumours arising from the perivascular epithelioid cells consisting of variable amounts of adipose, thick-walled blood vessels and smooth muscle cells. These benign tumours commonly occur in the kidney with only a few case reports of adrenal angiomyolipomas which have the potential to reach a large size and haemorrhage. Case presentation A 45-year-old lady presented with a 3-week history of right loin pain, nausea and vomiting. A CT scan revealed a right adrenal angiomyolipoma measuring 6.3 × 6.8 cm with associated haemorrhage. The lesion was successfully treated with right open adrenalectomy, and histology confirmed the diagnosis of adrenal angiomyolipoma. The patient remained well with no evidence of recurrence at the 36-month follow-up. Conclusion Adrenal angiomyolipomas are rare benign tumours that have the ability to reach a large size and potential to bleed. Here, we report the second case of spontaneous haemorrhage in an adrenal angiomyolipoma, which was successfully treated with open adrenalectomy.


2021 ◽  
Vol 8 (30) ◽  
pp. 2797-2803
Author(s):  
Rasheed Khan M ◽  
Thivyah Prabha A.G ◽  
Siva Kumar K

BACKGROUND Mineral metabolism is frequently disturbed in thyroid dysfunctions. Among thyroid dysfunctions, hypothyroidism is one of the most common form resulting from the deficiency of thyroid hormones. Studies done on serum calcium, phosphorus and magnesium in hypothyroid patients earlier have conflicting results. Hence the present study has been undertaken to study the levels of serum calcium, phosphorus, and magnesium among hypothyroid patients and analyse their correlation with thyroid stimulating hormone (TSH). METHODS The case control study was conducted in the Department of Biochemistry in Trichy SRM Medical College Hospital and Research Centre for a period of 6 months from 2017 January to July 2017. The study was undertaken involving 50 hypothyroid cases and 50 healthy volunteers as controls after proper ethical clearance and informed consent of all the study subjects. Serum calcium, phosphorus and magnesium were measured along with tri-iodothyronine (FT3), tetra-iodothyronine (FT4) and TSH among all study subjects. Statistical analysis of data was done using statistical package for social sciences (SPSS) software. RESULTS The mean value of serum total calcium and total magnesium was lower among hypothyroid cases and phosphorus value was increased as compared to controls. (P < 0.001) Statistically significant negative correlation was observed between serum calcium, magnesium and TSH among hypothyroid cases. Statistically significant positive correlation was observed between serum phosphorus and TSH among hypothyroid cases. CONCLUSIONS Among hypothyroid patients the values of serum calcium, magnesium and phosphorus is significantly altered. Thyroid disorders have an important role in bone and mineral metabolism. Thus, monitoring of these minerals among hypothyroid patients in regular follow up may effectively improve the clinical manifestations in them. Hence, monitoring of mineral status of the hypothyroid patients on follow-up will be of benefit to the patients. KEYWORDS Hypothyroidism, Calcium, Phosphorus, Magnesium, Minerals


2010 ◽  
Vol 2 (1) ◽  
pp. 2
Author(s):  
Stefan Endres ◽  
Axel Wilke

We evaluated our initial results in 57 patients who received the NexGen® CR-Flex Mobile knee system using the standard anterior approach in a prospective study. The bicondylar surface implant was cemented in position (Palacos®) without posterior patellar resurfacing. The clinical outcome and perioperative and post-operative complications were documented over 24 months of its use. Overall, after two years, good results were obtained for the categories of pain and ROM (range of motion), and for the HSS (knee society score) (pre-operative: 42/57; post-operative: 87/80). No pathological radiological findings were made during this period. Two patients, however, felt that the primary operation had not been successful because of lateral patellar tilt. This was corrected with revision surgery. It was remarkable that our patients achieved greater than 100° flexion within the first 14 days of the immediate post-operative period. Evaluation and comparison of the scores with those of conventional bicondylar surface replacement systems showed no relevant differences.


Author(s):  
Manjunath K. ◽  
Amardeep Singh ◽  
Manjunatha Rao S. V.

<p class="abstract"><strong>Background:</strong> The aim of this study was to determine the frequency of otomycosis, the clinical presentation, predisposing factors and treatment outcome.</p><p class="abstract"><strong>Methods:</strong> This observational study was conducted at ENT Department of Basaveshwara Medical College and Hospital, Research centre, Chitradurga from May 2018 to June 2019, 13 months study. There were 50 patients with documented diagnosis of otomycosis. There were 19 (38%) males and 31 (62%) females. The age of patients ranged from 3 years to 65 years with mean age of 32.5 years. Mean follow-up time was 1 year (~13 months). The frequency, predisposing factors and most common symptoms of otomycosis were recorded along with the response to different Antifungal agents were observed and results were recorded in percentages. Data were analysed using SPSS 12 software. Results are based on descriptive statistics.  </p><p class="abstract"><strong>Results:</strong> We prescribed 1% clotrimazole drops or lotion in 58% of patients and 2% salicylic acid in 31% cases. Both of these agents are effective. Topical 1% clotrimazole drops yielded highest resolution rate with lowest recurrent rate. To analyse the efficacy of 1% clotrimazole and 2% salicylic acid. We applied Z-test to calculate the difference between two proportions of patients before treatment with those patients who remained uncured after treatment.</p><p class="abstract"><strong>Conclusions:</strong> Otomycosis commonly prevented with hearing loss, pruritus, otalgia and otorrhoea. It usually resolves with local toilet of ear and installation of antifungal agents.</p>


