Suchergebnisse

Introduction: Currently, parathyroidectomy represents the elective surgical treatment and the only one curative that relieves the patient of metabolic complications and improves the quality of life of the patient. Intraoperative confirmation of PTH is required to reflect the fact that the correct parathyroid gland has been extracted. Material and method: The study is retrospective. The period on which the data was gathered over a period of 2 years. The values of the PTH assay were obtained from blood drawn from the ipsilateral cephalic vein of the hyperproductive parathyroid gland: 1. at the moment of anesthesia induction; 2. at identification; 3. at 10 minutes after the extraction; 4. at 20 minutes after extraction. Results: We identified a number of 25 patients operated for primary hyperparathyroidism. Preoperative values of PTH were 380pg/mL with a maximum value of 821 pg/mL. PTH values decreased by 55% at 5 min, 68% at 10 minutes and 74% at 15 minutes. A marked reduction in PTH values occurred after the first 5 minutes while the interval between 10-15minutes associated a variation of only 8-10% decrease. Conclusion: Intraoperative PTH assay is a useful technique to predict the success of the intervention. The technique is standard although some issues have been raised and are still under discussion.

Introduction: The incidence of cholelithiasis has recently increased in the pediatric population, although it remains a rare disease among children. The purpose of this study is to highlight the management and the appropriate time to perform surgery. Materials and Methods: We performed a retrospective study over 10 years (2010-2010) and we found 123 patients who presented with biliary lithiasis and who underwent surgery in our department. We divided the study population into two groups depending on the time of admission and we found that in the 2010-2015 period we had a number of 33 patients, while in the last 5 years we admitted 90 patients with this diagnosis. Patients with other conditions such as bile duct atresia, choledochal cyst, hepatoblastoma that required a cholecystectomy were excluded from our study. Results: After analyzing the two groups we concluded that the number of surgical procedures increased from 33 to 90, which represents a 2.6 times increase. There was no significant difference between the two groups regarding the average age on admission (12.6 +/- 3.37 in the first group vs. 13.91 +/-3.34 in the second group). Surgical management of lithiasis cholecystitis registered an important difference in the two groups. In the first group, 9 patients (27.3%) underwent classic cholecystectomy while 24 (72.7%) – patients benefited from the laparoscopic approach, while in the second group just one patient underwent open surgery with 89 (98.9%) patients undergoing laparoscopic surgery. The percentage of patients who benefited from surgery in the same hospitalization remained high in both groups studied with a statistically significant p-value (p = 0.0417). Conclusion: The number of cases with cholecystitis and lithiasis is increasing in the pediatric population. Surgical management for these patients has become similar to that of adult patients, with minimally invasive surgery becoming the gold standard approach.

": The term ""panniculitis"" refers to a heterogeneous group of conditions that involve inflammation of the subcutaneous cellular tissue. Although there is no universally accepted classification of panniculitis, to facilitate the diagnosis, they were divided into two large classes, based on the histopathological criteria: predominantly lobular and predominantly septal panniculitis. Depending on the presence or absence of vascular damage, each of the two classes mentioned above is divided in turn into panniculitis without vasculitis and panniculitis with vasculitis. The diagnosis of various types of panniculitis can sometimes be very difficult, due to the histopathological changes that occur in the various evolutionary stages of the lesions. Thus, the positive diagnosis relies on the corroboration of clinical data, histopathological examination, and ancillary laboratory tests. We provide an overview of the clinical and histopathological features of panniculitis, classified according to the histopathological criteria. "