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Molla YD, Alemu HT, Selamawi AE, Tesema AY, Answar IO, Tadesse AK. Adenocarcinoma ad mixed with neuroendocrine carcinoma of the cervix: A case report and review of literature. Case Rep Womens Health 2024; 41:e00594. [PMID: 38515997 PMCID: PMC10955200 DOI: 10.1016/j.crwh.2024.e00594] [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: 02/23/2024] [Revised: 03/11/2024] [Accepted: 03/11/2024] [Indexed: 03/23/2024] Open
Abstract
A 40-year-old Ethiopian woman presented with a six-month history of non-foul-smelling whitish vaginal discharge. She also reported a one-year history of postcoital bleeding. A pelvic examination revealed a nodular, hard, and fragile cervical mass. In addition, there were nontender, firm nodules in the epigastric, periumbilical, gluteal areas, and thyroid gland. Investigations, including abdominopelvic ultrasound, magnetic resonance imaging, fine-needle aspiration cytology, and immunohistochemistry, confirmed mixed neuroendocrine carcinoma of the cervix with metastasis to the abdominal wall, gluteal area, lumbar vertebrae, and thyroid gland. The patient was started on palliative chemotherapy. Metastatic adenocarcinoma admixed with neuroendocrine carcinoma of the cervix presents a formidable disease phenotype, characterized by complex diagnostic and therapeutic obstacles. Multidisciplinary cooperation among oncologists, radiologists, pathologists, and surgeons is required to refine treatment approaches and improve patient prognoses for this uncommon and intricate malignancy.
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Affiliation(s)
- Yohannis Derbew Molla
- Department of Surgery, College of Medicine and Health Sciences, University of Gondar, 196 Gondar, Ethiopia
| | - Hirut Tesfahun Alemu
- College of Medicine and Health Sciences, University of Gondar, 196 Gondar, Ethiopia
| | - Almaz Enku Selamawi
- Department of Radiology, College of Medicine and Health Sciences, University of Gondar, 196 Gondar, Ethiopia
| | - Amare Yeshitla Tesema
- Department of Oncology, College of Medicine and Health Sciences, University of Gondar, 196 Gondar, Ethiopia
| | - Isak Omer Answar
- Department of Pathology, College of Medicine and Health Sciences, University of Gondar, 196 Gondar, Ethiopia
| | - Amanuel Kassa Tadesse
- Department of Pathology, College of Medicine and Health Sciences, University of Gondar, 196 Gondar, Ethiopia
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Simjanoski M, de Azevedo Cardoso T, Frey BN, Minuzzi L, De Boni RB, Balanzá-Martínez V, Kapczinski F. Lifestyle in bipolar disorder: A cross-sectional study. Span J Psychiatry Ment Health 2023; 16:244-250. [PMID: 37839960 DOI: 10.1016/j.rpsm.2023.04.001] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/14/2023] [Accepted: 04/27/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Modifiable lifestyle behaviors are important factors for improving mental health, yet there has been a lack of research studying lifestyle as a multidimensional construct in bipolar disorder (BD). The aim of this cross-sectional study was to compare the lifestyle patterns of individuals with BD in a current mood episode with healthy controls (HCs) using the Short Multidimensional Inventory Lifestyle Evaluation (SMILE). MATERIALS AND METHODS The sample consisted of 46 individuals with BD currently experiencing a depressive or manic episode and 50 HC, assessed using the MINI International Neuropsychiatric Interview, Montgomery-Åsberg Depression Rating Scale (MADRS), and the Young Mania Rating Scale (YMRS). The SMILE scale assesses lifestyle across seven domains: diet and nutrition, substance abuse, physical activity, stress management, restorative sleep, social support, and environmental exposures. Between-groups comparisons were performed based on the presence of a psychiatric diagnosis and the type of BD episode. RESULTS We found significant differences in the total SMILE score (r=0.75, p<0.001) and in scores from each domain of the scale between BD and HC (p<0.05), where individuals with BD in a depressive or manic episode with or without mixed features reported worse lifestyle across all domains. Differences between individuals with BD in different mood episodes across domains on the SMILE scale were non-significant. CONCLUSION Findings from this study highlight the presence of unhealthy lifestyle patterns in people with BD regardless of the polarity of their mood episode. Implementation of multidimensional lifestyle assessments is an essential step toward detecting the clustering of unhealthy lifestyle patterns in BD.
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Affiliation(s)
- Mario Simjanoski
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada.
| | - Taiane de Azevedo Cardoso
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada
| | - Benicio N Frey
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Women's Health Concerns Clinic and Mood Disorders Program, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, Canada
| | - Luciano Minuzzi
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Women's Health Concerns Clinic and Mood Disorders Program, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, Canada
| | - Raquel B De Boni
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), 4365 Manguinhos, Rio de Janeiro, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Av. de Blasco Ibáñez, 13, Valencia, Spain
| | - Flavio Kapczinski
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Paulo Gama, 110, Porto Alegre, Brazil
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3
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Mastrosimini MG, Mafficini A, Tondulli L, Milella M, Piccoli P, Mattiolo P, Fassan M, Hong SM, Scarpa A, Luchini C. Recurrent gastric amphicrine tumor with neuroendocrine and pancreatic acinar cell differentiation and somatic MEN1 inactivation arisen during immunotherapy. Virchows Arch 2023; 483:415-419. [PMID: 37581694 DOI: 10.1007/s00428-023-03624-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/16/2023]
Abstract
Amphicrine neoplasms (ANs) are poorly understood epithelial malignancies composed of cells with co-existing exocrine-neuroendocrine features. Here, we report a recurrent mucin-producing gastric amphicrine tumor co-expressing neuroendocrine (chromogranin-A, synaptophysin, and CD56) and pancreatic acinar cell (BCL10 and trypsin) markers, arisen in a 64-year-old woman during adjuvant immunotherapy for melanoma. Ki-67 was < 2%. The gastric background context was atrophic gastritis. Next-generation sequencing showed MEN1 mutation (p.P71fs*42) coupled with loss of heterozygosity. The key lessons were as follows: (1) gastric ANs can show the co-existence of exocrine mucin-producing elements with neuroendocrine and pancreatic acinar differentiation; (2) they may represent a new entity arising in the context of atrophic gastritis and during immunotherapy; (3) they should be considered in the diagnostic workup of gastric neuroendocrine tumors; and (4) their molecular profile can show striking similarities with well-differentiated neuroendocrine tumors. These findings may be of help to improve the knowledge and the biological taxonomy of ANs.
