A Comparison of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Fine-Needle Biopsy in the Diagnosis of Solid Pancreatic Lesions.

Background and Aims: Endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) is the method of choice for sampling pancreatic lesions. This study compares the diagnostic accuracy and safety of FNB using a novel core needle to FNA in solid pancreatic lesions. Methods: A retrospective review of patients in whom EUS FNA or FNB was performed for solid pancreatic lesions was conducted. Diagnostic performance was calculated based upon a dual classification system: classification 1, only malignant pathology considered a true positive, versus classification 2, atypical, suspicious, and malignant pathology considered a true positive. Results: 43 patients underwent FNB compared with 51 FNA. Using classification 1, sensitivity was 74.0% versus 80.0%, specificity 100% versus 100%, and diagnostic accuracy 77.0% versus 80.0% for FNB versus FNA, respectively (all p > 0.05). Using classification 2, sensitivity was 97% versus 94.0%, specificity 100% versus 100%, and diagnostic accuracy 98.0% versus 94.0% for FNB versus FNA, respectively (all p > 0.05). FNB required significantly fewer needle passes (median = 2) compared to FNA (median = 3; p < 0.001). Adverse events occurred in two (4.5%) FNB patients compared with none in the FNA group (p > 0.05). Conclusion: FNA and FNB have comparable sensitivity and diagnostic accuracy. FNB required fewer passes.

Postocclusive Hyperemia Measured with Laser Doppler Flowmetry and Transcutaneous Oxygen Tension in the Diagnosis of Primary Raynaud's Phenomenon: A Prospective, Controlled Study.

The aim of this study was to measure the sensitivity and specificity of transcutaneous oxygen tension and postocclusive hyperemia testing using laser Doppler flowmetry in patients with primary Raynaud's phenomenon. One hundred patients and one hundred controls were included in the study. Baseline microvascular blood flow and then time to peak flow following occlusion were measured using laser Doppler flowmetry. Afterwards, the transcutaneous oxygen tension was recorded. The sensitivities of baseline microvascular blood flow, postocclusive time to peak flow, and transcutaneous oxygen tension were 79%, 79%, and 77%, respectively. The postocclusive time peak flow had a superior specificity of 90% and area under the curve of 0.92 as compared to 66% and 0.80 for baseline microvascular flow and 64% and 0.76 for transcutaneous oxygen tension. Time to postocclusive peak blood flow measured by laser Doppler flowmetry is a highly accurate test for differentiating patients with primary Raynaud's phenomenon from healthy controls.

Computed tomography morphometric analysis of the greater palatine canal: a study of 1,500 head CT scans and a systematic review of literature.

We have performed a detailed morphometric analysis of the length and anatomic routes of the greater palatine canal (GPC) and a systematic review of the literature on the anatomy of the GPC with the aim of informing dentists, maxillofacial surgeons, otorhinolaryngologists and other specialists performing procedures in the area of the GPC. In total, we analysed 1,500 archived adult head computed tomography scans to determine the length of the GPC and of the routes on both sides, as well as the dimensions and opening directions of the greater palatine foramen. The systematic review of the literature was performed according to PRISMA guidelines. The study group comprised 783 females (52.2%) and 717 males with a mean (± standard deviation) age of 42.1 ± 16.9 years; there was significant difference in age between sexes (p = 0.33). The average length of the GPC was 31.1 ± 2.9 (range 15-44) mm. The GPC travelled three different paths in the sagittal plane and four different paths in the coronal plane. Most often it descended from the pterygopalatine fossa inferiorly before changing to an anterior-inferior direction (68.4%; sagittal plane) and inferior-laterally before changing to an inferior-medial direction (40.7%; (coronal plane). In total, the GPF had four different opening directions: inferior-anterior-medial (82.1%), inferior-anterior-lateral (4.0%), anterior (7.6%), and vertical (5.3%). Twenty-five studies were included in the systematic review. In conclusion, the information presented here provides clinicians with the anatomical knowledge necessary to minimize the risk of complications when performing procedures involving infiltration of the GPC.

