Adrenocortical carcinoma presenting with signs of acute abdomen.

Background. Adrenocortical carcinomas represent rare malignancies. In cases of hormone-secreting tumors, the hormone in excess determines the nearly diagnostic clinical presentation.

Impact of antiplatelet treatment on colorectal cancer staging characteristics.

Aim: To evaluate whether antiplatelet medication leads to an earlier stage colorectal cancer (CRC) diagnosis.

Methods: From January 2002 until March 2010, patients that presented to our institution with the initial diagnosis of CRC and were submitted to an open curative CRC resection or a palliative procedure were retrospectively reviewed. Exclusion criteria were the use of antithrombotic medication, i.

Mesocaval shunt for portal hypertensive small bowel bleeding documented with intraoperative enteroscopy.

Introduction: Besides upper gastrointestinal tract, small bowel has also been implicated as a potential source of hemorrhage in patients with portal hypertension.

Presentation Of Case: We report an interesting case of recurrent massive small intestinal bleeding in a patient with portal hypertension secondary to liver cirrhosis treated with a mesocaval shunt. Endoscopic assessment with gastroscopy and colonoscopy failed to identify the source of hemorrhage.

A giant adrenal cyst difficult to diagnose except by surgery.

Introduction: Adrenal cysts represent rare clinical entities. Although surgical indications are well defined, pitfalls arise from the failure to establish an accurate preoperative diagnosis. Cystic lesions of other abdominal organs especially the pancreas complicate the diagnostic field.

Gestational trophoblastic neoplasia with retroperitoneal metastases: a fatal complication.

Background: Gestational Trophoblastic Neoplasia (GTN) is a pathologic entity that can affect any pregnancy and develop long after the termination of the pregnancy. Its course can be complicated by metastases to distant sites such as the lung, brain, liver, kidney and vagina. The therapeutic approach of this condition includes both surgical intervention and chemotherapy.

Surgical challenges in the treatment of leiomyosarcoma of the inferior vena cava: analysis of two cases and brief review of the literature.

Background: Leiomyosarcoma of the inferior vena cava (IVC) is a rare tumor of mesenchymal origin. Optimal treatment should include complete resection of the malignant lesion with preservation of venous return. We present our experience from two patients treated in our hospital in the last 3 years.

Correlation between early clinical response after catheter removal and diagnosis of catheter-related bloodstream infection.

We conducted a retrospective post hoc analysis of prospectively collected data of cancer patients with central venous catheters (CVCs) who developed bacteremia with positive quantitative blood cultures (QBCs) drawn simultaneously through peripheral vein and CVC and which grew the same microorganisms from both blood cultures. We investigated whether clinical response of bacteremia, within 24, 48, or 72 h post-CVC removal, could be diagnostic of catheter-related bloodstream infection (CRBSI) when compared with microbiologic methods. Clinical response to antimicrobial therapy within 24 h of CVC removal in a patient with bacteremia was found to be highly suggestive of CRBSI, a finding that correlated well with semiquantitative catheter cultures and differential QBCs.

Rifampicin-impregnated central venous catheters: a meta-analysis of randomized controlled trials.

Background: The use of antimicrobial-impregnated central venous catheters (CVCs) for the prevention of CVC microbial colonization and catheter-related bloodstream infection (CRBSI) remains controversial.

Methods: We performed a meta-analysis of randomized controlled trials (RCTs) evaluating CRBSI and colonization of CVCs impregnated with rifampicin-based antimicrobial combinations. Our main analysis compared the occurrence of CRBSI with rifampicin/minocycline-impregnated CVCs with that of non-rifampicin-impregnated CVCs.

Prospective study of the value of quantitative culture of organisms from blood collected through central venous catheters in differentiating between contamination and bloodstream infection.

Collection of blood through a central venous catheter for the diagnosis of bacteremia is a debated topic. Quantitative cultures of organisms from blood collected through central venous catheters were found to be highly sensitive, specific, and predictive of bacteremia, especially when a cutoff point of 15 colonies of skin organisms was used.

