Pancreatic abnormalities are common in inflammatory bowel disease (IBD) patients and represent a heterogeneous group of conditions that include acute pancreatitis, chronic pancreatitis, autoimmune pancreatitis and asymptomatic abnormalities. We sought to review the available evidence concerning the aetiology, clinical presentation, diagnosis and treatment of pancreatic conditions in IBD patients. A PubMed/Medline query was conducted addressing pancreatic disorders in IBD. Reference lists from studies selected were manually searched to identify further relevant reports. Relevant manuscripts about pancreatic disorders in patients with IBD were selected and reviewed. Thiopurines and gallstones are the most frequent causes of acute pancreatitis in IBD patients. Thiopurine-induced acute pancreatitis is usually uncomplicated and self-limited. Some evidence suggests that chronic pancreatitis may be more common in IBD. Most cases are idiopathic, affecting young males and patients with ulcerative colitis. Autoimmune pancreatitis is a relatively newly recognized disease and is increasingly diagnosed in IBD, particularly for type 2 autoimmune pancreatitis in ulcerative colitis patients. Asymptomatic exocrine insufficiency, pancreatic duct abnormalities and hyperamylasaemia have been identified in up to 18% of IBD patients, although their clinical significance and relationship with IBD remain undefined. The wide spectrum of pancreatic manifestations in IBD is growing and may represent a challenge to the clinician. A collaborative approach with a pancreas specialist may be the most productive route to determine aetiology, guide additional diagnostic workup, illuminate the aetiology and define the treatment and follow-up of these patients.

The article analyzes modern literature data on the importance of studying the hemodynamics of uterine tumors with dopplerometry in two- and three-dimensional regimens of echography for differential diagnosis of simple proliferating leiomyomas and sarcomas of the uterus. It is shown that the differential diagnosis of benign and malignant tumors using the dopplerometry is based on various features of the blood supply of these tumors. On the basis of the analysis of literature data, it was concluded that in the dopplerometry evaluation of benign, borderline and malignant tumors of myometrium in the two-dimensional regime, there were differences in the localization of the detected vessels in the CDM regimen, in the rates of vascular blood flow and vascular resistance in pulse dopplerometry. For a simple leiomyoma, the absence of a central intra-node localization of blood vessels in the CDM regimen, a low rate of arterial and venous blood flow, as well as an average resistance of arterial blood flow in the regime of impulsive dopplerometry are most typical; in a leiomyoma with eating disorders, the absence of a central intra-node localization of blood vessels, a low rate of arterial and venous blood flow in combination with high arterial resistance were more often observed. For the proliferating leiomyoma, the central intra-node localization of the vessels and the average blood flow velocities with low and medium resistance are characteristic. For sarcoma of the uterus, there is abundant vascularization both around the periphery and in the center, high blood flow rates and low resistance. The authors emphasize that there is information about the low specificity of this gradation, since the detection of a central type of vascularization and low resistance values can be in simple myomatous nodes with edema, eating disorders and destruction, and leads to diagnostic errors and suspicion of malignancy. In the three-dimensional dopplerometry mode for simple leiomyomas, low indices of volume perfusion indices were characteristic, and for proliferating leiomyomas and sarcomas of the uterus – high indices of volume perfusion indices exceeding those in the uterus as a whole. Based on the review of the literature, the authors concluded that the presently available echographic and dopplerometric two- and three-dimensional markers are characterized by high sensitivity, but very low specificity. The low specificity of the known ultrasonic and dopplerometric criteria combined with the rarity of cases of sarcoma in the uterus against the background of a large number of similar echographically and dopplerometrically leiomyomas lead to low

