Efficacy of fluorescein green dye in assessing intra-operative parathyroid gland vascularity and predicting post-thyroidectomy hypocalcaemia- A novel prospective cohort study

Alexandros G.Sfakianakis shared this article with you from Inoreader Efficacy of fluorescein green dye in assessing intra-operative parathyroid gland vascularity and predicting post-thyroidectomy hypocalcaemia- A novel prospective cohort study Μέσω Indian Journal of Endocrinology and Metabolism : 2014 - 18(1) Indian Journal of Endocrinology and Metabolism 2020 24(5):446-451 Background: Postoperative hypocalcaemia (POH) after total thyroidectomy (TT) is a common complication. Parathyroid hormone (PTH), an accurate predictor of POH cannot assess intra-operative viability of parathyroid glands (PGs). Different dyes including indocyanine green or carbon nanoparticles have been used, but they are expensive and not widely available. Fluorescein green dye (FD) has been used as a low-cost alternative to study viability of various organs, but seldom tried in visualizing PGs. This novel study aims to assess utility of FD in determining parathyroid viability and predicting POH. Material and Method: Total 72 out of 88 patients undergoing TT between January and December 2019 were included. Two ml of 25% FD was given intravenously before wound closure and attempts were made to visualize PGs under blue light. A numerical score was given according to the number of PGs visualized. Intact-PTH and corrected calcium were measured on postoperative day 1 and patients observe d for POH. Results: No PGs were visualized in 6 patients, 1 in 13, 2 in 30, 3 in 16 & 4 in 7 patients. Mean PTH was 6, 16.9, 31.6, 33.2 and 48.5 respectively. Corrected-calcium was 7.08, 7.7, 7.9, 8.5 and 8.5 respectively. All patients with score 0 received supplementary IV calcium, while 53.8% (score-1), 30% (score-2), 0% (scores-3, 4) received the same. Sensitivity, specificity and ROC of PG score of ≥2 on FD in predicting POH were 100%, 44% and 0.83 respectively. Conclusion: FD visualization of parathyroids post TT is feasible and can be used as low cost efficacious method to predict POH. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endocrine involvement in COVID-19: Mechanisms

Alexandros G.Sfakianakis shared this article with you from Inoreader Endocrine involvement in COVID-19: Mechanisms, clinical features, and implications for care Μέσω Indian Journal of Endocrinology and Metabolism : 2014 - 18(1) Indian Journal of Endocrinology and Metabolism 2020 24(5):381-386 Coronavirus 2019 (COVID -19) has rapidly emerged as a global pandemic with multi-system involvement. Involvement of the endocrine system is expected in COVID-19 as the interplay between severe acute respiratory syndrome corona virus-2 (SARS CoV-2) and the endocrine system occurs at multiple levels. The widespread presence of ACE-2 receptors on various tissues suggests scope for direct viral infection. The interactions via the activation of inflammatory mediators and indirect immune-mediated damage are also postulated. Evidence so far suggests that COVID-19 can cause functional hypopituitarism by direct and indirect effects on the hypothalamo-pituitary axis resulting in inappropriate adrenal response to stress. Several reports highlight possible immune-mediated damage to thyroid glands resulting in subacute thyroiditis. COVID-19 is implicated in precipitating hyperglycemia in known diabetics and uncovering insulin resistance in those previously undiagnosed. COVID-19 has also been show n to trigger Type 1 Diabetes with ketosis. Various mechanisms including direct virus-induced beta cell apoptosis and immune-mediated beta-cell damage have been demonstrated. The presence of virus in semen has unclear clinical significance at present. In this mini-review summarize the endocrine manifestations reported so far in COVID-19 disease and explore mechanisms to decipher how SARS CoV-2 may affect various endocrine organs. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical and severity profile of acute pancreatitis

Alexandros G.Sfakianakis shared this article with you from Inoreader Clinical and severity profile of acute pancreatitis in a hospital for low socioeconomic strata Μέσω Indian Journal of Endocrinology and Metabolism : 2014 - 18(1) Indian Journal of Endocrinology and Metabolism 2020 24(5):416-421 Introduction: There is an upsurge in the incidence of acute pancreatitis over the last few decades; although the case fatality rate has remained unchanged. This may either be due to increased incidence of gallstone disease or improvement in diagnostic modalities. It is a potentially life threatening disease with varying severity of presentation. Methods: This observational analytical study was conducted in the Department of General Surgery in our hospital for a period of one year. All patients of acute pancreatitis were included in the study as per inclusion & exclusion criteria. Observations and Results: Total 62 Patients were included in the study. Gall stones disease is the most common cause of acute pancreatitis. The mean age of the patients in the study was 39 years. 28 females and 34 male patients were present. 22 patients of the patients had severe disease as per Atlanta classification. Four out of these 22 severe pancreatitis patients expired. All patients in the severe p ancreatitis group had mild to life threatening complications and pleural effusion was the most common followed by necrosis. There was notable difference in terms of hospital stay between mild group and severe group of AP. Conclusion: The clinician should be aware that acute pancreatitis can occur in any age group and gender due to different etiology. The severity of AP does not depend on etiology, age or gender and it is associated with significant morbidity and mortality. SAP can be diagnosed on clinicoradiological basis and appropriate management can be done in those patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hyperhaemolytic Syndrome in Sickle cell disease: clearing the cobwebs

