Posterior mediastinal melanoma causing severe dysphagia: A case report

<p>Abstract</p> <p>Introduction</p> <p>We describe an original case of progressive severe dysphagia caused by a posterior mediastinal metastatic melanoma of unknown origin. To the best of our knowledge, such an event has never been described before in the literature.</p> <p>Case presentation</p> <p>A progressive severe dysphagia case is reported induced by a melanoma of unknown origin (metastatic to a posterior mediastinal lymph node). At the time of diagnosis, the lesion appeared as a large posterior mediastinal mass mimicking a neurogenic tumour with oesophageal involvement. After complete resection, pathological assessment of the tumour by immunohistochemistry was consistent with nodal metastatic melanoma.</p> <p>Conclusion</p> <p>This report of a posterior mediastinal lymph node melanoma is unique. The nodal origin is definitely unusual: a primary melanoma should always be carefully ruled out. In fact no other evidence, a part from the absence of the tumour elsewhere, can support the diagnosis of a primary nodal melanoma.</p

Low-grade myofibroblastic sarcoma of the breast.

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Rhino sinusal bilateral hamartoma: a case report

The hamartoma is a benign rare tumor constituted by a mixture of tissue. It is very unusual in the nasal cavity.The objective of the study is to describe all unusual case of bilateral nasal hamartoma. We report a 52-year-old male patient with a bilateral paranasal hamartoma of the ethmoid and maxillary sinus. Functional endoscopic sinus surgery was performed to completely remove the masses.The reported localization is unusual because the most common site in the nose is the posterior septum. Although hamartoma arising from the rhino sinusal region is very rare, head and neck surgeons Must know this entity in order to differentiate it from inverted papilloma and adenocarcinoma. Misinterpretation of this lesion may result in aggressive surgery for a benign lesion. (C) 2007 Elsevier Ireland Ltd. All rights reserved

The student academic performance in Anatomy is related to Circadian Typology?

In human species, circadian rhythmic expression differs among individuals and may be classified with the concept of Circadian Typology (CT), which consists of three chronotypes: i) Morning-type (M-types), subjects that go to bed early and wake up early and achieve their peak of mental and physical performance in the early part of the day; ii) Evening-type (E-types), subjects that go to bed and wake up late, and perform at their best toward the end of the day, during evening hours; iii) Neither-type (N-types), subjects that show intermediate characteristics between the previous samples. Circadian preferences may change during the life span and can influence academic and sport performance and job activities [1]. We collected data considering 427 students, 294 males and 133 females (age 18-25 years), attending the School of Sport Science, University of Milan. All participants compiled the Morningness-Eveningness Questionnaire (MEQ) for the assessment of chronotype; subsequently they have been evaluated taking into consideration their anatomy test marks. The chronotype distribution of the students was: 44 M-types, 280 N-types and 103 E-types. For M-types, the result in Anatomy exam was significantly higher compared to Evening-types (p< .01). Even the comparison between M-types and N-types showed a significant difference (p< .01). Instead, the performance for E- and N-types was similar. The present results provide a clear indication of a better academic performance for M-types students compared to E-types referring to Anatomy exam. In this way, the italian academic organization seems to be less favorable for E-types

Morningness-Eveningness preferences and academic results: correlation between practical and theoretic discipline

Human beings organize most of their biological and behavioural activities according to a 24h period. The biological rhythms show differences between individuals and this variability is known as Circadian Typology (CT). Morning-types (M-types), are active early in the morning and soon reach their peak in mental and physical performance but tire early in the evening. Evening-types (E-types) find difficult to get up in the morning and require more time to reach their optimal status. Neither-types (N-types) show intermediate characteristics. Many studies indicate that age and sex may influence: morningness preference increases with age in adults, and women show a stronger trend toward morningness than men [1]. Student chronotype can represent one of the factors that may affect academic achievement. This study investigates whether the CT of the students is related to the final exam grades of two different disciplines, theoretic (Anatomy) and practical (Athletics). Anatomy and Athletics grades are good indicators of the overall academic performance of the undergraduates. The aim of this study was to evaluate whether the performance in Anatomy is correlated with Athletics for the three chronotypes. Participants were recruited among students of the School of Sport Science, University of Milan. They were 427 (294 males; 133 females). They completed the Morningness-Eveningness Questionnaire (MEQ): 44 students were classified as M-types, 280 as N-types and 103 as E-types. Individual performance in the final exams of Anatomy and Athletic were collected among them. M-type students achieved better results on final exams in Anatomy and Athletic than either E-type or N-type students. Moreover for M-types (R2= 0.187), it was observed a higher correlation concerning the results of the two disciplines than E-types (R2=0.0727) and N-types (R2=0.0236)

Management of Relapsed/Refractory All with Inotuzumab During COVID-19. A Case Report