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Affiliation(s)
- Maria G Mastrosimini
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Piazzale Scuro, 10, 37134, Verona, Italy
| | - Andrea Mafficini
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Piazzale Scuro, 10, 37134, Verona, Italy
- ARC-Net Research Center, University of Verona, Verona, Italy
| | - Luca Tondulli
- Department of Medicine, Section of Oncology, University and Hospital Trust of Verona, Verona, Italy
| | - Michele Milella
- Department of Medicine, Section of Oncology, University and Hospital Trust of Verona, Verona, Italy
| | - Paola Piccoli
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Piazzale Scuro, 10, 37134, Verona, Italy
| | - Paola Mattiolo
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Piazzale Scuro, 10, 37134, Verona, Italy
| | - Matteo Fassan
- Surgical Pathology Unit, Department of Medicine (DIMED), University of Padua, and Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Seung-Mo Hong
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Aldo Scarpa
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Piazzale Scuro, 10, 37134, Verona, Italy
- ARC-Net Research Center, University of Verona, Verona, Italy
| | - Claudio Luchini
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Piazzale Scuro, 10, 37134, Verona, Italy.
- ARC-Net Research Center, University of Verona, Verona, Italy.
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Edmunds G, Beck S, Kale KU, Spasic I, O'Neill D, Brodbelt D, Smalley MJ. Associations Between Dog Breed and Clinical Features of Mammary Epithelial Neoplasia in Bitches: an Epidemiological Study of Submissions to a Single Diagnostic Pathology Centre Between 2008-2021. J Mammary Gland Biol Neoplasia 2023; 28:6. [PMID: 36961631 PMCID: PMC10039094 DOI: 10.1007/s10911-023-09531-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/25/2023] [Indexed: 03/25/2023] Open
Abstract
Mammary cancer is one of the most common neoplasms of dogs, primarily bitches. While studies have been carried out identifying differing risk of mammary neoplasia in different dog breeds, few studies have reported associations between dog breeds and clinical features such as number of neoplastic lesions found in an individual case or the likelihood of lesions being benign or malignant. Such epidemiological studies are essential as a foundation for exploring potential genetic drivers of mammary tumour behaviour. Here, we have examined associations between breed, age and neuter status and the odds of a diagnosis of a mammary epithelial-origin neoplastic lesion (as opposed to any other histopathological diagnosis from a biopsied lesion) as well as the odds of a bitch presenting with either a single mammary lesion or multiple lesions, and the odds that those lesions are benign or malignant. The study population consisted of 129,258 samples from bitches, including 13,401 mammary epithelial neoplasms, submitted for histological assessment to a single histopathology laboratory between 2008 and 2021.In multivariable analysis, breed, age and neuter status were all significantly associated with the odds of a diagnosis of a mammary epithelial-origin neoplastic lesion. Smaller breeds were more likely to receive such a diagnosis. In cases diagnosed with a mammary epithelial neoplasm, these three factors were also significantly associated with the odds of diagnosis with a malignant lesion and of diagnosis with multiple lesions. Notably, while neutered animals were less likely to have a mammary epithelial neoplasm diagnosed, and were less likely to have multiple neoplasms, they were more likely to have malignant disease. Exploration of the patterns of risk of developing malignant disease, or multiple lesions, across individual breeds showed no breed with increased odds of both outcomes. Breeds with altered odds compared to the Crossbreed baseline were either at increased risk of malignant disease and decreased risk of multiple lesions, or vice versa, or they were at significantly altered odds of one outcome with no change in the other outcome. Our analysis supports the hypothesis that age, neuter status and intrinsic biological and genetic factors all combine to influence the biological heterogeneity of canine mammary neoplasia.
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Affiliation(s)
- Grace Edmunds
- Bristol Veterinary School, Langford House, Langford, Bristol, BS40 5DU, UK
| | - Sam Beck
- VPG Histopathology (Formerly Bridge), Horner Court, Horfield, Bristol, BS7 0BJ, UK
- Present Address: Independent Anatomic Pathology Ltd, Bath, UK
| | - Kedar Umakant Kale
- School of Computer Science and Informatics, Cardiff University, Cardiff, CF24 4AG, UK
| | - Irena Spasic
- School of Computer Science and Informatics, Cardiff University, Cardiff, CF24 4AG, UK
| | - Dan O'Neill
- The Royal Veterinary College, North Mymms, Hatfield, Herts, AL9 7TA, UK
| | - David Brodbelt
- The Royal Veterinary College, North Mymms, Hatfield, Herts, AL9 7TA, UK
| | - Matthew J Smalley
- School of Biosciences, European Cancer Stem Cell Research Institute, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff, Wales, CF24 4HQ, UK.
