Angiokeratoma of tongue:a series of 14 cases

Angiokeratomas (AC) are vascular lesions which are defined histologically as one or more dilated blood vessels lying directly subepidermal and showing an epidermal proliferative reaction with ectatic capillaries in the papillary dermis. Only three other cases of isolated mucosal angiokeratoma have been reported in the indexed literature. We reviewed all cases of angiokeratoma located on the tongue, diagnosed in our department during a study period of 10 years (1995-2005). Histologically all 14 cases showed dilated and congested blood vessels in the upper papillary dermis. They lack deep dermal involvement. Hyperkeratosis and acanthosis were also seen in most of the cases. No clinical data was available to assess systemic disease. A higher incidence of of AC in tongue is seen in our study

COVID-19 Severity and Cardiovascular Outcomes in SARS-CoV-2-Infected Patients With Cancer and Cardiovascular Disease

BACKGROUND: Data regarding outcomes among patients with cancer and co-morbid cardiovascular disease (CVD)/cardiovascular risk factors (CVRF) after SARS-CoV-2 infection are limited. OBJECTIVES: To compare Coronavirus disease 2019 (COVID-19) related complications among cancer patients with and without co-morbid CVD/CVRF. METHODS: Retrospective cohort study of patients with cancer and laboratory-confirmed SARS-CoV-2, reported to the COVID-19 and Cancer Consortium (CCC19) registry from 03/17/2020 to 12/31/2021. CVD/CVRF was defined as established CVD RESULTS: Among 10,876 SARS-CoV-2 infected patients with cancer (median age 65 [IQR 54-74] years, 53% female, 52% White), 6253 patients (57%) had co-morbid CVD/CVRF. Co-morbid CVD/CVRF was associated with higher COVID-19 severity (adjusted OR: 1.25 [95% CI 1.11-1.40]). Adverse CV events were significantly higher in patients with CVD/CVRF (all CONCLUSIONS: Co-morbid CVD/CVRF is associated with higher COVID-19 severity among patients with cancer, particularly those not receiving active cancer therapy. While infrequent, COVID-19 related CV complications were higher in patients with comorbid CVD/CVRF. (COVID-19 and Cancer Consortium Registry [CCC19]; NCT04354701)

Heart failure prevention and monitoring strategies in HER2-positive breast cancer: a narrative review

PurposeCardiotoxicity from anti-human epidermal growth factor receptor 2 (HER2) therapy carries a short- and long-term risk of incident heart failure and increased cardiovascular mortality in patients with breast cancer. Interruptions in anti-HER2 therapy due to cardiotoxicity can lead to suboptimal cancer treatment. The purpose of this narrative review is to outline opportunities to optimize cardiovascular care in patients with HER2-positive breast cancer to prevent interruptions in therapy.MethodsThis case-based review presents the current literature on evidence-based strategies for personalized cardiotoxicity risk assessment, risk mitigation interventions, cardiac function surveillance tools, and management of asymptomatic left ventricular dysfunction in breast cancer patients receiving anti-HER2 therapy.ResultsPretreatment cardiac risk assessment incorporates both treatment-related risk factors and patient-related risk factors for the development of cardiac dysfunction. Prevention and monitoring strategies while on treatment utilize risk factor modification, imaging and biomarker surveillance. Management of asymptomatic left ventricular dysfunction due to anti-HER2 therapy is evolving. Permissive cardiotoxicity in asymptomatic patients while starting cardioprotective therapies requires close collaboration between oncology and cardiology, and referral to cardio-oncology if available.ConclusionsPatient-centered, multimodal strategies to prevent, detect, and manage cardiotoxicity from anti-HER2 therapy are necessary to improve outcomes in patients with HER2-positive breast cancer

Crohns colitis-induced myocarditis.

Myocarditis can be idiopathic or arise in response to numerous systemic insults. Myocarditis occurring in the setting of an exacerbation of inflammatory bowel disease is a rare extra-intestinal manifestation of both ulcerative and Crohns-related colitis. Here, we present a unique case of a 56-year-old female patient presenting with an acute Crohns colitis flare that was eventually complicated by myocarditis. Our case is unique in that we clearly delineate the clinical course and development of myocarditis in a patient with focal myocardial inflammation in a pattern that is atypical for myocarditis.

A phase three open label randomized controlled trial to compare the efficacy of oral hypoglycemic agents (OHA) with insulin in the treatment of gestational diabetes mellitus (GDM)

Background: The incidence of GDM is 1 – 14 % (5 – 8 % reported in most areas). It is globally on the rise in parallel with type 2 diabetes. The short and long term adverse maternal, fetal and neonatal outcomes in pregnancy with Diabetes are well known. Insulin therapy has been regarded as the gold standard medical intervention in pregnancy. It has limitations especially in poorly resourced, illiterate and non-compliant population. Studies have shown that some oral hypoglycemic agents (OHA) ( FDA category B:Glibenclamide and Metformin) are safe in pregnancy. Studies comparing these with insulin have found them to be as effective as insulin with comparable outcomes in pregnancy. Objectives: Primary objective:To compare efficacy of Oral Hypoglycemic Agents and Insulin in the treatment of GDM (percentage of subjects achieving target blood sugars at delivery). Secondary objective :To compare cost and acceptability to treatment in both groups. Methods: This is a collaborative study between the Department of Obstetrics and Gynaecology and the Section of Endocrinology, Department of Medicine. Results and conclusions: This clinical trial is in progress and is recruiting patients. Results will be communicated later o