Extragonadal mixed germ cell tumor of the right arm: description of the first case in the literature

<p>Abstract</p> <p>Background</p> <p>Extragonadal localization of germ cell tumors (GCTs) is rare; to the best of our knowledge, a location in the soft tissue of the arm has never been previously reported in the literature.</p> <p>Case presentation</p> <p>We report the case of a 37-year-old man who presented with a primary malignant mixed non-seminomatous GCT (teratocarcinoma variety) in the right arm, treated by a combination of cisplatin-based chemotherapy and surgery. After 18 months of close follow-up, no locoregional recurrence or distant metastases have been detected.</p> <p>Conclusions</p> <p>A combination of chemotherapy and surgery is the most appropriate treatment strategy for extragonadal GCTs, to ensure both local and systemic control.</p

Leydig Cell Tumor Associated with Testicular Adrenal Rest Tumors in a Patient with Congenital Adrenal Hyperplasia due to 11β-Hydroxylase Deficiency

Congenital adrenal hyperplasia (CAH) describes a group of inherited autosomal recessive disorders characterized by enzyme defects in the steroidogenic pathways that lead to the biosynthesis of cortisol, aldosterone, and androgens. Chronic excessive adrenocorticotropic hormone (ACTH) stimulation may result in hyperplasia of ACTH-sensitive tissues in adrenal glands and other sites such as the testes, causing testicular masses known as testicular adrenal rest tumors (TARTs). Leydig cell tumors (LCTs) are make up a very small number of all testicular tumors and can be difficult to distinguish from TARTs. This distinction is interesting because LCTs and TARTs require different therapeutic approaches. Hereby, we present an unusual case of a 19-year-old patient with CAH due to 11β-hydroxylase deficiency, who presented with TARTs and an epididymal Leydig cell tumor

Multiplication sexuée et asexuée d'Artemisia herba-alba Asso ; une espèce pastorale autochtone appréciée et surexploitée

Artemisia herba-alba is among the most important pastoral species, characterized by a high fodder value, especially for ruminants. However, Artemisia herba-alba steppes in Morocco are undergoing continuous degradation. Therefore, understanding the multiplication of this highly appreciated species is essential for its preservation and the rehabilitation of degraded pastures. The present study’s objective is to understand techniques of sexual and asexual multiplication of Artemisia herba-alba: germination and cutting. For sexual multiplication, three factors were considered: age of seeds, their origins and pre-treatments. For asexual multiplication, two factors were tested, i) the effect of Indole Acetic Acid IAA and ii) the cuttings type effect on the rooting of Artemisia herba-alba cuttings. The obtained results showed a high germination rate for freshly harvested seeds (88%), a decrease in the germination rate of seeds over the years, and those of the same year but lately collected (19.78%). Also, there is an increase is observed in the germination rate of seeds soaked for 48 h (21%) compared to the control (17%). In addition, an inhibitory effect of some IAA concentrations on the cuttings rooting was noted. The best rooting rate was observed in herbaceous cuttings control, collected in March (50%). Therefore, it can be concluded that cuttings represent the most efficient and promising technique for the propagation of Artemisia herba-alba.Artemisia herba-alba est l'une des espèces pastorales les plus importantes, caractérisée par une valeur fourragère élevée, en particulier pour les ruminants. Cependant. Les steppes à Artemisia herba-alba subissent une dégradation continue. La maitrise de la multiplication de cette espèce est indispensable, pour sa préservation et la réhabilitation des pâturages dégradés. La présente étude a pour objectif de maitriser les techniques de multiplication sexuée et asexuée d’Artemisia herba-alba: germination et bouturage. Pour étudier la multiplication sexuée, trois facteurs sont considérés: l’âge des graines, leurs provenances et leurs pré-traitements. Pour la multiplication asexuée, deux essais de bouturage sont menés, dans le but de tester l’effet i) du trempage dans une solution d’auxine AIA, et ii) de la nature des boutures (herbacées, semi-ligneuses et ligneuses) sur l’enracinement de ces boutures. Les résultats obtenus ont montré un taux de germination important pour les graines fraichement récoltées (88%), une diminution du taux de germination des graines au fil des années, et celles de l’année en cours, mais provenant du pastoretum et récoltées tardivement (19,78%). Aussi, une augmentation du taux de germination des graines imbibées pendant 48h (21%), par rapport au témoin (17%). Par ailleurs, nous avons noté un effet inhibiteur de certaines concentrations de l’AIA sur l’enracinement des boutures. Le meilleur taux d’enracinement a été observé chez les boutures herbacées témoins, collectées en mars (50%)

Stem cell therapy as a novel therapeutic intervention for resistant cases of alopecia areata and androgenetic alopecia

Background: Management of alopecia areata (AA) and androgenetic alopecia (AGA) is often challenging as patients may be resistant to currently available modalities of treatment. The use of stem cells may be a novel option for resistant cases. Objective: To evaluate the safety and efficacy of the use of autologous bone marrow derived mononuclear cells (including stem cells) as compared to follicular stems cells for the management of resistant cases of AA and AGA. Methods: This study included 40 patients (20 AA patients and 20 AGA patients), all patients were treated with a single session of intradermal injection of autologous stem cells (SCs) therapy. They were divided into four groups according to the applied modality [either autologous bone marrow derived mononuclear cells (bone marrow mononuclear cells [BMMCs] or autologous follicular stem cells [FSC]). Results: Six months after stem cell therapy (SCT) injection, there was a significant improvement, confirmed by immunostaining and digital dermoscopy. The mean improvement in all groups was “very good”. There was no significant difference between both methods in either type of alopecia. No serious adverse events were reported. Conclusion: Autologous BMMCs and FSC seem to be a safe tolerable and effective treatment for the management of both resistant AA and AGA

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)