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Bauman ZM, Menke B, Terzian WTH, Raposo-Hadley A, Cahoy K, Berning BJ, Cemaj S, Kamien A, Evans CH, Cantrell E. Focusing in on gallbladder disease. Do current imaging modalities accurately depict the severity of final pathology? Am J Surg 2022; 224:1417-1420. [PMID: 36272825 DOI: 10.1016/j.amjsurg.2022.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 09/27/2022] [Accepted: 10/13/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Accuracy of imaging modalities for gallbladder disease(GBD) remains questionable. We hypothesize ultrasonography(US), computed tomography(CT), and magnetic resonance imaging(MRI) poorly correlate with final pathologic analysis. METHODS This was a retrospective review of all patients who underwent cholecystectomy at our institution. Primary outcome was agreement between US, CT, and MRI, and final pathology report of the gallbladder. Cohen's Kappa statistic was used to describe the level of agreement (0 = agreement equivalent to chance, 0.1-0.2 = slight agreement, 0.21-0.40 = minimal/fair agreement, 0.41-0.60 = moderate agreement, 0.61-0.80 = substantial agreement, 0.81-0.99 = near perfect agreement, 1 = perfect agreement). Significance was set at p < 0.05. RESULTS 1107 patients were enrolled. Average age was 48.6(±17.6); 64.2% were female. There was minimal agreement between the three imaging modalities and final pathology (US = 0.363; CT = 0.223; MRI = 0.351;p < 0.001). CONCLUSION Poor agreement exists between imaging modalities and final pathology report for GBD. Urgent surgical intervention for patients presenting with symptoms of GBD should be considered, despite imaging results.
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Affiliation(s)
- Zachary M Bauman
- Division of Trauma, Emergency General Surgery and Critical Care Surgery Department of Surgery, University of Nebraska Medical Center Omaha, Nebraska, 68198, USA.
| | - Bryant Menke
- Division of Trauma, Emergency General Surgery and Critical Care Surgery Department of Surgery, University of Nebraska Medical Center Omaha, Nebraska, 68198, USA.
| | - W T Hillman Terzian
- Division of Trauma, Emergency General Surgery and Critical Care Surgery Department of Surgery, University of Nebraska Medical Center Omaha, Nebraska, 68198, USA.
| | - Ashley Raposo-Hadley
- Division of Trauma, Emergency General Surgery and Critical Care Surgery Department of Surgery, University of Nebraska Medical Center Omaha, Nebraska, 68198, USA.
| | - Kevin Cahoy
- Division of Trauma, Emergency General Surgery and Critical Care Surgery Department of Surgery, University of Nebraska Medical Center Omaha, Nebraska, 68198, USA.
| | - Bennett J Berning
- Division of Trauma, Emergency General Surgery and Critical Care Surgery Department of Surgery, University of Nebraska Medical Center Omaha, Nebraska, 68198, USA.
| | - Samuel Cemaj
- Division of Trauma, Emergency General Surgery and Critical Care Surgery Department of Surgery, University of Nebraska Medical Center Omaha, Nebraska, 68198, USA.
| | - Andrew Kamien
- Division of Trauma, Emergency General Surgery and Critical Care Surgery Department of Surgery, University of Nebraska Medical Center Omaha, Nebraska, 68198, USA.
| | - Charity H Evans
- Division of Trauma, Emergency General Surgery and Critical Care Surgery Department of Surgery, University of Nebraska Medical Center Omaha, Nebraska, 68198, USA.
| | - Emily Cantrell
- Division of Trauma, Emergency General Surgery and Critical Care Surgery Department of Surgery, University of Nebraska Medical Center Omaha, Nebraska, 68198, USA.
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Carotenuto A, Menke B, Jolton J, Dowdall JR. Recurrent Lingual Abscess in an Elderly Female With Bulbar Amyotrophic Lateral Sclerosis. Cureus 2022; 14:e28280. [PMID: 36158411 PMCID: PMC9492446 DOI: 10.7759/cureus.28280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 11/05/2022] Open
Abstract
A lingual abscess is a rare condition that was scarcely described in clinical textbooks. A lingual abscess recurrence is rare and has only been described twice in the literature. Typically, the tongue and oral cavity have multiple intrinsic properties which stave off intralingual infection; however, there may be situations in which these properties are compromised, as demonstrated in oro-motor disability. Lingual abscesses have the potential to develop into catastrophic obstructive airway issues; therefore, early detection and management are paramount. The following is a presentation of an elderly female with Bulbar Amyotrophic Lateral Sclerosis (ALS) treated conservatively for a lingual abscess with recurrence at eleven months post-treatment. Due to her baseline neuromuscular disorder and elevated anesthesia risk, she was treated in the interventional radiology suite with drain placement and Povidone-Iodine sclerotherapy under conscious sedation with excellent results.
