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Kongkam P, Orprayoon T, Yooprasert S, Sirisub N, Klaikaew N, Sanpawat A, Safa S, Ridtitid W, Kullavanijaya P, Rerknimitr R. Endoscopic ultrasound guided fine needle biopsy (EUS-FNB) from peritoneal lesions: a prospective cohort pilot study. BMC Gastroenterol 2021; 21:400. [PMID: 34689752 PMCID: PMC8542287 DOI: 10.1186/s12876-021-01953-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 09/29/2021] [Indexed: 11/10/2022] Open
Abstract
Background Diagnostic laparoscopy is often a necessary, albeit invasive, procedure to help resolve undiagnosed peritoneal diseases. Previous retrospective studies reported that EUS-FNA is feasible on peritoneal and omental lesions, however, EUS-FNA provided a limited amount of tissue for immunohistochemistry stain (IHC). Aim This pilot study aims to prospectively determine the effectiveness of EUS-FNB regarding adequacy of tissue for IHC staining, diagnostic rate and the avoidance rate of diagnostic laparoscopy or percutaneous biopsy in patients with these lesions. Methods From March 2017 to June 2018, patients with peritoneal or omental lesions identified by CT or MRI at the King Chulalongkorn Memorial Hospital, Bangkok, Thailand were prospectively enrolled in the study. All Patients underwent EUS-FNB. For those with negative pathological results of EUS-FNB, percutaneous biopsy or diagnostic laparoscopy was planned. Analysis uses percentages only due to small sample sizes. Results A total of 30 EUS-FNB passes were completed, with a median of 3 passes (range 2–3 passes) per case. For EUS-FNB, the sensitivity, specificity, PPV, NPV and accuracy of EUS-FNB from peritoneal lesions were 63.6%, 100%, 100%, 20% and 66.7% respectively. Adequate tissue for IHC stain was found in 25/30 passes (80%). The tissues from EUS results were found malignant in 7/12 patients (58.3%). IHC could be done in 10/12 patients (83.3%). Among the five patients with negative EUS results, two underwent either liver biopsy of mass or abdominal paracentesis, showing gallbladder cancer and adenocarcinoma. Two patients refused laparoscopy due to advanced pancreatic cancer and worsening ovarian cancer. The fifth patient had post-surgical inflammation only with spontaneous resolution. The avoidance rate of laparoscopic diagnosis was 58.3%. No major adverse event was observed. Conclusions EUS-FNB from peritoneal lesions provided sufficient core tissue for diagnosis and IHC. Diagnostic laparoscopy can often be avoided in patients with peritoneal lesions. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-021-01953-9.
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Affiliation(s)
- Pradermchai Kongkam
- Excellence Center for Gastrointestinal Endoscopy, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, and Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Pancreas Research Unit, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Theerapat Orprayoon
- Excellence Center for Gastrointestinal Endoscopy, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, and Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. .,Pancreas Research Unit, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| | - Sirilak Yooprasert
- Excellence Center for Gastrointestinal Endoscopy, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, and Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nakarin Sirisub
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Naruemon Klaikaew
- Department of Pathology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Anapat Sanpawat
- Department of Pathology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Shahram Safa
- Excellence Center for Gastrointestinal Endoscopy, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, and Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Pancreas Research Unit, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Wiriyaporn Ridtitid
- Excellence Center for Gastrointestinal Endoscopy, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, and Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pinit Kullavanijaya
- Excellence Center for Gastrointestinal Endoscopy, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, and Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Rungsun Rerknimitr
- Excellence Center for Gastrointestinal Endoscopy, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, and Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Hamdan R, Fakih S, Mohammad M, Charif F, Abdallah H, Safa S, Al Ali F, Issa M, Damen B, El Zein A, Younes M, Rabah A, Saab M. The Lebanese left ventricular assist device experience, a success story despite the odds. J Cardiothorac Surg 2020; 15:192. [PMID: 32723392 PMCID: PMC7388207 DOI: 10.1186/s13019-020-01235-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/20/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND AIM Heart failure is still a leading cause of mortality and morbidity. Assist devices are reserved for advanced heart failure patients with no other therapeutic options. We aim in this paper to describe the characteristics and outcome of Lebanese left ventricular assist device (LVAD) patients. RESULTS From 2010 till December 2019, 78 patients were implanted with assist devices at the Beirut cardiac Institute, 82 pumps were used. To the most recent follow up after 10 years, 26 patients died (34%). 24 patients of 35 (68%) survived more than 5 years. Seven patients only (9%) died during one month of surgery. One year mortality was 19% (15 patients). The leading cause of early mortality was infection, whereas cerebrovascular accidents CVA were the leading cause of late mortality. Pump thrombosis occurred in 12% of the cases. The most serious long term complication was haemorrhagic CVA. Only seven patients (9%) received heart transplantation, with a mean time on support prior to transplantation of 1303 ± 213 days. CONCLUSION In this manuscript we reported the characteristics and outcome of the largest population of LVAD patients in Lebanon. The survival rate was 81% at one year. These findings were comparable to the international registries except for rates of heart transplantation. More efforts should be made to encourage organ donation in Lebanon.