To review published literature concerning cataract surgery and dry eye disease (DED). A search was undertaken using the following PubMed (all years), Web of Science (all years), Ovid MEDLINE (R) (1946 to 12 December 2019), Ovid MEDLINE(R) Daily Update 10 December 2019, MEDLINE and MEDLINE nonindexed items, Embase (1974–2019, week 49), Ovid MEDLINE (R) and Epub Ahead of Print, In-Process and Other NonIndexed Citations and Daily (1946 to 12 December 2019), CENTRAL (including Cochrane Eyes and Vision Trials Register; Cochrane Library: Issue 12 of 12 December 2019), meta Register of Controlled Trials (mRCT) (www.con trolled-trials.com), Clinical Trials.gov (www.clinicaltrial.gov) and WHO International Clinical Trials Registry Platform (www.who.int/ictrp/search/en). Search terms included ‘cataract surgery’, ‘phacoemulsification’ and ‘cataract extraction’, combined with ‘dry eyes’ and ‘ocular surface’. Relevant in-article references not returned in our searches were also considered. Publications identified included systematic reviews, meta-analysis, randomized controlled trials, cohort studies, case series and laboratory-based studies. Published data highlighting the burden of DED both prior and following cataract surgery were reviewed as well as studies highlighting the effects of cataract surgery on the ocular surface, intra-operative measures to reduce deleterious effects on the ocular surface and current evidence on the management options of post-operative DED. DED is common and can be exacerbated by cataract surgery. Ophthalmologists need to assess for preexisting DED and instigate treatment before surgery; be aware of reduced accuracy of measurements for surgical planning in the presence of DED limit intra-operative surgical factors damaging to the ocular surface; and consider management to reduce DED post-operatively

Teratomas are the most common type of Germ Cell Tumors (GCTs). GCTs are classified as extragonadal, if there is no evidence of a primary tumor in neither the testicles, nor in the ovaries. Intracranial Mature Teratomas are tumors with a very low incidence, and clear male predominance. We present the case of a 21-year-old female patient, with a history of two seizures 15 days prior to admission, without any abnormalities upon physical examination. The Magnetic Resonance Imaging (MRI) performed at the admission evidenced an expansive, heterogeneous lesion in the frontal lobe, hypointense on T1-weighted images, hyperintense on T2-weighted images, and restriction on the diffusion imaging and ADC-mapping. The patient underwent microsurgical resection, and it was possible to achieve a near-total resection. During surgery, a welldefined capsule was identified, which was removed after adequate debulking. Tissues resembling hair were taken from inside the lesion. The patient recovered well, without any neurological deficits, and no further intervention was necessary. The authors aim to describe this rare pathology and their option for a surgical approach. Os teratomas são o tipo mais comum de Tumores de Células Germinativas (TCG). TGC são classificados como extragonadais, quando não há evidências de um tumor primário em nos testículos, ou nos ovários. Os Teratomas Maduros Intracranianas são tumores com uma incidência muito baixa, e com uma predileção pelo sexo masculino. Nós apresentamos o caso de uma paciente, feminina, 21 anos de idade, com história de dois episódios de convulsões tônico-clônicas generalizadas, 15 dias antes da admissão, sem nenhum déficit focal ao exame físico. A Ressonância Magnética realizada na chegada mostrou uma lesão sólida, expansiva, grande e heterogênea, hipointensa em T1, e hiperintensa em T2, com restrição a difusão e ADC-mapping. Foi realizado uma cirurgia, e foi possível obter uma ressecção quase total. Havia uma cápsula bem definida, a qual foi removida após adequada redução do volume tumoral. Dentro da lesão foi encontrado tecido semelhante a cabelo. A paciente se recuperou bem, e foi dado alta sem novos déficits neurológicos, não foi realizado mais nenhuma intervenção, e ela está sendo acompanhada regularmente. Os autores visam descrever essa patologia rara e sua opção por uma abordagem cirúrgica.

