Generalized Lymphadenopathy: Unusual Presentation of Prostate Adenocarcinoma

Generalized lymphadenopathy is a rare manifestation of metastatic prostate cancer. Here, we report the case of a 59-year-old male patient with supraclavicular, mediastinal, hilar, and retroperitoneal and inguinal lymphadenopathy, which suggested the diagnosis of lymphoma. There were no urinary symptoms. A biopsy of the inguinal lymph node was compatible with adenocarcinoma, whose prostatic origin was shown by immunohistochemical staining with PSA. The origin of the primary tumor was confirmed by directed prostate biopsy. We emphasize that a suspicion of prostate cancer in men with adenocarcinoma of undetermined origin is important for an adequate diagnostic and therapeutic approach

‘NEW TRICKS TO OLD DOGS’ THE USE OF INFOGRAPHIC FOR TEACHING GRAMMAR TO EFL LEARNERS; A CASE STUDY

Technology is an indispensable part of our daily lives nowadays and it has a huge impact on educational fields. The case is valid for English language education in which language teachers teach digital natives with a variety of developing technological tools, software, and aids. Visual aids are also transforming with the developing technology and infographics are one of the technological tools which have been developed by them in recent years. Grammar teaching with traditional teaching materials does not appeal to language learners anymore and it requires innovation as well. For this purpose, current research aims to investigate infographics’ effectiveness and utilization to teach grammar topics. The research was designed as experimental research. Pre-test, treatment, and post-test were administered to the experimental group while the control group traditionally received instruction. At the end of the post-test administration, an interview with five open-ended questions was administered to collect qualitative data. Results of the study show that infographics are effective technological tools to develop language learners’ grammatical knowledge. Moreover. Students have positive perceptions of using these technological visual aids to teach grammar topics

Multi-object segmentation using coupled nonparametric shape and relative pose priors

We present a new method for multi-object segmentation in a maximum a posteriori estimation framework. Our method is motivated by the observation that neighboring or coupling objects in images generate configurations and co-dependencies which could potentially aid in segmentation if properly exploited. Our approach employs coupled shape and inter-shape pose priors that are computed using training images in a nonparametric multi-variate kernel density estimation framework. The coupled shape prior is obtained by estimating the joint shape distribution of multiple objects and the inter-shape pose priors are modeled via standard moments. Based on such statistical models, we formulate an optimization problem for segmentation, which we solve by an algorithm based on active contours. Our technique provides significant improvements in the segmentation of weakly contrasted objects in a number of applications. In particular for medical image analysis, we use our method to extract brain Basal Ganglia structures, which are members of a complex multi-object system posing a challenging segmentation problem. We also apply our technique to the problem of handwritten character segmentation. Finally, we use our method to segment cars in urban scenes

Unraveling the significance of epithelial-associated bacteria in gastrointestinal diseases: Importance of choosing an optimal DNA extraction method

Understanding the significance of epithelial-associated bacteria in gastrointestinal diseases is essential for gaining insights into the complex host-microbiota interactions that influence disease development and progression. However, sequencing approaches face limitations due to the overwhelming presence of host DNA in the samples. PCR-based approaches like 16S rRNA gene amplicon sequencing enables taxonomic profiling and has been studied extensively in connection with a wide range of diseases and while still being a valuable method, microbiome research is moving towards metagenomic sequencing. This allows for the deciphering of both the bacterial community structure at a higher taxonomic resolution as well as insight into its functional potential. Here, we present a comparative study of three different DNA extraction methods for human colon biopsies: two commercially available kits (Qiagen Blood and tissue kit and Molzym ultra-deep microbiome prep) and one published optimized method (Saponin approach). The three methods were evaluated in terms of the ratio between host and bacterial DNA and their ability to retain the relative bacterial abundance at different taxonomic levels. Six colon biopsies (18 technical replicates) were sequenced with 16S rRNA gene amplicon and metagenomic sequencing resulting in distinct bacterial profiles dependent on the applied extraction method. The Saponin approach showed depletion of both host and bacterial DNA to an extent that the bacterial community structure was not retained when looking at 16S rRNA sequencing data. Furthermore, only the Molzym kit showed a satisfying sequencing depth suggesting that although Qiagens kit retained the community structure better than the Saponin approach, the vast amount of host DNA hampered the sequencing effort even after producing amplicons. When employing metagenomic sequencing to evaluate the bacterial:host DNA ratio, the Molzym kit showed up to a 10-fold enrichment of bacterial DNA compared to the Qiagen kit. Selecting an appropriate DNA extraction method is vital when studying epithelial-associated bacteria in gastrointestinal diseases and is essential for unravelling the intricate host-microbiota interactions underlying disease pathogenesis

Primary hyperparathyroidism

Primary hyperparathyroidism (PHPT) is an endocrinological disease with parathormone (PTH) and calcium elevation. It is the most common form of hypercalcemia in the community. In this review, the definition, diagnosis, differential diagnosis and treatment of hyperparathyroidism are described.</p

Hashimoto's Thyroiditis is Not a Negative Contributor to Papillary Thyroid Cancer