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Adas MA, Norton S, Balachandran S, Alveyn E, Russell MD, Esterine T, Amlani-Hatcher P, Oyebanjo S, Lempp H, Ledingham J, Kumar K, Galloway JB, Dubey S. Worse outcomes linked to ethnicity for early inflammatory arthritis in England and Wales: a national cohort study. Rheumatology (Oxford) 2022; 62:169-180. [PMID: 35536178 PMCID: PMC9788810 DOI: 10.1093/rheumatology/keac266] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 02/23/2022] [Revised: 04/01/2022] [Accepted: 04/19/2022] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To assess variability in care quality and treatment outcomes across ethnicities in early inflammatory arthritis (EIA). METHODS We conducted an observational cohort study in England and Wales from May 2018 to March 2020, including patients with a suspected/confirmed EIA diagnosis. Care quality was assessed against six metrics defined by national guidelines. Clinical outcomes were measured using DAS28. Outcomes between ethnic groups ('White', 'Black', 'Asian', 'Mixed', 'Other') were compared, and adjusted for confounders. RESULTS A total of 35 807 eligible patients were analysed. Of those, 30 643 (85.6%) were White and 5164 (14.6%) were from ethnic minorities: 1035 (2.8%) Black; 2617 (7.3%) Asian; 238 (0.6%) Mixed; 1274 (3.5%) Other. In total, 12 955 patients had confirmed EIA, of whom 11 315 were White and 1640 were from ethnic minorities: 314 (2.4%) Black; 927 (7.1%) Asian; 70 (0.5%) Mixed; 329 (2.5%) Other. A total of 14 803 patients were assessed by rheumatology within three weeks, and 5642 started treatment within six weeks of referral. There were no significant differences by ethnicity. Ethnic minority patients had lower odds of disease remission at three months [adjusted odds ratio 0.79 (95% CI: 0.65, 0.96)] relative to White patients. Ethnic minorities were significantly less likely to receive initial treatment withMTX[0.68 (0.52, 0.90)] or with glucocorticoids [0.63 (0.49, 0.80)]. CONCLUSION We demonstrate that some ethnic minorities are less likely to achieve disease remission in three months following EIA diagnosis. This is not explained by delays in referral or time to treatment. Our data highlight the need for investigation into the possible drivers of these inequitable outcomes and reappraisal of EIA management pathways.
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Affiliation(s)
| | | | | | - Edward Alveyn
- Centre for Rheumatic Disease, Department of Inflammatory Biology
| | - Mark D Russell
- Centre for Rheumatic Disease, Department of Inflammatory Biology
| | | | | | | | - Heidi Lempp
- Centre for Rheumatic Disease, Department of Inflammatory Biology
| | - Joanna Ledingham
- Rheumatology Department, Portsmouth Hospitals University NHS Trust, Portsmouth
| | - Kanta Kumar
- Institute of Clinical Sciences, University of Birmingham, Birmingham
| | - James B Galloway
- Correspondence to: James Galloway, Weston Education Centre, 10 Cutcombe Road, SE5 9RJ London, UK. E-mail:
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Desprez C, Turmel N, Chesnel C, Mistry P, Tamiatto M, Haddad R, Le Breton F, Leroi AM, Hentzen C, Amarenco G. Comparison of clinical and paraclinical characteristics of patients with urge, mixed, and passive fecal incontinence: a systematic literature review. Int J Colorectal Dis 2021; 36:633-644. [PMID: 33210162 DOI: 10.1007/s00384-020-03803-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Accepted: 11/11/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE Two subgroups of fecal incontinence (FI) are described in literature and used in clinical practice. However, the pertinence of this classification of FI is still unknown as there are no clear established guidelines. To a better understanding, we performed a systematic review to characterize the different types of FI (active, passive, or mixed) on the basis of clinical presentation and complementary explorations. METHODS This systematic literature review was performed in reference to recommendations for systematic review using PRISMA guidelines without date restriction, until May 2020. This systematic review was performed without temporal limitation using MEDLINE-PubMed, Cochrane Library, and Google Scholar databases. RESULTS Six hundred nine unique citations were identified from all the databases combined. Of those, 21 studies met the inclusion criteria, with 8 retrospective observational studies and 13 prospective observational studies. There was a lack of homogeneity in definitions of passive and urge (active) FI among studies. Prevalence of passive and urge FI was respectively of 4.0-5.0 and 15.0-35.0%. Clinical characteristics, physical examination, and endoanal imaging were not evaluated in most studies. In anorectal manometry, maximal squeeze pressure was higher in passive FI subgroup in most studies and results regarding maximal resting pressure remain discordant. There seemed to be no difference regarding first sensation volume and maximal tolerable volume among subgroups. A few studies evaluated pudendal terminal nerve motor latency with no difference among subgroups. CONCLUSION There is a lack of well-conducted prospective studies comparing the different subtypes of FI with validated definitions in both clinical and paraclinical examinations.
