RESUMO
Paragangliomas are rare, non-epithelial neuroendocrine neoplasms originating in paraganglia, for instance the adrenal medulla, or at extra-adrenal locations. The aim of this study was to review the literature regarding abdominal extra-adrenal paragangliomas diagnosed pre-operatively with fine-needle biopsy (FNA and/or FNB). The PubMed database was searched to identify such cases, using a specific algorithm and inclusion/exclusion criteria. An unpublished case from our practice was also added to the rest of the data, resulting in a total of 36 cases for analysis. Overall, 24 (67%) lesions were found in females, whereas 12 (33%) in males. Most (21/36; 58.33%) were identified around and/or within the pancreatic parenchyma. FNA and/or FNB reached or suggested a paraganglioma diagnosis in 17/36 cases (47.22%). Of the preoperative misdiagnoses, the most common was an epithelial neuroendocrine tumor (NET). Regarding follow-up, most patients were alive with no reported recurrence; however, 5/36 patients exhibited a recurrence or a widespread disease, whereas one patient died 48 months following her diagnosis. In two patients, transient hypertension was reported during the EUS-FNA procedure. In conclusion, this study showed that the preoperative diagnosis of these lesions is feasible and, while diagnostic pitfalls exist, they could significantly be avoided with the application of immunochemistry.
RESUMO
The objective of this work was to determine the composition and production rate of dental solid waste, produced by dental practices in the Prefecture of Xanthi, a multicultural area in Northeast Greece with a population of 102,000. For the study, 22 private dental practices and 1 public dental practice were selected of the 48 private and 5 public dental practices in operation. The 22 private dental practices included 16 owned by Christian Greek-born dentists, 3 by Moslem dentists and 3 by Christian dentists repatriated from the former Soviet Union. Differentiation on the basis of religion is directly related to the countries from which dentists received their training, e.g., Greece-European Union, Turkey and former Soviet Union. Thus, including the one public dental practice, 4 study groups were considered. Waste collection took place for 22 working days, from 20 May to 27 June 2002. This period was considered to be a representative one for a semi-rural area, such as Xanthi. Dentists were instructed to collect the total amount of waste they produced. A total of 260 kg dental solid waste was collected during the study period and was manually separated. Dental solid waste was classified in three main categories: (1) Infectious and potentially infectious waste, accounting for 94.7% by weight. (2) Non-infectious waste accounting for 2.0%. (3) Domestic-type waste, accounting for 3.3% by weight. The category of infectious waste is classified as hazardous and includes components containing metal (8.51%), components without metal (91.18%) and amalgam (0.33%). Using the weight data, the production rate of dental solid waste for the study period in the Prefecture of Xanthi was determined to be 513 g/practice/day and of infectious and potentially infectious waste 486 g/practice/day. The latter includes the production rate of sharps (9.8 g/practice/day), non-sharps (31.6), infectious waste without metal (443) and amalgam (1.6 g/practice/day). Since dental solid waste is currently disposed of in landfills together with the municipal solid waste, the results of the study were used to suggest an appropriate management scheme. The results were also used to compare the composition and production rates of dental solid waste produced by the 4 study groups.