A Rare Case of Metastatic Urachal Carcinoma

Urachal carcinoma is a rare tumor, it represents about 0.5-1% of all bladder malignancies.  In the majority of cases it is an adenocarcinoma. For the treatment it is recommended for resectable tumors, a partial cystectomy with resection of the urachal ligament, the bladder dome and umbilicus. There is no standard neoadjuvant or adjuvant treatment, and the combinations of 5-fluoruracil with cisplatin are active in metastatic stage. A higher risk of relapse after surgery has been observed in some situations:  positive margins, lymph node involvement, involvement of the peritoneal surface, or in the case of the umbilicus was not resected en-bloc

Yolk Sac TumorMasquerading AsPericarditis: A Case Report

Introduction:Yolk sac tumor is a rare form of a germ cell tumor (GCT).This case report describes an unusual presentation of a yolk sac tumor with pericarditis, pericardial effusionand bilateral microlithiasis (MT) in a young Vietnamese male with extragonadal GCT in the anterior mediastinum. Presentation of Case:A 23-year-old Vietnamese male with one-pack year smoking history, but no other significant past medical history presented with nonproductive cough and pleuritic chest pain for 2 weeks. Chest pain was described as sharp and localized to the right-side of his substernal area. B-symptoms were present for 1 month and included: weight loss of 10lbs, night sweats and fever.Physical exam showeddiminished breath sounds on the right side of the chest w/o accessory muscle use. CT of the chest revealed a large 14 cm round mass in the right middle lobe with possible extension to the mediastinum, moderate right pleural effusion and pericardial effusion.EKG showed a pattern consistent with pericarditis. Biopsy of the mediastinal mass was consistent with yolk sac tumor. LDH was 543, AFP 7200, and β-HCG2.Testicular ultrasound did not find any testicular masses, but there was bilateral testicular microlithiasis. The patient was started on BEP (Bleomycin + Etoposide + Cisplatin) chemotherapy with subsequent thoracotomy and mass resection.Conclusion:Younger patients presenting with pleural effusions and pericarditis need a detailed history and physical examination in order to diagnosea yolk sac tumor

An Examination of the Suitability of Transactional, Transformational and Situational Leadership Theories in Evaluating the Role of Gender in Determining the Leadership Style: a Comparison and Contrast of Three Leadership Theories

The purpose of this paper is to evaluate suitability of transactional, transformational and situational leadership theories in evaluating the role of gender as a determinant leadership style and organizational performance. These three theories were compared and contrasted and the research findings synthesized to ascertain the theory most appropriate for explaining leadership style within the context of gender. While these theories were posited many decades ago, the study showed that they continue to provide an important framework for leaders in the 21st century. Transformational leadership theory was however deemed most appropriate across alternate scenarios

Toxicity to immune checkpoint inhibitors presenting as pulmonary arterial vasculopathy and rapidly progressing right ventricular dysfunction

Introduction: Immune Checkpoint Inhibitors (ICIs) are antitumor drugs associated with a number of serious immune-related adverse events (IRAEs). ICIs enhance anti-tumor immunity, thereby  energized  patient's immune system to fight cancer. IRAEs may affect functions of various organs, including heart, and may lead to morbidity and, to some  extent  mortality. Left ventricle (LV) myocarditis with dysfunction is a known side effect of this class of drugs. However, right ventricle (RV) myocarditis and pulmonary vasculitis are an unknown entity and has not been previously reported.  Here, we present the first case of  IRAEs causing selective RV involvement with dysfunctions, attributed to immune checkpoint inhibitors described till date in medical literature.Presentation of Case: A 58-year male presented  with history of low-grade fever and  weight loss. On palpation, he had diffuse cervical lymphadenopathy. Histopathology evaluation of  lymph node revealed  metastatic lesions of Renal Cell Carcinoma (RCC).Conclusion: Fatal cardiovascular adverse events can occur as a side effect of ICI. The combination of RV myocarditis with progressive pulmonary hypertension is fatal. Treatment with high dose corticosteroids and immunomodulators may help in patient survival. Physicians treating patients with ICIs should be aware of their lethal cardiotoxic side effects  to reduce adverse cardiac outcomes. Because the number of patients exposed to this new immune therapy is expected to increase remarkably in the near future, our study encourages further work to define guidelines for cardiovascular monitoring and management

Impact of Climate variability and change on agricultural productivity in the three northern regions of Ghana

Agriculture in the three regions of the north is mainly subsistence and rain-fed with very limited irrigation facilities. Traditional approach to agriculture in the region is therefore being threatened by erratic rainfall, high temperature, drought and floods due mainly to a changing climate.  This research, therefore, examines the climate in the Upper West, Upper East and Northern regions and its impacts on agriculture productivity. It began with an extensive desktop study and the collection of rainfall and temperature data from 1961-2010 from the three regions.  The data was analyzed to determine the rainfall and temperature trends and their significance using XLSTAT software and basic statistical tools and subsequently tested with the Modified Mann-Kendal’s test to confirm the increasing or decreasing trends and their significance. The results showed that the climate is changing with an increasing temperature and decreasing rainfall trends across the three regions. The test also confirmed a significant increase in temperature but no trend in rainfall at 95% level of confidence. The change in the climate is also observed to have significant impact on agriculture. The knowledge in the climate variation and change will be relevant to decision and policy makers, farmers, water users, water providers, NGOs and students as a whole. The research was concluded with suggested strategies as policy options to help improve climate change adaptation and agricultural productivity

