31 research outputs found
Leukocytoclastic Vasculitis after Long-Term Treatment with Sunitinib: A Case Report
We report on a 63-year-old woman, previously in good health, who had undergone nephrectomy for clear cell renal cell carcinoma in 2002. Because of systemic relapse with multiple lung metastases in 2006, the patient was treated with sunitinib 50 mg daily on a 4-weeks on-/2-weeks off-schedule. After 3 years of treatment, she developed a purpuric rash on her feet and trunk. Biopsy revealed leukocytoclastic vasculitis. No other organ involvement was diagnosed. She was started on oral prednisone 30 mg daily with rapid resolution of the vasculitic skin lesions. Sunitinib was temporally discontinued and reintroduced at the same dose level. Reappearance of a less serious vasculitis after 2 cycles of re-treatment was resolved in the weeks off-treatment and by reducing the dose of sunitinib along with 5 mg of prednisone daily. One year after the diagnosis, the patient is still on this therapy. Oncology providers should be aware of this rare but potentially serious, possible adverse effect of sunitinib
Sexually Transmitted Infections in a Cohort of 15,921 Refugees (1926-1940) in the Region of Imathia, Northern Greece
This historical epidemiological study evaluates sexually transmitted
infections (STIs) among Greek refugees during the Interwar period
in the region of Imathia, Central Macedonia, Greece, as a part of the effort
against sexually transmitted infections in Greece (1910-1940). We examined
the archives of the Refugee Hospital of Veroia – the capital of the regional
unit of Imathia (March 5, 1926 to October 27, 1940). This is a report
of previously unpublished primary material comprising a cohort of 15,921
cases, among whom 41 patients were hospitalized on account of syphilis
and 19 on account of gonococcal infection. Descriptive statistics were estimated.
Primary (n=4), secondary (n=2), tertiary (n=13), congenital (n=7),
and not further specified (n=15) cases of syphilis were identified, whereas
a variety of differential diagnosis problems arose. Syphilis and gonococcal
infection/gonorrhea seemed to affect various social groups, as evidenced
by the variety of professions involved. Refugee patients originated from
various areas such as Caucasus, Thrace, Constantinople, Bithynia, and Pontus.
Lack of information and poor healthcare led to spreading of STIs in
Greece. Law 3032/1922 was crucial for the Greek effort against sexually
transmitted infection
Sexually Transmitted Infections in a Cohort of 15,921 Refugees (1926-1940) in the Region of Imathia, Northern Greece
This historical epidemiological study evaluates sexually transmitted
infections (STIs) among Greek refugees during the Interwar period
in the region of Imathia, Central Macedonia, Greece, as a part of the effort
against sexually transmitted infections in Greece (1910-1940). We examined
the archives of the Refugee Hospital of Veroia – the capital of the regional
unit of Imathia (March 5, 1926 to October 27, 1940). This is a report
of previously unpublished primary material comprising a cohort of 15,921
cases, among whom 41 patients were hospitalized on account of syphilis
and 19 on account of gonococcal infection. Descriptive statistics were estimated.
Primary (n=4), secondary (n=2), tertiary (n=13), congenital (n=7),
and not further specified (n=15) cases of syphilis were identified, whereas
a variety of differential diagnosis problems arose. Syphilis and gonococcal
infection/gonorrhea seemed to affect various social groups, as evidenced
by the variety of professions involved. Refugee patients originated from
various areas such as Caucasus, Thrace, Constantinople, Bithynia, and Pontus.
Lack of information and poor healthcare led to spreading of STIs in
Greece. Law 3032/1922 was crucial for the Greek effort against sexually
transmitted infection
Evaluation of six CTLA-4 polymorphisms in high-risk melanoma patients receiving adjuvant interferon therapy in the He13A/98 multicenter trial
<p>ABSTRACT</p> <p>Purpose</p> <p>Interferon is approved for adjuvant treatment of patients with stage IIb/III melanoma. The toxicity and uncertainty regarding survival benefits of interferon have qualified its acceptance, despite significant durable relapse prevention in a fraction of patients. Predictive biomarkers that would enable selection of patients for therapy would have a large impact upon clinical practice. Specific CTLA-4 polymorphisms have previously shown an association with response to CTLA-4 blockade in patients with metastatic melanoma and the development of autoimmunity.</p> <p>Experimental design</p> <p>286 melanoma patients and 288 healthy controls were genotyped for six CTLA-4 polymorphisms previously suggested to be important (AG 49, CT 318, CT 60, JO 27, JO30 and JO 31). Specific allele frequencies were compared between the healthy and patient populations, as well as presence or absence of these in relation to recurrence. Alleles related to autoimmune disease were also investigated.</p> <p>Results</p> <p>No significant differences were found between the distributions of CTLA-4 polymorphisms in the melanoma population compared with healthy controls. Relapse free survival (RFS) and overall survival (OS) did not differ significantly between patients with the alleles represented by these polymorphisms. No correlation between autoimmunity and specific alleles was shown. The six polymorphisms evaluated where strongly associated (Fisher's exact p-values < 0.001 for all associations) and significant linkage disequilibrium among these was indicated.</p> <p>Conclusion</p> <p>No polymorphisms of CTLA-4 defined by the SNPs studied were correlated with improved RFS, OS, or autoimmunity in this high-risk group of melanoma patients.</p
MC1R variants in childhood and adolescent melanoma: a retrospective pooled analysis of a multicentre cohort.
