Recurrent Non-Hodgkin’s lymphoma in the uterine cervix: a case report and a review of the literature

Background. Lymphomas are a heterogeneous group of malignant lymphoproliferative diseases. As primary localization, the most common histological subtype of female genital lymphomas is a Non-Hodgkin Lymphoma (NHL), the diffuse large B-cell type. However cervical relapse of NHL is a very rare condition (0.3%). Case presentation. A 42-year-old Peruvian woman experienced relapse of NHL with uterine localization. She complained at first of abnormal vaginal bleeding and stranguria. The cervical biopsy performed showed a diffuse large B-cell lymphoma in the uterine cervix. The lack of clinical studies on this topic and its rarity make this type of recurrence very difficult to treat. Conclusions. In case of a woman with vaginal bleeding and history of NHL, a disease relapse should always be considered, and a biopsy should be performed to confirm the diagnosis. © 2023, EDRA S.p.A. All rights reserved

Comprehensive Evaluation of Plasma 7-Ketocholesterol and Cholestan-3β,5α,6β-Triol in an Italian Cohort of Patients Affected by Niemann-Pick Disease due to NPC1 and SMPD1 Mutations

: Niemann-Pick C disease (NPCD) is a rare autosomal recessive neurovisceral disorder with a heterogeneous clinical presentation. Cholestan-3β,5α,6β-triol and 7-ketocholesterol have been proposed as biomarkers for the screening of NPCD. In this work, we assessed oxysterols levels in a cohort of Italian patients affected by NPCD and analyzed the obtained results in the context of the clinical, biochemical and molecular data. In addition, a group of patients affected by Niemann-Pick B disease (NPBD) were also analyzed. NPC patients presented levels of both oxysterols way above the cut off value, except for 5 siblings presenting the variant biochemical phenotype who displayed levels of 3β,5α,6β-triol below or just above the cut-off value; 2 of them presented also normal levels of 7-KC. Both oxysterols were extremely high in a patient presenting the neonatal systemic lethal phenotype. All NPB patients showed increased oxysterols levels. In conclusion, the reported LC-MS/MS assay provides a robust non-invasive screening tool for NPCD. However, false negative results can be obtained in patients expressing the variant biochemical phenotype. These data strengthen the concept that the results should always be interpreted in the context of the patients' clinical picture and filipin staining and/or genetic studies might still be undertaken in patients with normal levels of oxysterols if symptoms are highly suggestive of NPCD. Both oxysterols are significantly elevated in NPB patients; thus a differential diagnosis should always be performed in patients presenting isolated hepatosplenomegaly, a common clinical sign of both NPCD and NPBD

Structured activity and multiple group memberships as mechanisms of increased depression among young people not in employment, education or training

Aims Young people Not in Employment, Education and Training (NEET) are at increased risk of depression, yet mechanisms of this association are poorly understood. We hypothesised that being NEET has both behavioural and social identity consequences and that reductions in structured activity and multiple group memberships underlie increased depression in this group. Our purpose was to assess first whether depression was greater for NEET compared to non‐NEET young people from the same geographical locality, and secondly, whether a loss of structured activity leading to a reduction in multiple group memberships explains the NEET‐depression association. Methods The present study was a cross‐sectional between‐groups design using convenience sampling. Measures of depression, structured activity and multiple group memberships were obtained from 45 NEET young people and 190 university students (non‐NEET). Results The NEET group reported significantly more depression symptoms compared to the non‐NEET student control group. A path model specifying NEET status as a predictor of depression, with this association mediated by a reduction in structured activity and fewer multiple group memberships (standardised indirect = 0.03, unstandardised indirect = 0.62, P = 0.052, 95% bias corrected confidence intervals [0.21,1.44]), provided excellent fit to our data: χ2(3) = 0.26, P = 0.968, comparative fit index (CFI) = 1.00, root mean square error of approximation (RMSEA)<0.01, standardized root mean square residual (SRMR) = 0.01). Conclusions Our findings suggest that depression is elevated amongst NEET young people compared to non‐NEET students from the same locality. The association between NEET status and depression was partially mediated by reduced structured activity and its association with reduced multiple group memberships. Although using cross‐sectional data, our findings suggest social interventions may be a key resource in ameliorating depression amongst NEET young people; through preserving engagement in structured activity and the wellbeing benefits derived from arising multiple group memberships. Methods: The present study was a cross-sectional between-groups design using convenience sampling. Measures of depression, structured activity and multiple group memberships were obtained from 45 ‘NEET’ young people and 190 university students (Non-‘NEET’). Results: The NEET group reported significantly more depression symptoms compared to the Non-NEET student control group. A path model specifying NEET status as a predictor of depression, with this association mediated by a reduction in structured activity and fewer multiple group memberships (standardised indirect = 0.03, unstandardised indirect= 0.62, p= .052, 95% Bias Corrected CIs [0.21; 1.44]), provided excellent fit to our data χ2(3)= 0.26, p= .968, CFI= 1.00, RMSEA< .01, SRMR= .01, AIC= 2,792.75, BIC= 2,818.20). Conclusions: Our findings suggest depression is elevated amongst NEET young people compared to Non-NEET students from the same locality. The association between NEET status and depression was partially mediated by reduced structured activity and its association with reduced multiple group memberships. Although cross-sectional, our findings suggest social interventions may be a key resource in ameliorating depression amongst NEET young people; through preserving engagement in structured activity and the wellbeing benefits derived from arising multiple group memberships