In the article literary data and data of own supervision on one of actual problems of modern dermatology- lichen ruber planus (LRP) of a mucous membrane of oral cavity (MMOC) are cited. Lesion of the mucous membranes is a characteristic feature LRP and is one of the most frequent manifestations of dermatoses, and may be related carried to “great” attributes which is of important diagnostic value. According to supervision of the authors, lesion of the mucous membrane was marked in 69 (32,2%) of patients with LRP. The authors registered a significant variety of clinical forms and variants of LRP course of the mucous membranes. As it is known, skin and mucous membranes are the basic organs where numerous pathomorphologic pathological manifestations of LRP are developed. But existence of both endo and exogenous mechanisms, influence on intertissue and interorgan immune relations, homeostasis, and metabolic processes this cannot but affect clinical polymorphism of skin lesions and those of mucous membrane of the oral cavity in LRP. To the authors’ opinion, hereafter it would be perspective to detail and clear up what factors of LRP and in what way affect skin lesions and those of mucous membranes, as well as under what conditions they are realized.

It has been 4 years since the first, lon§-term (> 3 years) prospective comparison of adult-to-adult livin§ do- nor liver transplantation (A2ALLTx) to adult deceased donor liver transplantation (ADDLTx) was reported.1 In this follow up, prospective, IRB approved, 10-year comparison of A2ALLTx to ADDLTx we expand on our initial observations. This data includes: a§e, §ender, ethnicity, primary liver disease, waitin§ time, pretrans- plant CTP/YELD score, cold ischemia time (CIT), perioperative mortality, acute and chronic rejection, §raft and patient survival, char§es and post-transplant complications. In 10 years, 465 ADDLTx (81.3%) and 107 A2ALLTx (18.7%) were performed at VCUHS. Hepatitis C virus (HCV) was the most common reason for transplantation in both §roups (54.5% vs. 48.2%). Data re§ardin§ overall patient and §raft survival and retransplantation rates were similar. Comparison of patient/§raft survivals, retransplantation rates in patients with and without HCV were not statistically different. A2ALLTx patients had less acute rejection (9.6% vs. 21.7%) and more biliary complications (27.1% vs. 17.6%). In conclusion, A2ALLTx is as durable a liver replacement technique as the ADDLTx. Patients with A2ALLTx were youn§er, had lower YELD scores, less acute rejection and similar histolo§ical HCV recurrence. Biliary complications were more common in A2ALLTx but were not associated with increased §raft loss compared to ADDLTx.

Rectal bleeding is a common symptom experienced by pregnant women. Although the majority of cases are attributable to benign conditions such as haemorrhoids and anal fissures, other more serious diagnoses such as inflammatory bowel disease and malignancy should not be overlooked. Most investigations are safe during pregnancy and these should not be withheld as significant implications on both foetal and maternal morbidity may result. In these cases, a multidisciplinary team approach is essential. This review explores the differential diagnosis, investigation and management of rectal bleeding during pregnancy

To screen for keratoconus and potential associated risk factors in a tertiary student population sample. This cross sectional study included 1234 students attending An-Najah National University (Nablus, West Bank, Palestine), that were randomly selected from a total of 20,000 university students. 634 (51.3%) student participants responded by completing a self-administered questionnaire and were assessed by means of corneal topography. Following initial evaluation, participants were referred for Pentacam evaluation if they demonstrated either a mean keratometry of more than 45 diopters, corneal astigmatism of more than 2 diopters and/or if asymmetric topographic patterns were present. Pentacam images were analyzed by an experienced ophthalmologist based on a number of indices and the participants were classified as normal, keratoconus suspects, and keratoconus patients. A total of 620 participants (mean age, 20.1±1.6 years) were included in this study, 379 (61.1%) were females and 241 (38.9%) were males. Nine subjects were diagnosed with keratoconus, demonstrating a prevalence of 1.5%. 52 (8.4%) participants showed at least one abnormal pentacam index, and were considered as KC suspects. Keratoconus is a prevalent disease among the tertiary Palestinian student population. This may be related to a combination of genetic and environmental factors. The results of this study signal the need for public health outreach and intervention for keratoconus.