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Inoue K, Yasuda M, Hasegawa K, Kajihara T, Kozawa E. A case of ovarian endometrioid carcinoma: Atypical MR imaging. Radiol Case Rep 2024; 19:2245-2248. [PMID: 38523718 PMCID: PMC10957519 DOI: 10.1016/j.radcr.2024.02.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/22/2024] [Indexed: 03/26/2024] Open
Abstract
Endometrioid carcinoma is the second most common ovarian tumor, classified as an epithelial-stromal ovarian tumor, and is usually characterized by a cystic tumor with partial solid components on magnetic resonance (MR) images. In this case report, we discuss an 81-year-old female who presented with atypical genital bleeding and distended abdomen, for which she underwent abdominal computed tomography and MR imaging. Solid endometrioid carcinoma of the ovary is very rare but was confirmed in our patient during the histological examination after surgery.
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Affiliation(s)
- Kaiji Inoue
- Department of Radiology, Saitama Medical University Hospital, Saitama, Japan
| | - Masanori Yasuda
- Department of Diagnostic Pathology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Kosei Hasegawa
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Takeshi Kajihara
- Department of Obstetrics and gynecology, Saitama Medical University Hospital, Saitama, Japan
| | - Eito Kozawa
- Department of Radiology, Saitama Medical University Hospital, Saitama, Japan
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Shell AL, Crawford CA, Cyders MA, Hirsh AT, Stewart JC. Depressive disorder subtypes, depressive symptom clusters, and risk of obesity and diabetes: A systematic review. J Affect Disord 2024; 353:70-89. [PMID: 38432462 DOI: 10.1016/j.jad.2024.02.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Overlapping but divided literatures suggest certain depression facets may pose greater obesity and diabetes risk than others. Our objectives were to integrate the major depressive disorder (MDD) subtype and depressive symptom cluster literatures and to clarify which facets are associated with the greatest cardiometabolic disease risk. METHODS We conducted a systematic review of published studies examining associations of ≥2 MDD subtypes or symptom clusters with obesity or diabetes risk outcomes. We report which facets the literature is "in favor" of (i.e., having the strongest or most consistent results). RESULTS Forty-five articles were included. Of the MDD subtype-obesity risk studies, 14 were in favor of atypical MDD, and 8 showed similar or null associations across subtypes. Of the symptom cluster-obesity risk studies, 5 were in favor of the somatic cluster, 1 was in favor of other clusters, and 5 were similar or null. Of the MDD subtype-diabetes risk studies, 7 were in favor of atypical MDD, 3 were in favor of other subtypes, and 5 were similar or null. Of the symptom cluster-diabetes risk studies, 7 were in favor of the somatic cluster, and 5 were similar or null. LIMITATIONS Limitations in study design, sample selection, variable measurement, and analytic approach in these literatures apply to this review. CONCLUSIONS Atypical MDD and the somatic cluster are most consistently associated with obesity and diabetes risk. Future research is needed to establish directionality and causality. Identifying the depression facets conferring the greatest risk could improve cardiometabolic disease risk stratification and prevention programs.
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Affiliation(s)
- Aubrey L Shell
- Department of Psychiatry, Indiana University Health, United States of America
| | | | - Melissa A Cyders
- Department of Psychology, Indiana University-Indianapolis, United States of America
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Indianapolis, United States of America
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Indianapolis, United States of America.
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3
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Rodich S, Garza-Gongora R, So C, Ward R, Zreik R. Epithelioid angiosarcoma of the calf: a case report of an atypical imaging appearance. Skeletal Radiol 2024; 53:989-994. [PMID: 37787920 DOI: 10.1007/s00256-023-04456-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 10/04/2023]
Abstract
Angiosarcoma is an uncommon cause of soft tissue malignancy, accounting for approximately 2% of all soft tissue sarcomas. Of these, epithelioid angiosarcoma represents a morphologic subtype, where the malignant endothelial cells demonstrate a predominantly or exclusively epithelioid appearance. Overall, epithelioid angiosarcoma shares similar imaging characteristics to conventional angiosarcoma including a T1 hypointense to isointense and T2 hyperintense mass, which demonstrates avid enhancement, serpentine feeding vessels, and overlying skin thickening on MRI. The case herein describes a case of epithelioid angiosarcoma in a 65-year-old female presenting with an enlarging calf mass and lower extremity pain. Initial imaging features, particularly on MRI, were highly unusual for angiosarcoma which was thus not strongly considered in the initial differential diagnosis. However, once diagnosis of epithelioid angiosarcoma was confirmed following resection, pathologic correlates were utilized to account for the unusual imaging findings retrospectively. The goal of this study is to not only describe an atypical presentation of an uncommon diagnosis but also attempt to rationalize the unexpected imaging findings with gross and microscopic correlates. Further, the utility of radiology-pathology correlation demonstrated in this case may be useful to others when evaluating similar lesions with unexpected MRI characteristics.
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Affiliation(s)
- Sean Rodich
- Baylor Scott & White Health, Temple, TX, USA.
| | | | - Connie So
- Baylor Scott & White Health, Temple, TX, USA
| | | | - Riyam Zreik
- Baylor Scott & White Health, Temple, TX, USA
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4
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Wang J, Zhang H, Lin J, Yang L, Zhao L, Du A. Atypical and delayed spinal cord MRI features of COVID-19-associated myelopathies: a report of four cases and literature review. Neurol Sci 2024; 45:1835-1843. [PMID: 38430399 PMCID: PMC11021317 DOI: 10.1007/s10072-024-07351-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 01/22/2024] [Indexed: 03/03/2024]
Abstract
We reported four patients with coronavirus disease 2019 (COVID-19)-associated myelopathies, highlighting the delayed and atypical spinal cord magnetic resonance imaging (MRI) features and the literature review. All four patients were males, aged 37 to 72 years old. The latencies from COVID-19 to the onset of myelitis were 5, 15, 30, and 80 days. The initial symptoms were numbness and weakness of lower limbs in three cases, and back pain with weakness of lower limbs in one case. The peak symptoms included paraplegia, sphincter dysfunction, sensory disturbance level, and spastic gait. The EDSS scores were 7.5, 9.0, 9.0, and 7.5, respectively. Magnetic resonance imaging (MRI) showed delayed atypical spinal cord lesions at onset, i.e., two cases without lesions, one with linear spinal meningeal enhancement, and one with punctate lesions on T2-weighted imaging (T2WI). During the follow-up period, punctate, linear, and cloudy lesions in the lateral and posterior funiculus were seen on T2WI in the peak stage. The prominent features of spinal cord lesions were linear spinal meningeal enhancement, the mismatch of deteriorated clinical symptoms, and inapparent MRI findings. All four patients were left with an obvious disability, with two patients completely bedridden and two who could stand with support. This report highlights the recognition of COVID-19-associated myelopathy even months after initial infection, especially in patients with delayed and atypical spinal cord findings on MRI.
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Affiliation(s)
- Jie Wang
- Department of Neurology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200336, China
- Institute of Neurology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huijun Zhang
- Department of Neurology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200336, China
| | - Jingya Lin
- Department of Neurology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200336, China
| | - Lingli Yang
- Department of Neurology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200336, China
| | - Lipeng Zhao
- Department of Neurology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200336, China
| | - Ailian Du
- Department of Neurology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200336, China.
- Institute of Neurology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Teske N, Teske NC, Greve T, Karschnia P, Kirchleitner SV, Harter PN, Forbrig R, Tonn JC, Schichor C, Biczok A. Perifocal edema is a risk factor for preoperative seizures in patients with meningioma WHO grade 2 and 3. Acta Neurochir (Wien) 2024; 166:170. [PMID: 38581569 PMCID: PMC10998776 DOI: 10.1007/s00701-024-06057-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/25/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Patients with intracranial meningiomas frequently suffer from tumor-related seizures prior to resection, impacting patients' quality of life. We aimed to elaborate on incidence and predictors for seizures in a patient cohort with meningiomas WHO grade 2 and 3. METHODS We retrospectively searched for patients with meningioma WHO grade 2 and 3 according to the 2021 WHO classification undergoing tumor resection. Clinical, histopathological and imaging findings were collected and correlated with preoperative seizure development. Tumor and edema volumes were quantified. RESULTS Ninety-five patients with a mean age of 59.5 ± 16.0 years were included. Most tumors (86/95, 90.5%) were classified as atypical meningioma WHO grade 2. Nine of 95 tumors (9.5%) corresponded to anaplastic meningiomas WHO grade 3, including six patients harboring TERT promoter mutations. Meningiomas were most frequently located at the convexity in 38/95 patients (40.0%). Twenty-eight of 95 patients (29.5%) experienced preoperative seizures. Peritumoral edema was detected in 62/95 patients (65.3%) with a median volume of 9 cm3 (IR: 0-54 cm3). Presence of peritumoral edema but not age, tumor localization, TERT promoter mutation, brain invasion or WHO grading was associated with incidence of preoperative seizures, as confirmed in multivariate analysis (OR: 6.61, 95% CI: 1.18, 58.12, p = *0.049). Postoperative freedom of seizures was achieved in 91/95 patients (95.8%). CONCLUSIONS Preoperative seizures were frequently encountered in about every third patient with meningioma WHO grade 2 or 3. Patients presenting with peritumoral edema on preoperative imaging are at particular risk for developing tumor-related seizures. Tumor resection was highly effective in achieving seizure freedom.
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Affiliation(s)
- Nico Teske
- Department of Neurosurgery, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany.
| | - Nina C Teske
- Department of Neurosurgery, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Tobias Greve
- Department of Neurosurgery, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Philipp Karschnia
- Department of Neurosurgery, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Sabrina V Kirchleitner
- Department of Neurosurgery, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Patrick N Harter
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
- Center for Neuropathology and Prion Research, LMU University Hospital, LMU Munich, Munich, Germany
| | - Robert Forbrig
- Institute of Neuroradiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Joerg-Christian Tonn
- Department of Neurosurgery, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Christian Schichor
- Department of Neurosurgery, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Annamaria Biczok
- Department of Neurosurgery, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
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Barch DM. The human affectome: Cognitive, developmental, and atypicality considerations. Neurosci Biobehav Rev 2024; 159:105600. [PMID: 38387839 DOI: 10.1016/j.neubiorev.2024.105600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/11/2024] [Accepted: 02/19/2024] [Indexed: 02/24/2024]
Affiliation(s)
- Deanna M Barch
- Departments of Psychological & Brain Sciences, Psychiatry, and Radiology, Washington University in St. Louis, Box 1125, One Brookings Drive, St. Louis, MO 63130, USA
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Shen Y, Gosnell JM, Nawgiri R, Muthukumarana V. Application of the newly published International System for Reporting Serous Fluid Cytopathology in atypical and suspicious diagnosis: a four-year retrospective analysis. J Am Soc Cytopathol 2024:S2213-2945(24)00021-8. [PMID: 38637263 DOI: 10.1016/j.jasc.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 04/20/2024]
Abstract
INTRODUCTION Serous fluids offer crucial diagnostic insights, but inconsistent analysis hampers reporting quality, especially in indeterminate (ID) categories like atypia of undetermined significance (AUS) and suspicious for malignancy (SFM). The 2020 International System for reporting Serous Fluid Cytopathology (TIS) aims to standardize communication and reduce reporting disparities. This study evaluates TIS's role in AUS and SFM categories within our institution. MATERIAL AND METHODS A 4-year retrospective search of cytopathology reports from December 2015 to December 2019 for AUS and SFM diagnoses in pleural, ascitic, pericardial fluids, and peritoneal washings was performed and results reclassified using TIS definitions. The risk of malignancy (ROM) was calculated for existing and reclassified diagnoses. RESULTS Over 4 years, we received 2998 serous fluid specimens. AUS constituted 2.3% (70 cases), while SFM constituted 0.5% (16 cases). Excluding repeats, 80 cases were TIS-reviewed. Sixteen cases of ID diagnoses were reclassified. Two cases of AUS were changed to negative for malignancy (NFM) and 12 to SFM. Two SFM cases were upgraded to malignancy. ROM shifted from 63% to 60% for AUS and 100% to 85% for SF (TIS's ROM range: AUS: 66% ± 10%; SFM: 82% ± 4.8%). CONCLUSIONS This institution's ID diagnosis rate is low. AUS ROM is challenging but aligns with TIS, primarily favoring benign. All SFM diagnoses are highly suspicious but quantitatively inadequate for definitive malignancy, explaining the elevated ROM. AUS rate should gauge quality, not serve as a catch-all category. Algorithmic cytology with cell blocks and ancillary studies aids reclassification. TIS is user-friendly and is a consistent methodology for standardized reporting. Further studies are needed to evaluate ROM and define reproducible diagnostic criteria for each category for better system utilization.
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Affiliation(s)
- Yuan Shen
- Department of Pathology and Laboratory Medicine, MD Anderson Cancer Center, Houston, Texas
| | - Joseph M Gosnell
- Department of Pathology and Laboratory Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Ranjana Nawgiri
- Department of Pathology and Laboratory Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Vidarshi Muthukumarana
- Department of Pathology and Laboratory Medicine, University of Texas Medical Branch, Galveston, Texas.