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Affiliation(s)
- Charlotte Desprez
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France. .,Digestive physiology Unit, Rouen University Hospital, 1 rue de Germont, 76031, Rouen, France.
| | - N Turmel
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
| | - C Chesnel
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
| | - P Mistry
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
| | - M Tamiatto
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
| | - R Haddad
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
| | - F Le Breton
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
| | - A-M Leroi
- Digestive physiology Unit, Rouen University Hospital, 1 rue de Germont, 76031, Rouen, France
| | - C Hentzen
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
| | - G Amarenco
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
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Marques SG, Bomfim MRQ, Azevedo CDMPS, Martins CVB, Marques ACG, Gonçalves AG, Vicente VA, Dos Santos AM, Costa MC, Freitas GJC, Santos DA, de Resende-Stoianoff MA. Mixed secondary bacterial infection is associated with severe lesions of chromoblastomycosis in a neglected population from Brazil. Diagn Microbiol Infect Dis 2019; 95:201-207. [PMID: 31262546 DOI: 10.1016/j.diagmicrobio.2019.05.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 12/31/2018] [Revised: 05/16/2019] [Accepted: 05/27/2019] [Indexed: 11/16/2022]
Abstract
Chromoblastomycosis (CBM) is a chronic subcutaneous infection caused by melanotic fungi, affecting mainly rural workers in tropical and subtropical regions. Secondary bacterial infections (SBIs) in CBM lesions bring complications to the disease, but little is known about the agents involved. Fungal and bacterial identification and epidemiological profile of 50 patients with CBM were analyzed in this study. Bacteria were tested for susceptibility to antibacterial drugs. Fonseacea pedrosoi and Rhinocladiella aquaspersa were the fungal agents isolated. 88% of the patients presented SBI. Gram-positive bacteria coinfected mainly upper limbs, and Gram-negative bacteria were more isolated from lower limbs. Streptococcus pyogenes and mixed bacterial microbiota were associated with severe lesions. Staphylococcus aureus was associated with mixed infections and consequently with the severity of the infection. Resistance to β-lactams and methicillin was detected. Our results emphasize the necessity of bacterial culture and susceptibility testing as part of routine monitoring CBM cases.
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Affiliation(s)
- Sirlei G Marques
- Hospital Universitário da Universidade Federal do Maranhão, São Luiz, MA, Brazil; Laboratório Cedro, São Luiz, MA, Brazil; Universidade Federal de Minas Gerais, Departamento de Microbiologia, Belo Horizonte, MG, Brazil
| | | | - Conceição de Maria P S Azevedo
- Universidade Federal de Minas Gerais, Departamento de Microbiologia, Belo Horizonte, MG, Brazil; Universidade Federal do Maranhão, São Luis, MA, Brazil
| | | | | | | | | | | | - Marliete C Costa
- Universidade Federal de Minas Gerais, Departamento de Microbiologia, Belo Horizonte, MG, Brazil
| | - Gustavo J C Freitas
- Universidade Federal de Minas Gerais, Departamento de Microbiologia, Belo Horizonte, MG, Brazil
| | - Daniel A Santos
- Universidade Federal de Minas Gerais, Departamento de Microbiologia, Belo Horizonte, MG, Brazil.
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Pea A, Riva G, Bernasconi R, Sereni E, Lawlor RT, Scarpa A, Luchini C. Ampulla of Vater carcinoma: Molecular landscape and clinical implications. World J Gastrointest Oncol 2018; 10:370-380. [PMID: 30487949 PMCID: PMC6247104 DOI: 10.4251/wjgo.v10.i11.370] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [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: 06/01/2018] [Revised: 08/08/2018] [Accepted: 10/08/2018] [Indexed: 02/05/2023] Open
Abstract
Ampulla of Vater is a peculiar anatomical structure, characterized by the crossroad of three distinct epithelia: Intestinal, ductal pancreatic and biliary. Adenocarcinomas arising in this area represent an opportunity to understand the comparative biology of all periampullary malignancies. These neoplasms can exhibit intestinal, pancreaticobiliary or mixed features, whereas the subclassification based on morphology and immunohistochemical features failed in demonstrating a robust prognostic reliability. In the last few years, the molecular landscape of this tumor entity has been uncovered, identifying alterations that may serve as prognostic and predictive biomarkers. In this review, the histological and genetic characteristics of ampullary carcinomas are discussed, taking into account the main clinical and therapeutic implications related to this tumor type as well.
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Affiliation(s)
- Antonio Pea
- Department of Surgery, University and Hospital Trust of Verona, Verona 37134, Italy
| | - Giulio Riva
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona 37134, Italy
| | - Riccardo Bernasconi
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona 37134, Italy
| | - Elisabetta Sereni
- Department of Surgery, University and Hospital Trust of Verona, Verona 37134, Italy
| | - Rita Teresa Lawlor
- ARC-Net Research Center, University and Hospital Trust of Verona, Verona 37134, Italy
| | - Aldo Scarpa
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona 37134, Italy
| | - Claudio Luchini
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona 37134, Italy
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9
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Johnson MT, Smith KC, Tsai LL. Vaginal spindle cell epithelioma: A first complete MRI and histopathologic description. Clin Imaging 2018; 50:181-184. [PMID: 29604603 DOI: 10.1016/j.clinimag.2018.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/30/2017] [Revised: 03/20/2018] [Accepted: 03/26/2018] [Indexed: 11/19/2022]
Abstract
Spindle cell epithelioma of the vagina is a benign entity with fewer than sixty cases described in the literature, and only two with limited imaging findings, since the early 1950s. Early pathology literature suggested the lesions were mixed tumors of myoepithelial origin, but subsequent studies have found relatively few immunohistochemical characteristics in common with other mixed cell tumors. More recently, Mullerian, urogenital sinus epithelial, and pluripotential cell origins have been proposed. Given lesion rarity and a typical lack of imaging before excision, the imaging appearance of vaginal spindle cell epitheliomas has not been fully described in the radiology literature, and without comprehensive pathology correlation. The authors describe a case of spindle cell epithelioma in a 54-year-old woman which was incidentally discovered on MRI performed for uterine fibroid embolization planning. Pathology and immunohistochemistry confirmed the diagnosis.
