Incidental Lymphoplasmacytic Lymphoma Diagnosed Following Robotic-Assisted Laparoscopic Prostatectomy for Prostate Cancer

© 2019 The Author(s). This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission.We report a case of prostatic lymphoma of the Walden-ström's macroglobulinemia subtype in a 64-year-old gentleman who underwent a robotic-assisted laparoscopic prostatectomy following lower urinary tract symptoms and high grade adenocarcinoma on transperineal prostate biopsy's. Histopathological and immunohistochemistry analysis at the time of surgery was consistent with a CD5-negative small B-cell lymphoma. To our knowledge this is the first reported prostatic lymphoma identified following robotic-assisted laparoscopic prostatectomy and the first documented case of lymphoplasmacytic lymphoma involving prostate. Lymphoma of the prostate is an uncommon entity in surgical practice and their diagnosis often poses considerable difficulty as they often mimic carcinoma. We discuss this rare diagnosis and review the literature for current considerations and prognosis.Peer reviewedFinal Published versio

Association between obstructive sleep apnea (OSA) and depression and the effect of continuous positive airway pressure (CPAP) treatment

Amr Makram El-Sherbini1, Adel Salah Bediwy2, Ashraf El-Mitwalli31Department of Psychiatry, Elminia University Hospital, Faculty of Medicine, Elminia, 2Chest Department, Faculty of Medicine, Tanta University, 3Department of Neurology, Mansoura School of Medicine, University of Mansoura, Mansoura, EgyptBackground: Obstructive sleep apnea (OSA) is a relatively common disorder which has a negative impact on the psychological well-being of affected individuals.Objective: To assess the association between OSA and depression as well as the effect of treatment with continuous positive airway pressure (CPAP).Methods: A total of 37 newly diagnosed individuals with OSA underwent an overnight polysomnography and were assessed using the Epworth Sleepiness Scale (ESS), the Hamilton Depression Rating Scale (HDRS), and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Patients were assessed before and after 2 months of CPAP use.Results: Of the 37 patients included in the study, 21 (56.7%) had clinically relevant depression as indicated by a score >10 on the HDRS and eleven patients (29.7%) met the diagnostic criteria for a major depressive episode using the Structured Clinical Interview. Scores on the HDRS were correlated with the Apnea Hypoxia Index, ESS scores, and oxygen saturation. Patients showed a significant reduction in depressive symptoms and improvement in ESS scores after CPAP treatment.Conclusion: Patients with OSA should be screened carefully for depressive disorders. CPAP should be tried first before starting other treatment modalities for depression.Keywords: obstructive sleep apnea, depression in OSA, CPAP and depressio

Outcome and prognosis of middle cerebral artery occlusive disease in a sample of egyptian patients: A prospective hospital-based study

