Most are asymptomatic at diagnosis, frequency increases with age
Symptoms: acute pancreatitis (Wirsung obstructed by the cyst or mucus), pain, obstructive chronic pancreatitis, jaundice
> symptoms, >malignancy risk!
Cross-sectional imaging often reveals unexpected pancreatic cystic lesions, it is a frequent clinical problem, Should we observe or remove it? What's the diagnosis? Is our patient in danger of malignancy?
Don’t miss this @aegastro @my_ueg #EducAEG #UEGambassador twitter thread
Most are asymptomatic at diagnosis, frequency increases with age
Symptoms: acute pancreatitis (Wirsung obstructed by the cyst or mucus), pain, obstructive chronic pancreatitis, jaundice
> symptoms, >malignancy risk!
Mucinous: intraductal papillary mucinous neop. and mucinous cystic neop.
Nonmucinous: serous cystic neoplasm, solid pseudopapillary neoplasm and cystic neuroendocrine tumours
Endoderm- derived columnar epithelium is characteristic for mucinous lesions
👇
Characterized by papillary proliferation+mucus production. It may involve Wirsung (becomes dilated) and/or branch ducts (cysts connected to the ductal system). It may evolve to pancreatic cancer particularly if Wirsung is involved
Intestinal: main duct, head, 40%->coloid/tubular adenoca
Pancreatobiliary: main duct,head, 68%->tubular adenoca
Oncocytic: rare, nodules,50%-> coloid/tubular adenoca
Gastric: most frequent, branch-type, uncinate, 10%->tubular adenoca
https://t.co/CyvfrBGrXZ
Main duct involvement (60% in resected specimens vs 10 to 30% in resected side branch IPMNs), specially>1cm
Contrast-enhanced mural nodules
Size>3-4cm
Symptoms
Pts at risk of PDAC even in other regions of the gland without involvement
👇👇👇
European guidelines 2018 @Gut_BMJ @chiaro_del @MarcBesselink https://t.co/x8waod12xr
Fukuoka 2017 @pancreatology@SalviaRobi https://t.co/PaEYljt5N9
Characterized by mucinous epithelium and ovarian-type stroma, in body/tail
It is described as macrocystic, septated cyst with small number of cavities, it may have eccentric calcifications, no connection to ductal system
95% women, 5-7th decades
https://t.co/x8waod12xr
@chiaro_del @MarcBesselink @Gut_BMJ
70% women, 5-7th decades, NON-MUCINOUS solitary lesion
Classic SCN is microcystic (multiple small cysts, honeycomb-like) but can be macrocystic or solid. A central scar or calcification can be present
It is a pancreatic NET with a central cystic changes. Solitary lesion, 5-6th decades, frequently with wall contrast enhancement, 10% malignant potential
It seems that these cystic NET are less aggressive than solid NET
They have malignant potential(15%), >risk if >5 cm
Young women=90% (2-3rd decades),body/tail.Solid and cystic solitary masses, calcifications,often with intracystic bleeding.They can spread to the peritoneum or distant organs like the liver
https://t.co/dAuGI0qzLK
https://t.co/x8waod12xr
https://t.co/Ywp7zQF2wE
And Pancreatic cystic neoplasms, several articles from @UpToDate Editors: JR Saltzman S Grover Authors: Asif Khalid, MDKevin McGrath, MD https://t.co/nYN3MKTnl8
More from Health
Before we get too far into 2021, I thought I’d write a thread recapping some of the research that came out of my lab in 2020. Most of this work was led by my talented team of graduate students, Kerrianne Morrison, @kmdebrabander, and @DesiRJones.
Back in January, a news story was published about Kerrianne’s study showing improved social interaction outcomes for autistic adults when paired with another autistic partner.
A detailed thread about the study and a link to the paper can be found here (feel free to DM me your email address if you’d like a copy of the full paper for this study or any of our studies):
Another paper published early in 2020 (it appeared a few months earlier online) showed that traditional standalone tasks of social cognition are less predictive of functional and social skills among autistic adults than commonly assumed in autism research.
Next, @kmdebrabander led and published an innovative study about how well autistic and non-autistic adults can predict their own cognitive and social cognitive performance.
Back in January, a news story was published about Kerrianne’s study showing improved social interaction outcomes for autistic adults when paired with another autistic partner.
