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Abstract Background Cancer patients with pelviabdominal masses can suffer from lower extremity symptoms due to venous compression. The effectiveness of venous stenting has been established in extrinsic venous compression in benign conditions like May-Thurner syndrome. In this retrospective study we evaluate the efficacy and safety of caval, iliocaval and iliofemoral venous stenting for cases of extrinsic venous compression caused by malignant masses in cancer patients. Methods IRB-approved retrospective review of patients who underwent iliofemoral venography with venoplasty and stenting between January 2018 and February 2022 was performed. Patients with extrinsic venous compression caused by malignant masses were included. Data on patient demographics, pre-procedure symptoms, procedural technique, stent characteristics, outcomes and follow-up were collected. Descriptive statistics were used to assess technical success, clinical success, primary stent patency and adverse events of the procedure. Results Thirty-seven patients (19 males, 18 females) who underwent 45 procedures were included. Deep venous thrombosis (DVT) was present in 21 (57%) patients. Twenty-nine patients (78%, 95% CI 62–90%) reported clinical improvement of the presenting symptoms. The median overall survival after the procedure was 4.7 months (95% CI 3.58–5.99). Eight (22%) patients were alive at last follow up with median follow up of 10.33 months (Range 2–25 months). Twenty-six patients had patent stents on their last follow up imaging (70%, 95% CI 61%-91%). Two patients had a small access site hematoma which resolved spontaneously. Two patients developed moderate, and 1 patient developed severe adverse events related to post procedure therapeutic anticoagulation. Conclusion Venous stenting is a safe procedure and should be considered as part of the palliative care for patients with debilitating lower extremity symptoms related to iliocaval and iliofemoral venous compression. Graphical Abstract

PURPOSETo compare the safety and efficacy of sclerotherapy and lymphatic embolization (LE) in the treatment of symptomatic iatrogenic lymphoceles following the placement of a percutaneous drainage catheter.METHODSThis is a retrospective study of 46 patients who underwent sclerotherapy (17 patients) or LE (29 patients) for the management of symptomatic iatrogenic lymphoceles following percutaneous drain placement between January 2017 and December 2021. The demographic characteristics, time between surgery and lymphatic intervention, clinical presentation, number of procedures, drain output pre- and post-intervention, time from intervention to drain removal, and adverse events were collected and compared for both groups. The clinical success rate, defined as the successful removal of the drain after one procedure, was calculated. Adverse events were reported according to the Society of Interventional Radiology classification. A statistical analysis was conducted using SPSS, and the P value for statistical significance was set at 0.05. The Mann–Whitney U test was used to compare differences in the scale variables, and Fisher’s exact test was used to compare the categorical and ordinal variables between both groups.RESULTSA total of 46 patients with 49 lymphoceles met the inclusion criteria of the study. Of these patients, 17 patients (19 lymphoceles) underwent sclerotherapy, and 29 patients (30 lymphoceles) underwent LE as their initial procedures. The clinical success after one procedure was significantly higher (83% vs. 47%, P = 0.011), and the median time between the first intervention and drain removal was significantly shorter in the LE group (median duration of 6 vs. 13 days, P = 0.018) compared with the sclerotherapy group. No statistically significant difference in adverse events was noted between both groups (0.26 vs. 0.10, P = 0.11).CONCLUSIONThis study found that LE had a higher clinical success rate after the first procedure and a shorter time to drain removal compared with sclerotherapy. There was no difference in the rate of adverse events between both groups. Although LE is a safe and promising technique, a prospective study is needed to further compare the efficacy of both treatment modalities.

Introduction: Thyroid nodules are very common. Many are detected incidentally due to increased head and neck imaging. The majority are benign; however, malignancy can’t be excluded in many cases and tissue sampling is needed. Ultrasound guided fine needle aspiration is an easy and effective way to sample g thyroid nodules. Inadequate sampling was reported in 10-40% of the cases. Rapid On-site Evaluation (ROSE) was proposed to assess obtained sample for adequacy. The aim of this study is to identify the benefit of applying ROSE with US-FNA of thyroid nodules within our institution. Materials and methods: Patients who underwent FNA for thyroid nodules with ROSE availability documented in their procedure note between January 2017 to December 2018 were retrospectively included. All procedures were done by experienced radiologists. Aspirated material was Diff Quik stained for immediate evaluation. The final cytological diagnosis and specimen adequacy was based on The Bethesda system for reporting thyroid cytopathology. Specimen adequacy was compared between ROSE and non-ROSE groups. Results: 442 thyroid nodules were biopsied. ROSE was available for 65 nodules. Non-diagnostic rate with ROSE was 10.8% compared to 13.8% without ROSE with the difference being statistically insignificant. ROSE availability improved sample adequacy of nodules less than 3 cm with statistically significant difference of 100.0% with ROSE vs. 87% without ROSE. Conclusion: The current study does not justify the routine use of ROSE. However, ROSE availability is beneficial with smaller sized thyroid nodules and less experienced radiologists performing the procedure. Doi: 10.28991/SciMedJ-2021-0301-1 Full Text: PDF

Introduction: Hydrogen sulphide (H2S) is one of the gasotransmitters that was reported to have a cardioprotective effect at its physiological levels in blood. Previous determinations of H2S levels in cardiovascular disease (CVD) patients suffered from diversity of analytical methods, different targeted chemical forms of the gas, and multitude of matrices assessed.Objectives: In this study, a comparative biological sample preparation study is detailed for optimum selective determination of the unionized form of H2S in blood of CVD patients using a new in-house POCT portable spectrofluorometer together with a Reagent-Analyser system.Methods: Dansyl azide was synthesized to react with hydrogen sulfide in biological matrix to produce the fluorescent dansyl amide. Fluorescence was measured at λex 340 nm and λem 517 nm in the new in-house POCT portable spectrofluorometer. The method was validated according to ICH guidelines. Several blood sample treatments and reaction protocols were compared to achieve maximum fluorescence yield.Results: The H2S Analyser was verified in comparison to a benchtop spectrofluorometer where linearity was confirmed in the range of 3–300 μM, LOD being 1 μM, at λex 340 nm and λem 517 nm. Sample treatment involving blood centrifugation followed by addition of reagent on plasma produced maximum fluorescence yield. Analysis of blood samples of myocardial infarction (MI) patients and controls showed elevated levels of H2S in MI patients (28 μM ± 1.111) vs. controls (23 μM ± 1.036) at p = 0.0015.Conclusion: The study is novel in being a POCT approach for selective determination of H2S molecular form in plasma after simple optimized sample treatment. The study confirms that MI is associated with H2S elevated levels up to 10 hours from emergence of symptoms.