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Garaycochea O, Pérez-Fernández N. Variants of posterior semicircular canal involvement in benign paroxysmal positional vertigo. Acta Otorrinolaringol Esp (Engl Ed) 2024:S2173-5735(24)00045-0. [PMID: 38438080 DOI: 10.1016/j.otoeng.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/24/2024] [Indexed: 03/06/2024]
Abstract
Benign paroxysmal positional vertigo is the most common cause of peripheral vertigo. It is characterized by short and recurrent episodes of vertigo, trigged by specific head movements that displace otoconia within the semicircular canals. The movement of dislodge otoconia from the utricle cause abnormal positional endolymphatic currents. Primary treatment involves reposition maneuvers aimed at moving the displaced otoconia out the affected canal, therefore correct identification of the affected canal is essential for the diagnosis. The posterior semicircular canal (PSC) is the most frequently affected due to its spatial orientation and the force of gravity. Recent technological advances have allowed for better assessment of positional nystagmus during diagnostic and therapeutic maneuvers, revealing various possible scenarios of PSC involvement. Regarding the PSC, otoconia may be found in different parts of the canal, and not just in the expected location, floating in the long arm of the canal. The understanding of these variants is crucial, as the prognosis and the disease progression differ in such cases. This review aims to describe the six possible variants of PSC involvement described so far.
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Affiliation(s)
- Octavio Garaycochea
- Departamento de Otorrinolaringología, Hospital Vall d'Hebron, Barcelona, Spain.
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Raikot SR, Day CN, Boesch RP, Allen-Rhoades W, Polites SF. Factors Associated With Long-term Survival in Children With Bronchial and Lung Carcinoid Tumors. J Pediatr Surg 2024:S0022-3468(24)00106-4. [PMID: 38490884 DOI: 10.1016/j.jpedsurg.2024.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND AND AIMS Bronchial carcinoids are rare in children and the treatment is based on tumor behavior in adults. The purpose of this study was to determine factors and management strategies associated with long-term survival in the pediatric population using a national cohort. METHODS Patients aged ≤20 years with bronchial carcinoid tumors were identified in the 2004-2020 National Cancer Database using ICD-O-3 codes. Tumor characteristics and management were compared among typical (TC) and atypical (AC) histological subtypes using Chi-square and Fisher's exact tests. Kaplan-Meier and univariate Cox proportional hazards analyses were used to assess survival. RESULTS Of 273 patients, 251 (92%) had TCs, and 22(8%) had ACs. The median (IQR) age was 18 (16,19) years. Most patients underwent lobectomy or bilobectomy (67%), followed by sublobar resection (17%), no resection or bronchoscopic excision or ablation (8%), and pneumonectomy (7.7%). Margins were negative in 96%. Lymph node (LN) assessment was performed in 216 patients (84%) with a median (IQR) of 7(3,13) LNs, and 50 (23%) had ≥1 positive LN. There was no difference in age, resection, margin status, LN assessment, or positivity between TC and AC (all p > 00.05). Detection of nodal metastasis did not increase beyond the resection of 1-3 LNs (p = 0.72). Ten-year survival was worse for AC than TC (79% (41, 100) vs 98% (95, 100), HR = 6.9 (95% CI: 1.2-38.3, p = 0.03). Ten-year survival among those with and without LN assessment was 97% (94, 100) vs 91% (81, 100), HR = 4.0, 95% CI: 0.8-19.9, p = 0.09). There were no deaths in those with negative LN while 10-year survival was 89% (72, 100) in those with ≥1 positive LN. CONCLUSION Among children with bronchial carcinoids, survival is excellent with TC or negative LN. Atypical histology and positive LN have poor survival and should prompt close monitoring. These risk factors may be missed in the absence of surgical resection and lymph node sampling. LEVEL OF EVIDENCE III. TYPE OF STUDY Retrospective Study.
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Affiliation(s)
- Swathi R Raikot
- Division of Pediatric Surgery, Mayo Clinic, Rochester, MN, USA.
| | - Courtney N Day
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - R Paul Boesch
- Division of Pediatric Pulmonology, Mayo Clinic, Rochester, MN, USA
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Jones SA, Noppeney U. Multisensory Integration and Causal Inference in Typical and Atypical Populations. Adv Exp Med Biol 2024; 1437:59-76. [PMID: 38270853 DOI: 10.1007/978-981-99-7611-9_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Multisensory perception is critical for effective interaction with the environment, but human responses to multisensory stimuli vary across the lifespan and appear changed in some atypical populations. In this review chapter, we consider multisensory integration within a normative Bayesian framework. We begin by outlining the complex computational challenges of multisensory causal inference and reliability-weighted cue integration, and discuss whether healthy young adults behave in accordance with normative Bayesian models. We then compare their behaviour with various other human populations (children, older adults, and those with neurological or neuropsychiatric disorders). In particular, we consider whether the differences seen in these groups are due only to changes in their computational parameters (such as sensory noise or perceptual priors), or whether the fundamental computational principles (such as reliability weighting) underlying multisensory perception may also be altered. We conclude by arguing that future research should aim explicitly to differentiate between these possibilities.
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Affiliation(s)
- Samuel A Jones
- Department of Psychology, Nottingham Trent University, Nottingham, UK.
| | - Uta Noppeney
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
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Jain R, Gosavi S, Sethia D, Trimuke A. An Unusual Intraosseous Swelling of the Jaw: Two Rare Case Reports. Indian J Otolaryngol Head Neck Surg 2023; 75:4032-4040. [PMID: 37974818 PMCID: PMC10645956 DOI: 10.1007/s12070-023-04023-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 06/23/2023] [Indexed: 11/19/2023] Open
Abstract
Neurofibroma is the most common type of peripheral nerve neoplasm arising from a mixture of cell types, including schwann cells and perineurial fibroblasts. We report two unusual cases where patients presented with intraosseous swelling of the jaw. A complete examination followed by Imaging and histopathological examination were advised. Imaging showed ill-defined radiolucency in one case and well defined corticated radiolucency with soap-bubble appearance in the other case. Biopsy with adjuvant immunohistochemistry revealed features suggestive of neurofibroma. Both cases were managed surgically. The second case in the male patient, also showed multiple recurrences and subsequent transformation into atypical neurofibroma. In spite of being a benign tumor, neurofibroma is locally aggressive. Commonly found in soft tissues of the body, neurofibromas are rare in the head and neck region. But the intraosseous location of this tumor in the mandible is an exceptional case.
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Affiliation(s)
- Riya Jain
- Department of Oral and Maxillofacial Pathology, Government Dental College and Hospital, CSMT-400001 Mumbai, Maharashtra India
| | - Suchitra Gosavi
- Department of Oral and Maxillofacial Pathology, Government Dental College and Hospital, Nagpur, Maharashtra India
| | - Deepak Sethia
- Department of Critical Care Medicine, Deenanath Mangeshkar Hospital, Pune, Maharashtra India
| | - Akshay Trimuke
- Department of Oral and Maxillofacial Pathology, Government Dental College and Hospital, CSMT-400001 Mumbai, Maharashtra India
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Buss JF, Watts AL, Lorenzo-Luaces L. Methods for quantifying the heterogeneity of psychopathology. BMC Psychiatry 2023; 23:897. [PMID: 38037069 PMCID: PMC10690966 DOI: 10.1186/s12888-023-05377-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 11/13/2023] [Indexed: 12/02/2023] Open
Abstract
OBJECTIVES Specifiers for a major depressive disorder (MDE) are supposed to reduce diagnostic heterogeneity. However, recent literature challenges the idea that the atypical and melancholic specifiers identify more homogenous or coherent subgroups. We introduce the usage of distance metrics to characterize symptom heterogeneity. We attempt to replicate prior findings and explore whether symptom heterogeneity is reduced using specifier subgroups. METHODS We used data derived from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC Wave I; N = 5,749) and the Sequenced Treatment Alternatives to Relieve Depression study (STAR*D; N = 2,498). We computed Hamming and Manhattan distances from study participants' unique symptom profiles. Distances were standardized from 0-1 and compared by their within- and between-group similarities to their non-specifier counterparts for the melancholic and atypical specifiers. RESULTS There was no evidence of statistically significant differences in heterogeneity for specifier (i.e., melancholic or atypical) vs. non-specifier designations (i.e., non-melancholic vs. non-atypical). CONCLUSION Replicating prior work, melancholic and atypical depression specifiers appear to have limited utility in reducing heterogeneity. The current study does not support the claim that specifiers create more coherent subgroups as operationalized by similarity in the number of symptoms and their severity. Distance metrics are useful for quantifying symptom heterogeneity.
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Affiliation(s)
- John F Buss
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47405, USA.
| | - Ashley L Watts
- Department of Psychology, Vanderbilt University, Nashville, TN 37420, USA
| | - Lorenzo Lorenzo-Luaces
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47405, USA
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Patnaik A, Sekar A, Bansal S, Narayan Sahu R. Rare Case of Hemorrhagic Atypical Choroid Plexus Papilloma of Fourth Ventricle in Adult: A Diagnostic Dilemma. World Neurosurg 2023; 179:43-44. [PMID: 37562679 DOI: 10.1016/j.wneu.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
Choroid plexus papillomas are highly vascular tumors, and such tumors causing subarachnoid hemorrhage have been reported in literature. Similarly, few articles have reported atypical fourth ventricular choroid plexus tumors in adults. However, such an atypical tumor presenting with grossly hemorrhagic transformation without any acute symptoms could not be found in the literature.
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Affiliation(s)
- Ashis Patnaik
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
| | - Arunkumar Sekar
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sumit Bansal
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Rabi Narayan Sahu
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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McCutcheon RA, Harrison PJ, Howes OD, McGuire PK, Taylor DM, Pillinger T. Data-Driven Taxonomy for Antipsychotic Medication: A New Classification System. Biol Psychiatry 2023; 94:561-568. [PMID: 37061079 PMCID: PMC10914668 DOI: 10.1016/j.biopsych.2023.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/29/2023] [Accepted: 04/06/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Globally, there are more than 25 licensed antipsychotic medications. Antipsychotics are commonly described as either typical or atypical, but this dichotomous classification does not reflect the diversity of their pharmacological and clinical profiles. There is a need for a data-driven antipsychotic classification scheme suitable for clinicians and researchers that maps onto both pharmacological and clinical effects. Receptor affinity provides one starting point for such a scheme. METHODS We analyzed affinities of 27 antipsychotics for 42 receptors from 3325 in vitro receptor binding studies. We used a clustering algorithm to group antipsychotics based on receptor affinity. Using a machine learning model, we examined the ability of this grouping to predict antipsychotic-induced clinical effects quantified according to an umbrella review of clinical trial and treatment guideline data. RESULTS Clustering resulted in 4 groups of antipsychotics. The predominant receptor affinity and clinical effect "fingerprints" of these 4 groups were defined as follows: group 1, muscarinic (M2-M5) receptor antagonism (cholinergic and metabolic side effects); group 2, dopamine (D2) partial agonism and adrenergic antagonism (overall low side-effect burden); group 3, serotonergic and dopaminergic antagonism (overall moderate side-effect burden); and group 4, dopaminergic antagonism (extrapyramidal side effects and hyperprolactinemia). Groups 1 and 4 were more efficacious than groups 2 and 3. The classification was shown to predict out-of-sample clinical effects of individual drugs. CONCLUSIONS A receptor affinity-based grouping not only reflects compound pharmacology but also detects meaningful clinical differences. This approach has the potential to benefit both patients and researchers by guiding treatment and informing drug development.
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Affiliation(s)
- Robert A McCutcheon
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Department of Health, Oxford Health National Health Service Foundation Trust, Oxford, United Kingdom; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
| | - Paul J Harrison
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Department of Health, Oxford Health National Health Service Foundation Trust, Oxford, United Kingdom
| | - Oliver D Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom; H. Lundbeck A/S, København, Denmark
| | - Philip K McGuire
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Department of Health, Oxford Health National Health Service Foundation Trust, Oxford, United Kingdom; National Institute for Health and Care Research Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - David M Taylor
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Toby Pillinger
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom.
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Daher M, Roukoz S, Pearl A, Saleh K. Osteoid osteoma of the wrist: Recent advances. Hand Surg Rehabil 2023; 42:386-391. [PMID: 37182838 DOI: 10.1016/j.hansur.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/18/2023] [Accepted: 05/04/2023] [Indexed: 05/16/2023]
Abstract
Osteoid osteoma is a benign bone tumor usually arising in the diaphysis and metaphysis of the long bones, with male predominance (sex ratio, 2:1). Despite being the most common bone tumor in the wrist, it is still an atypical location for this lesion. The usual presentation is pain that is exacerbated at night and relieved by aspirin or non-steroidal anti-inflammatory drugs. This presentation is not always the case in the wrist, which leads to numerous differential diagnoses and often a delay in definitive diagnosis and treatment. Various imaging modalities can confirm the presence of the tumor and guide the surgical approach. Resection is the gold-standard, with radiofrequency gaining popularity in recent years.
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Affiliation(s)
- Mohammad Daher
- Saint Joseph University, Hotel Dieu de France, Beirut, Lebanon
| | - Sami Roukoz
- Saint Joseph University, Hotel Dieu de France, Beirut, Lebanon
| | - Adam Pearl
- Wayne State University School of Medicine, Detroit, MI, USA; John D Dingell Veterans Affairs Medical Center, Detroit, MI, USA
| | - Khaled Saleh
- John D Dingell Veterans Affairs Medical Center, Detroit, MI, USA.