A detailed thread about the study and a link to the paper can be found here (feel free to DM me your email address if you’d like a copy of the full paper for this study or any of our studies):
In our new paper out today, autistic adults held a \u201cget to know you\u201d conversation with an unfamiliar autistic or typically-developing (TD) person. We were curious: would social interaction outcomes differ when their partner was also autistic? THREAD https://t.co/4koqUKV9G1
— Noah Sasson (@Noahsasson) December 11, 2019
Another paper published early in 2020 (it appeared a few months earlier online) showed that traditional standalone tasks of social cognition are less predictive of functional and social skills among autistic adults than commonly assumed in autism research.
How well does social cognition predict functional and social skills in autism? Our new paper attempts to answer this question. This thread summarizes why we conducted the study, what we found, and why I think it\u2019s important. https://t.co/KB1nIpK0M2
— Noah Sasson (@Noahsasson) August 16, 2019
Next, @kmdebrabander led and published an innovative study about how well autistic and non-autistic adults can predict their own cognitive and social cognitive performance.
New by @kmdebrabander and our lab: Autistic adults don\u2019t differ from non-autistic adults in the accuracy of their self-assessment on general cognitive tasks but are less accurate on social cognitive tasks. This however was unrelated to social functioning https://t.co/0MrqMKKO0r
— Noah Sasson (@Noahsasson) September 20, 2020
this simple, counter narrative fact keeps cropping up all over the world.
hospital and ICU utilization has been and remains low this year.
it's terribly curious that so few of these monitoring tools provide historical baselines.
getting them is like pulling teeth.
we might think of this as an oversight until you see stuff like this:
this woman was arrested for filming and sharing the fact that their are empty hospitals in the UK.
that's full blown soviet. what possible honest purpose does that
this is the action of a police state and a propaganda ministry, not a well intentioned government and a public heath agency.
"we cannot let people see the truth for fear they might base their actions on real facts" is not much of a mantra for just governance.
90% full ICU sounds scary until you realize that 90-100% full is normal in flu season.
staffed ICU beds are expensive to leave empty. it's like flying with 15% of the plane empty. hospitals don't do that.
and all US hospitals are mandated to be able to flex to 120% ICU.
the US is currently at historically low ICU utilization for this time of year.
61% is "you're all going to go out of business" territory as is 66% full hospital use.
can you blame them for mining CARES act money? they'll die without it.
hospital and ICU utilization has been and remains low this year.
it's terribly curious that so few of these monitoring tools provide historical baselines.
getting them is like pulling teeth.
It took a Freedom of Information request but @Covid19DataUK acquired 2017-2019 averages for England hospitalizations.
— Yinon Weiss (@yinonw) December 31, 2020
2020 had 18% fewer hospitalizations than prior years.
All around the world, using hospital data without context of prior years is just a fear generating lie. pic.twitter.com/DJDpqhIQuw
we might think of this as an oversight until you see stuff like this:
this woman was arrested for filming and sharing the fact that their are empty hospitals in the UK.
that's full blown soviet. what possible honest purpose does that
this is the action of a police state and a propaganda ministry, not a well intentioned government and a public heath agency.
"we cannot let people see the truth for fear they might base their actions on real facts" is not much of a mantra for just governance.
90% full ICU sounds scary until you realize that 90-100% full is normal in flu season.
staffed ICU beds are expensive to leave empty. it's like flying with 15% of the plane empty. hospitals don't do that.
and all US hospitals are mandated to be able to flex to 120% ICU.
the US is currently at historically low ICU utilization for this time of year.
61% is "you're all going to go out of business" territory as is 66% full hospital use.
can you blame them for mining CARES act money? they'll die without it.
I applaud the #EUCancerPlan *BUT* caution: putting #meat 🥩 (a nourishing, evolutionary food) in the same box as 🚬 to solve a contemporary health challenge, would be basing policy on assumptions rather than robust data.
#FollowTheScience yes, but not just part of it!
THREAD👇
1/ Granted, some studies have pointed to ASSOCIATIONS of HIGH intake of red & processed meats with (slightly!) increased colorectal cancer incidence. Also, @WHO/IARC is often mentioned in support (usually hyperbolically so).
But, let’s have a closer look at all this! 🔍
2/ First, meat being “associated” with cancer is very different from stating that meat CAUSES cancer.