Alexandros G.Sfakianakis shared this article with you from Inoreader Hyperhaemolytic Syndrome in Sickle cell disease: clearing the cobwebs Μέσω MPP : Last 20 articles Sickle cell anaemia presents with a dynamic background haemolysis and deepening anaemia. This increases the demand for transfusion if any additional strain on haemopoiesis is encountered due to any other physiological or pathological. Patients with cerebrovascular accident are placed on chronic blood transfusion; those with acute sequestration and acute chest syndrome are likewise managed with blood transfusion. These patients are prone to develop blood transfusion complications including alloimmunization and hyperhaemolytic syndrome (HHS). This term is used to describe haemolysis of both transfused and 'own' red cells occurring during or post-transfusion in sickle cell patients. Hyperhaemolysis results in worsening post-transfusion haemoglobin due attendant haemolysis of both transfused and autologous red cells. The mechanism underlying this rare and usually fatal complication of sickle cell has been thought to be secondary to changes in the red cell membrane with associat ed immunological reactions against exposed cell membrane phospholipids. The predisposition to HHS in sickle cell is also varied and the search for a prediction pattern or value has been evasive. This review to discusses the pathogenesis, risk factors and treatment of hyperhaemolytic syndrome, elaborating what is known of this rare condition. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Red flags for the differential diagnosis of granulomatous mastitis: a case report

Alexandros G.Sfakianakis shared this article with you from Inoreader Red flags for the differential diagnosis of granulomatous mastitis: a case report Μέσω Journal of Medical Case Reports - Latest Articles Granulomatous mastitis (GM) is a rare benign chronic inflammatory breast disease. GM presents as a heterogeneous illness with variable clinical presentations, and its diagnosis is usually made by exclusion. Th... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

18 F-FDG PET/CT of off-target lymphoid organs in CD19-targeting chimeric antigen receptor T-cell therapy for relapsed or refractory diffuse large B-cell lymphoma

Alexandros G.Sfakianakis shared this article with you from Inoreader 18 F-FDG PET/CT of off-target lymphoid organs in CD19-targeting chimeric antigen receptor T-cell therapy for relapsed or refractory diffuse large B-cell lymphoma Μέσω Annals of Nuclear Medicine Abstract Objective The interplay between systemic inflammation, activity of lymphoid organs and lymphoma activity in CD19-targeting chimeric antigen receptor (CAR)-T-cell immunotherapy, and its significance for response and toxicity, is not well defined. Methods Using serial 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), metabolic parameters of lymphoma and lymphoid organs were analyzed in ten patients receiving Tisagenlecleucel (an autologous CD19 CAR-T cell product) for relapsed or refractory diffuse large B-cell lymphoma. The prevalence and severity of toxicity (e.g., neurotoxicity) were noted. Results Achieving remission required early metabolic response (P = 0.0476). Early suppression of metabolic activity of lymphoid organs (spleen, P = 0.0368; lymph nodes, P = 0.0470) was associated with poor outcome. Lymphoma metabolic activity was significantly higher in patients with neurotoxicity (P = 0.0489). Conclusions Early metabolic changes in lymphoma lesions and off-target lymphoid organs parallel medium-term response to CAR-T-cell therapy. PET can identify patients at risk for severe toxicity. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Roles of N-myc downstream-regulated gene 2 in the central nervous system: molecular basis and relevance to pathophysiology

Alexandros G.Sfakianakis shared this article with you from Inoreader Roles of N-myc downstream-regulated gene 2 in the central nervous system: molecular basis and relevance to pathophysiology Μέσω Latest Results for Anatomical Science International Abstract N-myc downstream-regulated gene 2 (NDRG2) is a member of the NDRG family, whose members have multiple functions in cell proliferation, differentiation, and stress responses. NDRG2 is widely distributed in the central nervous system and is uniquely expressed by astrocytes; however, its role in brain function remains elusive. The clinical relevance of NDRG2 and the molecular mechanisms in which it participates have been reported by studies using cultured cells and specimens of patients with neurological disorders. In recent years, genetic tools, including several lines of Ndrg2-knockout mice and virus-mediated gene transfer, have improved understanding of the roles of NDRG2 in vivo. This review aims to provide an update of recent growing in vivo evidence that NDRG2 is involved in brain function, focusing on research of Ndrg2-knockout mice with neurological disorders such as brain tumors, chronic neurodegenerative diseases, and acute brain insults including brain injury and cerebral stroke. These studies demonstrate that NDRG2 plays diverse roles in the regulation of astrocyte reactivity, blood–brain barrier integrity, and glutamate excitotoxicity. Further elucidation of the roles of NDRG2 and their molecular basis may provide novel therapeutic approaches for various neurological disorders. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.