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16
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Çetin M, Fındık G, Demirağ F, Türk İ, Aydoğdu K. Role of orthopedia homebox protein in subclassification of pulmonary carcinoid tumors: Retrospective analysis of 110 cases. INDIAN J PATHOL MICR 2023; 66:786-789. [PMID: 38084533 DOI: 10.4103/ijpm.ijpm_210_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Background Orthopedia homeobox protein (OTP), highlighted as a sensitive and specific marker for pulmonary carcinoids, may provide a more objective criterion for subclassification. Materials and Methods A total of 110 patients who underwent surgery for pulmonary carcinoids (2009-2019) were included. Gender, age, application complaint, tumor diameter and location, typical and atypical tumor type, lymph node involvement, stage, recurrence, and survival data were evaluated retrospectively with OTP nuclear staining. Results The sensitivity of OTP was 66.4%. OTP in subclassifying pulmonary carcinoids was not significant. There was no significant relationship between OTP and lymph node involvement, recurrence, and survival. Conclusion OTP does not provide significant results in the subclassification of typical and atypical carcinoid tumors and the evaluation of recurrence and survival of carcinoid tumor cases.
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Affiliation(s)
- Mehmet Çetin
- Department of Thoracic Surgery, Omer Halisdemir University Training and Research Hospital, Niğde, Turkey
| | - Göktürk Fındık
- Department of Thoracic Surgery, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Funda Demirağ
- Department of Pathology, Ataturk Chest Disease and Thoracic Surgery, Training and Research Hospital, Ankara, Turkey
| | - İlteriş Türk
- Department of Thoracic Surgery, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Koray Aydoğdu
- Department of Thoracic Surgery, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
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17
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Richards R, Agarwal S. Atypical Squamous Verrucous Lesions of the Oral Cavity: Challenges in Interpretation of Small Incisional Biopsies. Head Neck Pathol 2023; 17:607-617. [PMID: 37204686 PMCID: PMC10514020 DOI: 10.1007/s12105-023-01558-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/02/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Squamous verrucous proliferative lesions of oral cavity can pose a diagnostic challenge for the general pathologist, especially on small biopsies. The superficial nature of incisional biopsies and inconsistent histologic terminologies used for these lesions contribute to often-discrepant clinical diagnosis, resulting in delayed treatment. This study aims to explore the proliferative squamous lesions of oral cavity, correlate biopsy & resection diagnoses, and evaluate possible reasons for discrepant diagnosis (if any). DESIGN A retrospective review of oral verrucous squamous lesions was undertaken. Pathology database was searched for oral cavity biopsies from January2018 through August2022 with the keywords: atypical, verrucous, squamous, and proliferative. Cases with follow-up were included in this study. A blinded review of the biopsy slides was performed and documented by a single head and neck pathologist. Demographic data, biopsy and final diagnosis were recorded. RESULTS Twenty-three cases met criteria for inclusion. The mean patient age was 61.1 years with a male: female ratio of 1.09. Most frequent site was lateral border of tongue (36%) followed by buccal mucosa and retromolar trigone. The most common biopsy diagnosis was "Atypical squamoproliferative lesion, excision recommended" (n = 16/23, 69%) with 13/16 showing conventional squamous cell carcinoma (SCC) on follow-up resection. 2/16 atypical cases underwent repeat biopsy for confirmation of diagnosis. Overall, conventional SCC was the most prevalent final diagnosis (73%, n = 17), followed by verrucous carcinoma (17%, n = 4). On slide review, six initial biopsies were reclassified as SCC, while one final diagnosis was reclassified as a hybrid carcinoma (on resection specimen). Diagnostic concordance (biopsy and resection) was observed in three cases, all three were recurrences. The primary reasons for discrepant diagnosis on initial biopsies were found to be 1. Obscuring inflammation, 2. Superficial biopsies, and 3. Under recognition of morphologic features (e.g., tear shaped rete, loss of polarity, dyskeratotic cells, paradoxical maturation) that help differentiate dysplasia from reactive atypia. CONCLUSION This study highlights the rampant interobserver variability in diagnosis of oral cavity squamous lesions and emphasizes importance of identifying morphologic clues that can aid in correct diagnosis, thereby helping in adequate clinical management.
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Affiliation(s)
- Ryland Richards
- Department of Pathology, 1 University of New Mexico Health Sciences Center, MSC08 4640, Albuquerque, NM, 87131, USA
| | - Shweta Agarwal
- Department of Pathology, 1 University of New Mexico Health Sciences Center, MSC08 4640, Albuquerque, NM, 87131, USA.
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18
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Mundorf A, Ocklenburg S. Hemispheric asymmetries in mental disorders: evidence from rodent studies. J Neural Transm (Vienna) 2023; 130:1153-1165. [PMID: 36842091 PMCID: PMC10460727 DOI: 10.1007/s00702-023-02610-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 02/20/2023] [Indexed: 02/27/2023]
Abstract
The brain is built with hemispheric asymmetries in structure and function to enable fast neuronal processing. In neuroimaging studies, several mental disorders have been associated with altered or attenuated hemispheric asymmetries. However, the exact mechanism linking asymmetries and disorders is not known. Here, studies in animal models of mental disorders render important insights into the etiology and neuronal alterations associated with both disorders and atypical asymmetry. In this review, the current literature of animal studies in rats and mice focusing on anxiety and fear, anhedonia and despair, addiction or substance misuse, neurodegenerative disorders as well as stress exposure, and atypical hemispheric asymmetries is summarized. Results indicate overall increased right-hemispheric neuronal activity and a left-sided behavioral bias associated with symptoms of anxiety, fear, anhedonia, behavioral despair as well as stress exposure. Addiction behavior is associated with right-sided bias and transgenic models of Alzheimer's disease indicate an asymmetrical accumulation of fibrillar plaques. Most studies focused on changes in the bilateral amygdala and frontal cortex. Across studies, two crucial factors influencing atypical asymmetries arose independently of the disorder modeled: sex and developmental age. In conclusion, animal models of mental disorders demonstrate atypical hemispheric asymmetries similar to findings in patients. Particularly, increased left-sided behavior and greater right-hemispheric activity were found across models applying stress-based paradigms. However, sex- and age-dependent effects on atypical hemispheric asymmetries are present that require further investigation. Animal models enable the analysis of hemispheric changes on the molecular level which may be most effective to detect early alterations.
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Affiliation(s)
- Annakarina Mundorf
- Institute for Systems Medicine and Department of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany.
| | - Sebastian Ocklenburg
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
- ICAN Institute for Cognitive and Affective Neuroscience, Medical School Hamburg, Hamburg, Germany
- Institute of Cognitive Neuroscience, Biopsychology, Department of Psychology, Ruhr-University Bochum, Bochum, Germany
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19
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McGrath M, Hyde J, Nosewicz J, Kaffenberger B, Trinidad J, Chung C. Concordance of diagnostic modalities in atypical skin and soft tissue infections in hospitalized patients. Arch Dermatol Res 2023; 315:2139-2143. [PMID: 36369596 DOI: 10.1007/s00403-022-02437-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 08/19/2022] [Accepted: 10/13/2022] [Indexed: 11/13/2022]
Abstract
Skin and soft tissue infections (SSTIs) have high rates of morbidity and mortality worldwide but lack reliable standards for diagnostic workup. As a result, atypical infections, more prevalent among immunocompromised patients, can be missed due to deviance from classic features only to be revealed later through inconsistently performed ancillary studies. Our objectives included to evaluate the sensitivities of clinical impression, histopathology, tissue culture, and molecular and non-molecular ancillary tests in diagnosing inpatient SSTIs, as well as to qualitatively discuss the unusual features making a subset of infections "atypical." To do so, we retrospectively reviewed the histopathologic reports and charts of inpatient dermatologic consults at a single tertiary care institution over a 3-year period. We identified a total of 111 cases of SSTIs evaluated by the inpatient dermatology consultation service with concurrent skin or soft tissue biopsy, with 32.4% representing atypical infections. Among these, clinical impression suggested infection in 9(25.0%), routine histopathology in 21(58.3%), specialized stains for microorganisms in 22(68.8%), and tissue culture in 15(68.2%). Due to incomplete picture that each modality by itself creates, we conclude that clinicians and pathologists should carry a low threshold for including SSTIs in their differential diagnoses and should evaluate with skin biopsy, special stains for microorganisms, and ancillary studies, particularly in critically ill individuals who necessitate timely diagnoses.
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Affiliation(s)
- M McGrath
- The Ohio State University College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - J Hyde
- Department of Dermatology, Massachusetts General Hospital, Cambridge, MA, USA
| | - J Nosewicz
- Department of Dermatology, Massachusetts General Hospital, Cambridge, MA, USA
| | - B Kaffenberger
- Department of Dermatology, Massachusetts General Hospital, Cambridge, MA, USA
| | - J Trinidad
- Department of Dermatology, Massachusetts General Hospital, Cambridge, MA, USA
| | - C Chung
- Department of Dermatology, Massachusetts General Hospital, Cambridge, MA, USA.
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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20
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Marro J, Williams C, Pain CE, Oni L. A case series on recurrent and persisting IgA vasculitis (Henoch Schonlein purpura) in children. Pediatr Rheumatol Online J 2023; 21:85. [PMID: 37580746 PMCID: PMC10424434 DOI: 10.1186/s12969-023-00872-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/02/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND IgA vasculitis (IgAV) is a small vessel vasculitis that is more common in childhood. Very limited evidence exists on patients who experience an atypical disease course. The aim of this study was to describe a cohort of children diagnosed with recurrent or persisting IgAV to identify any themes associated with their disease course and areas of unmet needs. METHODS A single centre retrospective study of children diagnosed with recurrent or persisting IgAV at Alder Hey Children's Hospital (Liverpool, UK). Clinical data, including features at presentation and during follow up, potential triggers, abnormal laboratory and histology results, treatment and outcome at last clinical review were retrospectively collected. Key themes were identified. RESULTS A total of 13 children met the inclusion criteria (recurrent disease, n = 4; persisting disease, n = 9). Median age at first presentation was 10.2 years [2.6-15.5], female:male ratio 1.2:1. Children in the atypical cohort were significantly older than a larger cohort of children who followed a non-complicated disease course (median age 5.5 years (range [0.6-16.7], p = 0.003)). All children re-presented with a purpuric rash (either recurring or persisting), accompanied by joint involvement in 92% of patients (12/13). Disease-modifying anti-rheumatic drugs (DMARDs) were used in 8/13 (62%) children. The median time from first presentation to diagnosis of atypical disease was 18.4 months [5.3-150.8] and the time from first presentation to treatment was 24.1 months [1.8-95.4]. Use of corticosteroids was significantly higher in children with renal involvement (p = 0.026). During follow up, 8/13 (62%) children were admitted at least once, whilst 10/13 (77%) had re-presented at least once to the emergency department. Five (38%) children were referred to psychology services and 7 (54%) children reported feelings of frustration. CONCLUSIONS This series describes some characteristics of a small cohort of children with atypical IgAV. It also identifies unmet needs in children with atypical IgAV, which includes delays in diagnosis and lengthy waits for treatment, lack of high-quality evidence regarding treatment choices and a high unrecognised disease burden. Further research is needed to study this subgroup of children as evidence is lacking.
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Affiliation(s)
- Julien Marro
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Chloe Williams
- Royal Liverpool and Broadgreeen University Hospital Trusts, Liverpool, UK
| | - Clare E Pain
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust Hospital, Liverpool, UK
| | - Louise Oni
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
- Department of Paediatric Nephrology, University of Liverpool Alder Hey Children's NHS Foundation Trust Hospital, Institute in the Park Building, Eaton Road, Liverpool, L12 2AP, UK.
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21
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Peciu-Florianu I, Jaillard A, Tuleasca C, Reyns N. Benefits of combined use of 68-Ga Dotatoc and 5-ALA fluorescence for recurrent atypical skull-base meningioma after previous microsurgery and Gamma Knife radiosurgery: a case report. J Med Case Rep 2023; 17:300. [PMID: 37452350 PMCID: PMC10349456 DOI: 10.1186/s13256-023-04023-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 06/06/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Studies of novel microsurgical adjuncts, such as 5-aminolevulinic acid (5-ALA) fluorescence have shown various fluorescence patterns within meningiomas, opening new avenues for complete microsurgical resection. Here, we present a recurrent, radiation-induced meningioma, previously operated on two occasions (initial gross total resection and subtotal 12 years later) and also irradiated by Gamma Knife radiosurgery (GKR, 6 years after the first surgery). We thought to assess the usefulness of 68-Ga Dotatoc in surgical target planning and of 5-ALA as an adjunct for maximal microsurgical excision. CASE REPORT We report on a 43 years-old Caucasian male diagnosed with atypical, radiation induced WHO II meningioma, with left basal temporal bone implantation. Hodgkin lymphoma treated with cranial and mediastinal radiation during infancy marked his personal history. He underwent a first gross total microsurgical resection, followed 6 and 12 years later by Gamma Knife radiosurgery (GKR) and second subtotal microsurgical resection, respectively. Magnetic resonance imaging (MRI) displayed new recurrence 13 years after initial diagnosis. He was clinically asymptomatic but routine Magnetic resonance imaging showed constant progression. There was strong 68-Ga Dotatoc uptake. We used 5-ALA guided microsurgical resection. Intraoperative views confirmed strong fluorescence, in concordance with both preoperative Magnetic resonance imaging enhancement and 68-Ga Dotatoc. The tumor was completely removed, with meningeal and bone resection. CONCLUSION The authors conclude that fluorescence-guided resection using 5-ALA is useful for recurrent atypical, radiation-induced meningioma even despite previous irradiation and multiple recurrences.
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Affiliation(s)
| | - Alice Jaillard
- Nuclear Medicine and Functional Imaging, CHU Lille, Roger Salengro Hospital, Lille, France
| | - Constantin Tuleasca
- Neurosurgery Service, CHU Lille, Roger Salengro Hospital, Lille, France.
- Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV), Rue du Bugnon 44-46, BH-08, CH-1011, Lausanne, Switzerland.
- Faculty of Biology and Medicine (FBM), University of Lausanne (Unil), Lausanne, Switzerland.
- Signal Processing Laboratory (LTS 5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
| | - Nicolas Reyns
- Neurosurgery Service, CHU Lille, Roger Salengro Hospital, Lille, France
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Shehadah A, Yousef A, Hashem A, Mahmoud AA, Aggarwal A. Bullous herpes zoster masquerading as a bullous pemphigoid flare: A case report. IDCases 2023; 33:e01846. [PMID: 37502653 PMCID: PMC10368929 DOI: 10.1016/j.idcr.2023.e01846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/06/2023] [Accepted: 07/06/2023] [Indexed: 07/29/2023] Open
Abstract
Herpes zoster (HZ) results from the reactivation of dormant varicella zoster virus (VZV) in the posterior dorsal root ganglia manifesting as painful vesicles along the dermatomal distribution as shingles. The risk of reactivation is higher in immunocompromised patients. Herpes zoster lesions can have varied presentations including bullous forms, may induce BP flare, may co-exist in the same lesions, and should be included in the list of differentials for BP flares not responding to the standard of care. Here, we describe a case of a 74-year-old female with a history of recurrent bullous pemphigoid (BP) flares, who was on mycophenolate mofetil, and presented with skin lesions on her right thigh which were typical for her BP flares. Unlike prior flares, the lesions did not respond to prednisone therapy. Her hospitalization course was complicated by encephalopathy. Intravenous acyclovir was started empirically. Viral cultures and polymerase chain reaction from the lesions came back positive for VZV, but the patient succumbed to her illness shortly afterward.
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Affiliation(s)
- Ahmed Shehadah
- Department of Medicine, Rochester General Hospital, NY, USA
| | | | - Anas Hashem
- Department of Medicine, Rochester General Hospital, NY, USA
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Abstract
Meningiomas of the spinal canal are the most common intradural spinal canal tumors encountered in adults and account for 8% of all meningiomas. Patient presentation can vary considerably. Once diagnosed, these lesions are primarily treated surgically, but depending on location and pathological features, chemotherapy and radiosurgery may be required. Emerging modalities may represent adjuvant therapies. In this article, we review the current management of meningiomas of the spinal column.
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Affiliation(s)
- Vijay M Ravindra
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 North Medical Drive East, Salt Lake City, UT 84132, USA; Department of Neurosurgery, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Department of Neurosurgery, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134, USA
| | - Meic H Schmidt
- Department of Neurosurgery, University of New Mexico, 1155 University Bldvd. Southeast, Albuquerque, NM 87131, USA.
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Sinha SK, Garg V, Singh V. The Tug Test and Modified Ponseti Casting: A Simple and Reliable Method to Improve the Efficacy of Casting in Complex Clubfoot. Indian J Orthop 2023; 57:1147-1152. [PMID: 37384013 PMCID: PMC10293533 DOI: 10.1007/s43465-023-00910-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 05/12/2023] [Indexed: 06/30/2023]
Abstract
Background The clinical entity of complex clubfoot poses a significant challenge to correction by slippage of casts which further complicates the deformity and prolongs the treatment. A static and dynamic component associated with this deformity causing cast slippage was recognized. The purpose of this study was to evaluate the clinical outcomes at the end of the casting period while addressing these issues. Methods A retrospective study of 17 patients with 25 complex clubfeet over a period of 2 years was conducted. Tug test was used to ascertain the snugness of the cast. To address the dynamic component, distal extent of the cast was limited to metatarsal heads. Results The mean age of patients at diagnosis was 4.41 months (2-7 months). The mean pre-casting Pirani score was 4.8 (4-6) and post casting Pirani score was 0.4 (0-1). A total of 128 casts were applied to correct 25 complex clubfeet. The average number of casts required to achieve correction by the modified Ponseti technique was 5.12 (4-7). Overall, four incidences of cast slippage occurred. Conclusion The modified Ponseti technique is effective in the correction of complex clubfoot. Tug test can detect casts which are prone to slippage. Limiting the distal extent of the cast to the metatarsal heads can reduce cast slippage by reducing the repeated downward pressure by the toes on the cast.Level of evidence Level 4. Supplementary Information The online version contains supplementary material available at 10.1007/s43465-023-00910-w.
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Affiliation(s)
- Sourabh Kumar Sinha
- Department of Orthopedic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203 India
| | - Varun Garg
- Department of Orthopedic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203 India
| | - Vivek Singh
- Department of Orthopedic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203 India
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25
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Kooffreh-Ada M, Iheanacho OE, Nwagbara VI, Okpebri KO, Anisi CO, Itam-Eyo A, Uba-Mgbemena O, Ali OE, Essien OB, Akintomide AO, Eyong ME, Effa EE, Ngim NE. Case studies of multi-disciplinary team management of atypical gastric cancer: challenges and lessons learned (about two cases). Pan Afr Med J 2023; 45:113. [PMID: 37745919 PMCID: PMC10516756 DOI: 10.11604/pamj.2023.45.113.38579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/22/2023] [Indexed: 09/26/2023] Open
Abstract
There is a paradigm shift towards adopting a multidisciplinary team (MDT) model in the care of cancer patients, with increasing evidence to support its effectiveness. Cancers are biologically distinct, patients present in diverse ways and require, different therapeutic approaches in their management. Patient symptoms and treatment side-effects as well as physical and psychological impact vary according to cancer location and treatment plan. The varied clinical scenarios cancer patients present further buttress the need for MDT practice in hospitals to improve the quality of patient care, in contrast to the outdated concept of holistic treatment offered by a single physician. Unlike Europe, United States of America and Australia which have implemented successful MDT cancer care programs, Nigeria is just coming on board. We present two cases of gastric cancer (seen two months apart) with atypical presentation and the role of MDT in their evaluation and management. These case studies highlight the role of MDT in the management of cancer patients in Nigeria lending credence to the urgent need to implement this model of care in our cancer patients in a bid to improve the quality of care and outcome.
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Affiliation(s)
- Mbang Kooffreh-Ada
- Department of Internal Medicine, University of Calabar, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Obinna Ebere Iheanacho
- Department of Haematology, University of Calabar, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Victor Ikechukwu Nwagbara
- Department of Surgery, University of Calabar, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Komommo Okoi Okpebri
- Department of Obstetrics and Gynaecology, University of Calabar, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Chukwuemeka Okechukwu Anisi
- Department of Orthopaedics and Traumatology, University of Calabar, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Asa Itam-Eyo
- Department of Internal Medicine, University of Calabar, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Okezie Uba-Mgbemena
- Department of Internal Medicine, University of Calabar, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Oliver Emmanuel Ali
- Department of Internal Medicine, University of Calabar, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Ofonime Benjamin Essien
- Department of Haematology, University of Calabar, University of Calabar Teaching Hospital, Calabar, Nigeria
| | | | - Michael Eteng Eyong
- Department of Paediatrics, University of Calabar, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Emmanuel Edet Effa
- Department of Internal Medicine, University of Calabar, University of Calabar Teaching Hospital, Calabar, Nigeria
- Department of Internal Medicine, Edward Francis Small Teaching Hospital, Banjul, The Gambia
| | - Ngim Ewezu Ngim
- Department of Internal Medicine, University of Calabar, University of Calabar Teaching Hospital, Calabar, Nigeria
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Brooks JK, Sultan AS, Rabkin MP, Sands JM, Everett DE, Price JB, Basile JR. Recurrent peripheral odontogenic keratocyst: Review of the literature and presentation of a novel case initially masquerading as an atypical infected lateral periodontal cyst. J Stomatol Oral Maxillofac Surg 2023:101540. [PMID: 37327876 DOI: 10.1016/j.jormas.2023.101540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/14/2023] [Indexed: 06/18/2023]
Abstract
AIM To review published cases and case series of the peripheral odontogenic keratocyst (POKC) of the gingiva, report an unusual presentation, and discuss lesional recurrence. MATERIALS AND METHODS A search of the English language literature for gingival OKCs was conducted. The inclusion of new case yielded a database containing 29 affected patients. Clinical, surgical, radiographic, and histopathologic findings have been summarized. RESULTS With available patient demographics, 62.5% were female and 37.5% were male, with an overall mean age at diagnosis of 53.8 years. There was near-equal lesional affinity for the jaws, of which 44.0% occurred in the posterior region, 32.0% anteriorly, and 24.0% overlapped these areas. Twenty-five percent of lesions had a normal color, 30.0% appeared yellow, 20.0% were white, and 10.0% were blue. The majority of lesions were < 1 cm and nearly 42% manifested exudation or fluctuance. Lesional pain was infrequent. Pressure resorption was recorded in 45.8% of cases. Most lesions were managed with conservative surgical modalities. Follow-up information was available in 16 primary cases, of which 5 recurred, signifying a 31.3% recurrence rate, including the featured case, which recurred twice. CONCLUSION To reduce recurrence of a gingival OKC, supraperiosteal dissection is advocated. Further, it is advised to follow POKCs for 5-7 years postoperatively, remaining vigilant for subtle clinical manifestations of recurrence. Timely discovery and excision of a POKC of the gingiva may decrease the incidence of a mucogingival defect.
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Affiliation(s)
- John K Brooks
- Clinical Professor, Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD 21201, USA.
| | - Ahmed S Sultan
- Assistant Professor, Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, and Member, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Maryland 21201, USA
| | - Martha P Rabkin
- Formerly, Predoctoral student, University of Maryland School of Dentistry, Baltimore, Maryland 21201, At Present, Dentist, United States Navy, Norfolk, Virginia 23511, USA
| | - John M Sands
- Senior Resident, Department of Oral and Maxillofacial Surgery, University of Maryland School of Dentistry, Baltimore, Maryland 21201, USA
| | - Dwayne E Everett
- Clinical Instructor, Department of Oral and Maxillofacial Surgery, University of Maryland School of Dentistry, Baltimore, Maryland 21201, USA
| | - Jeffery B Price
- Clinical Professor, Director of Oral and Maxillofacial Radiology, Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, Maryland 21201, USA
| | - John R Basile
- Associate Professor, Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, Maryland, Member, Molecular and Structural Biology Branch, The Marlene and Stewart Greenebaum Center, Baltimore, Maryland 21201, USA
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Sinnayya D, Lott PW, Tajunisah I. Diagnostic Challenges in an Atypical Case of IRVAN Syndrome: Literature Review. Ocul Immunol Inflamm 2023:1-13. [PMID: 37134302 DOI: 10.1080/09273948.2023.2202758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
A 60-year-old female with known seropositive rheumatoid arthritis and other co-morbids, presented with right eye hypertensive retinopathy and exudative macroaneurysms. Over the years, she developed vitreous haemorrhage, macula oedema and full thickness macula hole. Fluorescein angiography showed macroaneurysms and ischaemic retinal vasculitis. Initial diagnosis was thought to be hypertensive retinopathy with macroaneurysms and retinal vasculitis secondary to rheumatoid arthritis. Laboratory investigations did not support other causes for macroaneurysms and vasculitis. Hence, delayed diagnosis of IRVAN syndrome was made after detailed review of clinical findings, investigations, and angiographic evidence. Our understanding of IRVAN continues to evolve in the face of challenging presentations. To our knowledge, this is the first reported case of IRVAN associated with rheumatoid arthritis.
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Affiliation(s)
- Dheveya Sinnayya
- Universiti Malaya Eye Research Centre, Department of Ophthalmology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Pooi Wah Lott
- Universiti Malaya Eye Research Centre, Department of Ophthalmology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - I Tajunisah
- Universiti Malaya Eye Research Centre, Department of Ophthalmology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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28
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Rozencweig S, Rozencweig G. Atypical treatment plans and anchoring. What are the criteria for choosing anchorage for these complex treatments? Orthod Fr 2023; 94:69-91. [PMID: 37114814 DOI: 10.1684/orthodfr.2023.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Introduction In orthodontics, we need to solve very diverse clinical situations. Classical situations for which the treatment plan will be, with experience, quite quickly carried out. More complex clinical situations for which we are led to think differently. Sometimes, we must modify a treatment plan along the way because unforeseen factors make our original goals unattainable. Faced with these atypical situations, the choice of anchorage arises with even more acuity. Methods Through the presentation of two atypical treatment cases, we will discuss the development of the treatment plan, the alternatives, and the choice of anchorage. Conclusion In recent years, the advent of mini screws and other bone anchorages have widened the range of possibilities. If, at first glance, conventional anchorage systems might seem to belong to 20th century orthodontics, we believe that they remain an option to consider when establishing even atypical treatment plans, as much for their contribution on the functional and aesthetic level as on the level of the patient journey.
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Solelhac G, Berger M, Strippoli MPF, Marchi NA, Stephan A, Petit JM, Bayon V, Imler T, Haba-Rubio J, Raffray T, Vollenweider P, Marques-Vidal P, Waeber G, Léger D, Siclari F, Geoffroy PA, Preisig M, Heinzer R. Objective polysomnography-based sleep features and major depressive disorder subtypes in the general population. Psychiatry Res 2023; 324:115213. [PMID: 37098299 DOI: 10.1016/j.psychres.2023.115213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/27/2023]
Abstract
Insomnia and its opposite hypersomnia are part of the diagnostic criteria for major depressive disorder (MDD). However, no study has investigated whether the postulated sleep alterations in clinical subtypes of MDD are reflected in polysomnography (PSG)-derived objective sleep measures. The objective of this study was to establish associations between the melancholic, atypical and unspecified subtypes of MDD and objective PSG-based sleep features. This cross-sectional analysis included 1820 community-dwelling individuals who underwent PSG and a semi-structured psychiatric interview to elicit diagnostic criteria for MDD and its subtypes. Adjusted robust linear regression was used to assess associations between MDD subtypes and PSG-derived objective sleep measures. Current melancholic MDD was significantly associated with decreased absolute delta power and sleep efficiency and with increased wake after sleep onset. Remitted unspecified MDD was significantly associated with increased rapid eye movements density. No other significant associations were identified. Our findings reflect that some PSG-based sleep features differed in MDD subtypes compared with no MDD. The largest number of significant differences were observed for current melancholic MDD, whereas only rapid eye movements density could represent a risk factor for MDD as it was the only sleep measure that was also associated with MDD in remitted participants.
