PD-1 Inhibitor Maintenance Therapy Combined Iodine-125 Seed Implantation Successfully Salvage Recurrent Cervical Cancer after CCRT: A Case Report

xlomafota13 shared this article with you from Inoreader PD-1 Inhibitor Maintenance Therapy Combined Iodine-125 Seed Implantation Successfully Salvage Recurrent Cervical Cancer after CCRT: A Case Report Via radioactive iodine Curr Oncol. 2021 Nov 9;28(6):4577-4586. doi: 10.3390/curroncol28060387. ABSTRACT Cervical cancer is the fourth most common cancer in females worldwide. Patients with stage III and IV cervical cancer based on the Federation of Gynecology and Obstetrics (FIGO) classification have higher recurrence rates. Because of organs at risk (OAR) protection and the low indication rate of salvage surgery, the choice of treatment is always challenging. Systemic chemotherapy is palliative and can be performed in conjunction with surgery or radiotherapy; however, it has no significant benefit to survival. Brachytherapy and stereotactic body radiotherapy (SBRT) are characterized by extremely high radiation doses applied to tumor cells while sparing the normal tissues. Several studies have investigated the efficacy of these technologies in recurrent cervical cancer and showed promising results. The immune checkpoint inhibitors approach was also investigated and showed promising results too. Herein, we report a case of a patient with cervical cancer that recurred five months after adjuvant chemotherapy and concurrent chemoradiotherapy. The disease prognosis after interstitial implantation brachytherapy (IIB) was determined. Then, the patient underwent radioactive 125I-seed implantation combined with PD-1 inhibitor treatment. The patient exhibited a partial response after seed implantation, and up to now, the duration of this partial response was 24 months. PMID:34898560 | DOI:10.3390/curroncol28060387 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vascular thrombosis and vasculitis in the gastrointestinal tract are associated with poor prognosis in patients with COVID-19

xlomafota13 shared this article with you from Inoreader Vascular thrombosis and vasculitis in the gastrointestinal tract are associated with poor prognosis in patients with COVID-19 Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Nov 15;14(11):1069-1079. eCollection 2021. ABSTRACT AIM: To report pathologic findings in the gastrointestinal (GI) tract of coronavirus disease 2019 (COVID-19) patients. MATERIAL AND METHODS: we evaluated clinical and GI tract histologic findings in six COVID-19 patients that presented with GI symptoms like diarrhea, and abdominal pain. This study includes surgical resection specimens from five patients and two sets of biopsy specimens from one patient. RESULTS: Idiopathic inflammatory bowel disease was considered in three of six cases based on clinical, radiologic, and endoscopic presentation. Histologically, the enteric mucosa had a spectrum of histologic changes, including active enteritis, chronic active enteritis, and transmural necrosis. Extensive thrombi in vessels and/or vasculitis were identified in three out of the six cases. The presence of extensive vascular thrombi is associated wit h poor prognosis, and the three patients deceased in a short period of time (ranges from 7-67 days, median 14 days) after admission for GI symptoms. Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) RNA was detected in bowel tissue of one case. The other three patients recovered and were discharged and free of GI symptoms (follow-up period ranges from 235 days to 270 days, median 237 days). CONCLUSION: COVID-19 associated enteritis may mimic Crohn's disease clinically, radiologically and endoscopically, and these two entities can be differentiated by pathologic findings. COVID-19 patients with GI symptoms may warrant a workup to evaluate for pathologic changes, as the presence of vasculitis and microthrombi may predict poor clinical outcome. PMID:34900075 | PMC:PMC8661070 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Double primary germ cell tumor

xlomafota13 shared this article with you from Inoreader Double primary germ cell tumor in a 45 year old woman: one case report and literature review Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Nov 15;14(11):1090-1094. eCollection 2021. ABSTRACT We report a rare case of double primary germ cell tumor: right ovarian yolk sac tumor and left ovarian dysgerminoma. A 45 year-old woman was admitted to our hospital due to irregular bleeding for 2 days and extended menstrual period. Right ovarian mass was discovered on transvaginal ultrasound. The pathology results revealed that right ovarian yolk sac tumor and left ovarian dysgerminoma. Total abdominal hysterectomy with bilateral salpingo-oophorectomy with debulking with pelvic lymphadenectomy was performed. The patient underwent adjuvant chemotherapy with BEP six courses in four months and AFP dropped from 8490 ng/ml to nearly 10 ng/ml. Conclusion: Total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by combination chemotherapy must be the treatment of first choice of germ cell tumor. PMID:34900077 | PMC:PMC8661071 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association of MIF gene polymorphisms with pemphigus vulgaris: a case-control study with comprehensive review of the literature

