ABSTRACT
Insulinoma is a rare functional neuroendocrine tumor of pancreas. The only recommended treatment is surgical removal. We present a case of a 46-year-old female patient who underwent the enucleation of insulinoma localized nearby pancreatic main duct after preoperative endoscopic insertion of pancreatic stent. The tumor was safely identified during the surgery and was enucleated without injury of pancreatic duct or postoperative complications.
ABSTRACT
Sepsis, severe sepsis, and septic shock represent a serious medicinal and general social problem and still maintain an important position among the present issues in the basic and clinical research. In the prospective analysis of patients satisfying the criteria of septic condition, we determined serum levels of bioparameters in three consecutive days from the first signs of sepsis depending on the stage or advancement of the septic condition. We determined the most significant parameter/parameters which are able to determine the stage of sepsis or to predict patient's death. In the group of 68 patients, all monitored biomarkers showed significant difference in serum concentrations versus the control group (P = 0.001). The strongest positive connection between the seriousness of sepsis and serum level is in case of procalcitonin. Predictor of mortality (r = -0.468; P = 0.001), transferrin (r = -0.506; P = 0.003), and tumor necrosis factor-α (r = 0.939; P = 0.001). Our results show that the monitored parameters (procalcitonin, C-reactive protein, tumor necrosis factor-α, and interleukin 6) have strong correlations between the serum levels and the stage of disease. Examination of at least one cytokine in normal clinical practice might lead to better interpretation of the patient's condition, determining the risk of death.
Subject(s)
Biomarkers/blood , Sepsis/blood , Sepsis/diagnosis , Adult , Aged , C-Reactive Protein/metabolism , Calcitonin/blood , Case-Control Studies , Female , Humans , Interleukin-6/blood , Male , Middle Aged , Predictive Value of Tests , Prospective Studies , Sepsis/mortality , Transferrin/metabolism , Tumor Necrosis Factor-alpha/bloodABSTRACT
Delayed graft function continues to pose a significant challenge to clinicians in the context of kidney transplantation. The objective of this retrospective, 5-year analysis is to identify the parameters of beating heart donors and those of recipients that affect the delayed development of graft function. The monitored group was composed of 152 beating heart donors and 179 recipients. Delayed graft function was identified in 32 (17%) patients. The predictor for development of delayed graft function was the body mass index of the donor (odds ratio: 1.1473; 95% confidence interval [CI]: 1.0017-1.3140; P = .0472), and the independent risk factors were donor body mass index 30 to 34.9 kg/m2 (hazard ratio [HR]: 6.0215; 95% CI: 1.4188-25.556; P = .0149), donor body mass index ≥35 kg/m2 (HR: 13.5484; 95% CI: 1.4575-125.938; P = .0220), and abuse of alcohol in the donor's history (HR: 1.779; 95% CI: 1.0679-2.964; P = .0270).
Subject(s)
Body Mass Index , Delayed Graft Function/etiology , Graft Rejection/etiology , Kidney Transplantation/adverse effects , Living Donors/statistics & numerical data , Transplant Recipients/statistics & numerical data , Adult , Female , Humans , Male , Middle Aged , Proportional Hazards Models , Retrospective Studies , Risk FactorsABSTRACT
We present a case report of a 30-year-old man, who hyperacutely rejected a blood group identical, HLA-haploidentical living related kidney graft in spite of the fact that he had never been immunized. Anti-endothelial IgG antibodies that did not react with monocytes were detected with flow cytometry, on a panel of human umbilical cord cells in his serum retrospectively. On the basis of this experience we put for consideration the possibility of regular examination of non-HLA antibodies in potential living graft recipients.
