Detecting a rare composite small bowel lymphoma by Magnetic Resonance Imaging coincidentally: A case report with radiological, surgical and histopathological features

INTRODUCTION

Diagnosing lymphoma continues to prove challenging in the clinical practice. Composite lymphoma (CL) is defined by the coexistence of different lymphoma subtypes in the same anatomical location. This condition has seldom been witnessed in the gastrointestinal (GI) tract. We weren't able to find previous cases in the literature about small bowel CL with follicular lymphoma (FL) and classical Hodgkin lymphoma (CHL). Surgery is the treatment of choice to obtain accurate histology, to manage and prevent acute complications. We state that this work has been reported in line with the SCARE criteria.

CASE PRESENTATION

We describe an extremely rare case of small bowel CL, presenting as an intestinal bulky mass with circumferential infiltration of bowel loops. The small bowel tumor was incidentally detected by abdominal Magnetic Resonance Imaging (MRI) in a 64-year-old man who suffered from rectal discomfort and non-specific clinical symptoms. After this radiological finding, the patient underwent multiphase contrast computed tomography (MDCT) for initial staging and to study vascular involvement. Surgery was recommended to obtain an accurate diagnosis both due to initial symptoms of the intestinal obstruction and to avoid small bowel complications. The histopathological examination revealed a small bowel CL composed mainly of B cells FL with also CHL components.

CONCLUSION

It is important to note that involvement of the proximal ileal loops is very rare in small bowel lymphoma. MRI represents a precious diagnostic tool to evaluate the intra and extramural extent of the tumor.

Impact of Preoperative CA 15-3 Levels in Operable Breast Cancer. Comparison with Tissue Polypeptide Antigen (TPA) and Carcinoembryonic Antigen (CEA)

CA 15-3, TPA and CEA were assayed before surgery in 60 patients with breast cancer. A significant association was found between preoperative CA 15-3 levels and some of the most important prognostic factors in breast cancer, such as lymph node status and tumor size. No similar association was discovered for CEA and TPA.

Preoperative CA 15-3 levels were also significantly associated with early recurrences of the disease, thus adding useful information to prognosis especially in N + patients.

Salivary α-amylase as a marker of stress reduction in individuals with intellectual disability and autism in response to occupational and music therapy

BACKGROUND

Although the benefits of a range of disability-centric therapies have been well studied, little remains known about how they work, let alone how to monitor these benefits in a precise and reliable way.

METHODS

Here, in two independent studies, we examine how sessions consisting of occupational or music therapy, both widely recognised for their effectiveness, modulate levels of salivary α-amylase (sAA), a now time- and cost-efficient marker of stress, in individuals with intellectual disability and autism spectrum disorder. Pre-session and post-session levels of sAA were compared in both groups in response to therapy and control sessions.

RESULTS

In comparison to control sessions, occupational therapy significantly dampened rises in sAA levels while music therapy significantly decreased baseline sAA levels, highlighting the ability of both types of therapy to reduce stress and by proxy contribute to enhancing overall well-being.

CONCLUSIONS

Not only do these results confirm the stress-reducing nature of two types of multisensory therapy, but they support the use of sAA as a potential tool for evaluating stress levels in individuals with intellectual disability and autism spectrum disorder, providing an important physiological lens that may guide strategies in clinical and non-clinical care for individuals with disabilities.

Comparison of the mesophilic and thermophilic anaerobic digestion of spent cow bedding in leach-bed reactors

Anaerobic digestion of spent cow bedding in batch leach-bed reactors (LBRs) was compared in mesophilic and thermophilic conditions for the first time. Results show that the use of thermophilic conditions enhanced only the degradation kinetics of easily-degradable matter during the first days of the digestion, whereas similar methane yields (80% of the Biomethane Potential) were reached after 42days at both temperatures. Therefore, the anaerobic digestion in LBRs of spent cow bedding, a substrate rich in slowly-degradable compounds, was not improved in term of methane production considering the overall digestion time. Moreover, the high initial biogas production rate in thermophilic reactors was found to significantly reduce the energetic performance of the cogeneration unit at industrial scale, leading to a 5.9% decrease in the annual electricity production when compared to a mesophilic one.

Leachate flush strategies for managing volatile fatty acids accumulation in leach-bed reactors

In anaerobic leach-bed reactors (LBRs) co-digesting an easily- and a slowly-degradable substrate, the importance of the leachate flush both on extracting volatile fatty acids (VFAs) at the beginning of newly-started batches and on their consumption in mature reactors was tested. Regarding VFA extraction three leachate flush-rate conditions were studied: 0.5, 1 and 2Lkg^-1TSd^-1. Results showed that increasing the leachate flush-rate during the acidification phase is essential to increase degradation kinetics. After this initial phase, leachate injection is less important and the flush-rate could be reduced. The injection in mature reactors of leachate with an acetic acid concentration of 5 or 10gL^-1 showed that for an optimized VFA consumption in LBRs, VFAs should be provided straight after the methane production peak in order to profit from a higher methanogenic activity, and every 6-7h to maintain a high biogas production rate.

