Thyroglobulin Antibodies and Tumor Epitope-Specific Cellular Immunity in Papillary Thyroid Cancer

Papillary thyroid carcinoma (PTC) is characterized by T cell infiltration and frequently by the presence of anti-thyroglobulin antibodies (TgAbs). The role of cellular immunity and of TbAbs in this context is a matter of debate. The aim of our study was to correlate the presence of TgAbs, tumor epitope-specific T cells and the clinical outcome of PTC patients. We studied n=183 consecutive patients with a diagnosis of PTC which were treated with total thyroidectomy plus 131I ablation. During a follow-up of in mean 97 months, most of the PTC patients had no signs of tumor relapse (n=157 patients). In contrast, one patient had serum Tg levels above the detection limit and<1 ng/ml, two patients Tg serum levels≥1 ng/ml and<2 ng/ml and n=23 patients had Tg serum levels≥2 ng/ml. Morphological signs of tumor recurrence were seen in 14 patients; all of these patients had serum Tg levels≥2 ng/ml. Importantly, with the exception of one patient, all TgAb positive PTC patients (n=27) had no signs of tumor recurrence as the serum Tg levels were below the assays functional sensitivities. Tetramer analyses revealed a higher number of tumor epitope-specific CD8+T cells in TgAb positive patients compared to TgAb negative PTC patients. In summary, we show that the occurrence of TgAbs may have an impact on the clinical outcome in PTC patients. This might be due to a tumor epitope-specific cellular immunity in PTC patients.

The DERIVO®2 Embolization Device in the treatment of ruptured and unruptured intracranial aneurysms: A multicenter analysis

BACKGROUND

Flow diverters are an increasingly used treatment option for intracranial aneurysms. A recent addition to the European market is the DERIVO®2 Embolization Device (DED2), promising improved radiopacity. We aimed to assess the safety and efficacy of the DED2 regarding angiographic and clinical outcomes in ruptured and unruptured cerebral aneurysms.

METHODS

We performed a multicenter trial at six interventional centers. Data were prospectively collected and all patients treated with the DED2 were included. The primary endpoint was angiographic aneurysm occlusion at 6 months as assessed by the O'Kelly Marotta (OKM) grading scale with a favorable outcome definition of OKM C + D. Clinical outcome was evaluated according to the modified Rankin scale (mRS).

RESULTS

Between August 2020 and July 2021, 37 patients were treated with the DED2 and were included in our analysis. Five patients presented with ruptured aneurysms. Median age was 60 years, 27 patients were female, and 10 male. Median mRS was 0 (range 0-4). Mean aneurysm size was 8.9 ± 7.1 mm with a mean neck size of 6.5 ± 6.1. The DED2 fully opened at deployment in all cases. Clinical follow-up was available for 30 patients (81%). Twenty-five (83%) had an mRS of 0 or 1. Three patients with ruptured aneurysms died during the follow-up period. No treatment-related major morbidity was observed. Follow-up imaging was available in 27 (90%) patients, with 23 patients (85%) showing satisfactory aneurysm occlusion OKM grade C-D.

CONCLUSION

In this small cohort, the DED2 provided safe and effective treatment of ruptured and unruptured intracranial aneurysms.

Emergency response, intervention, and societal recovery in Greece and Turkey after the 30th October 2020, MW = 7.0, Samos (Aegean Sea) earthquake

On 30 October 2020, an M_w = 7.0 earthquake struck the Eastern Aegean Sea with considerable impact on Samos Island in Greece and the area of Izmir in Turkey. It was the most lethal seismic event in 2020 worldwide, and the largest and most destructive in the Aegean Sea since the 1955 earthquake that also affected both countries. The Civil Protection authorities in Greece and Turkey were effectively mobilized responding to the earthquake emergency. The main response actions comprised initial announcements of the earthquake and first assessment of the impact, provision of civil protection guidelines through emergency communication services, search and rescue operations,medical care, set up of emergency shelters and provisions of essential supplies, psychological support, as well as education, training activities and financial support to the affected population. From the comparison of the Civil Protection framework and the implemented response actions, it is seen that actions at both sides of the eastern Aegean Sea, followed a single-hazard approach in disaster management with similar response activities coordinated by a main Civil Protection agency, which was in close cooperation with the respective authorities at a national, regional and local level. Based on the presented information, it is concluded that the post-earthquake response and emergency management were satisfactory in both countries, with valuable lessons learnt ahead of the next major earthquake. To this end, many aspects can be further addressed to enhance community resilience and introduce a multi-hazard approach in (natural and man-made) disaster management.