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Rißling J, Melzer J, Menke B, Petermann F, Daseking M. Sprachkompetenz und Verhaltensauffälligkeiten im Vorschulalter. Gesundheitswesen 2015; 77:805-13. [DOI: 10.1055/s-0035-1564080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- J. Rißling
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - J. Melzer
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | | | - F. Petermann
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - M. Daseking
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
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Abstract
BACKGROUND Despite it importance standardized treatment outcome-monitoring in tuberculosis patients is not officially done in Germany. METHODS In this retrospective study we investigated tuberculosis outcome in 494 patients with pulmonary tuberculosis using the international recommended definitions. RESULTS The median follow-up period was 62 month (36-180 month). A successful treatment could be observed in 378 (76.1%) of all patients. Treatment success was mostly documented as cure (n = 375). No documented treatment success was seen in 119 patients (23.9%). The most important reason for unsuccessful treatment was lost for follow up (transfer out) in 60/119 patients (51.2%), followed by death (24/119; 19.8%), an interrupted treatment (22/199; 18.3%) and treatment failure (13/119; 10.7%). No documented treatment success was significantly more common in retreatment cases compared to new cases (p = 0.0003) and in patients with at least a single drug resistance (p = 0.04). Beside these parameters treatment outcome was significantly superior in patients receiving a standard antituberculosis therapy including at least isoniazid and rifampin compared to patients treated with other regimens during both the initial phase (p = 0.0039) and the continuous phase (p = 0.0021) of therapy. CONCLUSION In this retrospective study the use of the international definitions for outcome monitoring showed a substantial proportion of patients with unsuccessful therapy. For the evaluation of the success of the tuberculosis programme in Germany a prospective documentation of treatment outcome data in all patients using the international definitions seems essential.
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Affiliation(s)
- B Menke
- Pneumologisches Zentrum Unterstedt, Diakoniekrankenhaus Rotenburg/Wümme
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Bläker F, Altrogge H, Hellwege HH, Menke B, Thimm K. [Treatment of severe haemolytic-uraemic syndrome by dialysis (author's transl)]. Dtsch Med Wochenschr 1978; 103:1229-32. [PMID: 352654 DOI: 10.1055/s-0028-1129236] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Since 1973 haemodialysis was performed on 30 children with severe haemolytic-uraemic syndrome. Serial measurements were made of blood pressure, blood picture, renal function, complement values, excretion of fibrinogen split-products and beta2-microglobulin in urine. Of 22 children in the acute severe stage two died, in one case treatment having been started too late, in the other as a result of fulminating pneumococcal pneumonia. Twenty children survived without residual symptoms and with normal renal function. Of six children with severe progressive haemolytic-uraemic syndrome two developed terminal renal failure. In one child a renal transplantation has since been performed. One child requires chronic dialysis after nephrectomy. Three children died as a result of arterial hypertension, one of yeast septicaemia. Of two children with recurrent haemolytic-uraemic syndrome one developed terminal renal failure which was successfully treated by renal transplantation. One child died in a hypertensive crisis. The overall death rate of the group was 23%, in the group with the acute severe haemolytic-uraemic syndrome it was 9%. The results suggest that haemodialysis significantly improves the prognosis of severe haemolytic-uraemic syndrome.
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Klöppel G, Altenähr E, Menke B. The ultrastructure of focal islet cell adenomatosis in the newborn with hypoglycemia and hyperinsulinism. Virchows Arch A Pathol Anat Histol 1975; 366:223-36. [PMID: 165615 DOI: 10.1007/bf00427411] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In a newborn severe persistent hypoglycemia due to an insulin-producing tumorous proliferation of pancreatic islet cells (insulinoma) was observed. The insulinoma showed the histologic pattern of focal adenomatosis of islet cells. According to the present literature the focal proliferation of islet cell complexes seems to be a frequent and particular feature of insulinomas in the newborn. Differential islet cell staining identified 80%-90% of the proliferated islet cells as B cells. 10%-20% of the cells were found to be A or D cells. Ultrastructurally the majority of the proliferated islet cells were well differentiated B cells. The remaining cells represented either A or D cells or a fourth islet cell type with small spheric granules. Electronmicrscopic evidence of transitions between differentiated islet cells, particularly B cells, and the fourth islet cell type suggests that the fourth islet cell type might represent a precursor cell within the APUD-cell system.
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