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Affiliation(s)
- Michael T Johnson
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, United States.
| | - Kristin C Smith
- Department of Pathology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, United States.
| | - Leo L Tsai
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, United States.
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Ashraf MT, Schmidt JE. Process simulation and economic assessment of hydrothermal pretreatment and enzymatic hydrolysis of multi-feedstock lignocellulose - Separate vs combined processing. Bioresour Technol 2018; 249:835-843. [PMID: 29136939 DOI: 10.1016/j.biortech.2017.10.088] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 09/13/2017] [Revised: 10/25/2017] [Accepted: 10/26/2017] [Indexed: 06/07/2023]
Abstract
Biorefinery based on multi-feedstock lignocellulose can be viable where a sustainable supply of a single substrate is limited, for example in arid regions. Processing of mixed feedstocks has been studied in lab scale, however, its economics are less studied. In this study, an economic comparison was made between separate and combined (mixed) processing approaches for multi-feedstock lignocellulose for the production of monomeric sugars. This modular approach of focusing on sugar platform makes the results applicable for many applications using the sugars as feedstock. Feedstock considered in this study were the green and woody lignocellulose residues: Bermuda grass, Jasmine hedges, and date palm fronds. Results showed that, at an identical total feed rate, combined processing was more advantageous as compared to separate processing. A further sensitivity analysis on mixed combined processing showed that the cellulase enzyme price and feed price are the two major factors affecting the production cost.
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Affiliation(s)
- Muhammad Tahir Ashraf
- Department of Chemistry, Khalifa University of Science and Technology, Masdar Institute, Masdar City, P.O. Box 54224, Abu Dhabi, United Arab Emirates
| | - Jens Ejbye Schmidt
- Department of Chemistry, Khalifa University of Science and Technology, Masdar Institute, Masdar City, P.O. Box 54224, Abu Dhabi, United Arab Emirates.
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11
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McClements DJ, Jafari SM. Improving emulsion formation, stability and performance using mixed emulsifiers: A review. Adv Colloid Interface Sci 2018; 251:55-79. [PMID: 29248154 DOI: 10.1016/j.cis.2017.12.001] [Citation(s) in RCA: 432] [Impact Index Per Article: 72.0] [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: 06/22/2017] [Revised: 12/01/2017] [Accepted: 12/02/2017] [Indexed: 12/14/2022]
Abstract
The formation, stability, and performance of oil-in-water emulsions may be improved by using combinations of two or more different emulsifiers, rather than an individual type. This article provides a review of the physicochemical basis for the ability of mixed emulsifiers to enhance emulsion properties. Initially, an overview of the most important physicochemical properties of emulsifiers is given, and then the nature of emulsifier interactions in solution and at interfaces is discussed. The impact of using mixed emulsifiers on the formation and stability of emulsions is then reviewed. Finally, the impact of using mixed emulsifiers on the functional performance of emulsifiers is given, including gastrointestinal fate, oxidative stability, antimicrobial activity, and release characteristics. This information should facilitate the selection of combinations of emulsifiers that will have improved performance in emulsion-based products.
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Affiliation(s)
- David Julian McClements
- Department of Food Science, University of Massachusetts, Chenoweth Laboratory, Amherst, MA, USA.
| | - Seid Mahdi Jafari
- Department of Food Materials and Process Design Engineering, Gorgan University of Agricultural Sciences and Natural Resources, Gorgan, Iran
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12
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Tyagaturu Renukaprasad M, Ismailsab M, Reddy PV, Baburao K, Nayak AS, Karegoudar TB. A comparative study of utilization of single and mixed phenolic compounds by individual and mixed culture. 3 Biotech 2017; 7:215. [PMID: 28669074 DOI: 10.1007/s13205-017-0815-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 05/17/2017] [Indexed: 11/25/2022] Open
Abstract
Three bacterial strains; Pseudomonas sp. TRMK1, Stenotrophomonas sp. TRMK2 and Xanthomonas sp. TRMK3 were isolated from agro-industrial waste by enrichment culture technique that are capable of utilizing phenolic acids as sole source of carbon and energy. These strains were found to utilize p-coumaric, ferulic and caffeic acid. The individual strains utilized 5 mM of mixed phenolic acids within 20 h of incubation. The bacterial consortium composing these strains was prepared and studied the efficient degradation of phenolic compounds. The bacterial consortium showed the enhanced utilization of 30 mM individual and 25 mM mixed phenolic acids within 32 and 40 h of incubation, respectively. The degradation efficiency of these strains in all the above experiments was above 90%. The prepared bacterial consortium serves as a suitable method for the in situ application of sites contaminated with wide range of phenolic compounds.
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Affiliation(s)
| | - Mukram Ismailsab
- Department of Biochemistry, Gulbarga University, Kalaburagi, Karnataka, 585106, India
| | - Pooja V Reddy
- Department of Biochemistry, Gulbarga University, Kalaburagi, Karnataka, 585106, India
| | - Kirankumar Baburao
- Department of Biochemistry, Gulbarga University, Kalaburagi, Karnataka, 585106, India
| | - Anand S Nayak
- Department of Biochemistry, Gulbarga University, Kalaburagi, Karnataka, 585106, India
| | - T B Karegoudar
- Department of Biochemistry, Gulbarga University, Kalaburagi, Karnataka, 585106, India.