Differential quantitative blood cultures for the diagnosis of catheter-related bloodstream infections associated with short- and long-term catheters: a prospective study.

We prospectively evaluated the value of two levels of differential quantitative blood culture (DQBC) ratio (> or =2:1 or > or =5:1) in diagnosing catheter-related bloodstream infections (CRBSIs) in patients with malignancy that have short-term and long-term central venous catheters (CVCs) (<30 and > or =30 days of placement). Diagnosis of CRBSIs was based on results of semiquantitative cultures of removed catheters. For short-term CVCs a 5:1 or greater DQBC ratio had an 18% sensitivity, 67% specificity, 18% positive predictive value (PPV) and 67% negative predictive value (NPV), whereas a 2:1 or greater cut-off point for the DQBC was associated with a 45% sensitivity, 48% specificity, 26% PPV, and 68% NPV for the diagnosis of CRBSIs.

Aspergillus terreus: an emerging amphotericin B-resistant opportunistic mold in patients with hematologic malignancies.

Background: Invasive aspergillosis (IA) has emerged as a common cause of morbidity and mortality among immunocompromised patients. At The University of Texas M. D.

Long-term silicone central venous catheters impregnated with minocycline and rifampin decrease rates of catheter-related bloodstream infection in cancer patients: a prospective randomized clinical trial.

Purpose: To evaluate the efficacy of long-term nontunneled silicone catheters impregnated with minocycline and rifampin (M-R) in reducing catheter-related bloodstream infections.

Patients And Methods: This prospective, randomized, double-blind clinical trial was conducted at M.D.

Differential time to positivity: a useful method for diagnosing catheter-related bloodstream infections.

Background: Catheter-related bloodstream infections are associated with recognized morbidity and mortality, especially in critically ill patients. Accurate diagnosis of such infections results in proper management of patients and in reducing unnecessary removal of catheters.

Objective: To evaluate differential time to positivity as a method for diagnosing catheter-related bacteremias caused by both short-term and long-term use of central venous catheters.

Clinical experience with minocycline and rifampin-impregnated central venous catheters in bone marrow transplantation recipients: efficacy and low risk of developing staphylococcal resistance.

In this retrospective evaluation of the 4-year clinical use of minocycline and rifampin-impregnated catheters in bone marrow transplantation (BMT) patients, we report low risk of development of staphylococcal resistance to the antibiotics coating the catheters and efficacy in preventing primary staphylococcal bloodstream infections.

In vitro and ex vivo activities of minocycline and EDTA against microorganisms embedded in biofilm on catheter surfaces.

Minocycline-EDTA (M-EDTA) flush solution has been shown to prevent catheter-related infection and colonization in a rabbit model and in hemodialysis patients. We undertook this study in order to determine the activities of M-EDTA against organisms embedded in fresh biofilm (in vitro) and mature biofilm (ex vivo). For the experiment with the in vitro model, a modified Robbin's device (MRD) was used whereby 25 catheter segments were flushed for 18 h with 10(6) CFU of biofilm-producing Staphylococcus epidermidis, Staphylococcus aureus, and Candida albicans per ml.

Antibiotic-coated hemodialysis catheters for the prevention of vascular catheter-related infections: a prospective, randomized study.

Purpose: To determine the efficacy of minocycline-rifampin-coated hemodialysis catheters in reducing catheter-related infections in patients requiring hemodialysis for acute renal failure.

Methods: Between May 2000 and March 2002, 66 patients were randomly assigned to receive a minocycline-rifampin-impregnated central venous catheter and 64 were randomly assigned to receive an unimpregnated catheter. Patients were followed prospectively until the catheter was removed.

Minocycline-ethylenediaminetetraacetate lock solution for the prevention of implantable port infections in children with cancer.

In this prospective cohort study, minocycline-ethylenediaminetetraacetate (M-EDTA) was used as a lock solution in indwelling ports inserted in 14 children with cancer. No port infections, thrombotic events, or other adverse events were observed, compared with 10 port infections that occurred in 48 control patients whose ports were flushed with heparin. M-EDTA is a promising lock solution in long-term catheters.