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Choroidal Metastases from Oncocytic Thyroid Cancer
No full textIntroduction: Choroidal and/or orbital metastases secondary to thyroid carcinoma are extremely uncommon and usually occur in late stage of the disease. The main symptoms are decreased vison and/or eye pain. However, they may be asymptomatic. They are diagnosed by clinical examination, ultrasounds, ocular computed tomography (OCT), and/or MRI. Radioactive iodine fixation is strongly suggestive of thyroid metastasis, but the certainty is given by histological study. When the last one is lacking, everyone agrees diagnosis of thyroid metastasis is nearly certain in the context of metastatic diffusion as in the following case:Case Presentation: A woman aged 58, harboring an oncocytic thyroid carcinoma with numerous metastases (lung, liver, bones, and adrenals) which did not fix radioiodine, consulted for a progressive decrease in her vision. Ophthalmological examination revealed a painless palpable mass in the left orbital arch corresponding to an orbital metastasis and a reduced visual acuity of the right eye due to a choroidal tumor. B-scan ultrasonography, retinography, angiography and OCT were suggestive of bilateral choroidal metastases. As those did not fix radioiodine, the patient received six cures of tyrosine-kinase inhibitors with a poor response for all metastatic localizations.Conclusion and Discussion: although very rare, choroidal metastases from thyroid carcinoma should be sought systematically, before the end stage of the disease, in order to prevent blindness and improve quality of life, especially when they are sensitive to radio iodine and/or to target therapy, which was not the case for our patient
Ischemia Toes: A Rare Complication of Pheochromocytoma. A Case Report
No full textThe peripheral ischemia associated with pheochromocytoma is extremely rare. It is secondary to intense cutaneous vasoconstriction which is itself a result of excess catecholamines. The following report describes a patient who presented necrotic areas at the toes as a complication of malignant pheochromocytoma. We report this observation to recall this complication and to emphasize the need to discuss the diagnosis of pheochromocytoma in any ischemia chart whatever its location is
Recent Updates on Small Molecule Inhibitors of Bromo and Extra C-Terminal Domain (BET) Family of Bromodomains
No full textThe bromo and extra C-terminal domain (BET) family of bromodomains (BRDs) are involved in binding epigenetic marks on histone proteins, more specifically É›-N-acetylated lysine residues. Inhibition of these targets leads to profound effects in relevant models of disease. BET BRDs inhibitors reported to date include benzodiazepines, benzotriazepines, 3,5-dimethylisoxoazole, dihydroquinazolinone, tetrahydroquinoline, thiazol-2-one, 4-acylpyrroles, diazobenzene, naphthyridines, and benzimidazole scaffold/moiety in their structure. Some potent inhibitors of BRD4, one of the bromodomain members, bind to asparagine140 residue of the acetylated-lysine site of BETs through triazole or isoxazole moieties. Some BET BRDs inhibitors also act as kinase inhibitors. Small molecules BET BRDs inhibitors have potential as anti-inflammatory, antiviral, and anticancer agents. Actions to produce a contraceptive for male rely on targeting BET family by a potent and selective bromodomain inhibitor. Several inhibitors targeting BRD4 are in preclinical/clinical trials as anticancer drugs
The Effect of Inspiration and Phonation on Vocal Fold Length
No full textThe detection of metric dimensions of laryngeal structures yielded valuable information for both clinical and research purposes. The aim of this paper was to evaluate the absolute dimensions of true vocal fold length (TVFL) during inspiration and phonation with a stroboscope coupling with laser equipment. Forty graduate student subjects including 20 males and 20 females were examined. The measurements were made during inspiration and phonation at a fixed fundamental frequency within each participant. The maximal TVFL was got from the inspiration and the minimal from the phonation. Results showed that the mean values of male inspiration and phonation TVFL were 12.81 + 2.97 mm and 10.92 + 4.40 mm respectively. While in female, they were 11.27 + 2.71 mm and 7.16 + 2.65 mm respectively. There was statistically significant between inspiration and phonation TVFL in the female group. In female, TVFL at phonation was significantly shortened than in male. We concluded stroboscope coupling with laser projection marking module could be used to assess physiological variation of TVFL. This technique enabled the detection of absolute spatial laryngeal dimensions, which was useful in providing valuable information in diagnostics and interpretation of voice disorders
Fractional Radio Frequency for Acne Scar Treatment