Author(s):  
Fatima K. Dzalaeva ◽  
S. O. Chikunov ◽  
A. S. Utyuzh ◽  
M. V. Mikhailova ◽  
M. K. Budunova

Background. This study aimed to improve the clinical effect of dental orthopedic treatment for patients who need a complete dental reconstruction, by making use of the temporomandibular joint characteristics. Materials and Methods. A total of 647 patients with adentia who needed a complete dental reconstruction were exposed to a comprehensive examination and treatment. Patients were divided into 3 groups: orthopedic rehabilitation group (218 patients), interdisciplinary rehabilitation group (195 patients), and multidisciplinary rehabilitation group (234 patients). The follow-up period was 7 years. Results. After the proposed rehabilitation approach, patients in the main group demonstrated an improvement in the VAS (Visual Analogue Scale) score, which was significantly smaller with respect to that in the comparison groups. The frequency of clicking and pain during chewing as well as soreness sensations in this group decreased at a significantly lower pace compared to that in the comparison groups. Conclusions. Dental reconstruction procedures aimed at restoring the shape of the teeth should focus on pain relief and temporomandibular joint function correction. The most important stage in implementing this approach is a complete and consistent examination of patients who need dental reconstruction.


BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e050524
Author(s):  
Íde O’Shaughnessy ◽  
Katie Robinson ◽  
Margaret O'Connor ◽  
Mairéad Conneely ◽  
Damien Ryan ◽  
...  

IntroductionOlder adults are clinically heterogeneous and are at increased risk of adverse outcomes during hospitalisation due to the presence of multiple comorbid conditions and reduced homoeostatic reserves. Acute geriatric units (AGUs) are units designed with their own physical location and structure, which provide care to older adults during the acute phase of illness and are underpinned by an interdisciplinary comprehensive geriatric assessment model of care. This review aims to update and synthesise the totality of evidence related to the effectiveness of AGU care on clinical and process outcomes among older adults admitted to hospital with acute medical complaints.DesignUpdated systematic review and meta-analysisMethods and analysisMEDLINE, Cumulative Index of Nursing and Allied Health Literature, Controlled Trials in the Cochrane Library and Embase electronic databases will be systematically searched from 2008 to February 2021. Trials with a randomised design that deliver an AGU intervention to older adults admitted to hospital for acute medical complaints will be included. The primary outcome measure will be functional decline at discharge from hospital and at follow-up. Secondary outcomes will include length of stay, cost of index admission, incidence of unscheduled hospital readmission, living at home (the inverse of death or institutionalisation combined; used to describe someone who is in their own home at follow‐up), mortality, cognitive function and patient satisfaction with index admission. Title and abstract screening of studies for full-text extraction will be conducted independently by two authors. The Cochrane risk of bias 2 tool will be used to assess the methodological quality of the included trials. The quality of evidence for outcomes reported will be assessed using the Grading of Recommendations Assessment, Development and Evaluations framework. A pooled meta-analysis will be conducted using Review Manager, depending on the uniformity of the data.Ethics and disseminationFormal ethical approval is not required as all data collected will be secondary data and will be analysed anonymously. The authors will present the findings of the review to a patient and public involvement stakeholder panel of older adults that has been established at the Ageing Research Centre in the University of Limerick. This will enable the views and opinions of older adults to be integrated into the discussion section of the paper.PROSPERO registration numberCRD42021237633.


Author(s):  
Sweta Shrestha ◽  
Shaili Pradhan ◽  
Ranjita Shrestha Gorkhali

Lipomas are benign tumours of mesenchymal origin (mature adipocytes) that are comparatively uncommon in the oral cavity corresponding to less than 4.4% of all benign oral soft tissue tumors. Clinically, they present as slow growing, soft, asymptomatic masses. Histopathologically, they appear as thinly encapsulated lesion composed of mature adipocytes with inconspicuous vascularity. The pathogenetic mechanisms of oral lipomas are still unclear. They are usually treated by surgical excision and bear excellent prognosis. Here we report a case of intraoral lipoma in 54 year old male patient in the left lower lingual alveolar mucosal region that was treated by surgical excision using electrocautery without any postsurgical complication. One-year follow-up showed no evidence of recurrence.