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Affiliation(s)
- Geoffroy Solelhac
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
| | - Mathieu Berger
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
| | - Marie-Pierre F Strippoli
- Center for research in Psychiatric Epidemiology and Psychopathology (CEPP), Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland.
| | - Nicola Andrea Marchi
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
| | - Aurélie Stephan
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Jean-Marie Petit
- Center for Psychiatric Neuroscience (CNP), Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - Virginie Bayon
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
| | - Théo Imler
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Jose Haba-Rubio
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland; Florimont Sleep Center, Lausanne, Switzerland.
| | - Tifenn Raffray
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland; Florimont Sleep Center, Lausanne, Switzerland.
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
| | - Gerard Waeber
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
| | - Damien Léger
- Université Paris Cité, VIFASOM, AP-HP, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, Paris, France.
| | - Francesca Siclari
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland; The Sense Innovation and Research Center, Lausanne and Sion, Switzerland; Department of Clinical Neurosciences Lausanne University Hospital (CHUV), Lausanne, Switzerland; Netherlands Institute for Neuroscience, Amsterdam, Netherlands.
| | - Pierre A Geoffroy
- GHU Paris - Psychiatry & Neurosciences, Paris, France; Université de Paris, NeuroDiderot, Inserm, Paris, France; Département de Psychiatrie et d'Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, Paris, France
| | - Martin Preisig
- Center for research in Psychiatric Epidemiology and Psychopathology (CEPP), Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland.
| | - Raphaël Heinzer
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
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Cain SA, Pope B, Mangiola S, Mantamadiotis T, Drummond KJ. Somatic mutation landscape in a cohort of meningiomas that have undergone grade progression. BMC Cancer 2023; 23:216. [PMID: 36882706 PMCID: PMC9990218 DOI: 10.1186/s12885-023-10624-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 02/09/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND A subset of meningiomas progress in histopathological grade but drivers of progression are poorly understood. We aimed to identify somatic mutations and copy number alterations (CNAs) associated with grade progression in a unique matched tumour dataset. METHODS Utilising a prospective database, we identified 10 patients with meningiomas that had undergone grade progression and for whom matched pre- and post-progression tissue (n = 50 samples) was available for targeted next-generation sequencing. RESULTS Mutations in NF2 were identified in 4/10 patients, of these 94% were non-skull base tumours. In one patient, three different NF2 mutations were identified in four tumours. NF2 mutated tumours showed large-scale CNAs, with highly recurrent losses in 1p, 10, 22q, and frequent CNAs on chromosomes 2, 3 and 4. There was a correlation between grade and CNAs in two patients. Two patients with tumours without detected NF2 mutations showed a combination of loss and high gain on chromosome 17q. Mutations in SETD2, TP53, TERT promoter and NF2 were not uniform across recurrent tumours, however did not correspond with the onset of grade progression. CONCLUSION Meningiomas that progress in grade generally have a mutational profile already detectable in the pre-progressed tumour, suggesting an aggressive phenotype. CNA profiling shows frequent alterations in NF2 mutated tumours compared to non NF2 mutated tumours. The pattern of CNAs may be associated with grade progression in a subset of cases.
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Affiliation(s)
- Sarah A Cain
- Department of Neurosurgery, The Royal Melbourne Hospital, 300 Grattan street, Parkville, VIC, Australia.
| | - Bernard Pope
- Melbourne Bioinformatics, The University of Melbourne, Parkville, Australia.,Department of Surgery (Royal Melbourne Hospital), Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.,Department of Medicine, Central Clinical School, Faculty of Medicine Nursing and Health Sciences, Monash University, Monash, Australia
| | - Stefano Mangiola
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - Theo Mantamadiotis
- Department of Microbiology & Immunology, The University of Melbourne, Parkville, Australia.,Department of Surgery (Royal Melbourne Hospital), Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Katharine J Drummond
- Department of Neurosurgery, The Royal Melbourne Hospital, 300 Grattan street, Parkville, VIC, Australia.,Department of Surgery (Royal Melbourne Hospital), Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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31
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Osasona OG, Oguntoye T, Eromon P, Abdulkareem L, Arowosaye AO, Ariyo OE, George UE, Yusuf M, Adewumi OM, Happi C, Folarin OA. Atypical serologic profiles of hepatitis B virus infection across clinical cohorts of patients in Southwestern Nigeria. J Immunoassay Immunochem 2023; 44:176-191. [PMID: 36681932 DOI: 10.1080/15321819.2023.2168556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Hepatitis B virus (HBV) infection follows a natural course of events predicted by a dynamic interaction between viral antigen and the host immune system, which forms the basis for HBV serological diagnosis. These interactions may deviate from the typical serologic patterns. This study investigates the types of atypical HBV serologic profiles (AHBSP) across clinical cohorts of patients with HBV infection in southwestern Nigeria. This is a cross-sectional, hospital-based, multi-centered study. Patients' sera were analyzed for HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc IgM, and anti-HBc IgG by ELISA from 279 study participants attending selected gastroenterology clinics between August 2019 and December 2020. The prevalence of atypical HBV serologic profiles was 27% (n = 76). The mean age of patients was 35.7 ± 11.2 years. The gender distribution involved 183 females (65.6%) and 96 males (34.4%). Across clinical cohorts of patients with atypical serologic profiles, HBeAg Negative, anti-HBe positive with detectable HBV DNA had the highest prevalence of 21% followed by isolated anti-HBc antibody positive, HBsAg negative and detectable HBV DNA, 5%. The atypical serologic profiles, HBeAg positive, HBsAg negative with detectable HBV DNA and concurrent anti-HBs with HBsAg, had the lowest prevalence, 0.4%, respectively. This study identified the considerable presence of atypical HBV serologic profiles across clinical cohorts of HBV infection in southwestern Nigeria.
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Affiliation(s)
| | - Tosin Oguntoye
- Department of Medicine, Federal Teaching Hospital Ido- Ekiti, Federal Teaching Hospital Ido-Ekiti, Ido Ekiti, Nigeria
| | - Philomena Eromon
- African Center of Excellence for Genomics of Infectious diseases Redeemer's University, Redeemer's University Ede, Ede, Nigeria
| | - Lukman Abdulkareem
- Department of Medicine, University of Abuja Teaching Hospital, Gwagwalada, Nigeria
| | | | - Olumuyiwa Elijah Ariyo
- Department of Medicine, Federal Teaching Hospital Ido- Ekiti, Federal Teaching Hospital Ido-Ekiti, Ido Ekiti, Nigeria
| | - Uwem Etop George
- Department of Biological Sciences, Redeemer's University, Osun, Nigeria
| | - Musa Yusuf
- Department of Medicine, Federal Teaching Hospital Ido- Ekiti, Federal Teaching Hospital Ido-Ekiti, Ido Ekiti, Nigeria
| | | | - Christian Happi
- African Centre of Excellence for Genomics of Infectious Diseases, Department of Biological Sciences, Redeemers University, Ede, Nigeria
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Cabral G, Serrazina F, Ramos J, Pinto M, Viana Baptista M. Atypical Imaging Findings in Anti-GQ1b Brainstem Encephalitis. Can J Neurol Sci 2023; 50:292-3. [PMID: 35581189 DOI: 10.1017/cjn.2022.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Kololgi SP, Kololgi PD, Hulmani M, Lahari CS. Becker's Birthmark: A Case Series of Pigmented Hairy Epidermal Naevus. Indian J Dermatol 2023; 68:205-207. [PMID: 37275790 PMCID: PMC10238991 DOI: 10.4103/ijd.ijd_927_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
Becker's naevus also known as Becker's melanosis (BM) or pigmented hairy epidermal naevus is a cutaneous hamartoma with brown hyperpigmentation and hypertrichosis. It commonly occurs during adolescence and rarely at birth. It usually affects young post-pubertal males and has a prevalence of 0.5%. A naevus usually consists of a circumscribed, unilateral, irregularly shaped, hyperpigmented spot usually located around the anterior upper body, with or without hypertrichosis and/or acneiform lesions. Sometimes developmental abnormalities can occur with Becker's naevus, which is called Becker's naevus syndrome (BNS). Becker's naevus was of atypical presentation in two patients over the forearm and leg. Hence, these case reports gain importance.
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Affiliation(s)
- Shreyas P. Kololgi
- From the Department of Dermatology, Venereology and Leprosy, SS Institute of Medical Sciences and Research Centre, Davanagere, Karnataka, India
| | - Prakash D. Kololgi
- From the Department of Dermatology, Venereology and Leprosy, SS Institute of Medical Sciences and Research Centre, Davanagere, Karnataka, India
| | - Manjunath Hulmani
- From the Department of Dermatology, Venereology and Leprosy, SS Institute of Medical Sciences and Research Centre, Davanagere, Karnataka, India
| | - C. S. Lahari
- From the Department of Dermatology, Venereology and Leprosy, SS Institute of Medical Sciences and Research Centre, Davanagere, Karnataka, India
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Sun Y, Xiao W, Wang QN, Wang J, Kong XD, Ma WH, Liu SX, Ren P, Xu LN, Zhang YJ. Multiple variation patterns of terpene synthases in 26 maize genomes. BMC Genomics 2023; 24:46. [PMID: 36707768 PMCID: PMC9881264 DOI: 10.1186/s12864-023-09137-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/13/2023] [Indexed: 01/28/2023] Open
Abstract
Terpenoids are important compounds associated with the pest and herbivore resistance mechanisms of plants; consequently, it is essential to identify and explore terpene synthase (TPS) genes in maize. In the present study, we identified 31 TPS genes based on a pan-genome of 26 high-quality maize genomes containing 20 core genes (present in all 26 lines), seven dispensable genes (present in 2 to 23 lines), three near-core genes (present in 24 to 25 lines), and one private gene (present in only 1 line). Evaluation of ka/ks values of TPS in 26 varieties revealed that TPS25 was subjected to positive selection in some varieties. Six ZmTPS had ka/ks values less than 1, indicating that they were subjected to purifying selection. In 26 genomes, significant differences were observed in ZmTPS25 expression between genes affected by structural variation (SV) and those not affected by SV. In some varieties, SV altered the conserved structural domains resulting in a considerable number of atypical genes. The analysis of RNA-seq data of maize Ostrinia furnacalis feeding revealed 10 differentially expressed ZmTPS, 9 of which were core genes. However, many atypical genes for these responsive genes were identified in several genomes. These findings provide a novel resource for functional studies of ZmTPS.
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Affiliation(s)
- Yang Sun
- Key Laboratory for Conservation and Use of Important Biological Resources of Anhui Province, Anhui Provincial Key Laboratory of Molecular Enzymology and Mechanism of Major Diseases, College of Life Sciences, Anhui Normal University, Wuhu, 241000, Anhui, China.
- State Key Laboratory for Biology of Plant Diseases and Insect Pests, Institute of Plant Protection, Chinese Academy of Agricultural Sciences, Beijing, 100193, China.
| | - Wenqing Xiao
- Key Laboratory for Conservation and Use of Important Biological Resources of Anhui Province, Anhui Provincial Key Laboratory of Molecular Enzymology and Mechanism of Major Diseases, College of Life Sciences, Anhui Normal University, Wuhu, 241000, Anhui, China
| | - Qing-Nan Wang
- Key Laboratory for Conservation and Use of Important Biological Resources of Anhui Province, Anhui Provincial Key Laboratory of Molecular Enzymology and Mechanism of Major Diseases, College of Life Sciences, Anhui Normal University, Wuhu, 241000, Anhui, China
- State Key Laboratory for Biology of Plant Diseases and Insect Pests, Institute of Plant Protection, Chinese Academy of Agricultural Sciences, Beijing, 100193, China
- Institute of Plant Protection and Agro-products Safety, Anhui Academy of Agricultural Sciences, Hefei, 230031, China
| | - Jing Wang
- Key Laboratory for Conservation and Use of Important Biological Resources of Anhui Province, Anhui Provincial Key Laboratory of Molecular Enzymology and Mechanism of Major Diseases, College of Life Sciences, Anhui Normal University, Wuhu, 241000, Anhui, China
- State Key Laboratory for Biology of Plant Diseases and Insect Pests, Institute of Plant Protection, Chinese Academy of Agricultural Sciences, Beijing, 100193, China
| | - Xiang-Dong Kong
- Institute of Bioinformatics, College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, China
| | - Wen-Hui Ma
- Key Laboratory for Conservation and Use of Important Biological Resources of Anhui Province, Anhui Provincial Key Laboratory of Molecular Enzymology and Mechanism of Major Diseases, College of Life Sciences, Anhui Normal University, Wuhu, 241000, Anhui, China
| | - Si-Xian Liu
- Key Laboratory for Conservation and Use of Important Biological Resources of Anhui Province, Anhui Provincial Key Laboratory of Molecular Enzymology and Mechanism of Major Diseases, College of Life Sciences, Anhui Normal University, Wuhu, 241000, Anhui, China
| | - Ping Ren
- Key Laboratory for Conservation and Use of Important Biological Resources of Anhui Province, Anhui Provincial Key Laboratory of Molecular Enzymology and Mechanism of Major Diseases, College of Life Sciences, Anhui Normal University, Wuhu, 241000, Anhui, China
| | - Li-Na Xu
- Institute of Plant Protection and Agro-products Safety, Anhui Academy of Agricultural Sciences, Hefei, 230031, China.
| | - Yong-Jun Zhang
- State Key Laboratory for Biology of Plant Diseases and Insect Pests, Institute of Plant Protection, Chinese Academy of Agricultural Sciences, Beijing, 100193, China.
