Monophasic synovial sarcoma presenting as a primary ileal mass: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Synovial sarcoma is a rare malignant mesenchymal tumor mainly arising in the peri-articular tissue in young adults. There are few cases reported in other areas.</p> <p>Case presentation</p> <p>We report the case of a 29-year-old Saudi woman of Arabian ethnicity with synovial sarcoma arising primarily from the ileum who presented with abdominal pain, a palpable mass and incomplete intestinal obstruction. A literature review was performed to gather information on this rare gastrointestinal tract sarcoma.</p> <p>Conclusions</p> <p>Although it is a rare tumor of the pre-articular tissues, synovial sarcoma can present, in exceedingly rare cases, in unusual anatomical sites such as the gastrointestinal tract. We believe the reporting of all rare or unexpected presentations of sarcoma will eventually improve our understanding of this relatively unusual malignancy.</p

Cytomegalovirus pneumonia in an immunocompetent host with primary ciliary dyskinesia: A case report

Primary ciliary dyskinesia (PCD) is an autosomal-recessive inherited disease caused by mutations in genes involved in ciliary structure and function leading to impaired mucociliary clearance and repeated or chronic, usually bacterial, infections of the upper and lower airways and decreased lung function and bronchiectasis. Cytomegalovirus (CMV) is a DNA virus that usually causes subclinical infection and in 10% of the patients causes a mononucleosis-like syndrome. CMV is a causative agent of serious illness in vulnerable immunocompromised groups such as transplant recipients, patients with immunodeficiency or malignancy and neonates. Life-threatening infection due to CMV, including CMV pneumonia, is not common in immunocompetent patients. In this report we describe a case of an otherwise immunocompetent woman, suffering from PCD, who developed severe CMV pneumonia

Vitamin D deficiency in patients evaluated for obstructive sleep apnea: is it associated with disease severity?

Purpose: The aim of the present study was to assess vitamin D levels in a large cohort of OSA patients and to investigate possible correlations with clinical and polysomnographic parameters. Methods: In this cross-sectional study, 685 consecutive patients underwent type 1 polysomnography (PSG) for OSA diagnosis. They were grouped according to apnea–hypopnea index (AHI) as mild, moderate, and severe. Patients with AHI &lt; 5 served as controls. Demographic, PSG data, and serum levels of vitamin D were measured and compared between groups. Results: OSA was diagnosed in 617 of the patients (90%). Of those, 94 (15%) had mild OSA, 150 (24%) moderate OSA, and 373 (61%) severe OSA. The risk of vitamin D deficiency (&lt; 20&nbsp;ng/mL) was observed in 38% of the cohort. OSA patients had lower vitamin D levels compared to controls (23&nbsp;ng/mL vs 26&nbsp;ng/mL, p = 0.006). The lowest levels of vitamin D [mean 21] (p &lt; 0.001 among all groups) and the higher prevalence for vitamin D deficiency (45%) were observed in severe OSA patients. After multiparametric adjustments for age, gender, obesity, and comorbidities, severe OSA showed significant independent associations with the risk of vitamin D deficiency [OR (95% CI) 2.002 (1.049–3.819), p = 0.035]. Conclusions: A large proportion of patients referred for OSA evaluation had vitamin D deficiency, which was independently associated with severe OSA. However, further research is needed in order to determine the role of vitamin D in OSA patients

Sex differences of continuous positive airway pressure treatment on flow-mediated dilation in&nbsp;patients with obstructive sleep apnea syndrome

Anastasios Kallianos,1 Athanasios Panoutsopoulos,1 Christoforos Mermigkis,2 Konstantinos Kostopoulos,1 Chrysanthi Papamichail,1 Ioannis Kokkonouzis,3 Christoforos Kostopoulos,1 Ioannis Nikolopoulos,4 Antonis Papaiwannou,5 Sofia Lampaki,5 John Organtzis,5 Georgia Pitsiou,5 Paul Zarogoulidis,5 Georgia Trakada1 1Sleep Disorders Unit, Department of Clinical Therapeutics, &ldquo;Alexandra&rdquo; General Hospital, Athens School of Medicine, 2Sleep Disorders Unit, Pulmonary Department, 401 General Army Hospital, 3Pulmonary Department, 251 Hellenic Air Force General Hospital, 4Sleep Disorders Unit, &ldquo;Sotiria&rdquo; Regional Chest Diseases Hospital of Athens, Athens, Greece; 5Pulmonary Department &ndash; Oncology Unit, George Papanikolaou General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, GreeceIntroduction: There is growing research evidence suggesting the presence of endothelial dysfunction and systemic inflammation in patients with obstructive sleep apnea syndrome (OSAS). Continuous positive airway pressure (CPAP) is the most effective method for treating OSAS; nonetheless, the effects of CPAP on the aforementioned pathophysiologic pathways as well as on the systemic disease that result or coexist with the OSAS remain elusive.Aim: To assess the effect of 3-month CPAP therapy on endothelial-dependent dilation, plasma levels of inflammatory markers, blood pressure (BP), and glucose control on male and female patients with OSAS.Methods: Our study group consisted of 40 (24 males and 16 females) patients with no prior history of cardiovascular disease, with an apnea&ndash;hypopnea index &ge;15, who were assigned to receive CPAP treatment. Measurements of flow-mediated dilation (FMD), 24-hour ambulatory BP, and blood analysis were performed at baseline and 3&nbsp;months after CPAP therapy.Results: Baseline FMD values were negatively correlated with the apnea&ndash;hypopnea index (r=&minus;0.55, P=0.001). After 3&nbsp;months of CPAP, there was an increase in the FMD values (5.40%&plusmn;2.91% vs 3.13%&plusmn;3.15%, P&lt;0.05) and a significant reduction in the patients&rsquo; 24-hour systolic BP (122.82&plusmn;11.88 mmHg vs 130.24&plusmn;16.75 mmHg, P&lt;0.05), diastolic BP (75.44&plusmn;9.14 mmHg vs 79.68&plusmn;11.09 mmHg, P&lt;0.05), and pulse pressure (47.38&plusmn;9.77 mmHg vs 52.72&plusmn;11.38 mmHg, P&lt;0.05); daytime systolic BP (125.76&plusmn;12.69 mmHg vs 132.55&plusmn;17.00 mmHg, P&lt;0.05) and diastolic BP (77.88&plusmn;10.39 mmHg vs 82.25&plusmn;11.01 mmHg, P&lt;0.05); nighttime systolic BP (118.17&plusmn;13.16 mmHg vs 126.22&plusmn;17.42 mmHg, P&lt;0.05) and pulse pressure (46.61&plusmn;10.76 mmHg vs 52.66&plusmn;11.86 mmHg, P&lt;0.05); and C-reactive protein and HbA1c levels (0.40 [0.40&ndash;0.70]&nbsp;mg/L vs 0.60 [0.40&ndash;0.84]&nbsp;mg/L and 5.45%&plusmn;0.70% vs 5.95%&plusmn;1.08%, respectively; P&lt;0.05). When divided by sex, only male patients produced similar statistically significant results, while female patients failed to show such associations.Conclusion: Our results suggest that CPAP therapy improves the endothelial function, the BP, and the glucose control in male patients with OSAS. Further research is warranted in order to verify these results and to further elucidate the impact of CPAP on the cardiovascular risk of male and female patients with OSAS. Keywords: obstructive sleep apnea syndrome, CPAP, CRP, blood pressure, glucose contro