Solid pseudopapillary neoplasm of the pancreas mimicking gastrointestinal stromal tumour.

Solid pseudopapillary neoplasm (SPN) of pancreas is an uncommon low-grade malignant tumour that has a remarkable postoperative cure rate. Improved awareness and widespread use of imaging have resulted in more frequent diagnosis of these tumours. We report a case of a woman in her 20s who had an abdominal lump identified as a gastrointestinal stromal tumour on imaging elsewhere. The patient was reevaluated in our hospital and given a provisional diagnosis of SPN on radiology, which was later confirmed on postoperative histopathology.

Approach to Cystic Lesions of the Pancreas: Review of Literature.

Pancreatic cystic lesions (PCL) have a wide range of demographical, clinical, morphological and histological characteristics. The distinction between these lesions is of paramount importance due to the risk of malignancy in specific categories of PCL. Considering the malignant potential for pancreatic cystic neoplasm (PCN) lesions, guidelines have been made to balance unnecessary treatment and manage the progression to malignancy. Various surgical procedures can be done for PCN depending on the location and size of the cyst; pancreatoduodenectomy is done for PCN located in the head of the uncinate process, whereas distal pancreatectomy is done for PCN in the body or tail. In the neck and proximal body of the pancreas, less extensive resections such as central pancreatectomy can be performed. Active surveillance of PCN is typically offered to asymptomatic PCNs of subtype intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms (MCN) without any concerning features. In recent years, numerous guidelines have been created to augment PCN diagnosis, classification and management. Despite this, the management of PCNs remains complex. Thus, discussions with multidisciplinary teams involving surgeons, gastroenterologists, pathologists, and radiologists are required to ensure optimum care for the patient.

Highly Active Ultrasmall Ni Nanoparticle Embedded Inside a Robust Metal-Organic Framework: Remarkably Improved Adsorption, Selectivity, and Solvent-Free Efficient Fixation of CO2.

We report integrating additional functionality in an amine decorated, robust metal-organic framework (MOF) by encapsulating Ni nanoparticles (NPs). In-depth characterization of the postmodified structure confirms well-dispersed and ultrasmall NPs inside the framework pores. Although, the surface area is more reduced than pristine MOF, the CO2 uptake capacity is remarkably increased by 35% with a large 10 kJ/mol rise in adsorption enthalpy that validates favorable interactions between CO2 and NPs. In particular, CO2 adsorption selectivity over N2 and CH4 displays significant improvement (CO2/N2 = 145.7, CO2/CH4 = 12.65), while multicycle CO2 uptake demonstrates outstanding sorption recurrence. Impressively, the embedded NPs act as highly active functional sites toward solvent-free CO2 cycloaddition with epoxides in 98% yield and 99% selectivity under relatively mild conditions. The catalyst shows high recyclability without leaching of any metal-ion/NPs and greater pre-eminent activity than the unmodified analogue or contemporary reports. Of note is that outstanding conversion and selectivity are maintained for a wide range of aliphatic and aromatic epoxides, while larger substrates exhibit insignificant conversion, demonstrating admirable size selectivity. Based on the literature reports and experimental outcome, a rationalized mechanism is proposed for the reaction. This study exclusively demonstrates how strategic encapsulation of Ni NPs influences the inherent electronic properties in a MOF for highly selective CO2 adsorption and represents a step forward to sustainable CO2 valorization in terms of abundant active sites, sufficient stability, and consistent usability.

Near Peer Group training on 'How to be a Foundation doctor' Course.

This article was migrated. The article was marked as recommended. Introduction After graduating from medical school, all UK based doctors enter the Foundation Programme. There is on-going evidence, both anecdotally and published, that final year medical students continue to feel unprepared about starting work. We thus designed a one-day course aiming to improve these students' preparedness and anxiety levels. Methods Pre-course material was provided to the students with information on the skills that were going to be explored in the course. After an initial introduction, there was an interactive demonstration to refresh the students' knowledge on assessment of an unwell patient using the recognised ABCDE approach- Airway; Breathing; Circulation; Disability; Exposure . Thereafter, the students were split into 10 groups of 3 and 4 and rotated around 10 different stations. Each station was 40 minutes long and breaks were interspersed amongst the teaching to ensure that concentration was maintained. The emphasis was on near-peer teaching with guidance from a recently qualified doctor. Feedback was requested immediately post-course and three months afterwards. Results and Feedback The immediate feedback was very positive with the overall quality rated at 3.93/4. Regarding the 3 month feedback, there was an average reduction in anxiety levels by 18.3% (p<0.0001) and improvement in perceived preparedness levels by 24.7% (p<0.0001). All students agreed that the course will help them in preparing to become a foundation doctor and that similar courses should be offered to all final year students. Conclusions Practical courses focusing on preparedness can provide a unique opportunity for collaborative training by universities and foundation trusts. These courses are well evaluated and are perceived to improve anxiety and preparedness levels.