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Raghunathan A, Giannini C. Histopathology of Meningiomas. Adv Exp Med Biol 2023; 1416:35-45. [PMID: 37432618 DOI: 10.1007/978-3-031-29750-2_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
Meningiomas are considered to arise from meningothelial cells, whose cytomorphology they recapitulate. In this chapter, we review the characteristic histological features of meningioma, including classic architectural and cytological features. There exists a broad spectrum of morphological variants of meningioma. The 2021 WHO Classification recognizes nine benign (grade 1), three intermediate-grade (grade 2), and three malignant (grade 3) variants. We review the characteristic histological features of these meningioma variants, describe immunohistochemical stains, which may assist with establishing a diagnosis, and discuss differential diagnostic considerations that may prove challenging for a diagnosis of meningioma.
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Affiliation(s)
- Aditya Raghunathan
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Caterina Giannini
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
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Vidal E, Sánchez-Martín MA, Eraña H, Lázaro SP, Pérez-Castro MA, Otero A, Charco JM, Marín B, López-Moreno R, Díaz-Domínguez CM, Geijo M, Ordóñez M, Cantero G, di Bari M, Lorenzo NL, Pirisinu L, d’Agostino C, Torres JM, Béringue V, Telling G, Badiola JJ, Pumarola M, Bolea R, Nonno R, Requena JR, Castilla J. Bona fide atypical scrapie faithfully reproduced for the first time in a rodent model. Acta Neuropathol Commun 2022; 10:179. [PMID: 36514160 PMCID: PMC9749341 DOI: 10.1186/s40478-022-01477-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/10/2022] [Indexed: 12/15/2022] Open
Abstract
Atypical Scrapie, which is not linked to epidemics, is assumed to be an idiopathic spontaneous prion disease in small ruminants. Therefore, its occurrence is unlikely to be controlled through selective breeding or other strategies as it is done for classical scrapie outbreaks. Its spontaneous nature and its sporadic incidence worldwide is reminiscent of the incidence of idiopathic spontaneous prion diseases in humans, which account for more than 85% of the cases in humans. Hence, developing animal models that consistently reproduce this phenomenon of spontaneous PrP misfolding, is of importance to study the pathobiology of idiopathic spontaneous prion disorders. Transgenic mice overexpressing sheep PrPC with I112 polymorphism (TgShI112, 1-2 × PrP levels compared to sheep brain) manifest clinical signs of a spongiform encephalopathy spontaneously as early as 380 days of age. The brains of these animals show the neuropathological hallmarks of prion disease and biochemical analyses of the misfolded prion protein show a ladder-like PrPres pattern with a predominant 7-10 kDa band. Brain homogenates from spontaneously diseased transgenic mice were inoculated in several models to assess their transmissibility and characterize the prion strain generated: TgShI112 (ovine I112 ARQ PrPC), Tg338 (ovine VRQ PrPC), Tg501 (ovine ARQ PrPC), Tg340 (human M129 PrPC), Tg361 (human V129 PrPC), TgVole (bank vole I109 PrPC), bank vole (I109I PrPC), and sheep (AHQ/ARR and AHQ/AHQ churra-tensina breeds). Our analysis of the results of these bioassays concludes that the strain generated in this model is indistinguishable to that causing atypical scrapie (Nor98). Thus, we present the first faithful model for a bona fide, transmissible, ovine, atypical scrapie prion disease.
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Affiliation(s)
- Enric Vidal
- grid.424716.2Unitat Mixta d’Investigació IRTA-UAB en Sanitat Animal, Centre de Recerca en Sanitat Animal (CReSA), Campus de la Universitat Autònoma de Barcelona (UAB), Bellaterra, Catalonia Spain ,grid.424716.2IRTA Programa de Sanitat Animal, Centre de Recerca en Sanitat Animal (CReSA), Campus de la Universitat Autònoma de Barcelona (UAB), Bellaterra, Catalonia Spain
| | - Manuel A. Sánchez-Martín
- grid.11762.330000 0001 2180 1817Transgenic Facility. Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Hasier Eraña
- grid.420175.50000 0004 0639 2420Centro de Investigación Cooperativa en Biociencias (CIC BioGUNE), Laboratorio de Investigación de Priones, Basque Research and Technology Alliance (BRTA), Derio, Bizkaia Spain ,ATLAS Molecular Pharma S. L., Derio, Bizkaia Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Sonia Pérez Lázaro
- grid.11205.370000 0001 2152 8769Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza–IA2, Zaragoza, Spain
| | - Miguel A. Pérez-Castro
- grid.420175.50000 0004 0639 2420Centro de Investigación Cooperativa en Biociencias (CIC BioGUNE), Laboratorio de Investigación de Priones, Basque Research and Technology Alliance (BRTA), Derio, Bizkaia Spain
| | - Alicia Otero
- grid.11205.370000 0001 2152 8769Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza–IA2, Zaragoza, Spain
| | - Jorge M. Charco
- grid.420175.50000 0004 0639 2420Centro de Investigación Cooperativa en Biociencias (CIC BioGUNE), Laboratorio de Investigación de Priones, Basque Research and Technology Alliance (BRTA), Derio, Bizkaia Spain ,ATLAS Molecular Pharma S. L., Derio, Bizkaia Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Belén Marín
- grid.11205.370000 0001 2152 8769Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza–IA2, Zaragoza, Spain
| | - Rafael López-Moreno
- grid.420175.50000 0004 0639 2420Centro de Investigación Cooperativa en Biociencias (CIC BioGUNE), Laboratorio de Investigación de Priones, Basque Research and Technology Alliance (BRTA), Derio, Bizkaia Spain
| | - Carlos M. Díaz-Domínguez
- grid.420175.50000 0004 0639 2420Centro de Investigación Cooperativa en Biociencias (CIC BioGUNE), Laboratorio de Investigación de Priones, Basque Research and Technology Alliance (BRTA), Derio, Bizkaia Spain
| | - Mariví Geijo
- grid.509696.50000 0000 9853 6743Animal Health Department, NEIKER-Basque Institute for Agricultural Research and Development, Basque Research and Technology Alliance (BRTA), Derio, Spain
| | - Montserrat Ordóñez
- grid.424716.2Unitat Mixta d’Investigació IRTA-UAB en Sanitat Animal, Centre de Recerca en Sanitat Animal (CReSA), Campus de la Universitat Autònoma de Barcelona (UAB), Bellaterra, Catalonia Spain ,grid.424716.2IRTA Programa de Sanitat Animal, Centre de Recerca en Sanitat Animal (CReSA), Campus de la Universitat Autònoma de Barcelona (UAB), Bellaterra, Catalonia Spain
| | - Guillermo Cantero
- grid.424716.2Unitat Mixta d’Investigació IRTA-UAB en Sanitat Animal, Centre de Recerca en Sanitat Animal (CReSA), Campus de la Universitat Autònoma de Barcelona (UAB), Bellaterra, Catalonia Spain ,grid.424716.2IRTA Programa de Sanitat Animal, Centre de Recerca en Sanitat Animal (CReSA), Campus de la Universitat Autònoma de Barcelona (UAB), Bellaterra, Catalonia Spain
| | - Michele di Bari
- grid.416651.10000 0000 9120 6856Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore Di Sanità, 00161 Rome, Italy
| | - Nuria L. Lorenzo
- grid.11794.3a0000000109410645CIMUS Biomedical Research Institute, University of Santiago de Compostela-IDIS, Santiago, Spain
| | - Laura Pirisinu
- grid.416651.10000 0000 9120 6856Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore Di Sanità, 00161 Rome, Italy
| | - Claudia d’Agostino
- grid.416651.10000 0000 9120 6856Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore Di Sanità, 00161 Rome, Italy
| | - Juan María Torres
- grid.419190.40000 0001 2300 669XCentro de Investigación en Sanidad Animal (CISA), Centro Superior de Investigaciones Científicas (CSIC) Valdeolmos, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), 28130 Madrid, Spain
| | - Vincent Béringue
- grid.417961.cMolecular Virology and Immunology, Institut National de La Recherche Agronomique (INRA), Université Paris-Saclay, Jouy-en-Josas, France
| | - Glenn Telling
- grid.47894.360000 0004 1936 8083Prion Research Center (PRC) and the Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO USA
| | - Juan J. Badiola
- grid.11205.370000 0001 2152 8769Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza–IA2, Zaragoza, Spain
| | - Martí Pumarola
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Campus de UAB, Bellaterra, 08193 Barcelona, Catalonia Spain
| | - Rosa Bolea
- grid.11205.370000 0001 2152 8769Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza–IA2, Zaragoza, Spain
| | - Romolo Nonno
- grid.416651.10000 0000 9120 6856Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore Di Sanità, 00161 Rome, Italy
| | - Jesús R. Requena
- grid.11794.3a0000000109410645CIMUS Biomedical Research Institute, University of Santiago de Compostela-IDIS, Santiago, Spain
| | - Joaquín Castilla
- grid.420175.50000 0004 0639 2420Centro de Investigación Cooperativa en Biociencias (CIC BioGUNE), Laboratorio de Investigación de Priones, Basque Research and Technology Alliance (BRTA), Derio, Bizkaia Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain ,grid.424810.b0000 0004 0467 2314IKERBASQUE, Basque Foundation for Science, Bilbao, Bizkaia Spain
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Chen WC, Perlow HK, Choudhury A, Nguyen MP, Mirchia K, Youngblood MW, Lucas CHG, Palmer JD, Magill ST, Raleigh DR. Radiotherapy for meningiomas. J Neurooncol 2022; 160:505-515. [PMID: 36315366 PMCID: PMC9722800 DOI: 10.1007/s11060-022-04171-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 10/13/2022] [Indexed: 12/12/2022]
Abstract
Meningiomas are the most common primary central nervous system neoplasm. Despite promising recent progress in elucidating the genomic landscape and underlying biology of these histologically, molecularly, and clinically diverse tumors, the mainstays of meningioma treatment remain maximal safe resection and radiation therapy. The aim of this review of meningioma radiotherapy is to provide a concise summary of the history, current evidence, and future for application of radiotherapy in meningioma treatment.
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Affiliation(s)
- William C Chen
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, 94143, USA. .,Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, 94143, USA.
| | - Haley K Perlow
- Department of Radiation Oncology, Ohio State University, Columbus, OH, 43210, USA
| | - Abrar Choudhury
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, 94143, USA.,Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Minh P Nguyen
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, 94143, USA.,Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Kanish Mirchia
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, 94143, USA.,Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, 94143, USA.,Department of Pathology, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Mark W Youngblood
- Department of Neurological Surgery, Northwestern University, Chicago, IL, 60611, USA
| | | | - Joshua D Palmer
- Department of Radiation Oncology, Ohio State University, Columbus, OH, 43210, USA
| | - Stephen T Magill
- Department of Neurological Surgery, Northwestern University, Chicago, IL, 60611, USA
| | - David R Raleigh
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, 94143, USA. .,Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, 94143, USA.
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38
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Pringle C, Portwood K, Viamonte MA, Rajderkar D. Imaging Findings in Neonatal and Pediatric Posterior Reversible Encephalopathy Syndrome (PRES) Differ From Adults. Pediatr Neurol 2022; 135:6-11. [PMID: 35963074 PMCID: PMC9903994 DOI: 10.1016/j.pediatrneurol.2022.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Posterior reversible encephalopathy syndrome (PRES) is classically a reversible clinical radiographic syndrome associated with predominantly posterior leukoencephalopathy on neuroimaging. Magnetic resonance imaging (MRI) in adults demonstrates almost universally reversible parietal-occipital disease. We aimed to demonstrate in a cohort of children that "atypical" distribution is expected, acutely and on follow-up. METHODS A retrospective review of children diagnosed with PRES from 2010 to 2018 at our children's hospital was performed. All had MRI at diagnoses, with over half having follow-up MRIs. Images were reviewed by a neuroradiology-trained pediatric radiologist for confirmation of findings consistent with PRES/identification of involved regions. RESULTS Nineteen patients (aged zero to 18 years, 53% female) were included. Notably, two were infants. Nearly all had seizures; all had altered mental status and hypertension. Fifteen (84%) had MRI described as "atypical." Distribution of MRI findings was anatomically widespread, including nine with frontal findings. Twelve (63%) had follow-up imaging, of which approximately half remained abnormal. CONCLUSIONS Pediatric PRES MRI findings were more often atypical at time of diagnosis. Vasogenic edema related to the acute phases of PRES typically resolved; however, follow-up imaging identified new volume loss in the areas affected. Two of our subjects were younger than 13 months, younger than typically described. Our series demonstrates that imaging distribution in children with PRES does not mirror the classical posterior, reversible distribution described in adults and continues the recent trend of identifying PRES in infants.