Background and purpose:  Changes of the flow velocities of transcranial color coded duplex ultrasound (TCCD) in symptomatic middle cerebral artery (MCA) occlusive disease may be related to the occurrence of further vascular events after stroke. The objective of this study was to investigate the outcome and the prognosis of the MCA occlusive disease. Methods:  Initial TCCD was done to detect MCA stenosis or occlusion in patients with MCA territory infarction. We repeated TCCD examinations 3 months later and recorded any TIA, cerebral stroke or acute coronary syndrome events during this period. The changes of MCA flow velocities were categorized as normalized, regressive, persistent and progressive groups, according to the changes of MCA velocities at 3 months. Results: We studied 31 patients with MCA territory infarction classified according to the initial TCCD results into normal MCA flow velocity group (15 patients), and abnormal MCA flow velocity group (16 patients). Eleven patients of the abnormal MCA group were re-evaluated by TCCD after 3 months as 5 patients died within the 3 months of the follow up. Two patients (18.2%) were normalized, 4 patients (36.4%) had persistent degree of stenosis, and 5 patients (45.5%) showed regression. The number of clinical events showed significant difference (p=0.037) between the normal and abnormal MCA groups. Only 1 patient (6.7%) of the normal MCA group had further cerebral stroke, while 7 patients (43.8%) of the abnormal MCA group suffered of further cerebral stroke. Conclusions:  Symptomatic MCA stenosis is associated with higher risk of recurrent cerebral stroke.   French title: Resultats et pronostic de la maladie occlusive de l'artere cerebrale moyenne chez un echantillon de patients Egyptiens. Étude prospective en milieu hospitalier Introduction:  Les variations des vitesses d'écoulement au Doppler transcrânien (DT) dans la maladie occlusive de l'artère cérébrale moyenne (ACM) symptomatique peuvent être liées à la survenue d'autres événements vasculaires après un AVC. L'objectif de cette étude était d'étudier le résultat et le pronostic de la maladie occlusive de l’ACM. Méthodes:  Le DT initial a été réalisé pour détecter la sténose ou l'occlusion de l’ACM chez les patients atteints d'infarctus du territoire de l’ACM Nous avons répété les examens DT 3 mois plus tard et enregistré tout AIT, accident vasculaire cérébral ou syndrome coronarien aigu au cours de cette période. Les changements des vitesses d'écoulement de l’ACM ont été classés en groupes normalisés, régressifs, persistants et progressifs, selon les changements des vitesses de l’ACM à 3 mois. Résultats:  Nous avons étudié 31 patients atteints d'infarctus du territoire de l’ACM classés selon les résultats initiaux du DT dans le groupe de vitesse d'écoulement de l’ACM normale (15 patients) et le groupe de vitesse d'écoulement de l’ACM anormale (16 patients). Onze patients du groupe ACM anormal ont été réévalués par DT après 3 mois car 5 patients sont décédés dans les 3 mois de suivi. Deux patients (18,2%) ont été normalisés, 4 patients (36,4%) avaient un degré de sténose persistant et 5 patients (45,5%) ont présenté une régression. Le nombre d'événements cliniques a montré une différence significative (p = 0,037) entre les groupes ACM normaux et anormaux. Seul 1 patient (6,7%) du groupe MCA normal a eu un autre AVC, tandis que 7 patients (43,8%) du groupe ACM anormal ont souffert d'un autre AVC. Conclusions:  La sténose symptomatique de l'ACM est associée à un risque plus élevé de récidive d’AVC

Non-Communicable Disease Risk Factors among Employees and Their Families of a Saudi University: An Epidemiological Study

Objectives:To assess the prevalence of non-communicable disease (NCD) risk factors among Saudi university employees and their families; to estimate the cardiovascular risk (CVR) amongst the study population in the following 10years. Methods:The NCD risk factors prevalence was estimated using a cross-sectional approach for a sample of employees and their families aged ≥ 18 years old, in a Saudi university (Riyadh in Kingdom of Saudi Arabia; KSA). WHO STEPwise standardized tools were used to estimate NCD risk factors and the Framingham Coronary Heart Risk Score calculator was used to calculate the CVR. Results:Five thousand and two hundred subjects were invited, of whom 4,500 participated in the study, providing a response rate of 87%. The mean age of participants was 39.3±13.4 years. The majority of participants reported low fruit/vegetables consumption (88%), and physically inactive (77%). More than two thirds of the cohort was found to be either overweight or obese (72%), where 36% were obese, and 59% had abdominal obesity. Of the total cohort, 22–37% were found to suffer from dyslipidaemia, 22% either diabetes or hypertension, with rather low reported current tobacco use (12%). One quarter of participants was estimated to have >10% risk to develop cardiovascular disease within the following 10-years. Conclusion:The prevalence of NCD risk factors was found to be substantially high among the university employees and their families in this study

Therapeutic approach to FSGS in children

Therapy of primary focal segmental glomerulosclerosis (FSGS) in children incorporates conservative management and immunosuppression regimens to control proteinuria and preserve kidney function. In long-term cohort studies in adults and children with primary FSGS, renal survival has been directly associated with degree of proteinuria control. This educational article reviews the current therapeutic approach toward children with primary FSGS

African Linguistics in Central and Eastern Europe, and in the Nordic Countries

Non peer reviewe