Unwarranted use of causal language is widespread in nutritional sciences, posing a systemic problem & undermining credibility.
3/ That’s because observational data are CONFOUNDED (even after statistical adjustment).
Healthy user bias is a major problem. Healthy middle classes are TOLD to eat less red meat (due to historical rather than rational reasons, cf link). So, they
4/ What’s captured here is sociology, not physiology.
Health-focused Westerners eat less red meat, whereas those who don’t adhere to dietary advice tend to have unhealthier lifestyles.
That tells us very little about meat AS SUCH being responsible for disease.
#FollowTheScience yes, but not just part of it!
THREAD👇
\U0001f534LIVE \U0001f4c5Today \u23f012:00 CET
— EU_HEALTH - #EUCancerPlan (@EU_Health) February 3, 2021
We are presenting today the #EUCancerPlan as part of a strong \U0001f1ea\U0001f1fa#HealthUnion
Follow the presentation live here: https://t.co/Cr8ATvzNkg#WorldCancerDay pic.twitter.com/zdByuklWV6
1/ Granted, some studies have pointed to ASSOCIATIONS of HIGH intake of red & processed meats with (slightly!) increased colorectal cancer incidence. Also, @WHO/IARC is often mentioned in support (usually hyperbolically so).
But, let’s have a closer look at all this! 🔍
2/ First, meat being “associated” with cancer is very different from stating that meat CAUSES cancer.
Unwarranted use of causal language is widespread in nutritional sciences, posing a systemic problem & undermining credibility.
3/ That’s because observational data are CONFOUNDED (even after statistical adjustment).
Healthy user bias is a major problem. Healthy middle classes are TOLD to eat less red meat (due to historical rather than rational reasons, cf link). So, they
4/ What’s captured here is sociology, not physiology.
Health-focused Westerners eat less red meat, whereas those who don’t adhere to dietary advice tend to have unhealthier lifestyles.
That tells us very little about meat AS SUCH being responsible for disease.
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The UN just voted to condemn Israel 9 times, and the rest of the world 0.
View the resolutions and voting results here:
The resolution titled "The occupied Syrian Golan," which condemns Israel for "repressive measures" against Syrian citizens in the Golan Heights, was adopted by a vote of 151 - 2 - 14.
Israel and the U.S. voted 'No' https://t.co/HoO7oz0dwr
The resolution titled "Israeli practices affecting the human rights of the Palestinian people..." was adopted by a vote of 153 - 6 - 9.
Australia, Canada, Israel, Marshall Islands, Micronesia, and the U.S. voted 'No' https://t.co/1Ntpi7Vqab
The resolution titled "Israeli settlements in the Occupied Palestinian Territory, including East Jerusalem, and the occupied Syrian Golan" was adopted by a vote of 153 – 5 – 10.
Canada, Israel, Marshall Islands, Micronesia, and the U.S. voted 'No'
https://t.co/REumYgyRuF
The resolution titled "Applicability of the Geneva Convention... to the
Occupied Palestinian Territory..." was adopted by a vote of 154 - 5 - 8.
Canada, Israel, Marshall Islands, Micronesia, and the U.S. voted 'No'
https://t.co/xDAeS9K1kW
View the resolutions and voting results here:
The resolution titled "The occupied Syrian Golan," which condemns Israel for "repressive measures" against Syrian citizens in the Golan Heights, was adopted by a vote of 151 - 2 - 14.
Israel and the U.S. voted 'No' https://t.co/HoO7oz0dwr
The resolution titled "Israeli practices affecting the human rights of the Palestinian people..." was adopted by a vote of 153 - 6 - 9.
Australia, Canada, Israel, Marshall Islands, Micronesia, and the U.S. voted 'No' https://t.co/1Ntpi7Vqab
The resolution titled "Israeli settlements in the Occupied Palestinian Territory, including East Jerusalem, and the occupied Syrian Golan" was adopted by a vote of 153 – 5 – 10.
Canada, Israel, Marshall Islands, Micronesia, and the U.S. voted 'No'
https://t.co/REumYgyRuF
The resolution titled "Applicability of the Geneva Convention... to the
Occupied Palestinian Territory..." was adopted by a vote of 154 - 5 - 8.
Canada, Israel, Marshall Islands, Micronesia, and the U.S. voted 'No'
https://t.co/xDAeS9K1kW
