Synchronous Detection of Hairy Cell Leukemia and HIV-Negative Kaposi's Sarcoma of the Lymph Node: A Diagnostic Challenge and a Rare Coincidence

Hairy cell leukemia (HCL) is an uncommon chronic lymphoproliferative disorder and accounts for around 2% of all forms of leukemias. The association of HCL with other neoplasms, mainly non-Hodgkin's lymphomas, is well known. However, the simultaneous diagnosis of HCL and Kaposi's sarcoma is rare, with only few cases of such an association having been reported. We describe a 42-year-old male patient with a well characterized HCL and in whom HIV-negative Kaposi's sarcoma of the lymph node was detected

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Primary Diffuse Large B Cell Lymphoma of Thyroid Gland; Germinal Center and Non-germinal Center B Types: Experience of a Single Center

Diffuse large B cell lymphoma (DLBCL) is the most common histological subtype accounting for approximately 70% of primary thyroid lymphoma (PTL) cases. Its prognosis depends on the histology, spread, and the stage of the disease. DLBCL usually displays a better prognosis, but it shows heterogeneity according to the histological subtype. Germinal center B cell (GCB) subtype has a more favorable prognosis than the non-germinal center (non-GCB) subtype. Most of these patients required combined modality management. This study included eight patients with stage I/IIE thyroid DLBCL. Analysis of clinicopathologic features of all PTL patients diagnosed at Cerrahpasa Faculty of Medicine. Pathology reports and slides of patients diagnosed between years of 2000 and 2013 were evaluated. Four of them were GCB and the other four cases were non-GCB type. All patients underwent thyroidectomy. Three of them were treated with chemotherapy and the three patients were treated with chemotherapy followed by radiotherapy. Five patients are presently alive. Due to the fact that PTLs are rare types of tumors, only small case series were published in that field. Increasing the number of cases in the literature for thyroid DLBCL, its histopathologic features will provide a better understanding

The effects of somatostatin and ursodeoxycholic acid in preventing the ischemic injury of the liver following pringle maneuver in obstructive jaundice-rat model

Background/Aims: In our study, the effects of Somatostatin (SS) and Ursodeoxycholic acid (UDCA) on ischemic liver injury were studied in (obstructive) jaundice-rat model