Metastatic Eccrine Porocarcinoma Respond to Combination Chemotherapy Docetaxel, Cisplatin and Infusion 5 FU with Long Disease Control

Introduction: Eccrine porocarcinoma (EPC) is a rare tumor. It develops from the intraepidermal ductal portion of the eccrine sweat gland. Many chemotherapeutic agents were reported to have efficacy in treatment of metastatic EPC; two of very effective agents were docetaxel and 5FU.Case Presentation: We are reporting a case of 60 years old female who was diagnosed as metastatic eccrine porocarcinoma to mediastinum which was treated by systemic chemotherapy in the form of DCF: docetaxel 75 mg/m2 D1, cisplatin 75 mg/m2 D1 and continues infusion 5FU 750 mg/m2 from D1 to D4, and this regimen was repeated every 28 days for 6 cycles.Conclusion: DCF regimen can be one of the best options for stage IV EPC with long overall survival and best response rate

Disease Control of Pulmonary Inflammatory Pseudotumor by Multidisciplinary Approach

Introduction: Inflammatory pseudotumor is a rare tumor of the lung, which is usually misdiagnosed as malignancy. Most of early cases are treated with complete excision, but advanced cases: radiation therapy, steroids and chemotherapy will be a part of treatment plan. Multidisciplinary approach can save many cases of inflammatory pseudotumor and other rare diseases.Case Report: we reporting a case of advanced inflammatory pseudotumor with had a long disease control with multidisciplinary approach in the form of chemotherapy, steroids, radiation therapy and surgery.Conclusion: Advanced IP of the lung is rare disease with unknown etiology, where multidisciplinary team is needed for diagnosis and treatment: maximum safe debulking, chemotherapy, radiation therapy and steroids can be the suitable combined treatment for many advanced case

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Utilizing Empathy Philosophy In Advertising Design

The research focuses on studying the philosophy of empathy and how to utilize it in advertising design. Empathy is one of the most effective ways to communicate with the other. Empathy can be an entry point for designing the advertisement so that the designer put themselves in the shoes of the recipient and the audience, and thus the designers can learn more deeply about the opinions and behaviors of the audience and their trends by asking them directly about their desires, hopes, pains and goals. Empathy also means that the designer is aware of the recipient's feeling and emotional state when interacting with the advertisement presented. Thus, empathy based design research such as the empathy map aims to find common ground with the audience to apply the concept of empathy, and thus formulate advertising ideas from the view of the feelings and desires of the recipient and the requirements and objectives of the advertisement. Hence, the research problem lies in identifying the philosophy and theories of Empathy and how they can be used and utilized in the design of the advertisement, also studying how to use the empathy map in understanding the recipient, and how the advertisement can be designed in light of the emotion classification scheme. The research aims to benefit from the principles and theories of Empathy, as well as the empathy map as a way to reach a deep understanding of the recipient and thus formulate advertising ideas that attract the recipient and correspond to his needs and desires, as well as studying the classifications of feelings categories and how to employ them, formulating advertising ideas in light of the concept of Empathy. The research follows the descriptive approach accompanied by an analytical study. The research has found the importance of the empathy map in reaching a deep understanding of the feelings and needs of the recipient, and then creating the advertising message according to the emotion scheme

Role of tomosynthesis and ultrasound in the assessment of asymmetric breast densities: a comparative prospective study

Abstract Background Tomosynthesis is a recent advancement of full-field digital mammography involves transforming two-dimensional (2D) breast images into three dimensions (3D) images. It reduces the adverse effect of tissue superimposition on conventional 2D- mammography, therefore having high potential enhancing identification and assessment of asymmetric breast densities. The aim of the study was to assess and compare the diagnostic performance of breast ultrasound and 3D digital breast tomosynthesis in the assessment of asymmetric breast densities. Results In the current study, 80 patients with 80 mammographically and/or tomosynthesized breast asymmetries were included. The patients' ages ranged from 30 to 70 years old, with a mean age of 47.2 ± 9.2 SD. Breast ultrasound outperformed digital breast tomosynthesis in terms of diagnostic performance. Tomosynthesis had a sensitivity of 86.4%, specificity of 93.1%, positive predictive value of 82.6%, negative predictive value of 94.7%, and accuracy of 91.3% compared to ultrasounds' sensitivity of 100.00%, specificity of 93.1%, positive predictive value of 84.6%, negative predictive value of 100.00%, and accuracy of 95%. Conclusions Incorporating ultrasonography in the assessment of asymmetric breast densities outperformed tomosynthesis and shown to be more precise in characterisation of lesions underlying asymmetric breast density

Investigations on the vaginal temperature, cycle stages, and steroid hormone concentrations during the breeding season in camels (Camelus dromedarius)