BACKGROUND: Germline variants in the melanocortin 1 receptor gene (MC1R) might increase the risk of childhood and adolescent melanoma, but a clear conclusion is challenging because of the low number of studies and cases. We assessed the association of MC1R variants with childhood and adolescent melanoma in a large study comparing the prevalence of MC1R variants in child or adolescent patients with melanoma to that in adult patients with melanoma and in healthy adult controls. METHODS: In this retrospective pooled analysis, we used the M-SKIP Project, the Italian Melanoma Intergroup, and other European groups (with participants from Australia, Canada, France, Greece, Italy, the Netherlands, Serbia, Spain, Sweden, Turkey, and the USA) to assemble an international multicentre cohort. We gathered phenotypic and genetic data from children or adolescents diagnosed with sporadic single-primary cutaneous melanoma at age 20 years or younger, adult patients with sporadic single-primary cutaneous melanoma diagnosed at age 35 years or older, and healthy adult individuals as controls. We calculated odds ratios (ORs) for childhood and adolescent melanoma associated with MC1R variants by multivariable logistic regression. Subgroup analysis was done for children aged 18 or younger and 14 years or younger. FINDINGS: We analysed data from 233 young patients, 932 adult patients, and 932 healthy adult controls. Children and adolescents had higher odds of carrying MC1R r variants than did adult patients (OR 1·54, 95% CI 1·02-2·33), including when analysis was restricted to patients aged 18 years or younger (1·80, 1·06-3·07). All investigated variants, except Arg160Trp, tended, to varying degrees, to have higher frequencies in young patients than in adult patients, with significantly higher frequencies found for Val60Leu (OR 1·60, 95% CI 1·05-2·44; p=0·04) and Asp294His (2·15, 1·05-4·40; p=0·04). Compared with those of healthy controls, young patients with melanoma had significantly higher frequencies of any MC1R variants. INTERPRETATION: Our pooled analysis of MC1R genetic data of young patients with melanoma showed that MC1R r variants were more prevalent in childhood and adolescent melanoma than in adult melanoma, especially in patients aged 18 years or younger. Our findings support the role of MC1R in childhood and adolescent melanoma susceptibility, with a potential clinical relevance for developing early melanoma detection and preventive strategies. FUNDING: SPD-Pilot/Project-Award-2015; AIRC-MFAG-11831
Imiquimod: an immune response modifier in the treatment of precancerous and skin cancer
Actinic keratosis (AK) and basal cell carcinoma (BCC) are precancerous
and cancerous skin lesions that should be treated especially when
multiple or in cosmetically important areas. Apart from 5%
5-fluorouracil topical cream, which some feel is the gold standard
topical treatment for AK, several invasive treatment modalities are
available for AK and superficial BCC, such as cryotherapy,
electrodessication, carbon dioxide laser and surgery causing patients
discomfort and pain, pigmentary changes or necessitate multiple office
visits. Additionally, there are precancerous lesions that necessitate
non-invasive treatment with good esthetic results or skin cancer
refractory to invasive techniques. Imiquimod is an immune response
modifier approved by the FDA for the treatment of AK and superficial BCC
lesions and its use is gradually expanded to various off-label
precancerous and cancerous skin lesions
Fully Connected Visual Words for the Classification of Skin Cancer Confocal Images
Reflectance Confocal Microscopy (RCM) is an ancillary, non-invasive
method for reviewing horizontal sections from areas of interest of the
skin at a high resolution. In this paper, we propose a method based on
the exploitation of Bag of Visual Words (BOVW) technique, coupled with a
plain neural network to classify extracted information into discrete
patterns of skin cancer types. The paper discusses the technical details
of implementation, while providing promising initial results that reach
90% accuracy. Automated classification of RCM images can lead to the
establishment of a reliable procedure for the assessment of skin cancer
cases and the training of medical personnel through the quantization of
image content. Moreover, early detected benign tumours can reduce
significantly the number of time and resource consuming biopsies
Familial Kaposi’s Sarcoma: A Report of Five Cases from Greece
Introduction. Familial cases of Kaposi’s sarcoma have rarely been reported. Kaposi’s sarcoma is not uncommon in Greece; its incidence is estimated at 0.20 per 100.000 habitants, showing an increased predominance in the Peloponnese, in Southern Greece. Case Report. We describe five cases of familial clustering of KS originating from Greece. Discussion. The pathogenesis of familial Kaposi’s sarcoma is still far from being completely understood. Genetic, environmental, and infectious factors have been incriminated
Soft-tissue sarcomas and reconstruction options - Twenty-two years of experience
Soft tissue sarcomas (STS) are particularly rare malignancies that
constitute less than 1% of all malignancies. In recent years,
prognostic clinical factors have been defined that help to stratify
patients regarding their risk for local and distant recurrence and death
from disease. Tumor grade, size, depth, completeness of resection, and
presentation status are among the independent prognostic factors.
At present, the treatment of these tumors constitutes a wide or marginal
excision, adequate primary reconstruction, and radiotherapy. Surgery has
generally been recommended as the primary method of treatment for
achieving local control. Modem reconstructive surgery, especially
musculocutaneous, either pedicle or free flaps, has made more extensive
resections possible, while providing acceptable cosmetic and functional
results.
This study deals with our experience in the treatment of resectable STS
with selective combination of treatment modalities