Second primary carcinoma arising on a flap: a new primary or a relapse?

BACKGROUND AND AIM

Free flaps or pedicle flaps are the mainstay of cancer surgery in the head and neck area. However, their long-term sequelae are still poorly understood. Among these, the development of a secondary primary tumor on a flap is a rare and uncertain reported event.   Methods: A computer-aided systematic literature search was performed by using the PubMed, EMBASE and Cochrane Library databases. A systematic review of the literature, following the PRISMA checklist, was carried out with the aim of analyzing all the citations reporting this second primary, with attention to risk factors, behavior, etiological causes.   Results: Overall, 27 cases of second primary squamous cell carcinoma arising on a pedicle or free flap were identified. In addition, other three cases were discussed.   Conclusions: Persistent exposure to oral stimuli such saliva, oral microbiome, smoke or a colonization by the adjacent mucosa were considered as a possible cause of second primary carcinoma. Although rare, a new neoplasm onset should know and considered as a new concept in the follow-up of patients undergoing reconstruction with free or pedicle flaps.

Adult onset Xanthogranuloma presenting as a solitary laryngeal localization: case report and review of literature

Juvenile Xanthogranuloma (XG) is a rare disorder that belongs to the heterogeneous group of histiocytic neoplasms, characterized by a clonal expansion of non-Langerhans cell histiocytes that share a dermal macrophage phenotype. Although the head and neck region is the most common reported site of involvement by the Juvenile Xanthogranuloma family, laryngeal localization is extremely rare. We report a unique case of Adult Onset Xanthogranuloma with subglottic localization, presenting as a solitary laryngeal mass without other systemic or cutaneous lesions. A review of the previously described cases of laryngeal Xanthogranuloma has been performed, highlighting 7 cases of Juvenile Xanthogranuloma and only 3 cases of Adult Onset Xanthogranuloma. Despite the extreme rarity of laryngeal localization of XG, this histiocytic neoplasm should be considered as a differential diagnosis for laryngeal masses causing airway obstruction, even in the absence of other concomitant manifestations.

Anomaly of digastric muscle: an alarm bell for head and neck surgeon

Objectives: Here follows the discussion of a case of hypoplasia of both bellies of digastric muscle and the difficult during neck dissection, because of his surgical importance like a pivotal landmark.

METHODS

We reported a case report concerning digastric muscle abnormalities, accidentally discovered during neck dissection due to surgical excision of a glottic squamous cell carcinoma staged as cT3N0. A brief literature review was done to compare and research similar cases.

RESULTS

Literature counts several reports of digastric muscle abnormalities, namely involving the anterior belly. Little has been written about hypoplasia of digastric muscle.

CONCLUSION

Digastric muscle abnormalities are rare, which can be absent or, more frequently, duplicated. Albeit its anomalies are anecdotal, it is advisable to give due consideration to the hypoplasia of both bellies of the digastric muscle during the analysis of radiological imaging, in order to prevent the risk of operative complications. According to our knowledge, this is the first and singular case of digastric muscle's hypoplasia.

Antibody Persistence 6 Months Post-Vaccination with BNT162b2 among Health Care Workers

BACKGROUND

We present immunogenicity data 6 months after the first dose of BNT162b2 in correlation with age, gender, BMI, comorbidities and previous SARS-CoV-2 infection.

METHODS

An immunogenicity evaluation was carried out among health care workers (HCW) vaccinated at the Istituti Fisioterapici Ospitalieri (IFO). All HCW were asked to be vaccine by the national vaccine campaign at the beginning of 2021. Serum samples were collected on day 1 just prior to the first dose of the vaccine and on day 21 just prior to the second vaccination dose. Thereafter sera samples were collected 28, 49, 84 and 168 days after the first dose of BNT162b2. Quantitative measurement of IgG antibodies against S1/S2 antigens of SARS-CoV-2 was performed with a commercial chemiluminescent immunoassay.

RESULTS

Two hundred seventy-four HWCs were analyzed, 175 women (63.9%) and 99 men (36.1%). The maximum antibody geometric mean concentration (AbGMC) was reached at T2 (299.89 AU/mL; 95% CI: 263.53-339.52) with a significant increase compared to baseline (p < 0.0001). Thereafter, a progressive decrease was observed. At T5, a median decrease of 59.6% in COVID-19 negative, and of 67.8% in COVID-19 positive individuals were identified with respect to the highest antibody response. At T1, age and previous COVID-19 were associated with differences in antibody response, while at T2 and T3 differences in immune response were associated with age, gender and previous COVID-19. At T4 and T5, only COVID-19 positive participants demonstrated a greater antibody response, whereas no other variables seemed to influence antibody levels.

CONCLUSIONS

Overall our study clearly shows antibody persistence at 6 months, albeit with a certain decline. Thus, the use of this vaccine in addressing the COVID-19 pandemic is supported by our results that in turn open debate about the need for further boosts.

Experimental realization of optimal noise estimation for a general Pauli channel

We present the experimental realization of the optimal estimation protocol for a Pauli noisy channel. The method is based on the generation of 2-qubit Bell states and the introduction of quantum noise in a controlled way on one of the state subsystems. The efficiency of the optimal estimation, achieved by a Bell measurement, is shown to outperform quantum process tomography.

[Alcoholism and pregnancy]

The T-ACE test, introduced by Sokol, is currently used in the screening of the pregnant women at risk for alcohol abuse. In this study, this test has been applied to a group of 150 pregnant women to verify the congruity of the methodology used, sensitivity and specificity of the test. According to the answers given by the patients in the preliminary interview, 9 patients (6%) proved at risk for alcohol abuse. At the subsequent, control, interview, the answers given were all in agreement with the data obtained with the T-ACE test. The results obtained confirmed the high sensitivity and specificity of this method. Even though the comprehension of the utilized verbalization was excellent, nevertheless the test, applied to patients of a different culture in comparison with that studied by Sokol, cannot be applied in its original form, but must be diluted within a group of questions.

[Lipid-metabolic and blood coagulation factors in chronic peripheral arteriopathies]

The authors have tested serum levels of cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol, with the plasmatic levels of Antithrombin III and other parameters (Quick time, PTT, fibrinogenaemia and platelets) in patients affected by chronic obstructive arterious diseases in various stages including a group of patients affected by diabetes mellitus. The results show that there is a correlation between the behaviour of the parameter tested and the follow-up of the diseases, particularly for HDL and LDL cholesterol and Antithrombin III. The authors suggest the use of these tests for monitoring this kind of vascular peripheral diseases.