Preoperative Parathyroid Needle Localization: A Minimally Invasive Novel Technique in Reoperative Settings

Background. Reoperative parathyroid surgery for primary hyperparathyroidism can be challenging. Numerous preoperative localization techniques have been employed to facilitate a more focused surgical exploration. This paper describes a novel, minimally invasive, and highly successful method of parathyroid localization. Methods. Patients with recurrent or persistent primary hyperparathyroidism underwent parathyroidectomy following CT scan or ultrasound-guided wire localization of the parathyroid. Accurate placement was confirmed by fine-needle aspiration with immunocytochemistry or PTH washout. The guide wire was left in situ to guide surgical excision of the gland. Curative resection was established by monitoring intact serum PTH levels after excision of the adenoma. Results. All ten patients underwent successful redo-targeted parathyroidectomy. Nine of the ten patients were discharged on the day of surgery. One patient was observed overnight due to transient postoperative hypocalcemia, which resolved with calcium supplementation. Conclusion. Placement of a localization wire via preoperative high-resolution ultrasound or CT can expedite reoperative parathyroid surgery. It allows identification of parathyroid adenoma via a minimally invasive approach, especially in cases where a sestamibi scan is inconclusive

POLYMORPHIC DELETIONS OF GLUTATHIONE S-TRANSFERASES M1, T1 AND BLADDER CANCER RISK IN ALGERIAN POPULATION

Objective: Glutathione S-transferase mu 1 (GSTM1) and GST theta 1 (GSTT1) genes are two xenobiotic metabolizing genes in Phase II of the detoxification process. The polymorphisms of GSTM1, GSTT1 genes, and smoking are involved in many cancers such as bladder cancer. Our aim was to assess the role of smoking status and GSTM1 and GSTT1 null genotypes in bladder cancer development in Algerian population.Methods: The current case–control study included 175 bladder cancer patients and 188 controls matched for age, gender, and ethnic origin. The GSTM1 and GSTT1 genotypes were determined by multiplex polymerase chain reaction using blood genomic DNA. Possible associations of stage and grade with the obtained genotypes were also tested.Results: A significant associations were observed between bladder cancer risk and tobacco smoke (p value: p=1.21E-08), GSTM1 null genotype (p=0.018), GSTT1 null genotype (p=0.009), and GSTM1/GSTT1-double null genotype (p=0.001). The combined effect of smoking and testing deletions increased the risk of bladder cancer and the most important risk was observed among smokers carrying GSTM1/GSTT1-double null genotype (p=1.09E-05). No significant association was shown between stage and grade of bladder cancer and the testing genotypes.Conclusion: This study indicated that smoking, GSTM1 null, GSTT1 null, and GSTM1/GSTT1-double null genotypes individually represent a risk factor for bladder cancer in Algerian population. The interaction smoking gene increased the risk considerably. In fact, it is suggested that patients with cigarette smoking habit and combined GSTM1 and T1 genes deletion might be at increased risk of bladder cancer

Pediatric Moyamoya Presenting as a Subarachnoid Hemorrhage from a Ruptured Anterior Cerebral Artery Aneurysm.

BACKGROUND: The incidence of Moyamoya disease (MMD)-associated intracranial aneurysms ranges from 3% to 14% in adult patients, whereas this complication has rarely been reported in children. CASE DESCRIPTION: We herein report the first case, to our knowledge, of an extremely rare subarachnoid hemorrhage presentation of a child with a ruptured anterior cerebral artery dissecting aneurysm secondary to a newly discovered, unilateral Moyamoya-like pathology. CONCLUSIONS: MMD-associated aneurysms are extremely rare in children, and hemorrhage may be the initial presentation of the disease. Prompt intervention is essential to exclude the ruptured aneurysm that is at risk of rebleeding because of persistent hemodynamic stress

The Return Back to Typical Practice From the “Battle Plan” of the Coronavirus Disease 2019 (COVID-19) Pandemic: A Comparative Study

Background: Every aspect of the medical field has been heavily affected by the coronavirus disease 2019 (COVID-19) pandemic, and neurosurgical services are no exception. Several departments have reported their experiences and protocols to provide insights for others impacted. The goals of this study are to report the load and variety of neurosurgical cases and clinic visits after discontinuing the COVID-19 Battle Plan at an academic tertiary care referral center to provide insights for other departments going through the same transition. Methods: The clinical data of all patients who underwent a neurosurgical intervention between May 4, 2020, and June 4, 2020 were obtained from a prospectively maintained database. Data of the control group were retrospectively collected from the medical records to compare the types of surgeries/interventions and clinic visits performed by the same neurosurgical service before the COVID-19 pandemic started. Results: One hundred sixty-one patients underwent neurosurgical interventions, and seven-hundred one patients were seen in clinic appointments, in the 4-week period following easing back from our COVID-19 “Battle Plan.” Discontinuing the “Battle Plan” resulted in increases in case load to above-average practice after a week but a continued decrease in clinic appointments throughout the 4 weeks compared with average practice. Conclusions: As policy-shaping crises like pandemics abate, easing back to “typical” practice can be completed effectively by appropriately allocating resources. This can be accomplished by anticipating increases in neurosurgical volume, specifically in the functional/epilepsy and brain tumor subspecialties, as well as continued decreases in neurosurgical clinic volume, specifically in elective spine

UV-Vis optoelectronic properties of α-SnWO4: A comparative experimental and density functional theory based study

We report a combined experimental and theoretical study on the optoelectronic properties of α-SnWO4 for UV-Vis excitation. The experimentally measured values for thin films were systematically compared with high-accuracy density functional theory and density functional perturbation theory using the HSE06 functional. The α-SnWO4 material shows an indirect bandgap of 1.52 eV with high absorption coefficient in the visible-light range (>2 × 105 cm−1). The results show relatively high dielectric constant (>30) and weak diffusion properties (large effective masses) of excited carriers