xlomafota13 shared this article with you from Inoreader Association of <em>MIF</em> gene polymorphisms with pemphigus vulgaris: a case-control study with comprehensive review of the literature Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Nov 15;14(11):1080-1089. eCollection 2021. ABSTRACT BACKGROUND: Functional macrophage migration inhibitory factor (MIF) gene polymorphisms are associated with elevated serum levels of MIF and increased susceptibility to various autoimmune diseases. MIF levels in the sera of pemphigus vulgaris (PV) patients are increased; however, no definite association has been demonstrated between PV and MIF gene polymorphisms. The present study was conducted to ascertain any association between MIF-173*G-C and MIF-794*CATT5-8 polymorphisms and PV. METHODS: Seventy-five patients with PV and 252 healthy, unrelated, voluntary controls were enrolled randomly in the study. MIF-173*G-C polymorphism (rs755622) was genotyped using polymerase chain reaction (PCR) followed by restriction fragment length analysis, and MIF-794*CATT5-8 (rs5844572) was genotyp ed using PCR followed by capillary gel electrophoresis. Subsequently, the allelic, genotype, and haplotype frequencies were determined and compared for both groups. Data were also analyzed with respect to sex, age at onset, type of disease, and duration of disease. RESULTS: No significant association was observed in terms of allelic, genotype, and haplotype frequencies of MIF gene polymorphisms in PV patients. However, a significantly lower prevalence of the C allele (P=0.02) and CATT7 allele (P=0.03) was seen in our patient population compared to healthy controls. Analysis of the effect of various factors such as gender, age at onset, type of disease, and disease duration revealed no significant association with the genetic variants. CONCLUSIONS: MIF-173*G-C and -794*CATT5-8 polymorphisms are not associated with PV. PMID:34900076 | PMC:PMC8661066 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chromophobe renal cell carcinoma-like thyroid carcinoma: possible misdiagnosis as metastatic renal cell carcinoma

xlomafota13 shared this article with you from Inoreader Chromophobe renal cell carcinoma-like thyroid carcinoma: possible misdiagnosis as metastatic renal cell carcinoma Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Nov 15;14(11):1095-1101. eCollection 2021. ABSTRACT To date, multiple thyroid cancer variants have been reported. Herein, we report a rare case of chromophobe renal cell carcinoma-like thyroid carcinoma (CRETHCA) in a 60-year-old woman, for which the morphologic findings resembled those of chromophobe renal cell carcinoma (ChRCC). ChRCC of the kidney is characterized by large polygonal tumor cells with distinct cell borders, perinuclear clearing, multiple binucleate cells, and strongly positive immunostaining for paired box gene 8 (PAX8) and carbonic anhydrase IX (CA IX). In our case, the thyroid gland tumor was incidentally detected by routine medical screening without sufficient medical information; it showed similar histology and immunohistochemical features to ChRCC and was initially misdiagnosed as metastatic ChRCC. Additional tests, including kidney computed tomography and positron emission tomography, revealed no abnormalities in the patient's kidney; therefore, we diagnosed the tumor as CRETHCA. Focal weak staining for thyroid transcription factor 1 (TTF-1) was the only supporting evidence that it was a primary thyroid neoplasm. To the best of our knowledge, this is the second report of CRETHCA in literature. This novel variant is very difficult to distinguish from metastatic ChRCC and can be a diagnostic challenge for pathologists. Further studies of similar cases should be done to define this new entity. PMID:34900078 | PMC:PMC8661068 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Analysis of risk factors for delayed iatrogenic cerebrospinal fluid otorrhinorrhea

xlomafota13 shared this article with you from Inoreader Analysis of risk factors for delayed iatrogenic cerebrospinal fluid otorrhinorrhea Via leak of cerebrospinal fluid Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec;35(12):1111-1114. doi: 10.13201/j.issn.2096-7993.2021.12.011. ABSTRACT Objective:To explore the common causes of iatrogenic cerebrospinal fluid（CSF） otorrhinorrhea, and further analyze the risk factors for delayed iatrogenic CSF otorrhinorrhea. Methods:The clinical data of 35 iatrogenic CSF otorrhinorrhea patients in department of Otorhinolaryngology Head and Neck Surgery from January 2010 to January 2020 were retrospectively analyzed. Patients were divided into delayed and non-delayed iatrogenic CSF leak groups, according to the time intervals from medical intervention to CSF leak occurrence. The differences of baseline data, complications and success rate between the two groups were analyzed, and the risk factors of delayed iatrogenic cerebrospinal fluid otorrhinorrhea were further analyzed. Results:Endoscopic sinus surgery （n=11）, transsphenoidal p ituitary surgery（n=8）, craniotomy（n=12）, and radiotherapy（n=4） all contribute to iatrogenic CSF otorrhinorrhea. Compared with the non-delayed group, the incidence of meningitis in the delayed group was significantly higher（20% vs 60%, P=0.041）. There were no significant differences in gender, radiation, hypertension, diabetes, and success rate between the two groups. Additionally, binary logistic regression analysis showed that sex, age, history of radiation, hypertension and diabetes, as well as causes of CSF otorrhinorrhea had no association with delayed iatrogenic CSF leakage. Conclusion:Patients with delayed iatrogenic CSF otorrhinorrhea have an increased risk of meningitis. Timely diagnose and intervention with appropriate surgical approach and reconstruction method ensures good clinical outcomes. PMID:34886626 | DOI:10.13201/j.issn.2096-7993.2021.12.011 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Upregulation of TLR9 may contribute to activation of microglia and painful diabetic neuropathy via the p38 MAPK pathway in rats