Background and Aim: Estrus detection plays a crucial role in the success of animal reproduction. It was previously reported that body temperature changes during estrus. This study aimed to investigate the relationship between vaginal temperatures (VTs) measured by a data logger, ovarian activity, and hormonal cyclic changes in camels. Materials and Methods: Six mature, healthy, non-pregnant dromedary, and 10-12-year-old camels were included in the study. The ovarian activity was monitored with ultrasonography, and estrus behavior was evaluated using an active and virile male camel. Animals were inserted with a blank controlled internal drug release device attached with an intravaginal data logger. Every hour, the ambient temperature was recorded by another data logger. Blood samples were collected, and sera were used to measure estradiol and progesterone levels. Results: The whole follicular cycle lasted 25.41±1.36 days, and the maximum sizes of the dominant follicle in the first and second follicular waves were 1.63±0.27 cm and 1.94±0.42 cm, respectively. There was a significant positive correlation between the follicular diameter and estradiol-17β level (p0.05, r=0.038), which remained low during the whole period of the experiment. The mean daily VT was significantly correlated with the diameter of the dominant follicle (1.7-2.2 cm, p<0.01, r=0.52). Conclusion: Measurement of VT will improve the accuracy of estrus prediction. Further studies are recommended to validate VT in camel reproduction

Influence of dietary mannan-oligosaccharides supplementation on hematological characteristics, blood biochemical parameters, immune response and histological state of laying hens

ABSTRACT: This study aimed to determine the influence of dietary mannan-oligosaccharides (MOS) on the immune system, hematological traits, blood biochemical parameters, and histological state of laying hens. At 34 wk of age, The Mandarah chicken strain's 120 laying hens and 12 cocks were divided into 4 groups, each with 30 hens and 3 cocks. The first group performed as a control group, which nourished on a basal diet. The second, third, and fourth experimental groups received 0.1, 0.2, and 0.5 g/kg of MOS and a base diet, respectively. Birds obtained MOS at numerous doses significantly (P ˂ 0.05) raised serum levels of immunoglobulin Y (IgY), immunoglobulin M (IgM), and avian influenza (AI) antibodies compared to control birds. Furthermore, adding MOS at a level of 0.1 g/kg diet significantly improved the immune response of the control group. Additionally, compared to the control group, treated birds with MOS at various dosages did not significantly enhance hematological parameters such as red blood cells (RBCs), white blood cells (WBCs), hemoglobin, and hematocrit. Compared to control birds, birds fed MOS at all levels exhibited considerably lower serum cholesterol, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) values. Also, compared to other treated birds, MOS-treated birds displayed improved histological examination of the small intestine, isthmus, and testis compared to the control group, particularly in birds fed MOS at 0.1 and 0.2 g/kg diet. It could be concluded that using MOS at 0.1 or 2 g/kg diet can successfully improve the physiological performance and overall health of laying hens

Immune response, hematological traits, biochemical blood parameters, and histological status of laying hens influenced by dietary chitosan-oligosaccharides

ABSTRACT: This experiment aimed to examine the effect of chitosan-oligosaccharides (COS) supplementation in laying hens' diets affected their immune response, hematological characteristics, blood biochemical parameters, and histological status. At the age of 34 wk, 200 laying hens and 20 cocks of the Mandarah chicken strain were allotted into four groups, each consisting of 50 hens and five cocks. The first group acted as a control group, fed on a basal diet. The second, third, and fourth experimental groups each received 0.1, 0.2, and 0.5 g/kg of COS in addition to a base diet. Birds received COS at various dosages had significantly (P ˂ 0.05) increased serum concentration of immunoglobulins, avian influenza, and Newcastle disease antibodies compared with the control birds. Moreover, adding COS at level 0.2 g/kg diet insignificantly enhanced immune response than the rest of the treatment groups. Also, treated birds with COS at different levels had insignificantly improved hematological parameters such as red blood cells, white blood cells, hemoglobin and hematocrit compared to the control group. Birds fed COS at all levels had significantly decreased serum cholesterol, triglycerides, Ca++ and alanine aminotransferase concentrations compared with control birds. In addition, compared to the control group, chitosan-treated birds showed enhanced histological examination of the small intestine, isthmus, and testis, notably in birds given COS at 0.1 g/kg diet compared to other treated birds. Cocks fed COS at all levels improved testicular tissues and increased the number and diameter of seminiferous tubules compared with control birds Morphological examination of the ileum showed increased villi number, height, and crypt depth. It is possible to conclude that laying hens' physiological performance and general health can be effectively improved by using chitosan at 0.1 or 2 g/kg diet levels enhanced immune response