Objective: Hashimoto's thyroiditis is the most common autoimmune thyroid disease. Papillary thyroid cancer is the most common thyroid cancer. Whether Hashimoto's thyroiditis is a predisposing factor for papillary thyroid cancer remains unclear. In this study, the frequency of papillary thyroid cancer was investigated in patients with Hashimoto's thyroiditis who underwent total thyroidectomy. Methods: In this study, 534 patients were screened retrospectively. Preoperative thyroid function tests, anti-thyroid antibodies, ultrasonography findings, fine-needle aspiration biopsies, and thyroidectomy pathology results were examined. According to the pathology, 139 patients had Hashimoto's thyroiditis. Patients with Hashimoto's thyroiditis (group 1) and non-Hashimoto's thyroiditis (group 2) were compared. Results: Papillary thyroid cancer was found in 70 patients (50.4%) in group 1 and 156 patients (39.5%) in group 2 (P =.026). The odds ratio was 1.59 (95% CI; 1.07-2.34). There was no difference for sex, age, tumor size, microcarcinoma-macrocarcinoma-distribution, subtype, number of tumor focus, lymph node metastasis, vessel invasion, and extrathyroidal spread. Conclusion: We found more papillary thyroid cancer and less capsular invasion in patients with Hashimoto's thyroiditis, but we did not find any differences between groups in terms of age, gender, tumor size, vascular invasion, and metastasis. According to these findings, Hashimoto's thyroiditis may be a risk factor for papillary thyroid cancer

Malignancy outcomes and the impact of repeat fine needle aspiration of thyroid nodules with Bethesda category III cytology: A multicenter experience

Background The clinical management of Bethesda III category thyroid nodules has some undefined points and differs among centers and conflicting malignancy rates are present in the literature. The aim of this study was to investigate the Bethesda category III thyroid nodule outcomes in our centers, to determine malignancy rates and also to evaluate clinical and sonographic features which may help to predict malignancy. Methods This retrospective study included 333 patients with thyroid nodules who had Bethesda category III on fine needle aspiration (FNA) in three tertiary medical centers of Turkey. Results Among 333 patients, 302 had appropriate follow up. Eighteen patients received thyroidectomy after the first FNA, with a malignancy rate of 38.89% (7/18) and 284 patients received a second FNA. After the second FNA, thyroidectomy was performed in 80 patients and 41 patients needed the third FNA. Thirteen thyroidectomies were performed after the third FNA. Totally 111 patients received thyroidectomy with a malignancy rate of 48.65% (54/111) among patients with surgery and the lower bound was detected as 17.88% (54/302). Of these patients the malignancy rates of patients receiving thyroidectomy with two and three FNAs were 47.50% (38/80) and 69.23% (9/13), respectively. Hypoechogenicity, microcalcification, and irregular margin were found as good predictors for malignancy. Conclusion We demonstrated that the malignancy rate was 48.65% in patients receiving thyroidectomy. We showed a higher malignancy rate than the traditionally rate of 5%-15%. This study showed that repeat FNAs decrease the rate of unnecessary surgery performed for benign lesions by increasing the rate of malignancy detection

The Diagnostic Utility of Artificial Intelligence-Guided Computed Tomography-Based Severity Scores for Predicting Short-Term Clinical Outcomes in Adults with COVID-19 Pneumonia

Chest computed tomography (CT) imaging with the use of an artificial intelligence (AI) analysis program has been helpful for the rapid evaluation of large numbers of patients during the COVID-19 pandemic. We have previously demonstrated that adults with COVID-19 infection with high-risk obstructive sleep apnea (OSA) have poorer clinical outcomes than COVID-19 patients with low-risk OSA. In the current secondary analysis, we evaluated the association of AI-guided CT-based severity scores (SSs) with short-term outcomes in the same cohort. In total, 221 patients (mean age of 52.6 ± 15.6 years, 59% men) with eligible chest CT images from March to May 2020 were included. The AI program scanned the CT images in 3D, and the algorithm measured volumes of lobes and lungs as well as high-opacity areas, including ground glass and consolidation. An SS was defined as the ratio of the volume of high-opacity areas to that of the total lung volume. The primary outcome was the need for supplemental oxygen and hospitalization over 28 days. A receiver operating characteristic (ROC) curve analysis of the association between an SS and the need for supplemental oxygen revealed a cut-off score of 2.65 on the CT images, with a sensitivity of 81% and a specificity of 56%. In a multivariate logistic regression model, an SS > 2.65 predicted the need for supplemental oxygen, with an odds ratio (OR) of 3.98 (95% confidence interval (CI) 1.80–8.79; p p = 0.011), adjusted for age, sex, body mass index, diabetes, hypertension, and coronary artery disease. We conclude that AI-guided CT-based SSs can be used for predicting the need for supplemental oxygen and hospitalization in patients with COVID-19 pneumonia

Laboratory Parameters Predict Complications in Primary Hyperparathyroidism: A Multicenter Cross-sectional Study

Aim: There is no study predicts the development of complications with laboratory parameters in patients with primary hyperparathyroidism (PHPT). We aimed to determine the laboratory parameters that predict the development of osteoporosis or nephrolithiasis in patients with PHPT and identify high-risk patients. Methods: This multicenter retrospective cross-sectional study was conducted between January 2018 and January 2020. The study group consisted of 389 patients who were diagnosed with PHPT (68 patients without surgical indications and 321 patients with PHPT who underwent surgery), and 451 individuals without any additional disease as a control group. Patients' data was obtained from the hospital automation system. All patients were divided into three groups (control, unoperated and operated), and laboratory parameters were compared. Results: The Wisconsin index (WIN), which is used to detect hyperfunctional glands in addition to parathyroid adenoma in PHPT, and the Parathyroid functional index (PFIndex), which is used to differentiate HPT secondary to vitamin D deficiency, can identify patients at high risk of nephrolithiasis or osteoporosis in patients with PHPT. In patients who have been operated on due to PHPT-related complications, the WIN value of 283.29 showed 95% sensitivity and 72% specificity in predicting osteoporosis, while the PFIndex of 36.43 had 86% sensitivity and 68% specificity for predicting nephrolithiasis. Conclusion: The WIN and PFIndex can be used to refer patients with PHPT for surgery before the onset of osteoporosis or nephrolithiasis. Although no risk factor could be found for nephrolithiasis, WIN was found as an independent risk factor for osteoporosis