xlomafota13 shared this article with you from Inoreader Upregulation of TLR9 may contribute to activation of microglia and painful diabetic neuropathy via the p38 MAPK pathway in rats Via Cellular and Molecular Biology Histol Histopathol. 2021 Dec 10:18405. doi: 10.14670/HH-18-405. Online ahead of print. ABSTRACT Painful diabetic neuropathy is a common chronic complication of diabetes, and the underlying mechanism remains largely elusive. A rat model of painful diabetic neuropathy was established via streptozotocin (STZ) injection and assessed as increased heat and mechanical hypersensitivity. An upregulation of TLR9 was observed in the spinal cords of rats injected with STZ and rat microglia (primary microglia and immortalized microglia HAPI) treated with high glucose. To investigate the role of TLR9 in high glucose-induced microglia activation, short hairpin RNAs targeting TLR9 were used in vitro to knock down TLR9 in HAPI cells. TLR9 interference suppressed the high glucose-induced expression and secretion of inflammatory cytokines (TNF-α, IL-1β, and IL-6), IBA-1 expression and the chemotaxis of HAPI microglia. Similar results were obtained when HAPI microglia were incubated with a p38 inhibitor (SB203580). P38 and ERK were downstream of TLR9 because TLR9 ablation markedly inhibited the phosphorylation of p38 and ERK. TLR9 was also knocked down in vivo via the injection of shTLR9 lentiviral vector into the rat spinal cord. Relief of STZ-induced heat and mechanical hypersensitivity was observed in rats with TLR9 interference, and TLR9 knockdown prevented STZ-induced inflammatory cytokine secretion and microglial and MAPK signaling activation. Our study revealed the participation of TLR9 in microglial activation and diabetes-induced hyperalgesia likely via the MAPK pathway. The targeting of TLR9 may be an effective strategy for the treatment of painful diabetic neuropathy. PMID:34889455 | DOI:10.14670/HH-18-405 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Voice Performance Chart: A Pedagogical Tool to Enhance Vocal Expressive Ability in Acting Students

xlomafota13 shared this article with you from Inoreader Voice Performance Chart: A Pedagogical Tool to Enhance Vocal Expressive Ability in Acting Students Via Journal of Voice The purpose of the present study was to explore the effectiveness of the Voice Performance Chart (VPCH) as a pedagogical training tool to enhance vocal expressive ability of 1st year acting students. Forty recorded audio samples were perceptually assessed by six blinded raters, using a five-points Likert scale for each of the dependent variables observed. Results showed that loudness, pitch, and speech rate variations significantly differ when comparing the vocal condition before and after a 11 weeks training period. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effectiveness of Interventions for Dysphagia in Parkinson Disease: A Systematic Review