No full textAcne scar is formed in teen and early adult life. Several treatment options such as chemical peeling, punch excision, fillers and laser resurfacing.We used fractional LIFTRON RF system which delivers radio frequency energy via needles in the disposable applicator tip in 15 patients with age range of 20-40 years old, the treatment used for 4 sessions with one month interval. Photographic documents before and after sessions were taken and punch biopsy were taken from 5 patients.Improvement occurred 30%-70%, without any complications as erythema, keloid or hyperpigmentation as occurred with other methods of treatment.The important point is that patients returned back to work after 2 days
Dermoscopy of Bowen’s Disease in Brown Skin: A Case Report
No full textBowen’s disease (BD) is a rare pre-malignant intraepithelial tumor affecting older adults and should be differentiated from other pigmented lesions including pigmented basal cell carcinoma, melanocytic nevus and melanoma. Therefore, distinction of BD is difficult clinically, requiring histopathology for confirmation. Since it is a pre-malignant condition, management highly depends on the accurate diagnosis. Hence, there is a need for diagnostic technique which can clinically diagnose BD. Authors evaluated dermoscopic patterns in BD and found specific patterns which are characteristic of BD and it would aid in the early detection of BD
A Review of the Psychiatric Care Provided to Patients who Subsequently Offended
No full textBackground: An examination (audit) of the files of patients who had received any mental health services in the year prior to an alleged offence may inform our understanding of the relationship between mental health and crime. More helpfully, it may provide information to facilitate a reduction in the rate of such tragic eventsMethod: The records of all patients assessed by the Midland Regional Forensic Psychiatric service in the 26 months from January 2010 were screened. The 222 who received a diagnosis of a non-organic psychosis and who were recorded as having offended within one year of a previous psychiatric service attendance formed the cohort. The data extracted from their clinical files, relating primarily to that pre-offence psychiatric contact, included legal, clinical and contextual information.Results: Analysis examined the characteristics of this forensic population and most particularly, of their pre-offending service contact. This identified clinical practice and delivery issues which could reduce the rate of conversion of psychiatric patients to “forensic†status.Conclusions: The results inform issues of effectiveness of adult service delivery with particular consideration of the intensity of clinical contact, antipsychotic drug choice and adherence and the use of assertive treatment
Opinion: Presumable Reason of Interrelationship between Autoimmune Hemolytic Anemia and Cancer Arising
No full textThe mechanism of malignant transformation in autoimmune hemolytic anemia can be based on the inclusion of immunocompetent cells in different cellular cooperations. Antibodies and T-cytotoxic cells can induce perforations of different degree on somatic cells plasma membranes. Total negative charge of plasma membranes decrease, and the cells acquire the capability of closely approaching, which frequently, especially upon coincidence of the perforated parts, may serve as a prerequisite to fusion process and formation of cancerous cell
High Pulse Pressure is a Risk Factor for Stroke in Elderly Individuals with Coronary Heart Disease and Diabetes Mellitus
No full textBackground: The association between pulse pressure and the risk of stroke in elderly patients with multiple comorbidities is not well understood. The present study aimed to investigate the association between pulse pressure and the risk of stroke in elderly patients.Measurements: We retrospectively assessed stroke/ transient ischemic attack (TIA) risk factors in 623 patients (33% female, median age, 74 years) with coronary heart disease (CHD) and diabetes mellitus (DM) at Chinese PLA General Hospital. The effects of systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure on the risk of stroke/TIA were assessed using a binary logistic regression analysis. The ability of changes in blood pressure to predict the risk of stroke/TIA was assessed using a receiver operating characteristics curve.Results: 228 (36.59%) patients had a stroke/TIA. DBP was significantly lower in the patients with stroke/TIA than in those without (75.83 ± 11.14 vs. 78.91 ± 11.85, P = 0.001). Pulse pressure was markedly higher in the stroke/TIA compared with the non-stroke/TIA group (61.34 ± 14.59 vs. 56.01 ± 14.65, P < 0.001). SBP was not significantly different between the groups. The multivariate analysis revealed pulse pressure (odds ratio, (OR), 1.02, 95% confidential interval (CI), 1.01–1.04, P < 0.001) and DBP ≤70 mmHg (OR, 95% CI, 1.44, 1.01–2.06, P=0.044) were independently associated with the risk of stroke/TIA. The c-statistics (95% CI) for pulse pressure and DBP ≤70 mmHg for predicting stroke/TIA were 0.62 (0.57–0.66; P<0.001) and 0.56 (0.51-0.61; P=0.006), respectively. A cutoff of 38 mmHg pulse pressure showed good predictive ability for the risk of stroke/TIA (sensitivity 97%, specificity 96%).Conclusion: Low DBP and high pulse pressure, most likely the result of the low DBP, were risk factors for stroke/TIA in elderly patients with CHD and DM