Unicentric castleman’s disease of neck node in old age- rare presentation of a rare disease

Castleman’s disease is an uncommon lymphoproliferative disorder that may be unicentric or multicentric disease. We are reporting a case of 75 year old female presented with left level 3 cervical lymph node, whose final diagnosis was unicentric castleman’s disease. This presentation is uncommon because unicentric castleman’s disease is usually seen in younger adults and it usually affects lymph nodes in chest or abdomen. People with localized Castleman’s disease are usually cured by surgical removal of the affected lymph nodes

Advanced PVT and Core Analysis for Enhanced Oil Recovery Study of Unconsolidated Sandstone Reservoir

Abstract In the matured unconsolidated sandstone reservoir of oil field, enhanced oil recovery (EOR) is important to be implemented. It is to ensure the oil production with the optimum recovery from the reservoir. It requires an integration multi disciplines rock and fluid properties evaluation. In this EOR Study with core-gas injection, it has used engineering of gas injection in advanced PVT analysis that requires a series of laboratory data to properly understand the injection solvent/reservoir fluid phase behavior and EOR displacement in core flooding. The PVT study has been performed, initially on the gas miscibility and phase behavior that consists swelling test, minimum miscibility pressure (MMP), vapour liquid equilibrium (VLE) and multi-contact evaluation and flow assurance studies. The oil and water from the particular reservoir conditions have been used in the analysis. Then it continued with reservoir characterization, core-gas injection and water alternating gas (WAG) analysis. It has involved an in-house integrated petrophysical, geological, reservoir characterization and model in the EOR study. A 3D computed tomography (CT) image and the available RRT model have been used for core plugs selection of the EOR study. The unconsolidated core samples have been plugged successfully by liquid nitrogen and cleaned, inject the higher salinity water until reaching a high water cut, inject the low salinity water in the same manner, and the wettability restoration a steady-state relative permeability with the selected fluids. The steady-state floods (gas-oil, water-oil and gas-water) have been designed to obtain relative permeability on plugs representing selected reservoir rock types at reservoir conditions (pressure and temperature). A digital rock analysis with steady state floods on the same rock types is validated, then digital rock analysis is used to obtain relative permeability data on all remaining rock types for fast time and effective cost. The saturation is determined by in situ saturation monitoring (ISSM) with X-Ray attenuation through the core. Injection continues until the pressure drop across the core sample and the measured saturation are stable. Gas and oil are injected into a sample initially at initial water saturation (Swi) with increasing gas/oil ratios up to maximum gas injection and the sample is at residual oil saturation. The optimum conditions for WAG and related parameters controlled by the core properties on the EOR displacement analysis are defined. This special integrated approach of EOR study has provided the reliable technical basis and assurance for the development of unconsolidated sandstone reservoirs. The oil recovery with current reservoir conditions range has been measured. It has benefits to maximize oil recovery from current main producing reservoir with utilizing the available gas, fluid, core, logs, production and others reservoir data which is important for successful of the field development.</jats:p

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide. Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters. Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 per cent of patients (2901 of 4223). Major complication rates (Clavien–Dindo grade at least IIIa) were 24, 18, and 27 per cent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 per cent; however, it was 41 per cent in low-to-middle- compared with 19 per cent in very high-HDI countries. Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)