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Affiliation(s)
- Charlene Pringle
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Florida College of Medicine, Gainesville, Florida.
| | - Katherin Portwood
- Division of Pediatric Neurology, Department of Pediatrics, University of Florida College of Medicine, Gainesville, Florida
| | - Manuel A Viamonte
- Division of Pediatric Critical Care, Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Dhanashree Rajderkar
- Division of Pediatric Radiology, Department of Radiology, University of Florida College of Medicine, Gainesville, Florida
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39
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Ojha PT, Barvalia PP, Singh R, Soni G, Kadam N, Nagendra S, Aglave V, Jagiasi K. Atypical Optic Neuritis: The Potential Red Flags. Neurol India 2022; 70:1982-1987. [PMID: 36352598 DOI: 10.4103/0028-3886.359189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Many potential causes of optic nerve inflammation exist, including typical and atypical causes, which require different management strategies. OBJECTIVE The objective of this study is to identify red flags that help differentiate typical from atypical optic neuritis (ON). MATERIALS AND METHODS This prospective study included 66 patients (100 eyes) with immune-mediated ON from January 2016 to June 2019, carefully excluding the nonimmune causes. The clinico-radiological features, investigations, therapy, and outcome were analyzed. RESULTS We evaluated 33 cases each of typical and atypical ON. The typical group included 29 idiopathic ON and four associated with multiple sclerosis. Atypical ON included 19 neuromyelitis optica (NMO), seven MOG-associated ON (MOG-ON), and others due to Sjogren's syndrome, granulomatous polyangiitis, sarcoidosis, and IgG4 disease. Atypical ON occurred significantly and more frequently with extremes of ages (<10 or >70 years), bilateral simultaneous or severe vision loss with early disc pallor, multiple attacks, symptoms/neuro-imaging indicating non-MS disease e.g., long segment ON/myelitis, large confluent lesions, the involvement of optic tract, chiasma, area postrema or diencephalon, and (pachy) meningitis. Systemic involvement and poor outcomes despite steroids and second-line immunosuppression were observed more often in the atypical ON. CONCLUSIONS The red flags indicating atypical ON are onset at extremes of age, multiple attacks, bilateral simultaneous or severe to very severe vision loss, early disc pallor, neurological symptoms, or imaging abnormalities suggesting non-MS disease, systemic involvement, and poor steroid responsiveness. The awareness might help the clinician promptly identify and escalate therapy to ensure a better outcome.
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Affiliation(s)
- Pawan T Ojha
- Department of Neurology, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Prachi P Barvalia
- Department of Neurology, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Rakesh Singh
- Department of Neurology, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Girish Soni
- Department of Neurology, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Nikhil Kadam
- Department of Neurology, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Shashank Nagendra
- Department of Neurology, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Vikram Aglave
- Department of Neurology, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Kamlesh Jagiasi
- Department of Neurology, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
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40
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Gorgani-Firouzjaee T, Kalantari N, Ghaffari S. Molecular identification and genotyping of Toxoplasma gondii isolated from sheep and cattle in northern Iran. Vet Res Forum 2022; 13:371-378. [PMID: 36320300 PMCID: PMC9548222 DOI: 10.30466/vrf.2021.138408.3080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 03/01/2021] [Indexed: 11/22/2022]
Abstract
Toxoplasmosis, a foodborne disease, in human occurs commonly after the ingestion of tissue cysts via the raw and/or undercooked meat of different infected intermediate hosts such as sheep and cattle. The current study aimed to detect the genetic structure of Toxoplasma gondii isolated from various organs of sheep and cattle in the north of Iran. Conventional PCR was carried out by B1 and REP-529 genes of T. gondii. Nested and RFLP-PCR were performed for all positive samples using SAG2 and GRA6 genetic markers. Amplicons from second round of nested-PCR were sequenced and analyzed with NCBI database. Among of 179 examined samples, 38(21.20%) were positive. The highest of positive cases were found in kidney (28.60%). PCR-RFLP of SAG2 and GRA6 genes demonstrated the alleles of clonal type III in the all of isolates. Sequence analysis of the amplicons revealed the alleles of clonal type III and atypical isolates (Tg-67, Tg-100 and Tg-106). Phylogenetic analyses showed separate clade for the atypical isolates from others in the present study and the reference strains clades. In conclusion, the genetic characterization of T. gondii isolates from sheep and cattle showed high genetic diversity compared with standard type I, II and III genotypes. These results support the hypothesis of the existence of polymorphic and overlapping strains within livestock in Iran. It also suggested the necessity of increased genotyping and sampling efforts to accurately estimate T. gondii intra specific genetic diversity.
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Affiliation(s)
- Tahmineh Gorgani-Firouzjaee
- Department of Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Narges Kalantari
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Salman Ghaffari
- Department of Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Babol, Iran; ,Correspondence Salman Ghaffari. PhD Department of Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Babol, Iran. E-mail:
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41
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Wang A, Zhang X, Sun KK, Li C, Song ZM, Sun T, Wang F. Deep Sylvian fissure meningiomas: A case report. World J Clin Cases 2022; 10:7438-7444. [PMID: 36158020 PMCID: PMC9353933 DOI: 10.12998/wjcc.v10.i21.7438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 03/30/2022] [Accepted: 06/03/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Deep Sylvian meningiomas are rare and difficult to diagnose when small tumours lead to various symptoms. The difficulty associated with surgery is underestimated. Our case involved a mass (11 mm × 12 mm × 12 mm in size) in the right Sylvian fissure. It is the smallest deep Sylvian meningioma known and might be more easily misdiagnosed than previous examples.
CASE SUMMARY A well-enhanced mass in the right Sylvian fissure of a 26-year-old male with a three-month history of seizure was identified via magnetic resonance imaging. The patient underwent operations twice for seizure control. During the first operation, the tumour was surrounded by the second segment of the middle cerebral artery and its numerous perforators. Partial resection had to be selected due to mild arterial damage. After the first operation, the patient presented with simple partial seizure. During reoperation, we isolated the anatomical structure near the tumour and the tumour over and removed it from its dorsal side by piecemeal resection.
CONCLUSION This case reported the smallest deep Sylvian meningioma according to a literature review. Preoperative diagnosis is a crucial step due to deep Sylvian meningioma firmly adhering to the middle cerebral artery and its perforators. Adequate preparation is crucial to ensure the success of surgery.
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Affiliation(s)
- Anni Wang
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China
| | - Xu Zhang
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China
| | - Kun-Kun Sun
- Department of Pathology, Peking University People's Hospital, Beijing 100000, China
| | - Can Li
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China
| | - Zi-Mu Song
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China
| | - Tao Sun
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China
| | - Feng Wang
- Department of Neurosurgery, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750001, Ningxia Hui Autonomous Region, China
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Delgado-López PD, Ortega-Cubero S, González Bernal JJ, Cubo-Delgado E. Seizure prophylaxis in meningiomas: a systematic review and meta-analysis. Neurologia (Engl Ed) 2022:S2173-5808(22)00036-0. [PMID: 35781420 DOI: 10.1016/j.nrleng.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/01/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION No formal indication currently exists for seizure prophylaxis in neurosurgical oncology patients. Neither have specific recommendations been made on the use of antiepileptic drugs (AED) in seizure-free patients with meningiomas scheduled for surgery. AEDs are generally prescribed on a discretionary basis, taking into consideration a range of clinical and radiological risk factors. We present a systematic review and meta-analysis exploring the effectiveness of antiepileptic prophylaxis in patients with meningioma and no history of seizures. METHODS We performed a systematic review of the PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Embase, and clinicaltrials.gov databases. Of a total of 4368 studies initially identified, 12 were selected for extraction of data and qualitative analysis. Based on the clinical data presented, we were only able to include 6 studies in the meta-analysis. We performed heterogeneity studies, calculated a combined odds ratio, evaluated publication bias, and conducted a sensitivity analysis. RESULTS AED prophylaxis in patients with meningioma and no history of seizures did not significantly reduce the incidence of post-operative seizures in comparison to controls (Mantel-Haenszel combined odds ratio, random effects model: 1.26 [95% confidence interval, 0.60-2.78]; 2041 patients). However, we are unable to establish a robust recommendation against this treatment due to the lack of prospective studies, the presence of selection bias in the studies reviewed, the likelihood of underestimation of seizure frequency during follow-up, and the strong influence of one study on the overall effect. CONCLUSIONS Despite the limitations of this review, the results of the meta-analysis do not support the routine use of seizure prophylaxis in patients with meningioma and no history of seizures.
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Rangasamy K, Baburaj V, Gopinathan NR, Behera P, Sudesh P, Ravi Subramanian S. Correction results of atypical clubfeet managed with modified Ponseti technique: A meta-analysis of 354 feet. J Clin Orthop Trauma 2022; 31:101939. [PMID: 35818375 DOI: 10.1016/j.jcot.2022.101939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/19/2022] [Accepted: 06/23/2022] [Indexed: 10/17/2022] Open
Abstract
BACKGROUND/PURPOSE Atypical clubfeet are distinct from idiopathic clubfeet. It is resistant to correction by conventional casting methods and often requires a modification of Ponseti's casting technique. Although the initial correction rates are reasonable, relapse and complications are frequent. There is limited literature on the results of modified Ponseti casting of these feet. We conducted this meta-analysis to study a few important aspects of atypical/complex clubfeet treatment by the modified Ponseti technique. RESEARCH QUESTION What are the results of atypical or complex clubfeet after treatment by the modified Ponseti technique? METHODOLOGY Five electronic databases (PubMed, Embase, Scopus, Ovid, and Cochrane Library) were searched for articles reporting on the results of atypical/complex clubfeet treated by the modified Ponseti technique. Details of the number of casts required for correction, rate of percutaneous Achilles tenotomy (PAT), other soft tissue procedures required, complications, and relapse rates were extracted into spreadsheets, and meta-analysis was carried out using OpenMeta Analyst software. RESULTS Ten studies were included for analysis with a total of 240 patients with 354 clubfeet. The initial correction was achieved in all feet. A pooled analysis of the data showed that a mean of six casts was required for the initial correction. The rate of PAT was 98.3%. The overall complication rate was 16.8%. 7.2% required an additional soft tissue procedure apart from the PAT, and relapse of the deformity was observed in a mean of 19.8% cases. CONCLUSION Modified Ponseti technique is effective in the initial management of atypical/complex clubfeet. Although the PAT rate is slightly higher in the Modified Ponseti technique, the remaining result parameters are comparable with the results of idiopathic clubfoot managed with the Ponseti method of casting. However, these children should be kept under follow-up for a longer duration to find the exact relapse rates.
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Megías J, San-Miguel T, Sánchez M, Navarro L, Monleón D, Calabuig-Fariñas S, Morales JM, Muñoz-Hidalgo L, Roldán P, Cerdá-Nicolás M, López-Ginés C. Desmoplastic infantile astrocytoma with atypical phenotype, PTEN homozygous deletion and BRAF V600E mutation. Acta Neuropathol Commun 2022; 10:88. [PMID: 35725578 PMCID: PMC9208153 DOI: 10.1186/s40478-022-01392-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/01/2022] [Indexed: 11/30/2022] Open
Abstract
Desmoplastic infantile astrocytoma (DIA) is rare, cystic and solid tumor of infants usually found in superficial cerebral hemispheres. Although DIA is usually benign, uncommon cases bearing malignant histological and aggressive clinical features have been described in the literature. We report a newborn patient who was diagnosed with a DIA and died postresection. Pathologic examination revealed that the main part of the tumor had benign features, but the internal region showed areas with a more aggressive appearance, with higher-proliferative cells, anaplastic GFAP positive cells with cellular polymorphism, necrosis foci, vascular hyperplasia with endothelial proliferation and microtrombosis. Genetic study, performed in both regions of the tumor, showed a BRAF V600E mutation and a homozygous deletion in PTEN, without changes in other relevant genes like EGFR, CDKN2A, TP53, NFKBIA, CDK4, MDM2 and PDGFRA. Although PTEN homozygous deletions are described in gliomas, the present case constitutes the first report of a PTEN mutation in a DIA, and this genetic feature may be related to the malignant behavior of a usually benign tumor. These genetic findings may point at the need of further and deeper genetic characterization of DIAs, in order to better understand the biology of this tumor and to obtain new prognostic approaches, a better clinical management and targeted therapies, especially in malignant cases of DIA.