Epidemiological Study on Rift Valley Fever Virus among Domestic Animals in Taiz Governorate (Yemen)

Rift Valley Fever Virus (RVFV) is the causative agent of Rift Valley Fever (RVF), transmitted either by hematophagous insects that infect animals and humans or by direct contact with infected animals. This study was performed to preparing RVF antigen from liver of infected lamb to be used in detecting anti-RVFV antibodies by using Enzyme Linked immunosorbent assay (ELISA) and to study epidemiological prevalence of anti-RVFV IgM and IgG antibodies among animals which conducted in the Researches Center of Taiz University and Central Health Laboratory, Taiz Governorate, Southwestern Yemen. RVFV antigen was successfully prepared at a titer dilution of 1: 3200 by Chessboard (CB) ELISA assay. However, out of 188 samples, 147 samples were positive for ELISA assay, of which 12 (8.2 %) were positive for anti-RVFV IgM and 135 (91.8 %) for anti-IgG antibodies. The antigen was successfully produced, and successfully adhered to ELISA plates. Simple and inexpensive methods give good results. The results can be used to develop and refine predictive database for RVF transmission based on environmental and remote sensing data

Nanocomposite in Sensor Application

Polymeric nanocomposites have extended wide interest in applied sensor technology. Nanocomposite-based sensors have been developed to offer unique potential for varied purposes. Various polymers have been employed in this regard. Sensing polymeric nanocomposites have been used in wide variety of sensors such as gas sensor, biosensor, temperature sensor, pH sensor, etc. The article summarizes polymeric nanocomposite-based sensors, types, current status, and advantages in advance technical fields

Carbon Nanotube Nanocomposite: Toxicology Impact

Carbon nanotube is an important new type of technological material with numerous advantageous properties. Carbon nanotube nanocomposites have found success in several material science applications. This review actually focused toxicological effects and standards for the use of carbon nanotube nanocomposites. Assessments of toxicological properties of inhaled nanomaterials, skin contacted, and ingested materials have mentioned their toxicity and safe use is warranted. Investigations have shown that the uncertainty of nature, mechanism, and exposure response of carbon nanotube nanocomposites may cause adverse effects. Functionalization and modification of nanoparticles must be concentrated for advance applications and may prevent oxidative stress and inflammation of organs

Paraneoplastic Eosinophilia: Report of 2 Cases

Introduction: Eosinophilia is associated to parasitic infections, allergy, collagen-vascular and hypersensitivity diseases, while Paraneoplastic Eosinophilia is an infrequent finding associated to hematologic or solid tumors]. The physiopathological mechanism is not fully understood, despite the involvement of several growth factors.Presentation of Case:The authors present two cases of paraneoplastic eosinophilic disease: in the first case, a 52 year-old man with history of sudden onset dyspnea, weight loss and asthenia. The chest Roëntnography showed opacity in the lower two-thirds of the right hemithorax and the blood work showed an eosinophilia of 14.300/microL (AC). The patient was admitted and performed all possible diagnostic workup, without direct signs of tumor. Despite the absence of neoplastic definitive diagnostic, the eosinophilia increased to 18.800/microL (AC), chemotherapy was considered, however after unfavorable clinical development the patient died after 31 days of hospital admission.The other patient, a 60 year-old man with previous diagnostic and treatment of a colonic adenocarcinoma, clinically stable and without evidence of disease progression, was found evidence in a control bloodwork an eosinophilia of 4800/microL (AC). Despite discarded other causes of eosinophilia causes, was found evidence of neoplastic recurrence. The patient was eligible for chemotheraphy, the eosinophilia was oscillating during all the treatment, suspended by the 3rd cycle due to clinical deterioration. The patient died 2 weeks after treatment discontinuation.Conclusion:Eosinophilia secondary to solid tumors is a rare finding but usually is a sign of advanced neoplastic disease or progression of a previous condition, with poor prognosis at the time of diagnostic

The Pipeline: Less is More, Slower is Better, and Smaller is Possible

Background and Purpose:Despite experience gained with the Pipeline Embolization Device (PED), the following remain unclear: the significance of intra-procedural aneurysm occlusion after PED placement, if PED’s should be used for treatment of smaller aneurysms, and whether multiple PED’s are needed to achieve occlusion.Methods: Between October 2009 and December 2015, 299 patients, with 342 aneurysms distributed at the internal carotid artery and posterior circulation underwent PED embolization by a single team. Data was collected prospectively and analyzed retrospectively. A new metric assessing flow into the aneurysm following PED placement was created: the Post Stenting Flow Scale (PSFs). It ranges from 0 (no residual flow) to 3 (no significant change in flow). Clinical complications, as well as aneurysm occlusion rates and their predictors, were calculated.Results: The overall peri-procedural clinical complication rate was 18/299 (6%) including 2.7% mortality. All mortality occurred in the giant and fusiform groups. Predictors of clinical complication were aneurysm location (posterior vs. anterior circulation) and the use of multiple PED’s. Clinical complications were more common in fusiform and giant aneurysms 15/168 (9%) than in other aneurysms 3/131 (2.2%). PSFs of 0 was a predictor of vascular complications. Occlusion rate was 77%. PSFs was its only significant predictor.Conclusions: Using a single PED for aneurysm embolization is enough. Rapid and total occlusion of the aneurysm following PED deployment is an ominous sign and warrants clinical attention. Expanding the use of PED’s to treat smaller aneurysms located at the internal carotid artery appears to be a valid strategy