Randomized study comparing endoscopic ultrasound-guided Trucut biopsy and fine needle aspiration with high suction.

OBJECTIVES: Endoscopic ultrasound (EUS)-guided Trucut biopsy (TCB) enables acquisition of tissue cores for histological assessment. Because of the rigid needle and the spring mechanism, tissue acquisition can be difficult from regions that require sharp angulation of the echoendoscope. Fine needle aspiration with high suction (FNAHS) has been proposed as a method to obtain histological tissue cores while affording the flexibility to obtain specimens even with extreme endoscope angulation. The objective was to compare prospectively these two methods in their ability to obtain specimens for histological assessment and in their diagnostic accuracy, including cytological diagnosis when achieved. METHODS: Eighty lesions in 77 patients were amenable to transoesophageal, transgastric or transrectal biopsy and were randomized to TCB (n = 44) or FNAHS (n = 36). Each specimen was assessed for adequacy (scoring system where a score of 0 was no material, 1-2 was considered cytological, and 3-5 was considered histological). Follow-up information was obtained to establish a gold standard final diagnosis. RESULTS: The median histological scores for FNAHS and TCB were 2 and 5, respectively. Histological cores were obtained in 95.3% of TCB, as opposed to 27.8% in the FNAHS group (P < 0.0001). Although the diagnostic accuracy for TCB was greater than that for FNAHS (88.3% and 77.8%, respectively), this was not statistically significant (P = 0.24). CONCLUSION: If histological information is required, TCB is superior to FNAHS. The difference in diagnostic accuracy did not reach statistical significance due to low numbers and the fact that FNAHS often enabled a cytological diagnosis.

Serum interleukins and urinary microglobulin in children with idiopathic nephrotic syndrome.

We studied 60 children affected with idiopathic nephrotic syndrome (INS) plus 20 age and sex matched controls. The children with INS were divided into 3 groups of 20: first presentation, remission and relapse. A complete blood picture and complete urinalysis were done. Serum interleukin (IL)-1beta, IL-6, tumour necrosis factor (TNF) and quantitative urinary beta-2-microglobulin (beta-2-m) excretion were estimated. IL-1beta and IL-6 were significantly higher in the study groups, the first presentation and relapse groups having the highest concentrations. Serum TNF concentration and urinary beta-2-m excretion were significantly higher in the first presentation and relapse groups. Serum IL-1beta, IL-6 and TNF concentrations were able to select positively (100%) the first presentation and relapse groups, while these plus urinary beta-2-m excretion selected negatively (100%) the control group.

Serum interleukins and urinary microglobulin in children with idiopathic nephrotic syndrome

We studied 60 children affected with idiopathic nephrotic syndrome [INS] plus 20 age and sex matched controls. The children with INS were divided into 3 groups of 20: first presentation, remission and relapse. A complete blood picture and complete urinalysis were done. Serum interleukin [IL]-1beta, IL-6, tumour necrosis factor [TNF] and quantitative urinary beta-2-microglobulin [beta-2-m] excretion were estimated. IL-1beta and IL-6 were significantly higher in the study groups, the first presentation and relapse groups having the highest concentrations. Serum TNF concentration and urinary beta-2-m excretion were significantly higher in the first presentation and relapse groups. Serum IL-1beta, IL-6 and TNF concentrations were able to select positively [100%] the first presentation and relapse groups, while these plus urinary beta-2-m excretion selected negatively [100%] the control group

Treatment of scabies: preliminary report.

Five topical treatments for scabies compared for efficacy in 85 infants with scabetic infestation. Preliminary results during the six-month study period showed lindane to be the most effective, with furacin the least effective.