Pain as a First Manifestation of Paraneoplastic Neuropathies: A Systematic Review and Meta-Analysis.

INTRODUCTION: Paraneoplastic neurological syndromes (PNS) consist of a heterogeneous group of neurological disorders triggered by cancer. The aim of this systematic review is to estimate the reported prevalence of pain in patients with paraneoplastic peripheral neuropathy (PPN). METHODS: A systematic computer-based literature search was conducted on PubMed database. RESULTS: Our search strategy resulted in the identification of 126 articles. After the eligibility assessment, 45 papers met the inclusion criteria. Full clinical and neurophysiological data were further extracted and involved 92 patients with PPN (54.5% males, mean age 60.0 ± 12.2 years). The commonest first manifestation of PPN is sensory loss (67.4%), followed by pain (41.3%), weakness (22.8%), and sensory ataxia (20.7%). In 13.0% of the cases, pain was the sole first manifestation of the PPN. During the course of the PPN, 57.6% of the patients may experience pain secondary to the neuropathy. CONCLUSIONS: Pain is very prevalent within PPN. Pain specialists should be aware of this. Detailed history-taking, full clinical examination, and requesting nerve conduction studies might lead to an earlier diagnosis of an underlying malignancy

New constraints on the Pb and Nd isotopic evolution of NE Atlantic water masses

Time series of lead (Pb) and neodymium (Nd) isotope compositions were measured on three ferromanganese crusts recording the evolution of NE Atlantic water masses over the past 15 Ma. The crusts are distributed along a depth profile (∼700–4600 m) comprising the present-day depths of Mediterranean Outflow Water and North East Atlantic Deep Water. A pronounced increase of the 206Pb/204Pb in the two deeper crusts starting at ∼4 Ma and a decrease in 143Nd/144Nd in all three crusts took place between ∼6–4 Ma and the present. These patterns are similar to isotope time series in the western North Atlantic basin and are consistent with efficient mixing between the two basins. However, the changes occurred 1–3 Ma earlier in the eastern basin indicating that the northeastern Atlantic led the major change in Pb and Nd isotope composition, probably due to a direct supply of Labrador Seawater via a northern route. The Pb isotope evolution during the Pliocene-Pleistocene can generally be explained by mixing between two end-members corresponding to Mediterranean Outflow Water and North East Atlantic Deep Water, but external sources such as Saharan dust are likely to have played a role as well. The Pb isotope composition of the shallowest crust that grew within the present-day Mediterranean Outflow Water does not show significant Pb isotope changes indicating that it was controlled by the same Pb sources throughout the past 15 Ma

Erratum: A real world multicenter retrospective study on extramedullary disease from Balkan Myeloma Study Group and Barcelona University: Analysis of parameters that improve outcome (Haematologica (2020) 10:51 (201-208) DOI: 10.3324/haematol.2019.219295)

We have noticed an error in the progression-free survival of patients with extramedullary plasmacytoma in our article published in Haematologica in January 2020 (doi: HAEMATOL/2019/219295). The following sentence in the abstract: “Extramedullary plasmacytoma at relapse had the worst prognosis with a PFS of 13.6 months and overall survival of 11.4 months.” Should be replaced by: “Extramedullary plasmacytoma at relapse had the worst prognosis with a PFS of 9.1 months and overall survival of 11.4 months.” Likewise, on page 205, the following sentence: “However, if diagnosed at relapse, PFS and OS were 13.6 months and 11.4 months for EMP compared to 20.9 months (P=0.249) and 39.8 months (P=0.093) for PO, respectively (Table 2 and Figure 1).” Should be replaced by: “However, if diagnosed at relapse, PFS and OS were 9.1 months and 11.4 months for EMP compared to 20.9 months (P=0.249) and 39.8 months (P=0.093) for PO, respectively (Table 2 and Figure 1).” The error was also present in Table 2. The corrected Table 2 is shown below. © 2021 Ferrata Storti Foundatio