Methylene blue (5 mg/kg) is routinely given at our institution during parathyroidectomy. The dye stains the parathyroid glands and helps in better surgical visualisation. The technique is generally considered to be safe except for causing pseudo-cyanosis. We report a case of a patient who had confusion, agitation and altered mental status during the early postoperative course probably secondary to methylene blue infusion.

in colorectal carcinoma, carcinoembryonic antigen (CEA) is a recommended marker for surveillance after curative resection. The aim of the present study was to determine the association of preoperative CEA with recurrence of colorectal carcinoma in our population. The study included 55 patients with all operable stages of colorectal adenocarcinoma treated during the 2012-2014 period, evaluated retrospectively and followed-up for recurrence for 2 years. Data on the baseline (preoperative) CEA levels were retrieved from patient files. On data analysis, SPSS 16.0 was used. in patients with normal preoperative CEA, the rate of recurrence was significantly low (p=0.008) and the likelihood of no recurrence 1.55-fold greater as compared to patients with raised initial CEA levels (p=0.028). in patients with raised preoperative CEA, the risk of recurrence was 5.26-fold greater as compared to those with normal CEA levels (p=0.028). A significant weak positive correlation (r s =0.297) was found between raised CEA and recurrence. A highly significant (p=0.002) moderate positive correlation was recorded in patients aged <50 and moderate positive correlation of borderline significance in males (r s =0.324, p=0.058). Sensitivity was 94.4% and specificity 32.4% in predicting recurrence. Accordingly, preoperative elevated CEA showed a significant weak positive correlation with recurrence while normal preoperative CEA moderately decreased the likelihood of recurrence.

25 Background: Although up to 15% of patients with gastric cancer present at young age, the characteristics of these patients are not well described. We sought to determine if there are different clinical and pathologic characteristics associated with race and ethnicity in young gastric cancer patients. Methods: We identified all gastric adenocarcinoma patients who were younger than 45 years in the National Cancer Data Base between 2006 and 2013. We analyzed patient, tumor, and treatment-related factors as well as overall survival using standard statistical methods. Results: 5,869 patients were identified with 40.6% being Non-Hispanic Whites (NHW), 27.7% Hispanics (HS), 16.9% African Americans (AA), and 9.0% Asians (AS). HS patients presented at a younger age compared to the other groups (p < 0.01). HS presented most often with metastatic disease (59.2%) followed by AA (50.2%), NHW (49.6%), and AS (49.8%; p < 0.01). NHW presented more often with tumors in the cardia (45.7%) compared to AA (12.7%), HS (12.5%), and AS (9.6%, p < 0.01). HS (28.4%) and AA (14.2%) were more likely to be uninsured compared to AS (12.0%) and NHW (7.1%; p < 0.01). AA (60.5%) and HS (49.1%) were more likely to have below median income compared to NHW (35.8%) and AS (24.2%, p < 0.01). AS had better overall outcome, with median overall survival of 22.7 months compared to 15.2 months for NHW, 14.0 months for HS and 13.6 months for AA (p < 0.01). Independent variables associated with favorable survival included being AS or HS, cardia tumor, treatment at an academic center, higher income, and low Charlson Comorbidity Index. Conclusions: There is racial/ethnic variability in disease presentation, treatment delivery, and outcomes in young gastric cancer patients. Further studies are warranted to determine whether these variations are due to disparity in health care access and/or inherent difference in biology.

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