Health Scan: Rare benign tumor removed from pancreas with radio waves

Shaare Zedek Hospital (photo credit: MARC ISRAEL SELLEM/THE JERUSALEM POST)
Shaare Zedek Hospital
Radio-frequency ablation (RFA) to remove insulinoma – a rare, usually benign tumor of the pancreas that is derived from beta cells and secretes insulin – has been used for the first time in Israel at Jerusalem’s Shaare Zedek Medical Center. The technique, performed recently on a 44-year-old man, was developed by doctors in South Korea.
Dr. Alain Dancour, head of the endoscopic ultrasound unit in the hospital’s gastroenterology department, performed the procedure on the patient, who was suffering from repeated drops in blood sugar. The non-invasive treatment made it unnecessary to perform major surgery, which would include the complete removal of the duodenum and the head of the pancreas.
The man had suffered from hypoglycemia – bouts of low blood sugar –for five years, causing confusion and even loss of consciousness. The tumor, which releases insulin in large amounts, had to be removed.
But the man, who works as a lifeguard, refused to undergo the major operation because it would take so long to recover and endanger his job.
When Dancour was at a medical conference in Marseille, he learned of RFA on the pancreas. Since then, he took advanced training for several months in radio ablation that included conducting experiments and performing procedures. He noted that it is suitable not only for insulinoma but also for other procedures involving the pancreas.
RFA involves use of a new device that consists of a regular echo-endoscopy device mounted on an ultrasound transducer through which a needle is introduced. The radio waves heat up the needle that, when touching the diseased tissue, burns the tumor.
Shaare Zedek said it was one of the first times anywhere that RFA was used to treat an insulinoma; only about 15 cases have been reported, and only three have been published in medical journals.
The Jerusalem patient feels well and has no pain. His blood sugar levels have dropped to an almost-normal range thanks to the removal of the tumor. He was discharged 24 hours later.
A clinic for treating eating disorders in adults (over the age of 18) has opened at Hadassah University Medical Center in Jerusalem’s Ein Kerem with the aim of preventing hospitalization. It is claimed to be the only such framework for people in this age group who suffer from anorexia, bulimia and other conditions.
The multidisciplinary staff teaches patients healthy eating habits to ensure stable weight and functioning.
They also aim at producing a positive body image and helping patients cope with personal, family and social difficulties.
Recovery, if at all, from eating disorders usually takes between four and seven years. Many sufferers, especially women, are hospitalized repeatedly.
Dr. Shikma Keller, an eating disorders expert, runs the program, which includes eating three meals a day to inculcate good habits. It operates five days a week and is staffed by a psychiatrist, psychologists, clinical dietitians, social worker, art therapist and more. Treatment is given in individual and group sessions.
Most treatment centers for eating disorders in the country are for inpatients and serve only children and adolescents, rather than adults, said Hadassah Medical Organization director-general Prof Zeev Rotstein.
With pharmaceutical companies reluctant to develop new antibiotics because they prefer more profitable drugs for chronic diseases – and in light of the growing bacterial resistance due to overuse of antibiotics, the World Health Organization has published its first-ever list of antibiotic- resistant “priority pathogens.”
The catalogue includes 12 families of bacteria that pose the greatest threat to human health.
The list was drawn up in a bid to guide and promote research and development of new antibiotics, as part of the WHO’s efforts to address growing global resistance to antimicrobial medicines.
The list highlights in particular the threat of gram-negative bacteria that are resistant to multiple antibiotics.
These bacteria have built-in abilities to find new ways to resist treatment and can pass along genetic material that allows other bacteria to become drug-resistant as well.
“This list is a new tool to ensure that R&D responds to urgent public health needs,” said Dr Marie- Paule Kieny, WHO’s assistant director- general for health systems and innovation.
“Antibiotic resistance is growing, and we are fast running out of treatment options. If we leave it to market forces alone, the new antibiotics we most urgently need are not going to be developed in time.”
The most critical group of all includes multi-drug-resistant bacteria that pose a particular threat in hospitals, nursing homes and among patients whose care requires devices such as ventilators and blood catheters. They include Acinetobacter, Pseudomonas and various Enterobacteriaceae (including Klebsiella, E. coli, Serratia, and Proteus) that can cause severe and often deadly infections, such as bloodstream infections and pneumonia.
These bacteria have become resistant to a large number of antibiotics, including carbapenems and third generation cephalosporins – the best available antibiotics for treating multi-drug resistant bacteria.
The second and third tiers in the list – the high and medium priority categories – contain other increasingly drug-resistant bacteria that cause more common diseases such as gonorrhea and food poisoning caused by salmonella.
While more R&D is vital, it cannot solve the problem alone, the WHO said. To address resistance, there must also be better prevention of infections and appropriate use of existing antibiotics in humans and animals, as well as rational use of any new antibiotics that are developed in future.