Meibomian gland carcinoma of the lower eyelid: a rare case

Meibomian gland carcinoma (MGC) is a rare but highly malignant slow growing tumor of the eyelid. MGC usually arises from meibomian gland located in the tarsal plate although rarely it can originates in the gland of zeis, sebaceous gland of caruncle, and periocular skin. MGC is more common in cases of elderly females. Upper eyelid is more commonly affected where the meibomian glands are more. Early diagnosis is very important but in most of the cases the diagnosis is delayed as it mimics chalazion or blepharo-conjunctivitis. This leads to inappropriate treatment and increase in morbidity and/or mortality. Special feature of this carcinoma is that it spread intra-epithelial and causes skipped lesions

A study to assess serum levels of superoxide dismutase and catalase in senile cataract patients with and without diabetes mellitus at tertiary care hospital

Background: The objective was to assess the possible relationship of serum levels of superoxide Dismutase and catalase and development of senile cataract in patients with and without diabetes mellitus.Methods: The study was done in the Department of Ophthalmology with support of Department of Biochemistry at Geetanjali Medical College and Hospital, Geetanjali University, Udaipur, Rajasthan. The study has been conducted during the time period of October 2014 and October 2015. Blood samples of 120 senile cataract patients, i.e. 60 with diabetes and 60 without diabetes were taken and levels of superoxide dismutase and catalase were studied.Results: Statistically significant difference in age wise occurrence of cataract was found between diabetic and non-diabetic patients i.e. cataract was found at a later age in senile non diabetic patients as compared with senile diabetic patients (p<0.001). Senile diabetic patients had significantly lower serum level of SOD as compared to senile non diabetic patients (p<0.001 for both). Similarly, senile diabetic patients had significantly lower serum levels of catalase as compared to senile non diabetic patients (p<0.001 for both).Conclusions: Increase in oxidative stress and decrease in anti-oxidant enzyme activities have a role in the early development of cataract in senile patients with diabetes. Thus, diabetic cataract seems to be associated with decrease in serum levels of SOD and catalase

Perceived Stress, Quality of Life and Pregnancy Outcomes Among Women with Hypertensive Disorders of Pregnancy (HDP) And Role of Midwives in It: A Systematic Review

Hypertensive disorders during pregnancy are one of the leading causes of maternal &amp; newborn death across the world. Many of the hypertensive antenatal women often end of with admission to ICU due to severe pre-eclampsia and eclampsia, or delivering dead babies of term pregnancy, even if live baby delivered, they mostly admitted to NICU due to respiratory distress and prematurity. Hence, they need continuous educational intervention and follow up by healthcare personnel. And a midwife is the right person for this. Midwives play an important role in encouraging pregnant mothers to adhere to treatment through various education and follow up resulting in safe pregnancy outcome among these mothers. But in Indian scenario in many places the role of midwives are often ignored while managing pregnancy complications. Therefore, current paper aimed to explore the expanded role of midwives in identifying the affected quality of life and its impact on pregnancy outcome among women with HDPs. The empirical research papers of various countries were searched through the electronic databases like Pro-Quest, Embase, Research Gate, Science direct, PUBMED, MEDLINE, CINAHL-EBSCO, web of science, Google Scholar etc and the references were also searched of those primary articles. A total of 15 out of 275 studies including both RCTs, Systematic &amp; narrative review papers were analysed. In this paper 4 relevant points were analyzed, like- perceived stress, quality of life (QOL), pregnancy outcomes and role of midwife in GHTN management in rural India. The research papers on pregnancy outcomes as well as stress and QOL secondary to gestational outcome were plenty, but very less studies were retrieved on role of midwives. Mother’s with GHTN has more stress regarding the fetal wellbeing which ultimately affects the quality of life. Interventional studies revealed reduction in stress and improved perinatal outcome secondary to some integrated midwifery management approach. More research on addressing quality of life and exploring the stressors and interventional programs by midwifes are recommended to bring solution to this problem. The result of this review can be incorporated into nursing research to empower the women with gestational hypertension to have a positive pregnancy experience

Statistical learning methods as a preprocessing step for survival analysis: evaluation of concept using lung cancer data