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Affiliation(s)
- R Hamdan
- Cardiology department, Beirut Cardiac Institute, Beirut, Lebanon.
| | - S Fakih
- Cardiology fellow, Cardiology department, Beirut Cardiac Institute, Beirut, Lebanon
| | - M Mohammad
- Lebanese Society of Cardiology, Cardiology department, Bahman Hospital, Beirut, Lebanon
| | - F Charif
- Critical care unit, Beirut Cardiac Institute, Beirut, Lebanon
| | - H Abdallah
- Cockrell school of engineering, University of Texas, Austin, TX, USA
| | - S Safa
- Cardiology fellow, Cardiology department, Beirut Cardiac Institute, Beirut, Lebanon
| | - F Al Ali
- Cardiac surgeon, Cardiac Surgery department, Beirut Cardiac Institute, Beirut, Lebanon
| | - M Issa
- Cardiac Surgery department, Beirut Cardiac Institute, Beirut, Lebanon
| | - B Damen
- Cardiac Surgery department, Beirut Cardiac Institute, Beirut, Lebanon
| | - A El Zein
- Cardiac Surgery department, Beirut Cardiac Institute, Beirut, Lebanon
| | - M Younes
- Cardiology department, Beirut Cardiac Institute, Beirut, Lebanon
| | - A Rabah
- Cardiac Surgery department, Beirut Cardiac Institute, Beirut, Lebanon
| | - M Saab
- Cardiac Surgery department, Beirut Cardiac Institute, Beirut, Lebanon
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Safa S, Soleimani A, Heravi Moussavi A. Improving Productive and Reproductive Performance of Holstein Dairy Cows through Dry Period Management. Asian-Australas J Anim Sci 2013; 26:630-7. [PMID: 25049832 PMCID: PMC4093332 DOI: 10.5713/ajas.2012.12303] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/26/2012] [Revised: 01/04/2013] [Accepted: 09/10/2012] [Indexed: 11/27/2022]
Abstract
To determine the effects of dry period (DP) length on milk yield, milk composition, some blood metabolites, complete blood count (CBC), body weight and score and follicular status, twenty five primiparous and multiparous Holstein cows were assigned to a completely randomized design with DP-60 (n = 13) and DP-20 (n = 12) dry period lengths. Cows in the DP-60 produced more milk, protein, SNF, serum non-esterified fatty acids (NEFA) and beta hydroxyl butyrate acid (BHBA) compared with cows in DP-20 (p≤0.05). Serum glucose, blood urea nitrogen (BUN), urea, and glutamic oxaloacetic transaminase (GOT) were all similar among the treatments. Body Condition Score (BCS), body weight (BW), complete blood count (CBC) and health problems were similar between the treatments. Diameter of the first dominant follicle and diameter of the dominant follicle on d 14 were different among the treatments. Thus, results of this study showed that reducing the dry period length to DP-20 had a negative effect on milk production, milk composition and reproductive performance in Holstein dairy cows.
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Affiliation(s)
- S. Safa
- Department of Animal Science, Ferdowsi University of Mashhad, Mashhad, Khorasan Razavi,
Iran
| | - A. Soleimani
- Department of Animal Science, Ferdowsi University of Mashhad, Mashhad, Khorasan Razavi,
Iran
| | - A. Heravi Moussavi
- Department of Animal Science, Ferdowsi University of Mashhad, Mashhad, Khorasan Razavi,
Iran
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