Solitary fibrous tumor developing in the right retroperitoneal space

Solitary fibrous tumor (SFT) is a rare mesenchymal tumor that is quite aggressive and prone to recurrence and metastasis. Most SFTs are benign, but the identification of the histological features that define the dedifferentiation of SFTs can predict the aggressiveness of the tumor and the presence of a reserved prognosis. We present a rare case of conventional SFTs with features of malignancy and highlight the diagnostic and therapeutic difficulties related to this case. Computed tomography aspect suggested a possible gastrointestinal stromal tumor. Surgical intervention was performed through median laparotomy and a tumor of approximately 15∕12 cm was found, developed from the level of the right retroperitoneal space, and pushing anteriorly the ascending colon, cecum, and terminal ileum. The immunohistochemical aspect correlated with the histopathological one suggests a SFT most likely malignant. In conclusion, the early diagnosis of SFTs is essential in establishing an appropriate treatment. Immunohistochemistry is indispensable in establishing the diagnosis of SFTs.

Spinal Epidural Abscess: Early Suspicion in Emergency Department Using C-Reactive Protein and Erythrocyte Sedimentation Rate Tests

Background

Spinal epidural abscess (SEA) is an uncommon but serious differential diagnosis of acute spinal pain with high paralysis and mortality rate. This study aims to provide local data on its bioclinical characteristics and evaluate potential strategies to enhance its diagnostic rate in accident and emergency department (AED).

Methods

A retrospective case study from 2013 to 2019 was conducted in United Christian Hospital. SEA cases were classified as study group, spinal pain due to non-SEA cases were classified as control group. Data collected from study group included symptoms, radiological diagnosis, microbiological culture, treatment, and outcome. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) of both groups were compared to analyze their diagnostic power.

Results

In the study group (n = 42), 93% of patients had spinal pain, 55% had fever, 60% had neurological deficits, and only 26% had the classic triad on presentation. Seventy-four percent of patients presented with spinal cord or cauda equina compression in their first magnetic resonance imaging. Mortality rate was 23.8%, and paralysis rate was 7.1%. Diagnostic accuracy in AED was 12%. Admission to orthopedic ward (n = 23) resulted in a significantly lower mean time-to-imaging (4.39 days vs. 14.58 days) and mean time-to-treatment (6.56 days vs. 16.9 days) as compared to other specialties. The area under curves of CRP and ESR were 0.893 and 0.874 respectively, the optimal threshold levels were 45.9 mg/L (sensitivity 82.9%, specificity 79%) and 59.5 mm/hr (sensitivity 87.2%, specificity 80.4%), respectively.

Conclusion

Diagnosis of SEA in emergency department based on clinical symptomatology is not reliable due to low incidence of the classic triad, despite a more advanced disease on presentation. We proposed incorporating CRP and ESR tests into evaluation of patients with spinal pain since both tests demonstrated excellent discriminative power in diagnosing SEA.

Clinical and audiological values in the early diagnosis of hearing impairments and risk groups among ship repair workers

OBJECTIVE

Introduction: The hazardous effect of industrial noise exposure on ship repair workers has been highlighted in a number of studies. However, no data are currently available for studying the effect of noise exposure on the auditory system and general health of ship repair workers. The aim: The study is focused on the early diagnosis of hearing impairments and identifying risk groups among the workers.

PATIENTS AND METHODS

Materials and methods: It was examined two groups of workers of approximately the same age and length of employment. The Group 1 included workers from the Azov Shiprepair Yard (Mariupol city, Ukraine) who were exposed to workplace noise impact of less than 80 dBA threshold level, the workplace noise level in the Group 2 was above 80 dBA. Audiometric testing was conducted in a sound-treated room using the MA 31 clinical audiometer (Germany).

RESULTS

Results: Our findings indicate that all the noise-exposed groups of ship repair workers should be conducted audiometric testing. The hearing levels at the audiometric test frequencies of 4, 6 and 8 kHz, as well as differential thresholds at the audiometric test frequencies of 4 kHz by the Luscher-Zwislocki method should be taken into account. Such complaints as increased annoyance, sleep disorder, tinnitus aurium, hypertension should be considered as most hazardous.

CONCLUSION

Conclusions: We recommend that the ship repair workers undergo routine medical check-ups and systematic prophylactic observation. All these preventive measures will contribute to the early detection of hearing impairments, thereby timely preventing the development and progression of occupational sensorineural hearing loss.

[Dynamic serum metabolomics study of liver injury in rats caused by Polygonum multifulorum]

Liquid chromatography-mass spectrometry method was used for determination of metabolic fingerprint spectrum in rat serum, and the method of multivariate statistical analysis was used to compare the metabolism spectrum difference and screen significantly related biomarkers. The dynamic change trend was investigated at the same time. The dynamic metabonomics changes of liver injury in rats caused by Polygonum multifulorum(PM) were investigated; significantly related biomarkers were found and their dynamic change trend was investigated to provide basis for internal mechanism and early clinical diagnosis. There was certain difference in serum metabolic profile of the rats at different time points. Six potential biomarkers were screened through comparative analysis, including oleamide, lysoPC(16∶0), leukotriene A4, trans-tetra-dec-2-enoic acid, dihydrocortisol and 7a-hydroxydehydroepiandrosterone. These markers presented the dynamic change trend in the process of PM causing liver damage. The biomarkers contents had a significant change after one week of drug administration, more sensitive than ALT and AST. It can reveal the dynamic mechanism of PM causing liver damage and hepatic self-healing performance to some extent, with important application value and significance for monitoring liver function and early detecting diagnosis for patients with PM.