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13
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Sjogren PP, Arnold RW, Skirko JR, Grimmer JF. Anatomic distribution of cervicofacial lymphatic malformations based on lymph node groups. Int J Pediatr Otorhinolaryngol 2017; 97:72-75. [PMID: 28483255 DOI: 10.1016/j.ijporl.2017.02.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 10/20/2016] [Revised: 01/17/2017] [Accepted: 02/26/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate radiographic characteristics and to identify locations of cervicofacial lymphatic malformations in children based on known lymph node groupings. METHODS Retrospective chart review of pediatric patients with cervicofacial lymphatic malformations who underwent imaging with magnetic resonance imaging (MRI), computed tomography (CT) or ultrasonography (US). Ninety charts were reviewed from November 2005 to June 2015. Demographic information and imaging characteristics were evaluated. RESULTS Ninety children were included. The average age at presentation was 52 months (range, 1 day to 170 months). Imaging modalities were MRI in 73 (81%), CT in 7 (8%), US in 6 (7%), and multimodality imaging in 4 (4%) cases. Nearly half (49%) of lesions were found in the parotid and submandibular nodal group, 32% in the cervical group, and 19% in the midline face and oral cavity group. The lymphatic malformations were found on the left in 39 (43%) of cases, on the right in 30 (33%) of cases, and were bilateral in 21 (23%) cases. Nineteen (21%) lesions were macrocystic, twenty-two (24%) were microcystic, and forty-nine (49%) had mixed features. Mixed lesions were more likely to be extensive and involve multiple lymph node groups (P = 0.0005). Adjacent lymphadenopathy was present in 20 (22%) among all subjects, with an average size of 1.22 (± 1.92) cm in the short-axis. CONCLUSION The results of this study demonstrate three lymph node groupings in which LM are commonly identified. The midline face and oral cavity lesions are predominantly microcystic, the parotid and submandibular lesions are predominately of mixed morphology, and the cervical lesions are predominately macrocystic and mixed. Further studies are needed to determine if such a classification system demonstrates clinically significant difference in disease progression and response to therapy.
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Affiliation(s)
- Phayvanh P Sjogren
- Division of Otolaryngology - Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Ryan W Arnold
- Pediatric Radiology, Primary Children's Hospital, Salt Lake City, UT, USA
| | - Jonathan R Skirko
- Division of Otolaryngology - Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Johannes F Grimmer
- Division of Otolaryngology - Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.
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14
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Stahl SM, Morrissette DA, Faedda G, Fava M, Goldberg JF, Keck PE, Lee Y, Malhi G, Marangoni C, McElroy SL, Ostacher M, Rosenblat JD, Solé E, Suppes T, Takeshima M, Thase ME, Vieta E, Young A, Zimmerman M, McIntyre RS. Guidelines for the recognition and management of mixed depression. CNS Spectr 2017; 22:203-19. [PMID: 28421980 DOI: 10.1017/S1092852917000165] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [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] [Indexed: 12/29/2022]
Abstract
A significant minority of people presenting with a major depressive episode (MDE) experience co-occurring subsyndromal hypo/manic symptoms. As this presentation may have important prognostic and treatment implications, the DSM-5 codified a new nosological entity, the "mixed features specifier," referring to individuals meeting threshold criteria for an MDE and subthreshold symptoms of (hypo)mania or to individuals with syndromal mania and subthreshold depressive symptoms. The mixed features specifier adds to a growing list of monikers that have been put forward to describe phenotypes characterized by the admixture of depressive and hypomanic symptoms (e.g., mixed depression, depression with mixed features, or depressive mixed states [DMX]). Current treatment guidelines, regulatory approvals, as well the current evidentiary base provide insufficient decision support to practitioners who provide care to individuals presenting with an MDE with mixed features. In addition, all existing psychotropic agents evaluated in mixed patients have largely been confined to patient populations meeting the DSM-IV definition of "mixed states" wherein the co-occurrence of threshold-level mania and threshold-level MDE was required. Toward the aim of assisting clinicians providing care to adults with MDE and mixed features, we have assembled a panel of experts on mood disorders to develop these guidelines on the recognition and treatment of mixed depression, based on the few studies that have focused specifically on DMX as well as decades of cumulated clinical experience.
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Kishida Y, Matsubayashi H, Sasaki K, Honda S, Uemura S, Uesaka K, Todaka A, Ono H. A case of multicentric pancreatic mixed acinar-ductal carcinoma diagnosed by a yogurt-like cell clump flowing from the papilla of Vater. BMC Gastroenterol 2017; 17:20. [PMID: 28114893 PMCID: PMC5260055 DOI: 10.1186/s12876-017-0575-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 01/16/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Histological confirmation is needed when the pancreatic lesions is uncertain for neoplastic or nonneoplastic. Current case with multicentric pancreatic carcinomas showing indefinite clinical images was successfully diagnosed by a biopsy of a novel object expelled from the papilla. CASE PRESENTATION A 71-year-old male was referred because of elevated serum pancreatic enzymes. Computed tomography revealed an unclear low-density area in the pancreatic body without evidence of tumor and mild dilation of the upstream main pancreatic duct (MPD). Other images, including abdominal ultrasound, endoscopic ultrasound, and magnetic resonance imaging, did not demonstrate cancerous findings. Endoscopic retrograde cholangiopancreatography showed a crab-claw-like obstruction in the MPD. Surprisingly, the component constituting the obstruction was moved by contrast injection and spilled out of the papilla orifice as a yogurt-like white object. Biopsy of this object by histology revealed a cancer cell clump. Pancreatectomy was performed, and pathology of the resected pancreas showed multiple nodular tumors replacing the acini and extending into the MPD. These neoplasms histologically resembled mixed acinar-ductal carcinoma. CONCLUSION Current report presented a rare tumor with multicentric pancreatic lesions, preoperatively diagnosed by a biopsy of an uncommon substance.
