Incidental neuroendocrine tumor of the appendiceal base less than20 mm in diameter: is appendectomy enough?

The appendixis the second primary site for neuroendocrine tumors. The management of incidentelly discovered neuroendocrine tumor of the appendiceal base less than 20 mm in diameter is still controversal. The aim of this study was to discuss the management of such tumors. Three patients were operated on for acute  appendicitis. Histopathologic examination of surgery specimens revealed neuroendocrine tumors of the appendiceal base less than 20 mm in diameter. Since no one presented with poor prognostic factors, no complementary right hemicolectomy was performed. No recurrence was observed. The existence of  poorprognostic factors at histopathologic examination should indicate complementary right hemicolectomy for incidental neuroendocrine tumor of the appendiceal base less than 20 mm in diameter.Key words: Neuroendocrine tumors, appendix, treatmen

Incidental neuroendocrine tumor of the appendiceal base less than20 mm in diameter: is appendectomy enough? Case series Open Access

Abstract The appendixis the second primary site for neuroendocrine tumors. The management of incidentelly discovered neuroendocrine tumor of the appendiceal base less than 20 mm in diameter is still controversal. The aim of this study was to discuss the management of such tumors. Three patients were operated on for acute appendicitis. Histopathologic examination of surgery specimens revealed neuroendocrine tumors of the appendiceal base less than 20 mm in diameter. Since no one presented with poor prognostic factors, no complementary right hemicolectomy was performed. No recurrence was observed. The existence of poorprognostic factors at histopathologic examination should indicate complementary right hemicolectomy for incidental neuroendocrine tumor of the appendiceal base less than 20 mm in diameter

High-risk clonal lineages among extended-spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae from urban and rural stagnant water samples in Tunisia

This study sought to investigate the occurrence and subsequently to characterize extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae from urban and rural stagnant water samples during the wet season (December to February) in several regions of northern Tunisia. From 56 stagnant water samples, 14 ESBL-producing Enterobacteriaceae were recovered, including 9 Escherichia coli, 3 Klebsiella pneumoniae, and 2 K. oxytoca. Most isolates were multidrug-resistant, with ESBL production primarily encoded by bla(CTX-M-15) (n = 8) and bla(CTX-M-1) (n = 4) followed by bla(CTX-M-55) (n = 1) and bla(TEM-26) (n = 1). One K. pneumoniae isolate co-harbored bla(KPC) and bla(CTX-M-15) genes. Class 1 integrons were detected in 4 isolates, however, sul1, sul2, and aac(60)-Ib-cr genes were detected in eleven, two, and four isolates, respectively. The nine E. coli isolates belonged to seven sequence types namely, B2/ST131 (3 isolates), A/ST164, A/ST10, A/ST224, A/ST38, A/ST155, and A/ST69 (each of them one isolate). The three K. pneumoniae isolates were assigned to three sequence types: ST101, ST405 (harboring CTX-M-15 and KPC), and ST1564. Overall, the phenotypic and genotypic traits of collected isolates mirror the molecular epidemiology of ESBL-producing enterobacteria in Tunisia and highlight the potential role of stagnant water in both urban and rural areas as a reservoir of ESBL-producing Enterobacteriaceae