Clear cell chondrosarcoma of the head and neck

Clear cell chondrosarcoma is a rare variant of chondrosarcoma that mostly involves the end of long bones. However, nine cases have been reported in the head and neck: four in larynx, two in nasal septum, two in maxilla and one in the skull. These cases form the basis of this review. Head and neck cases accounts for less than 5% of Clear cell chondrosarcomas in the whole body and the larynx is the most common place. The histological findings of head and neck cases are consistent with general features of this entity in the whole body and nearly all tumors in this case series had a component of conventional chondrosarcoma. Clear cell chondrosarcoma is an intracompartmental tumor and retains "Grenz zone" just beneath the epithelium. Therefore, the overlying mucosa remained intact in all laryngeal cases. Nasal tumor caused ballooning of the septum and the maxillary lesion did not involve the oral mucosa. This tumor presents various radiographic features in the head and neck area. Chondroblastoma, chondroma, osteoblastoma, osteosarcoma and metastatic renal cell carcinoma are included in the histologic differential diagnoses. Differentiation from chondroblastic osteosarcoma is important in the maxilla. A wide resection is adequate in most cases. However, some laryngeal cases show tendency to recur. Clear cell chondrosarcoma is a slow growing tumor and this necessitates a long time follow-up of patients. Due to the extreme rarity in the head and neck, diagnosis of Clear cell chondrosarcoma in this area, must be confirmed by histochemical and immunohistochemical studies

Long-term follow-up with Granulocyte and Monocyte Apheresis re-treatment in patients with chronically active inflammatory bowel disease

<p>Abstract</p> <p>Background</p> <p>Patients with IBD and chronic inflammation refractory to conventional therapy often demonstrate higher risk of serious complications. Combinations of immunosuppression and biological treatment as well as surgical intervention are often used in this patient group. Hence, there is need for additional treatment options. In this observational study, focused on re-treatment and long-term results, Granulocyte/Monocyte Adsorption (GMA, Adacolumn^®) treatment has been investigated to study efficacy, safety and quality of life in IBD-patients with chronic activity.</p> <p>Methods</p> <p>Fifteen patients with ulcerative colitis and 25 patients with Crohn's disease, both groups with chronically active inflammation refractory to conventional medication were included in this observational study. The patients received 5-10 GMA sessions, and the clinical activity was assessed at baseline, after each completed course, and at week 10 and 20 by disease activity index, endoscopy and quality of life evaluation. Relapsed patients were re-treated by GMA in this follow-up study up to 58 months.</p> <p>Results</p> <p>Clinical response was seen in 85% and complete remission in 65% of the patients. Ten patients in the UC-group (66%) and 16 patients in the CD-group (64%) maintained clinical and endoscopic remission for an average of 14 months. Fourteen patients who relapsed after showing initial remission were re-treated with GMA and 13 (93%) went into a second remission. Following further relapses, all of seven patients were successfully re-treated for the third time, all of three patients for the fourth time and one for a fifth time.</p> <p>Conclusions</p> <p>IBD-patients with chronic inflammation despite conventional therapy seem to benefit from GMA. Re-treatment of relapsing remission patients seems to be effective.</p

Limited genetic variation and structure in softshell clams (Mya arenaria) across their native and introduced range

Author Posting. © Springer, 2009. This is the author's version of the work. It is posted here by permission of Springer for personal use, not for redistribution. The definitive version was published in Conservation Genetics 10 (2009): 803-814, doi:10.1007/s10592-008-9641-y.To offset declines in commercial landings of the softshell clam, Mya arenaria, resource managers are engaged in extensive stocking of seed clams throughout its range in the northwest Atlantic. Because a mixture of native and introduced stocks can disrupt locally adapted genotypes, we investigated genetic structure in M. arenaria populations across its current distribution to test for patterns of regional differentiation. We sequenced mitochondrial cytochrome oxidase I (COI) for a total of 212 individuals from 12 sites in the northwest Atlantic (NW Atlantic), as well as two introduced sites, the northeast Pacific (NE Pacific) and the North Sea and Europe (NS Europe). Populations exhibited extremely low genetic variation, with one haplotype dominating (65-100%) at all sites sampled. Despite being introduced in the last 150-400 years, both NE Pacific and NS Europe populations had higher diversity measures than those in the NW Atlantic and both contained private haplotypes at frequencies of 10% to 27% consistent with their geographic isolation. While significant genetic structure (FST = 0.159, p<0.001) was observed between NW Atlantic and NS Europe, there was no evidence for genetic structure across the pronounced environmental clines of the NW Atlantic. Reduced genetic diversity in mtDNA combined with previous studies reporting reduced genetic diversity in nuclear markers strongly suggests a recent population expansion in the NW Atlantic, a pattern that may result from the retreat of ice sheets during Pleistocene glacial periods. Lack of genetic diversity and regional genetic differentiation suggests that present management strategies for the commercially important softshell clam are unlikely to have a significant impact on the regional distribution of genetic variation, although the possibility of disrupting locally adapted stocks cannot be excluded.This work was supported by NSF grants OCE-0326734 and OCE-0215905 to L. Mullineaux and OCE- 0349177 (Biological Oceanography) to PHB