Anatomical landmarks for the localization of the greater palatine foramen--a study of 1200 head CTs, 150 dry skulls, systematic review of literature and meta-analysis.

Accurate knowledge of greater palatine foramen (GPF) anatomy is necessary when performing a variety of anaesthesiological, dental or surgical procedures. The first aim of this study was to localize the GPF in relation to multiple anatomical landmarks. The second aim was to perform a systematic review of literature, and to conduct a meta-analysis on the subject of GPF position to aid clinicians in their practice. One-hundred and fifty dry, adult, human skulls and 1200 archived head computed tomography scans were assessed and measured in terms of GPF relation to other anatomical reference points. A systematic literature search was performed using the PubMed, Embase and Web of Science databases, and a meta-analysis on the subject of GPF relation to the maxillary molars was conducted. On average, in the Polish population, the GPF was positioned 15.9 ±â€…1.5 mm from the midline maxillary suture (MMS), 3.0 ±â€…1.2 mm from the alveolar ridge (AR) and 17.0 ±â€…1.5 mm from the posterior nasal spine (PNS); 74.7% of GPF were positioned opposite the third maxillary molar (M3). Twenty-seven studies were included in the systematic review and 23 in the meta-analysis (n = 6927 GPF). The pooled prevalence of the GPF being positioned opposite the M3 was 63.9% (95% confidence interval = 56.6-70.9%). Concluding, the GPF is most often located opposite the M3 in the majority of the world's populations. The maxillary molars are the best landmarks for locating the GPF. In edentulous patients the most useful points for approximating the position of the GPF are the AR, MMS and PNS. This study introduces an easy and repeatable classification to reference the GPF to the maxillary molars.

Analysis of body composition among children and adolescents - a cross-sectional study of the Polish population and comparison of body fat measurement methods.

OBJECTIVE: The first aim of the present study was to analyze the body composition of Polish children ages 7-17 years old to add to the current body of literature. The second aim was to compare two body fat measurement methods (bioimpedance vs. Slaughter equation) on the abovementioned population. METHODS: Height (cm) and weight (kg) of 308 (161 males and 147 females) participants, ages 7-17, were measured, and body mass index (BMI) scores were calculated. Skinfold thickness (SFT) was measured for the triceps, subscapular, abdominal, suprailiac, thigh, and medial thigh skin folds on the left side of the body. Fat mass, fat percentage in the whole body (%BF), fat-free mass, and total body water were assessed using bioelectrical impedance analysis (BIA). RESULTS: In the present sample, 29.5% of males were overweight, and 11.3% of these were obese. Among females, 27.2% were classified as overweight, and 6.8% of these were obese. Males had a higher total body water (median=27.25 vs. 24.8 kg, p<0.001) and fat-free mass (median=37.25 vs. 33.90 kg, p<0.001), while females showed a higher total body fat percentage (median=22 vs. 14.55%, p<0.001) and fat mass (median=9.1 vs. 5.9 kg, p<0.001). %BF calculated using Slaughter equations overestimated those obtained by BIA in both genders (p<0.0001). CONCLUSIONS: The percent of youths classified as overweight and obese has increased in Krakow (Poland). Calculation of body fat percent derived from bioimpedance provides better estimates than the use of Slaughter equations, which tended to overestimates the values.

Methods for intravenous self administration in a mouse model.

Animal models have been developed to study the reinforcing effects of drugs, including the intravenous self-administration (IVSA) paradigm. The advantages of using an IVSA paradigm to study the reinforcing properties of drugs of abuse such as cocaine include the fact that the drug is self-administered instead of experimenter-administered, the schedule of reinforcement can be altered, and accurate measurement of the quantities of drug consumed as well as the timing and pattern of IV injections can be obtained. Furthermore, the intravenous route of administration avoids potential confounds related to first pass metabolism or taste, and produces rapid increases in blood and brain drug levels. As outlined in this video, intravenous self-administration can be obtained without prior food restriction or prior drug training following careful catheter placement during surgery and meticulous daily catheter flushing and maintenance. Experimental procedures outlined in this paper include a description of animal housing and acclimation methods, operant training using sweetened milk solutions, and catheter implantation surgery.