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Affiliation(s)
- Yoshihiro Kishida
- Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Suntogun, Shizuoka, 411-8777 Japan
| | - Hiroyuki Matsubayashi
- Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Suntogun, Shizuoka, 411-8777 Japan
| | - Keiko Sasaki
- Division of Pathology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Shinsaku Honda
- Division of Hepato-Pancreato-Biliary Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | - Sunao Uemura
- Division of Hepato-Pancreato-Biliary Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | - Katsuhiko Uesaka
- Division of Hepato-Pancreato-Biliary Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | - Akiko Todaka
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Hiroyuki Ono
- Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Suntogun, Shizuoka, 411-8777 Japan
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16
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Naqos N, Naim A, Jouhadi H, Taleb A, Bouchbika Z, Benchakroune N, Tawfiq N, Sahraoui S, Benider A. [Mucinous carcinoma of the breast: Clinical, biological and evolutive profile]. Cancer Radiother 2016; 20:801-804. [PMID: 27793528 DOI: 10.1016/j.canrad.2016.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 07/10/2014] [Revised: 06/19/2016] [Accepted: 06/25/2016] [Indexed: 11/16/2022]
Abstract
PURPOSE Mucinous carcinoma of the breast accounts for 1 to 4% of all breast cancer. There are two histological subtypes: mixed mucinous carcinoma, where the ductal carcinoma is associated with the colloid component, and pure mucinous carcinoma, with a favorable prognosis, where the mucus surrounds the tumour tissue and constitutes a mechanical barrier limiting cell invasion and making this form less aggressive. Our study aimed to determine retrospectively the main epidemiological, clinical, biological, and therapeutic features, as well as the prognosis of this rare form of breast carcinoma. MATERIALS AND METHODS The authors report 32 cases of mucinous carcinoma of the breast diagnosed in Mohammed-VI centre for cancer treatment in Casablanca. RESULTS The average tumour size was 4.5cm (0.5-7cm). We found ten positive lymph node dissections, seven of them were of mixed mucinous carcinoma with a tumour size ranging between 4 and 7cm. Mucinous carcinoma was pure in 16 cases, mixed in 14 and a neuroendocrine differentiation was found in two cases. Most tumours were of an intermediate histological grade (n=19) with positive hormonal receptors (68%). After a mean follow-up of 30 months, complete remission was maintained in 92% of evaluable patients. CONCLUSION Mucinous carcinoma is a rare type of breast cancer, with a favourable prognosis for the pure form.
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Affiliation(s)
- N Naqos
- Centre Mohammed-VI pour le traitement des cancers, CHU Ibn-Rochd, Casablanca, Maroc.
| | - A Naim
- Centre Mohammed-VI pour le traitement des cancers, CHU Ibn-Rochd, Casablanca, Maroc
| | - H Jouhadi
- Centre Mohammed-VI pour le traitement des cancers, CHU Ibn-Rochd, Casablanca, Maroc
| | - A Taleb
- Centre Mohammed-VI pour le traitement des cancers, CHU Ibn-Rochd, Casablanca, Maroc
| | - Z Bouchbika
- Centre Mohammed-VI pour le traitement des cancers, CHU Ibn-Rochd, Casablanca, Maroc
| | - N Benchakroune
- Centre Mohammed-VI pour le traitement des cancers, CHU Ibn-Rochd, Casablanca, Maroc
| | - N Tawfiq
- Centre Mohammed-VI pour le traitement des cancers, CHU Ibn-Rochd, Casablanca, Maroc
| | - S Sahraoui
- Centre Mohammed-VI pour le traitement des cancers, CHU Ibn-Rochd, Casablanca, Maroc
| | - A Benider
- Centre Mohammed-VI pour le traitement des cancers, CHU Ibn-Rochd, Casablanca, Maroc
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Landbloom RL, Mackle M, Wu X, Kelly L, Snow-Adami L, McIntyre RS, Mathews M, Hundt C. Asenapine: Efficacy and safety of 5 and 10mg bid in a 3-week, randomized, double-blind, placebo-controlled trial in adults with a manic or mixed episode associated with bipolar I disorder. J Affect Disord 2016; 190:103-110. [PMID: 26496015 DOI: 10.1016/j.jad.2015.06.059] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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: 04/06/2015] [Revised: 06/26/2015] [Accepted: 06/29/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Asenapine is an atypical antipsychotic for acute treatment of manic or mixed episodes associated with bipolar I disorder in adults. The recommended asenapine starting dose is 10mg bid with the option to reduce the dose to 5mg bid if needed due to adverse effects/tolerability. METHODS Phase IIIb, international, double-blind, fixed-dose, parallel-group, 3-week placebo-controlled trial of asenapine 5 and 10mg bid in adults with an acute bipolar I disorder manic or mixed episode. Primary outcome was difference in asenapine versus placebo in mean change from baseline to day 21 in the Young-Mania Rating Scale (YMRS) total score. Others included difference in asenapine versus placebo in the Clinical Global Impression Scale for Bipolar Severity (CGI-BP-S) and rate of YMRS responders. RESULTS Both asenapine doses were statistically superior to placebo in mean change from baseline to day 21 in YMRS total score (-10.9, -14.4, and -14.9 for placebo, asenapine 5mg bid, 10mg bid, respectively). Both asenapine doses had statistically superior improvement in mean change in CGI-BP-S score at day 21. Neither asenapine dose had significantly more YMRS responders at day 21 than placebo. LIMITATIONS Results may not be generalizable to the entire population with bipolar I disorder owing to strict inclusion criteria. CONCLUSIONS This study evaluated, by a fixed-dose design, the efficacy and safety of asenapine versus placebo in patients with bipolar I disorder. Both asenapine 5 and 10mg bid were efficacious in treating mania associated with bipolar I disorder and were generally well tolerated.
