Aims: The purpose of this study was to analyze the diagnostic yield and accuracy of the ultrasound (US) guided core biopsy in a population of patients with osteolytic metastasis. Materials and methods: We performed a retrospective analysis of 16 consecutive cases of US-guided core biopsies of osteolytic lesions performed in our Ultrasound Unit, from January 2006 to May 2017. We used 18G or 16G Tru-cut needles coupled with automated biopsy guns. We procured a maximum number of two tissue specimens per patient.Results: We obtained a diagnostic yield and accuracy of 93.75% (15 of 16 patients) for US-guided core biopsy of osteolytic metastasis. Most of our cases were metastasis of adenocarcinomas (8 patients), squamous cell carcinomas (3 patients) followed by multiple myelomas (2 patients). Other pathologic lesions recorded were undifferentiated carcinoma (1 patient) and mesenchimal undifferentiated tumor (1 patient). The pathologic result was inconclusive in one patient.Conclusions: Our study supports the important diagnostic role of US-guided core biopsy for osteolytic bone metastasis. Two US-guided passages may be sufficient to procure a diagnostic tissue samples from osteolytic bone metastasis, if theirlength is at least 10 mm.
The present study focused on the relationship between the adolescent's perception of minor stress in diff erent domains (school, relationship with parents, managing free time, romantic relationships, work and future) and the social support received from the family, friends, and other important people and perceived as such. The study participants were 525 students, from which 186 masculine and 339 feminine, with ages between 15 and 18, from three high schools from Maramures county. The instruments used for collecting the data were Problem Questionnaire (PQ), by Seiff ge-Krenke, which allowed us to identify the stress perceived in diff erent domains, and Multidimensional Scale of Perceived Social Support (MSPSS), by Gregory Zimet, for evaluating the social support perceived from family, friends or other important people. From the analyses done, it results the fact that adolescents who registered a high score regarding the social support perceived from family members, evaluate the issues with parents, issues regarding the managing of free time, self-issues and issues on their whole as being less stressful in comparison with the group which reports a lower level of social support perceived from the family. On the other hand, high values of social support perceived from friends represent a protection factor only in the case of the problems which adolescents have with themselves, in comparison with the group which declares that has a low social support from friends. Finally, the article underlines the need to educate the teenagers and parents as well in receiving and giving social support, as a factor of protection against problematic life situations.
Congenital extrahepatic portosystemic shunt (Abernethy malformation) is a rare condition characterized by developmental abnormalities of the portal venous system resulting in the diversion of the portal blood from the liver to the systemic venous system through a complete or partial shunt of the portomesenteric blood. We report the case of an 18 year-old female examined for abdominal pain, presenting cholestasis syndrome and an elevated serum aspartate aminotransferase level. Liver ultrasound examination revealed the absence of the portal vein with a complete extrahepatic shunt of the portal blood, multiple focal liver lesions, and multiple associated vascular anomalies. A surgical portosystemic shunt and a secondary portosystemic shunt due to portal vein thrombosis were excluded, enabling the diagnosis of a congenital portosystemic shunt. A complex investigation also discovered bone anomalies, and the liver biopsy of the dominant focal lesion revealed adenoma. On a short-term follow-up under hepatoprotective medication, the biochemical parameters improved mildly; however, the size of the main focal lesion increased. Congenital absence of the portal vein often remains an incidental diagnosis. In experienced hands, ultrasonography can diagnose it, but a comprehensive thoraco-abdominal evaluation is compulsory, considering the many potential associated anomalies. In these patients, development of adenomatous liver lesions secondary to Abernethy type Ib malformation represents an indication for liver transplantation.
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