Management of patients with concomitant acute lymphoblastic leukemia (ALL) and COVID-19 infection is challenging. We describe the clinical history of a 40-year-old male with relapsed B-common ALL who developed Sars-CoV2 prior to treatment initiation with inotuzumab. Since the patient was asymptomatic for COVID-19, the first dose of inotuzumab was administered, followed by remdesivir as prophylaxis. However, a worsening in respiratory findings led to a delay in administering the following doses of inotuzumab. Interestingly, even if the patient did not receive the full inotuzumab cycle, he achieved a complete hematologic remission: furthermore, he spontaneously developed anti-sars-COV2 antibodies. COVID-19 treatment also included convalescent plasma, leading to negativization of the viral load. The patient, after COVID-19 recovery, received a second full cycle of inotuzumab, underwent allogeneic transplantation, and is currently in complete hematologic and molecular remission, in good clinical conditions, five months from allograft

Sleep behavior and daily activity levels in people with metabolic syndrome: effect of 1 year of metformin treatment

Impaired sleep and low daily activity levels increase the risk of developing metabolic syndrome (MS). Metformin (MET), an insulin sensitizer drug, is effective in regressing MS and has been recently studied as an adjuvant agent for managing sleep disorders. The present study aimed to assess whether 1,700 mg/day of MET treatment modifies sleep and daily activity levels in people with MS evaluated by Rest-Activity circadian Rhythm (RAR), which is the expression of 24 h of spontaneous activity parameters. A total of 133 subjects with MS, randomized into the MET (n = 65) or placebo (PLA, n = 68) group, underwent a clinical/anthropometric examination and carried out a continuous 7-day actigraphic monitoring to investigate sleep and RAR parameters at baseline and after 1 year of intervention. After 1 year of intervention, 105 subjects were analyzed. The MET group showed greater anthropometric and metabolic improvements compared with placebo, with a significant reduction in weight (p = 0.01), body mass index (p = 0.01), waist circumference (p = 0.03), and glucose (p &lt; 0.001). With regard to sleep parameters, the MET group showed a significant increase in actual sleep time (p = 0.01) and sleep efficiency (p = 0.04) compared with placebo. There were no significant changes reported in the RAR parameters. Our study suggests that MET might be used as an adjuvant treatment for sleep disorders in people with MS

BRCA Mutation Status in Triple-Negative Breast Cancer Patients Treated with Neoadjuvant Chemotherapy: A Pivotal Role for Treatment Decision-Making

Simple Summary In this retrospective observational study, we evaluated data from patients with triple-negative breast cancer (TNBC) treated with neoadjuvant chemotherapy (NACT) in order to better define the impact of germline BRCA1/2 (gBRCA1/2) mutation status on outcomes in this patient population. Our results show that patients with BRCA1/2 mutation had a higher pathologic complete response (pCR) rate than non-mutated patients; nevertheless, the benefit was confirmed only in the subset of patients who received a platinum-based NACT. Furthermore, pCR was associated with improved Event Free Survival (EFS) and Overall Survival (OS), regardless of BRCA1/2 mutation status and type of NACT received. Long-term follow-up analyses are needed to further define the impact of gBRCA mutation status in patients with early-TNBC. Triple-negative breast cancer (TNBC) is characterized by earlier recurrence and shorter survival compared with other types of breast cancer. Moreover, approximately 15 to 25% of all TNBC patients harbor germline BRCA (gBRCA) 1/2 mutations, which confer a more aggressive phenotype. However, TNBC seems to be particularly sensitive to chemotherapy, the so-called 'triple negative paradox'. Therefore, Neoadjuvant chemotherapy (NACT) is currently considered the preferred approach for early-stage TNBC. BRCA status has also been studied as a predictive biomarker of response to platinum compounds. Although several randomized trials investigated the addition of carboplatin to standard NACT in early-stage TNBC, the role of BRCA status remains unclear. In this retrospective analysis, we evaluated data from 136 consecutive patients with Stage I-III TNBC who received standard NACT with or without the addition of carboplatin, in order to define clinical features and outcomes in BRCA 1/2 mutation carriers and non-carrier controls. Between January 2013 and February 2021, 67 (51.3%) out of 136 patients received a standard anthracyclines/taxane regimen and 69 (50.7%) patients received a platinum-containing chemotherapy regimen. Deleterious germline BRCA1 or BRCA2 mutations were identified in 39 (28.7%) patients. Overall, patients with deleterious gBRCA1/2 mutation have significantly higher pCR rate than non-carrier patients (23 [59%] of 39 vs. 33 [34%] of 97; p = 0.008). The benefit of harboring a gBRCA mutation was confirmed only in the subset of patients who received a platinum-based NACT (17 [65.4%] of 26 vs. 13 [30.2%] of 43; p = 0.005) while no differences were found in the platinum-free subgroup. Patients who achieved pCR after NACT had significantly better EFS (OR 4.5; 95% CI 1.9-10.7; p = 0.001) and OS (OR 3.3; 95% CI 1.3-8.9; p = 0.01) than patients who did not, regardless of BRCA1/2 mutation status and type of NACT received. Our results based on real-world evidence show that TNBC patients with the gBRCA1/2 mutation who received platinum-based NACT have a higher pCR rate than non-carrier patients, supporting the use of this chemotherapy regimen in this patient population. Long-term follow-up analyses are needed to further define the role of gBRCA mutation status on clinical outcomes in patients with early-TNBC