2021 ◽  
pp. 1-8
Author(s):  
Mehmet Biçer ◽  
Mehmet Dedemoğlu ◽  
Oktay Korun ◽  
Hüsnü F. Altın ◽  
Okan Yurdakök ◽  
...  

Abstract Background: We aimed to compare the results of two surgical methods for the treatment of congenital supravalvular aortic stenosis. Methods: From May 2004 to January 2020, 29 patients underwent surgical repair for supravalvular aportic stenosis in a single centre. The perioperative evaluation of the patients was retrospectively reviewed. Results: Fifteen (51.7%) and 14 (48.2%) patients were treated with the Doty and the McGoon methods, respectively. The median age of our cohort was 4.5 (3.0–9.9) years. Ten (34.5%) patients had Williams–Beuren syndrome, and pulmonary stenosis was observed in 12 (41.3%) patients. The median follow-up time was 2.5 (0.7–7.3) years. On follow-up, five patients had residual stenosis with the McGoon technique and one with the Doty technique (p = 0.05). One patient died early in the post-operative period in the Doty group, and three patients were re-operated on due to restenosis in the McGoon group. Freedom from re-operation in the Doty group at 1, 3, 5, and 10 years was 100%. In the McGoon group, freedom from re-operation rates at the 1-, 3-, and 7-year follow-up were 100, 88.9, and 44.4%, respectively (p = 0.08). Conclusion: Our results with both surgical techniques suggest that supravalvular aortic stenosis can be treated with good results. The Doty method provided better relief for the supravalvular aortic segment, considering the residual stenosis and the re-operation rates.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Daniela Prozorovscaia ◽  
Emma Jacquier ◽  
Florent Dudan ◽  
Suttipong Mungkala ◽  
Hilary Green

AbstractIntroductionFood choice is complex. Digital nutrition applications are emerging to help decisions about food choices. Nestlé's Meal Nutritional Score (MNS) is a number between 0 and 100 that provides a measure of the extent to which a meal meets US dietary recommendations. The objective was to evaluate if the MNS influences food choices in a workplace restaurant.Materials and MethodsA workplace education campaign ran over two weeks in order to introduce the MNS to employees. This was done during the lunch break at the entrance to the cafeteria of Nestlé's research centre, which serves around 250 hot meals at lunchtime every day. Employees choose between a typical Western meal, a healthy meal and a vegetarian meal. During the campaign, and for three weeks afterwards, LED screens displayed the MNS for the three different types of meal, every day. Employees’ voluntary feedback on the MNS was collected using a closed-ended questionnaire. Descriptive analyses were done for the scores and sales of each type of meals for one week before the education campaign, immediately after the campaign and three weeks later. Data are reported as mean ± 1 standard deviation.ResultsFeedback was obtained from 152 employees, of whom 96% said the MNS helped them to understand the nutritional balance of the meals, and 38% said the MNS influenced their meal choices. The MNS scores pre-campaign, post-post campaign and 3 weeks later were 52 ± 14, 50 ± 16 and 56 ± 11 for the Western meal; 54 ± 14, 62 ± 6 and 67 ± 6 for the healthy meal and 64 ± 11, 57 ± 14 and 57 ± 12 for the vegetarian meal, respectively. The percentage of sales pre-campaign, post-post campaign and 3 weeks later were 48 ± 10%, 43 ± 9% and 33 ± 9% for the Western meal; 25 ± 10%, 30 ± 8% and 36 ± 10% for the healthy meal, and 27 ± 4%, 27 ± 4% and 30 ± 8% for the vegetarian meal, respectively.DiscussionThe number of people selecting the healthy meal, which usually had the best score, increased during the three weeks following the education campaign, suggesting that the MNS positively influences food choices. The MNS may also help chefs to design more nutritionally balanced meals. Longer-term follow up is necessary to evaluate if these are sustained behaviour changes as well as to test the impact of the MNS in a different workplace environment.


2019 ◽  
Vol 22 (1) ◽  
pp. 26-30
Author(s):  
Mukund Raj Joshi ◽  
Sujan Regmee ◽  
Tanka Prasad Bohara ◽  
Rupesh Chakradhar ◽  
Mandesh Shrestha

Laparoscopic pancreaticoduodenectomy was described in 1994. It is considered the most challenging abdominal surgery. Although the procedure was found to be feasible in initial reports, the benefits were not considered favorable. In recent days, with the increasing experience of surgeons, acceptable outcomes are being observed and have been found to be technically beneficial and oncologically safe in selective cases in experienced hands. We performed the procedure in a 42-year-old gentleman with good operative and post-operative outcomes. The patient’s follow-up for six post-operative months seems satisfactory. The operation took 840 minutes with minimal blood loss. The resected specimen was adequate and satisfactory from an oncological and technical point of view. The patient developed some inherent complications of the procedure in the post-operative period. He recovered well. Details of the case and technical aspects are being discussed.  


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