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR &lt; 60 mL/min/1.73 m2) or eGFR reduction &gt; 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR &lt; 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR &gt; 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Neuropsychological assessment at school-age and prenatal low-level exposure to mercury through fish consumption in an Italian birth cohort living near a contaminated site

The relative effects of prenatal and postnatal low-level mercury exposure and fish intake on child neurodevelopment are still controversial. Limited evidence is available from Mediterranean populations. In this prospective study, we measured the Verbal and Performance IQ in Italian children at school-age who were resident in an area declared as a National contaminated site because of mercury pollution, taking into account the possible beneficial effect of fish consumption and potential confounders. A mother-child cohort made up of 242 children was established at birth in Northeastern Italy in 2001. Their mothers were interviewed approximately 2 months after delivery to determine type, quantity, and origin of fish consumed during pregnancy and about a number of mother, child and family characteristics. Total mercury (THg) and methyl mercury (MeHg) were assessed in maternal hair and breast milk and in the child's hair. When children reached 7-9 years of age, 154 (63.6%) parents gave consent to participate in a follow-up evaluation. On that occasion, a child's hair sample was collected to determine the current concentration of THg, mothers were asked to complete a self-administered questionnaire, and children underwent neuropsychological testing. Verbal IQ, performance IQ and full scale IQ were measured by the Wechsler Intelligence Scale for Children (WISC III) administered by psychologists at school or local health centers. Demographic, socioeconomic and lifestyle information, medical information of the child's family and the child's dietary habits were collected using a questionnaire filled in by mothers. Multivariable linear regression models were used to evaluate the association between prenatal THg exposure through fish consumption of mothers in pregnancy and children's IQ after adjustment for possible confounders such as fish consumption of mothers in pregnancy, child's fish consumption at follow-up, child's birthweight, maternal cigarette smoking during pregnancy, house size and property place of residence during pregnancy and gender. THg in the child's hair at 7 years of age was fairly correlated with THg in maternal hair at delivery (rs=0.35; p<0.0001) and was strongly correlated with child's seafood consumption (rs=0.50, p<0.0001). No differences in maternal THg levels were found when comparing children with low or extremely low or high or extremely high scores vs others, considering separately full scale, verbal, and performance IQs. Children born from mothers with hair THg levels greater than or equal to 2000ng/g had full scale, verbal and performance IQs which were 4-5 points lower than children born from women with lower THg levels, but these differences were not statistically significant. Fresh fish intake of mothers in pregnancy was slightly positively associated with full scale and performance but not so with verbal IQs. Canned fish showed to be negatively associated with all the outcome variables. Unexpectedly, children born to mothers from one town showed IQ scores significantly lower than the other children; however, none of the many variables considered in these analyses could explain this result. The relatively low Hg levels found in the biological samples did not provide evidence of high and extensive Hg exposure in this population. Although THg levels in maternal and child's biological samples are correlated with fish consumption, the effects of THg and fish on neurological outcomes go in opposite directions. These results do not allow to develop recommendations regarding fish consumption in pregnancy but suggest that keeping THg hair levels<2000ng/g might be desirabl

Translanguaging, Emotionality, and English as a Second Language Immigrants: Mongolian Background Women in Australia

Drawing on the translanguaging practices of Mongolian background English as a Second Language (ESL) immigrant women in Australia, this paper points out two main theoretical points: (1) when translanguaging moves beyond the classroom, it may provide ESL immigrants with an emotionally and linguistically safe space where they feel comfortable in managing their negative emotions through employing multiple entangled layers of linguistic and paralinguistic resources; (2) translanguaging data further presents that these ESL immigrants are deeply emotional and are prone to depression, putting their mental well-being in jeopardy. As a result of their depression, their academic concentration is inhibited, as is their ability to learn English well or easily. We, as TESOL educators, therefore, need to consider two critical educational implications: (1) how ESL immigrant students use different linguistic repertoires outside the classroom, what they talk about, and which emotions they prefer to express in which forms of their linguistic repertoire; and their multiple emotions, traumas and psychological issues embedded within their multiple ways of learning, being, and speaking; (2) consolidate appropriate interventions aimed at reducing depressive symptoms that have the potential to negatively impact academic performance existing in L2 sociocultural contexts