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Affiliation(s)
- Javier Megías
- Department of Pathology, Faculty of Medicine and Dentistry, University of Valencia, Avenida de Blasco Ibáñez, 15, 46010, Valencia, Spain.
| | - Teresa San-Miguel
- Department of Pathology, Faculty of Medicine and Dentistry, University of Valencia, Avenida de Blasco Ibáñez, 15, 46010, Valencia, Spain
| | - Mirian Sánchez
- Department of Pathology, Faculty of Medicine and Dentistry, University of Valencia, Avenida de Blasco Ibáñez, 15, 46010, Valencia, Spain
| | - Lara Navarro
- Department of Pathology, Faculty of Medicine and Dentistry, University of Valencia, Avenida de Blasco Ibáñez, 15, 46010, Valencia, Spain
| | - Daniel Monleón
- Department of Pathology, Faculty of Medicine and Dentistry, University of Valencia, Avenida de Blasco Ibáñez, 15, 46010, Valencia, Spain
| | - Silvia Calabuig-Fariñas
- Department of Pathology, Faculty of Medicine and Dentistry, University of Valencia, Avenida de Blasco Ibáñez, 15, 46010, Valencia, Spain.,Centro de Investigación Biomédica en Red en Cáncer (CIBERONC), Valencia, Spain
| | - José Manuel Morales
- Department of Pathology, Faculty of Medicine and Dentistry, University of Valencia, Avenida de Blasco Ibáñez, 15, 46010, Valencia, Spain
| | - Lisandra Muñoz-Hidalgo
- Department of Pathology, Faculty of Medicine and Dentistry, University of Valencia, Avenida de Blasco Ibáñez, 15, 46010, Valencia, Spain
| | - Pedro Roldán
- Department of Neurosurgery, Clinic Hospital of Valencia, Valencia, Spain
| | - Miguel Cerdá-Nicolás
- Department of Pathology, Faculty of Medicine and Dentistry, University of Valencia, Avenida de Blasco Ibáñez, 15, 46010, Valencia, Spain.,INCLIVA, Clinic Hospital of Valencia, Valencia, Spain
| | - Concha López-Ginés
- Department of Pathology, Faculty of Medicine and Dentistry, University of Valencia, Avenida de Blasco Ibáñez, 15, 46010, Valencia, Spain
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Kwan YH, Shuy YJ, Shi CJ, Ng AS. Plate osteosynthesis for atypical femoral fractures in patients with severely bowed femurs: comparing short versus long segment fixation - a case series. Int J Burns Trauma 2022; 12:73-82. [PMID: 35891970 PMCID: PMC9301159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Intramedullary nail fixation is currently the modality of choice in surgical treatment for atypical femoral fractures (AFF). Its uses are limited, however, in severely bowed femurs, narrow medullary canals, or in the presence of thick endosteal callus at the apex of the femoral curve. In these cases, extramedullary plate osteosynthesis is preferred. The consideration when adopting plate osteosynthesis is whether a short or long segment fixation is superior. We hypothesize that a long segment fixation has the potential advantage of protecting the entire length of the femur from future fractures in the adynamic bone. In this series, we present two cases from our institution, with the aims of discussing the benefits and limitations of short versus long segment plate fixation in AFF. CASE SUMMARY We report two uncommon cases of bisphosphonate-related AFF in two Asian patients with severe femoral curvature, who were treated with extramedullary plate osteosynthesis at our institution. One patient underwent fixation with a short segment plate osteosynthesis, and the other received a long plate osteosynthesis spanning the proximal to distal femur in an attempt to protect the bone from future fractures. Both patients showed a favourable and uncomplicated course post-surgery, with early return to ambulation and radiographic bone union at follow up. CONCLUSION We expect to see an increase in the number of patients with AFF and bowed femurs, especially with the increased usage of bisphosphonates given an ageing Asian population. Surgical treatment with short and long plate osteosynthesis are options with their own advantages and limitations. With the advent of new anatomical plate options, long segment fixation has become more accessible and may be considered in this patient group as it has the potential advantage of protecting the adynamic femur from future fractures. Further studies should be targeted to determine which method of treatment is superior in this particular group of patients.
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Affiliation(s)
- Yiu Hin Kwan
- Department of Orthopaedic Surgery, Khoo Teck Puat Hospital 90 Yishun Central, 768828, Singapore
| | - Yao Jie Shuy
- Department of Orthopaedic Surgery, Khoo Teck Puat Hospital 90 Yishun Central, 768828, Singapore
| | - Claris Jy Shi
- Department of Orthopaedic Surgery, Khoo Teck Puat Hospital 90 Yishun Central, 768828, Singapore
| | - Allan Sh Ng
- Department of Orthopaedic Surgery, Khoo Teck Puat Hospital 90 Yishun Central, 768828, Singapore
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Cuvelier GDE, Schoettler M, Buxbaum NP, Pinal-Fernandez I, Schmalzing M, Distler JHW, Penack O, Santomasso BD, Zeiser R, Angstwurm K, MacDonald KPA, Kimberly WT, Taylor N, Bilic E, Banas B, Buettner-Herold M, Sinha N, Greinix HT, Pidala J, Schultz KR, Williams KM, Inamoto Y, Cutler C, Md H, Lee SJ, Sarantopoulos S, Pavletic SZ, Wolff D. Towards a Better Understanding of the Atypical Features of Chronic Graft-Versus-Host Disease: A Report from the 2020 National Institutes of Health Consensus Project Task Force. Transplant Cell Ther 2022:S2666-6367(22)01334-3. [PMID: 35662591 DOI: 10.1016/j.jtct.2022.05.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/16/2022] [Accepted: 05/24/2022] [Indexed: 12/31/2022]
Abstract
Alloreactive and autoimmune responses after allogeneic hematopoietic cell transplantation can occur in non-classical chronic graft-versus-host disease (chronic GVHD) tissues and organ systems or manifest in atypical ways in classical organs commonly affected by chronic GVHD. The National Institutes of Health (NIH) consensus projects were developed to improve understanding and classification of the clinical features and diagnostic criteria for chronic GVHD. While still speculative whether atypical manifestations are entirely due to chronic GVHD, these manifestations remain poorly captured by the current NIH consensus project criteria. Examples include chronic GVHD impacting the hematopoietic system as immune mediated cytopenias, endothelial dysfunction, or as atypical features in the musculoskeletal system, central and peripheral nervous system, kidneys, and serous membranes. These purported chronic GVHD features may contribute significantly to patient morbidity and mortality. Most of the atypical chronic GVHD features have received little study, particularly within multi-institutional and prospective studies, limiting our understanding of their frequency, pathogenesis, and relation to chronic GVHD. This NIH consensus project task force report provides an update on what is known and not known about the atypical manifestations of chronic GVHD, while outlining a research framework for future studies to be undertaken within the next three to seven years. We also provide provisional diagnostic criteria for each atypical manifestation, along with practical investigation strategies for clinicians managing patients with atypical chronic GVHD features.
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Sarma MS, Ravindranath A. Pediatric acute viral hepatitis with atypical variants: Clinical dilemmas and natural history. World J Hepatol 2022; 14:944-955. [PMID: 35721282 PMCID: PMC9157701 DOI: 10.4254/wjh.v14.i5.944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/20/2022] [Accepted: 05/07/2022] [Indexed: 02/06/2023] Open
Abstract
Classical acute viral hepatitis (AVH) has an uncomplicated outcome. Acute liver failure has a grave prognosis. Atypical manifestations of AVH are a group of disorders that causes significant morbidity and dilemmas in children. These include prolonged cholestasis, relapsing hepatitis, ascitic form of AVH, late-onset hepatic failure (LOHF), intravascular hemolysis, and provoking an autoimmune trigger leading to autoimmune hepatitis. These entities cause significant liver dysfunction or worsening and are often difficult to differentiate from chronic liver disease (CLD). Ascitic form of AVH, LOHF, decompensated CLD and acute-on-chronic liver failure have significant overlapping features that need to be carefully dissected out. In many cases, only on long-term follow-up, these clinical entities can be separately identified. Intravascular hemolysis is usually caused by associated glucose-6-phosphate dehydrogenase deficiency. Rarely CLD such as Wilson disease and autoimmune hepatitis can also present with hemolysis in the initial presentation, which can mimic AVH with hemolysis. Identifying deviations from typical manifestations aid in avoiding unnecessary investigations, allowing focused therapy and alleviating anxiety.
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Affiliation(s)
- Moinak Sen Sarma
- Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
| | - Aathira Ravindranath
- Division of Pediatric Gastroenterology, Apollo BGS Hospitals, Mysuru 570023, Karnataka, India
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Farahbakhsh N, Bagherian N, Shabanpourhaghighi S, Khalilzadeh S, Tabatabaii SA, Khanbabaee G. Corneal opacification, an atypical presentation of cystic fibrosis: a case report and review of the literature. J Med Case Rep 2022; 16:188. [PMID: 35546413 PMCID: PMC9097421 DOI: 10.1186/s13256-022-03410-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 04/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Respiratory and gastrointestinal manifestations are the main causes of mortality and morbidity in cystic fibrosis. Although these symptoms are well recognized, ophthalmic involvement of cystic fibrosis secondary to vitamin A deficiency is uncommon and has been reported very rarely in the medical literature. CASE PRESENTATION Here, we report a 2.5-year-old Iranian boy who presented with bilateral corneal xerosis and corneal opacity secondary to vitamin A deficiency related to cystic fibrosis malabsorption. CONCLUSION Malabsorption of fat-soluble vitamins is a common presentation in cystic fibrosis, but corneal opacity secondary to vitamin A deficiency as the initial presentation of cystic fibrosis is a very rare manifestation of fat malabsorption. This highlights the importance of complete systemic examination besides ophthalmic examination in approaching a child with ophthalmic complaint.
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Affiliation(s)
- Nazanin Farahbakhsh
- Department of Pediatric Pulmonology, Mofid Pediatrics Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Neda Bagherian
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Soheila Khalilzadeh
- Department of Pediatric Pulmonology, Mofid Pediatrics Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Ghamartaj Khanbabaee
- Department of Pediatrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Marchetti M, Pinzi V, Iezzoni C, Morlino S, Tramacere I, De Martin E, Cane I, Fariselli L. Multisession radiosurgery for grade 2 (WHO), high risk meningiomas. A phase II clinical trial. J Neurooncol 2022; 157:397-403. [PMID: 35378640 PMCID: PMC8979484 DOI: 10.1007/s11060-022-03978-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/23/2022] [Indexed: 12/03/2022]
Abstract
Purpose Patients suffering from recurrent and residual grade 2 (WHO) meningiomas after subtotal excision should be considered as high-risk groups with an uncertain prognosis. Adjuvant radiotherapy seems to be the best approach to reduce disease progression. The primary aim of this phase II explorative, monocentric, single arm study was to evaluate the safety of adjuvant multisession radiosurgery (mRS) in this group of patients; the efficacy in terms of tumour local control was the secondary endpoint. Methods Patients recruited from April 2017 to May 2019 were over 18 years old, had a histologically-documented intracranial recurrent or residual Grade 2 meningioma (WHO 2016) and a KPS > 70. Patients with NF2, concomitant neoplasm or pregnancy were excluded. Descriptive statistics were provided for categorical variables. Progression free survival (PFS) was modelled using the Kaplan–Meier method. Results Twenty-four patients were enrolled. All 24 patients underwent mRS: twenty-two patients received 28 Gy in 4 fractions, 2 patients received 24 Gy in 4 Treatment related adverse events (CTCAE 4.3) were limited to grade 2 in 1 patient (4.1%). At a median follow-up of 28 months, 8 patients (33.3%) had disease progression, either out-of-field or infield, compared with the planning target volume. Considering both infield and out-of-field progressions, 3-year PFS was 47% (95% confidence interval, CI, 22–69%); considering only the infield ones, 3-year PFS was 86% (95% CI 55–96%), and local control at last follow-up was 92%. Conclusion mRS provides good local control of the tumour volume (TV) and is associated with a low rate of toxicity. These results call for further investigation to confirm favourable outcomes in patients with high-risk meningioma. Trial information NCT05081908, October 18, 2021, retrospectively registered.
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Affiliation(s)
- Marcello Marchetti
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C Besta, Via Celoria 11, 20133, Milan, Italy
| | - Valentina Pinzi
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C Besta, Via Celoria 11, 20133, Milan, Italy
| | - Cecilia Iezzoni
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C Besta, Via Celoria 11, 20133, Milan, Italy
| | - Sara Morlino
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C Besta, Via Celoria 11, 20133, Milan, Italy
| | - Irene Tramacere
- Department of Research and Clinical Development, Scientific Directorate, Fondazione IRCCS Istituto Neurologico C Besta, Milan, Italy
| | - Elena De Martin
- Heath Department, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italia
| | - Irene Cane
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C Besta, Via Celoria 11, 20133, Milan, Italy
| | - Laura Fariselli
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C Besta, Via Celoria 11, 20133, Milan, Italy.
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Hamza SB. Severe SARS-COV-2 infection in pediatric patient with atypical Hemolytic Uremic Syndrome: A case report. Ann Med Surg (Lond) 2022; 75:103400. [PMID: 35228868 PMCID: PMC8867980 DOI: 10.1016/j.amsu.2022.103400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/10/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction and important There is a high incidence of acute kidney injury with COVID-19 infections. We report a child with atypical Hemolytic Uremic Syndrome (aHUS) admitted to Intensive care Unit (ICU) due to severe SARS-COV-2 infection. Children are recognised as at lower risk of severe COVID-19 compared with adults, but the impact of atypical Hemolytic Uremic Syndrome is yet to be determined. Case presentation An eleven years old male presented to Mohammed Alamin Hamid Pediatric Hospital with generalize body swelling, skin rash and red urine. Examination reveal hepatomegaly and hemic murmur. Investigations reveal anemia, normal platelets, and impaired renal function. Peripheral blood picture shows shistocytes, crenated RBCs, occasional poikilocytes and mild neutrophilia.During hospital stay the patient developed severe shortness of breath and fever, diagnosed as COVID-19 and required ICU admission 2 days later due to severe respiratory compromised. Clinical discussion An atypical Hemolytic Uremic Syndrome with normal platelets is extremely rare condition. SARS-COV-2 infection in patients atypical Hemolytic Uremic Syndrome has not been reported in literature. Conclusion Our study shown that severe SARS-COV-2 infection can be developed in pediatric patients patients with co-existing atypical Hemolytic Uremic Syndrome. We present a rare case of SARS-COV-2 infection in pediatric patient with aHUS. A typical HUS with normal platelets is extremely rare. No apparent diarrheal prodrome in this case.
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Affiliation(s)
- Salih Boushra Hamza
- Internal Medicine Department, Faculty of Medicine and Health Sciences, Omdurman Islamic University, Khartoum, Sudan.,PSO_Research Unit, Sudan
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