Examining cross-cultural differences in autism spectrum disorder: A multinational comparison from Greece, Italy, Japan, Poland, and the United States

Autism spectrum disorder (ASD) is characterized by social and communication impairments as well as restricted, repetitive behavior patterns. Despite the fact that ASD is reported worldwide, very little research exists examining ASD characteristics on a multinational scale. Cross-cultural comparisons are especially important for ASD, since cultural differences may impact the perception of symptoms. Identifying behaviors that are similarly reported as problematic across cultures as well as identifying behaviors in which there is cultural variation could aid in the development and refinement of more universally effective measures. The present study sought to examine similarities and differences in caregiver endorsement of symptom severity through scores on the Baby Infant Screen for Children with aUtIsm Traits (BISCUIT). The BISCUIT was utilized to examine ASD core symptomology in 250 toddlers diagnosed with ASD from Greece, Italy, Japan, Poland, and the United States. Significant differences in overall ASD symptom severity and endorsement were found between multinational groups. Implications of the results are discussed.

Mesophilic anaerobic digestion of several types of spent livestock bedding in a batch leach-bed reactor: substrate characterization and process performance

Spent animal bedding is a valuable resource for green energy production in rural areas. The properties of six types of spent bedding collected from deep-litter stables, housing either sheeps, goats, horses or cows, were compared and their anaerobic digestion in a batch Leach-Bed Reactor (LBR) was assessed. Spent horse bedding, when compared to all the other types, appeared to differ the most due to a greater amount of straw added to the litter and a more frequent litter change. Total solids content appeared to vary significantly from one bedding type to another, with consequent impact on the methane produced from the raw substrate. However, all the types of spent bedding had similar VS/TS (82.3-88.9)%, a C/N well-suited to anaerobic digestion (20-28, except that of the horse, 42) and their BMPs were in a narrow range (192-239NmLCH₄/gVS). The anaerobic digestion in each LBR was stable and the pH always remained higher than 6.6 regardless of the type of bedding. In contrast to all the other substrates, spent goat bedding showed a stronger acidification resulting in a methane production lag phase. Finally, spent bedding of different origins reached, on average, (89±11)% of their BMP after 60days of operation. This means that this waste is well-suited for treatment in LBRs and that this is a promising process to recover energy from dry agricultural waste.

CTA and DSA Evaluation of Patients with Subarachnoid Haemorrhage

We correlate digital subtraction angiography (DSA) and computed tomography with angiographic 3D reconstruction (CTA) in patients with subarachnoid haemorrhage. 45 patients were evaluated with both techniques (CTA and DSA) within 3–4 days after acute haemorrhage: source CT images, MIP and 4D-angio reconstruction and standard DSA were performed and correlated. The MIP tecnique is very easy and quick to perform and operator independent, while 4D-angio reconstruction requires at least 30 minutes to obtain good quality images.

CTA and DSA were equivalent in demonstrating the presence of all 57 aneurysms in the 45 patients. Most aneurysms were located at the level of the circle of Willis; CTA was not adequate to demonstrate the neck of aneurysms in 7 cases located in of the syphon, vertebral artery and posterior communicating artery; CTA gave a good display of the thrombus within the aneurysm.

Patients could go directly from the CT diagnostic room to the operating room in certain types of aneurysm such as those in the anterior communicating artery or middle cerebral artery in which there is a correlation between site of the haemorrhage and the aneurysm. In the future, improvements in MR technology will also exclude aneurysms in sites difficult to evaluate by CTA such as the syphon, so that DSA will be performed only in selected doubtful cases.

Categorizing the cries of infants with ASD versus typically developing infants: A study of adult accuracy and reaction time

BACKGROUND

The cries of children with Autism Spectrum Disorder (ASD) contain atypical acoustic features. The cries of typically developing infants elicit automatic adult responses, but little is known about how the atypical cries of children with ASD affect the speed with which adults process them.

METHOD

We used a reaction time (RT) categorical task to analyze adults' categorization of typically developing cries, atypical (ASD) cries, mammalian animal cries, and environmental noise control sounds. 40 nonparent women (M age = 27 years) were instructed to categorize acoustic stimuli as human infant cries or non-human sounds as quickly as possible.

RESULTS

The RTs for correctly categorizing the cries of children with ASD (M = 831ms, SEM = 27) were slower than RTs for typically developing child cries (M = 680ms, SEM = 6) as well as mammalian animal cries (801ms, SEM = 11) and environmental noise control sounds (M = 692ms, SEM = 10).

CONCLUSIONS

This difference may reflect difficulties in adults' perceiving and processing atypical cries of children with ASD, and the findings may have implications for the parent-child relationship and for the quality of care children with ASD receive.