xlomafota13 shared this article with you from Inoreader Effectiveness of Interventions for Dysphagia in Parkinson Disease: A Systematic Review Via swallowing exercises Am J Speech Lang Pathol. 2021 Dec 10:1-23. doi: 10.1044/2021_AJSLP-21-00145. Online ahead of print. ABSTRACT PURPOSE: Dysphagia is a common sequela of Parkinson disease (PD) and is associated with malnutrition, aspiration pneumonia, and mortality. This review article synthesized evidence regarding the effectiveness of interventions for dysphagia in PD. METHOD: Electronic searches were conducted in Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL, an d speechBITE. Of the 2,015 articles identified, 26 met eligibility criteria: interventional or observational studies with at least five or more participants evaluating dysphagia interventions in adults with PD-related dysphagia, with outcomes measured using videofluoroscopic swallowing study (VFSS), fiberoptic endoscopic evaluation of swallowing (FEES), or electromyography (EMG). Risk of bias (RoB) was evaluated using the Evidence Project tool and predetermined criteria regarding the rigor of swallowing outcome measures. RESULTS: Interventions were classified as follows: pharmacological (n = 11), neurostimulation (n = 8), and behavioral (n = 7). Primary outcome measures varied across studies, including swallowing timing, safety, and efficiency, and were measured using VFSS (n = 17), FEES (n = 6), and EMG (n = 4). Critical appraisal of study findings for RoB, methodological rigor, and transparency showed the majority of studies failed t o adequately describe contrast media used, signal acquisition settings, and rater blinding to time point. Low certainty evidence generally suggested improved swallow timing with exercises with biofeedback and deep brain stimulation (DBS), improved safety with DBS and expiratory muscle strength training, and improved efficiency with the Lee Silverman Voice Treatment and levodopa. CONCLUSIONS: Studies with lower RoB and greater experimental rigor showed potential benefit in improving swallowing efficiency but not safety. Further research investigating discrete changes in swallowing pathophysiology post-intervention is warranted to guide dysphagia management in PD. Supplemental Material https://doi.org/10.23641/asha.17132162. PMID:34890260 | DOI:10.1044/2021_AJSLP-21-00145 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sinonasal blue nevus: a case report and review

xlomafota13 shared this article with you from Inoreader Sinonasal blue nevus: a case report and review Via ear nose throat Ear Nose Throat J. 2021 Dec 10:1455613211064014. doi: 10.1177/01455613211064014. Online ahead of print. ABSTRACT Blue nevus is a type of uncommon benign pigmented lesion in the skin or the mucosa of human body which is featured by pigmented dendritic melanocytes and spindled melanocytic cells. Sinonasal blue nevus is extremely rare. We reported a sinonasal blue nevus case with the background of pituitary adenoma, type 2 diabetes mellitus, and hypertension (including endoscop ic and histological pictures). Further, the existing literature about blue nevus is reviewed. This paper puts a spotlight on the potential correlation between blue nevus with the endocrine system disorder and provides support for further experimental research. PMID:34892997 | DOI:10.1177/01455613211064014 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

EFFECT OF BRAFV600E AND TERT PROMOTER MUTATIONS ON THYROGLOBULIN RESPONSE IN DISTANT-METASTATIC DIFFERENTIATED THYROID CANCER

xlomafota13 shared this article with you from Inoreader EFFECT OF BRAF<sup>V600E</sup> AND TERT PROMOTER MUTATIONS ON THYROGLOBULIN RESPONSE IN DISTANT-METASTATIC DIFFERENTIATED THYROID CANCER Via radioactive iodine Endocr Pract. 2021 Dec 7:S1530-891X(21)01410-5. doi: 10.1016/j.eprac.2021.12.005. Online ahead of print. ABSTRACT OBJECTIVE: To assess the impact of BRAFV600E and telomerase reverse transcriptase (TERT) promoter mutations in distant-metastatic differentiated thyroid cancer (DM-DTC) patients based on thyroglobulin (Tg) response to radioactive iodine (RAI) therapy. METHODS: BRAFV600E and TERT mutations in primary tumors or metastatic lymph nodes of 114 DM-D TC patients were retrospectively examined. RAI avidity was evaluated based on posttreatment 131I-WBS. Tg response was dynamically assessed with a median follow-up of 56.50 months (interquartile range, 28.43-97.98 months). RESULTS: BRAFV600E was detected in 38.6% of cases and TERT mutation in 21.1% of cases, and both BRAFV600E and TERT mutations were observed in 14.9% of cases. Patients with both mutations tended to be older at diagnosis (P<0.001), less multifocal (P=0.011) and have more aggressive histologic subtypes (P=0.011) and a higher Ki-67 index (P=0.003). Patients with neither mutation tended to be more RAI-avid than those with the BRAFV600E mutant alone or both mutations (P=0.001, <0.001, respectively). Patients with both mutations presented more unfavorable Tg response than those without both mutations and with the BRAFV600E mutant alone (P=0.001, 0.013, respectively). Tg progression-free survival (Tg-PFS) w as shorter in patients with TERT mutation alone than in those with neither mutation (P=0.021), and it tended to be shorter when BRAFV600E coexisted (P<0.001); however, no significant difference was observed between BRAFV600E alone and neither mutation (P=0.890). CONCLUSIONS: Coexistence of BRAFV600E and TERT promoter mutations synergistically induce loss of RAI avidity and an undesirable Tg response in DM-DTC. TERT promoter mutation appears to affect Tg response more than the BRAFV600E mutation. PMID:34890787 | DOI:10.1016/j.eprac.2021.12.005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.