Fistulizing Crohn's disease

Fistulas are common in Crohn's disease. A population-based study has shown a cumulative risk of 33% after 10 years and 50% after 20 years. Perianal fistulas were the most common (54%). Medical therapy is the main option for perianal fistula once abscesses, if present, have been drained, and should include antibiotics (both ciprofloxacin and metronidazole) and immunomodulators. Infliximab should be reserved for refractory patients. Surgery is often necessary for internal fistulas. [Ed.]]]> oai:serval.unil.ch:BIB_AF7333F61ACB 2022-05-07T01:25:05Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_AF7333F61ACB La plus ancienne Vie de Vincent Ferrier racontée par le dominicain allemand Jean Nider (ca. 1380-1438) Chène, C info:eu-repo/semantics/bookPart incollection 2006 Mirificus praedicator oai:serval.unil.ch:BIB_AF7392846823 2022-05-07T01:25:05Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_AF7392846823 Caractéristiques cliniques et sociodémographiques des adolescents consultant au service des urgences de l’Hôpital de l’Enfance SCHWITZGUEBEL, J. Université de Lausanne, Faculté de biologie et médecine info:eu-repo/semantics/masterThesis masterthesis 2017 <![CDATA[Résumé 1.1 Contexte Les adolescents ont le plus souvent recours au système de soins par une consultation dans un service d’urgences. Les caractéristiques des adolescents qui consultent aux urgences ont été évaluées dans des études sur différents sites. Il n’y a pas à notre connaissance d’études effectuées en Suisse romande sur les adolescents aux urgences pédiatriques. Les adolescents représentent une part importante des consultations aux urgences de l’HEL1. Au mois de septembre 2014, 30% des consultations aux urgences ont été effectuées par des adolescents entre 10 et 18 ans. 1.2 Objectifs L’étude 1 vise à étudier les caractéristiques administratives et cliniques des adolescents qui consultent aux urgences de l’HEL. L’étude 2 vise à recueillir des données sociodémographiques, relatives à la santé des adolescents et à leur utilisation du système de soin. 1.3 Méthode L’étude 1 est rétrospective, à partir des dossiers médicaux des adolescents de 14 à 18 ans qui ont consulté aux urgences de l’HEL entre le 1er et le 30 septembre 2015. L’étude 2 est prospective, effectuée au moyen d’auto-questionnaires anonymes à choix multiples distribués aux adolescents entre 12 et 18 ans venus aux urgences de l’HEL entre le 1er et le 25 septembre 2015. La population des deux études étant différente, les résultats ont été analysés de manière indépendante. 1.4 Résultats principaux 301 dossiers ont été inclus dans l’étude 1. Les adolescents comptent pour 47.2% des consultations et les adolescentes 52.8%. Le score de tri est de 4 ou 5 dans 94% des cas. Le taux d’hospitalisation suite à la consultation est de 3.3%. Le suivi n’a pas été documenté dans 63.5% des cas. Ils consultent en majorité pour des motifs chirurgicaux (48.8%) et médicaux (46.6%). Les motifs psychiatriques représentent 4.6% des cas. Les diagnostics de sortie sont moins bien documentés que les motifs de consultation. 10.9% des adolescents consultaient un service d’urgences pour la 5ème fois ou plus au cours de l’année écoulée. L’étude 2 a inclus 90 patients. Aucun adolescent n’a rapporté être sans activité, avec une majorité à l’école obligatoire, au gymnase ou en apprentissage (86.6%). Ils sont de nationalité suisse dans 62.2% des cas. Ils vivent avec l’un ou leurs deux parents dans 93.3% des cas. 95.6% d’entre eux considèrent être en excellente ou bonne santé habituelle. Ils sont 91.1% à avoir un médecin de premier recours et parmi eux, 17.1% ne l’ont jamais vu au cours de l’année écoulée. 81% des jeunes ont consulté en présence d’un adulte. Ils ont choisi eux-mêmes de consulter dans un tiers des cas. 10% déclarent s’être rendus aux urgences plus de 5 fois au cours de l’année écoulée. 1.5 Discussion et Conclusion Les deux études présentées ont permis de mieux caractériser la population adolescente qui consulte aux urgences de l’HEL. Après comparaison avec la littérature, les enjeux auxquels sont confrontés les services d’urgences accueillant des adolescents semblent partagés par l’HEL. Nous proposons plusieurs axes de réflexion pour l’amélioration de la prise en charge des adolescents aux urgences de l’HEL. Différents biais ont affecté les deux études de ce travail. D’autres recherches seront nécessaires pour préciser et confirmer nos observations