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Affiliation(s)
| | | | - Xiao Wu
- Forest Research Institute (now Actavis), Jersey City, NJ, USA
| | | | | | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, ON, Canada
| | - Maju Mathews
- Forest Research Institute (now Actavis), Jersey City, NJ, USA
| | - Carla Hundt
- Forest Research Institute (now Actavis), Jersey City, NJ, USA.
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Minaya-Bravo AM, Garcia Mahillo JC, Mendoza Moreno F, Noguelares Fraguas F, Granell J. Large cell neuroendocrine - Adenocarcinona mixed tumour of colon: Collision tumour with peculiar behaviour. What do we know about these tumours? Ann Med Surg (Lond) 2015; 4:399-403. [PMID: 26635955 PMCID: PMC4637338 DOI: 10.1016/j.amsu.2015.10.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [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: 07/18/2015] [Revised: 09/20/2015] [Accepted: 10/01/2015] [Indexed: 12/17/2022] Open
Abstract
Introduction Mixed glandular-endocrine carcinomas are rare tumours of gastrointestinal tract (MANEC). They are more frequent in stomach and hardly one hundred cases have been described in colon. According to Lewis, they are classified into collision (side by side pattern), composite (intermingled) or amphicrine (neuroendocrine and glandular features inside a same cell). Collision tumours are related to biclonal theory: two simultaneous cancerogenic events. Conversely, multidirectional differentiation from a stem cell is accepted as origin of composite tumours. The aim of this paper is to analyse the behaviour of these tumours, with an especial concern about how these tumours metastasise, and the different theories about carcinogenesis. Presentation of case We report a rare case of collision adenocarcinoma-large cell neuroendocrine tumour of colon that after a three-year period of follow-up has presented a retroperitoneal recurrence that features adenocarcinoma and large cell neuroendocrine components. Discussion After an exhaustive review of the English literature, we found that only two cases of collision tumour of colon with metastases showing glandular and endocrine components have been described up to date, so we report the third case, and the first happening in transverse colon. Conclusion We conclude that not all collision tumours follow the biclonal theory and more studies are needed to clarify the origin of these neoplasms, and consequently, to reach an adequate treatment. MANEC are defined as mixed adenoneuroendocrine carcinoma. They are divided into composite and collision. The poorest differentiated component will determine the prognosis. Metastases occur frequently at liver and nodes. Colon is a very rare place.
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Affiliation(s)
- Ana María Minaya-Bravo
- Principe de Asturias Hospital, Department of General Surgery, Carretera Alcala, Meco s/n, CP 28805, Alcala de Henares, Madrid, Spain
| | | | - Fernando Mendoza Moreno
- Principe de Asturias Hospital, Department of General Surgery, Alcala de Henares, Madrid, Spain
| | | | - Javier Granell
- Principe de Asturias Hospital, Department of General Surgery, Alcala de Henares, Madrid, Spain
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Al-Azzawi IS. The first Iraqi experience with the rectus fascia sling and transobturator tape for female stress incontinence: A randomised trial. Arab J Urol 2014; 12:204-8. [PMID: 26019950 PMCID: PMC4434883 DOI: 10.1016/j.aju.2014.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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: 01/04/2014] [Revised: 04/04/2014] [Accepted: 04/06/2014] [Indexed: 11/30/2022] Open
Abstract
Objectives To present the first experience in Iraq of autologous rectus fascia sling (RFS) procedures and transobturator tape (TOT) for treating female stress urinary incontinence (SUI), and to review the validity of the RFS in the era of synthetic tapes. Patients and methods From December 2004 to July 2012, 80 female patients with SUI were enrolled in the study, and randomly assigned into two types of surgery, with 40 treated by RFS (retropubic route) and 40 by TOT. The surgical results were compared between the groups and with those from previous studies. Results The mean operative duration was 80 min for RFS vs. 20 min for TOT. The early cure rate was 98% for RFS (with one failure due to prolonged urinary retention) and 95% for TOT (with two failures due to persistent incontinence). The early complications were mainly abdominal wound problems (20%) for RFS, and groin and upper thigh pain (13%) for TOT. The late complications were the development of postvoid residual urine (8% in RFS vs. 5% in TOT) and de novo detrusor overactivity (5% in each group). There were no vaginal or urethral erosions up to the end of the study. Conclusions RFS and TOT have comparable efficacy and safety in treating SUI. Nevertheless RFS, with its more invasive nature and long operative duration, should only be used when synthetic tapes are not available or not preferable.
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Affiliation(s)
- Issam S Al-Azzawi
- Department of Urology, College of Medicine, Al-Mustansiriya University, Baghdad, Iraq
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20
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Abstract
This paper reviews the bipolar spectrum concept historically and empirically. It describes how the concept derives from Kraepelin, but was lost with DSM-III, which divided the broad manic-depressive illness concept, based on recurrent mood episodes of either polarity, to the bipolar versus unipolar dichotomy, based on allowing non-recurrent mood episodes of only one polarity. This approach followed the views of Karl Leonhard and other critics of Kraepelin. Thus post DSM-III American psychiatry is not neo-Kraepelinian, as many claim, but neo-Leonhardian. The bipolar spectrum approach, as advocated by Akiskal and Koukopoulos first, harkens back to the original broad Kraepelinian view of manic-depressive illness. The evidence for and against this approach is discussed, and common misconceptions, including mistaken claims that borderline personality is similar, are revealed and critiqued.
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Affiliation(s)
- S. Nassir Ghaemi
- Department of Psychiatry, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
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