<p>Abstract</p> <p>Background</p> <p>Statistical learning (SL) techniques can address non-linear relationships and small datasets but do not provide an output that has an epidemiologic interpretation.</p> <p>Methods</p> <p>A small set of clinical variables (CVs) for stage-1 non-small cell lung cancer patients was used to evaluate an approach for using SL methods as a preprocessing step for survival analysis. A stochastic method of training a probabilistic neural network (PNN) was used with differential evolution (DE) optimization. Survival scores were derived stochastically by combining CVs with the PNN. Patients (n = 151) were dichotomized into favorable (n = 92) and unfavorable (n = 59) survival outcome groups. These PNN derived scores were used with logistic regression (LR) modeling to predict favorable survival outcome and were integrated into the survival analysis (i.e. Kaplan-Meier analysis and Cox regression). The hybrid modeling was compared with the respective modeling using raw CVs. The area under the receiver operating characteristic curve (Az) was used to compare model predictive capability. Odds ratios (ORs) and hazard ratios (HRs) were used to compare disease associations with 95% confidence intervals (CIs).</p> <p>Results</p> <p>The LR model with the best predictive capability gave Az = 0.703. While controlling for gender and tumor grade, the OR = 0.63 (CI: 0.43, 0.91) per standard deviation (SD) increase in age indicates increasing age confers unfavorable outcome. The hybrid LR model gave Az = 0.778 by combining age and tumor grade with the PNN and controlling for gender. The PNN score and age translate inversely with respect to risk. The OR = 0.27 (CI: 0.14, 0.53) per SD increase in PNN score indicates those patients with decreased score confer unfavorable outcome. The tumor grade adjusted hazard for patients above the median age compared with those below the median was HR = 1.78 (CI: 1.06, 3.02), whereas the hazard for those patients below the median PNN score compared to those above the median was HR = 4.0 (CI: 2.13, 7.14).</p> <p>Conclusion</p> <p>We have provided preliminary evidence showing that the SL preprocessing may provide benefits in comparison with accepted approaches. The work will require further evaluation with varying datasets to confirm these findings.</p

Trimodality Therapy in the Treatment of Stage III N2-Positive Non-Small Cell Lung Cancer: A National Cancer Database Analysis

Background: Significant controversy remains regarding the care of patients with clinical stage III (N2-positive) NSCLC. Although multimodality therapy is effective, the roles of surgery, chemotherapy, and radiotherapy are not fully defined and the optimal treatment approach is not firmly established. We analyzed outcomes and predictors associated with trimodality therapy (TT) in the National Cancer Database. Materials and Methods: The NCDB was queried from 2004 to 2014 for patients with NSCLC diagnosed with stage III (N2) disease and treated with chemotherapy and radiation (CRT). Three cohorts of patients were studied: CRT only/no surgery (NS), CRT plus lobectomy (LT), and CRT plus pneumonectomy (PT). The univariate and multivariable analyses (MVA) were conducted using Cox proportional hazards model and log-rank tests. Results: A total of 29,754 patients were included in this analysis: NS 90.1%, LT 8.4%, and PT 1.5%. Patient characteristics: median age 66 years; male 56% and white 85%. Patients treated at academic centers were more likely to receive TT compared with those treated at community centers (odds ratio: 1.85 [1.53–2.23]; p <.001). On MVA, patients that received TT were associated with better survival than those that received only CRT (hazard ratio: 0.59 [0.55–0.62]; p <.001). The LT group was associated with significantly better survival than the PT and NS groups (median survival: 62.8 months vs. 51.8 months vs. 34.2 months, respectively). In patients with more than two nodes involved, PT was associated with worse survival than LT and NS (median survival: 51.4 months in LT and 39 months in NS vs. 37 months in PT). The 30-day and 90-day mortality rates were found to be significantly higher in PT patients than in LT. Conclusion: TT was used in less than 10% of patients with stage III N2 disease, suggesting high degree of patient selection. In this selected group, TT was associated with favorable outcomes relative to CRT alone. Implications for Practice: This analysis demonstrates that trimodality therapy could benefit a selected subset of patients with stage III (N2) disease. This plan should be considered as a treatment option following patient evaluation in a multidisciplinary setting in experienced medical centers with the needed expertise. © AlphaMed Press 202

Treatment Guidance for Patients With Lung Cancer During the Coronavirus 2019 Pandemic

The global coronavirus disease 2019 pandemic continues to escalate at a rapid pace inundating medical facilities and creating substantial challenges globally. The risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with cancer seems to be higher, especially as they are more likely to present with an immunocompromised condition, either from cancer itself or from the treatments they receive. A major consideration in the delivery of cancer care during the pandemic is to balance the risk of patient exposure and infection with the need to provide effective cancer treatment. Many aspects of the SARS-CoV-2 infection currently remain poorly characterized and even less is known about the course of infection in the context of a patient with cancer. As SARS-CoV-2 is highly contagious, the risk of infection directly affects the cancer patient being treated, other cancer patients in close proximity, and health care providers. Infection at any level for patients or providers can cause considerable disruption to even the most effective treatment plans. Lung cancer patients, especially those with reduced lung function and cardiopulmonary comorbidities are more likely to have increased risk and mortality from coronavirus disease 2019 as one of its common manifestations is as an acute respiratory illness. The purpose of this manuscript is to present a practical multidisciplinary and international overview to assist in treatment for lung cancer patients during this pandemic, with the caveat that evidence is lacking in many areas. It is expected that firmer recommendations can be developed as more evidence becomes available

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas

Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment