Downregulation of Caspase 8 in a group of Iranian breast cancer patients – A pilot study

Acknowledgments Author contributions: MA performed related laboratory work, helped with sample collection, analysed the data and drafted the manuscript. ND and FAJ helped with sample collection and laboratory work. ASF and MG confirmed the diagnosis and provided the appropriate specimens. AP conceived and designed the study, supervised the project and edited the manuscript. The authors would like to thank the research council of Mashhad University of Medical Sciences, Mashhad, Iran for the financial support (Grant Number: 940936).Peer reviewedPublisher PD

Depression, anxiety and quality of life in caregiver spouses of veterans with chronic spinal cord injury

Objective: We were curious about the degree of anxiety and depression and their effect on the quality of life of the caregivers of veterans with spinal cord injury (SCI). Methods: A convenience sample of 72 out of 120 caregiver spouses of veterans with spinal cord injury participated in our study. The Hospital Anxiety and Depression Scale (HADS) were considered as a measure of depression and anxiety. The World Health Organization Quality of Life BREF questionnaire (WHOQOL-BREF) was considered to evaluate the quality of life. To compare the caregivers, we enrolled 74 matched caregiver spouses of patients without spinal cord injury. Results: The average age of the spouses was 44.7±6.5. The average time elapsed from the injury was 26.4±3.1 years. There was a significant difference in all domains of quality of life and depression between the caregivers and the control group, but there was not a significant difference in terms of anxiety. There was a negative correlation between depression and age, level of education and quality of life. Conclusion: Mental care support should be implemented for veterans and their spouses in addition to the provided facilities

Quality of life and the related factors in spouses of veterans with chronic spinal cord injury

BACKGROUND: The quality of life (QOL) of caregivers of individuals with chronic spinal cord injuries may be affected by several factors. Moreover, this issue is yet to be documented fully in the literature. The purpose of this study was to evaluate the health related quality of life of spouses who act as primary caregivers of veterans with chronic spinal cord injuries in Iran. METHODS: The study consisted of 72 wives of 72 veterans who were categorized as spinal cord injured patients based on the American Spinal Injury Association (ASIA) classification. Health related quality of life was assessed by the Short Form (SF-36) Health Survey. Pearson's correlation was carried out to find any correlation between demographic variables with SF-36 dimensions. To find the effect of the factors like age, employment status, duration of care giving, education, presence or absence of knee osteoarthritis, and mechanical back pain on different domains of the SF-36 health survey, Multivariate analysis of variance (MANOVA) was used. RESULTS: The mean age of the participants was 44.7 years. According to the ASIA classification 88.9% and 11.1% of the veterans were paraplegic and tetraplegic respectively. Fifty percent of them had a complete injury (ASIA A) and 85% of the spouses were exclusive care givers. All of the SF-36 scores of the spouses were significantly lower than the normal population. Pearson's correlation demonstrated a negative significant correlation between both age and duration of caring with the PF domain. The number of children had a negative correlation with RE and VT. CONCLUSION: The burden of caregiving can impact the QOL of caregivers and cause health problems. These problems can cause limitations for caregiver spouses and it can lead to a decrease in the quality of given care

Perianal Paget’s Disease in a Forty-Five-Year-Old Man and Review of the Literature

Introduction Extramammary Paget’s disease is a rare neoplasm of the skin that might develop in perianal region. Although different management options are available, wide local excision is still the method of choice. Case Presentation A 45-year-old man presented with perianal itchy lesions for one year with no response to local treatments. Perianal Paget’s disease was diagnosed by performing a surgical biopsy. Wide excision and flap reconstruction was done, while loop sigmoid colostomy was performed for fecal diversion. Re-excision of the involved margins was performed during the second operation. Conclusions A good outcome and no recurrence or complications was noticed in a follow-up period of 24 months. It is important to consider this uncommon disease as a probable diagnosis when evaluating a perianal lesion

Factors Affecting Recurrence of Idiopathic Granulomatous Mastitis: A Systematic Review

Idiopathic granulomatous mastitis is a rare and benign disease that primarily affects young women of reproductive age. Various factors have been suggested as possible causes, including pregnancy, breastfeeding, history of taking birth control pills, hyperprolactinemia, smoking, and history of trauma. Due to unknown etiology, opinions on its treatment have varied, resulting in differing recurrence rates and side effects. Therefore, conducting a comprehensive systematic review and meta-analysis can aid in understanding the causes and recurrence of the disease, thereby assisting in the selection of effective treatment and improving the quality of life. A systematic literature review was conducted using predefined search terms to identify eligible studies related to risk factors and recurrence up to June 2022 from electronic databases. Data were extracted and subjected to meta-analysis when applicable. A total of 71 studies with 4735 patients were included. The mean age of the patients was 34.98 years, and the average mass size was 4.64 cm. About 3749 of these patients (79.17%) were Caucasian. Patients who mentioned a history of pregnancy were 92.65% with 76.57%, 22.7%, and 19.7% having a history of breastfeeding, taking contraceptive pills, and high prolactin levels, respectively. Around 5.6% of patients had previous trauma. The overall recurrence rate was 17.18%, with recurrence rates for treatments as follows: surgery (22.5%), immunosuppressive treatment (14.7%), combined treatment (14.9%), antibiotic treatment (6.74%), and observation (9.4%). Only antibiotic and expectant treatments had significant differences in recurrence rates compared to other treatments (p value = 0.023). In conclusion, factors such as Caucasian race, pregnancy and breastfeeding history, and use of contraceptive hormone are commonly associated with the disease recurrence. Treatment should be tailored based on symptom severity and patient preference, with surgery or immunosuppressive options for recurrence

Uterocutaneous Fistula Following Cesarean Section: Successful Management of a Case

A uterocutaneous fistula is a rare clinical presentation that occurs following Cesarean section and other pelvic operations. There are only a few reports discussing the treatments. We describe a patient with successful surgical management and review the literature. A 25-year-old woman referred to our department 13 months after her first Cesarean section. She had a history of an abdominal mass and collection 2 months after surgery and some fistula opening with discharge from her previous incision. She had a previous surgical operation and antibiotic therapy without complete response. We performed fistulography to evaluate the tracts. In the operation — she had fistula tracts, one of which was between the uterus and skin. We debrided the necrotic tissue in the uterus, excised the fistula tracts, and drained the uterine cavity. At 8 months’ postoperative follow-up, she had no recurrence. A uterocutaneous fistula is a rare condition with many causes and needs proper investigation and timely medical and surgical management

Evaluation of The Value of Core Needle Biopsy in The Diagnosis of a Breast Mass

Background: Core needle biopsy (CNB) with histological findings is regarded as one of the most important diagnostic measures that make preoperative assessment and planning for appropriate treatment possible. The aim of this study was to determine the sensitivity and specificity of core biopsy results in our patients with benign and malignant breast lumps, especially for borderline breast lesions, by using a classification method. Methods: In this study, 116 patients who were referred to the Surgery Clinic of Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran with breast lump and underwent diagnostic procedures such as mammography and ultrasound were selected. Core needle biopsy (Tru-cut #14 or 16) was performed. After that, excisional biopsy was done. The benign, malignant and unspecified samples obtained by core needle biopsy were evaluated with the samples of the surgical and pathological findings. Then, false positive, false negative, sensitivity, specificity, and diagnostic accuracy of the core needle biopsy method were calculated. Also, the National Health Service Breast Screening Program (NHSBSP) classification was employed. Results: The mean age of the participants in this study was 39±13.13 years and the mean tumor size was 2.7 cm. An average of 3.35 biopsies was taken from all patients. Most of the pathology samples taken from CNB and excisional biopsy were compatible with invasive ductal carcinoma. Of the B type classifications, B5 was the most frequent in both methods. Borderline lesions B3 and B4 had a change in their category after surgery. About 2.5% of the samples in core biopsy were inadequate. Skin bruising was the most common core biopsy complication reported. While, the most common complication of excisional biopsy was hematoma. Accuracy, sensitivity, specificity, positive and negative predictive values of the core needle biopsy procedure compared with excisional biopsy was 95.5%, 92.6%, 100%, 100%, and 91.8%, respectively. Conclusions: Core needle biopsy has a high sensitivity and specificity with few side effects. Borderline classifications need more evaluation to rule out cancers

Assessment of Ultrasound / Radio-guided Occult Lesion Localization in Non-palpable Breast Lesions

Objective(s): Controversy exists about the localization of non-palpable breast lesions. In many countries, the gold standard for the diagnosis of these lesions is needle localization due to its accuracy. This study sought to compare the ultrasoundand radio-guided occult lesion localization (ROLL) as a simple method with the conventional procedures in terms of their diagnostic power. Methods: This study was conducted on 94 patients with non-palpable breast lesions detected by ultrasonography and localized by the combination of ultrasonography and using radiopharmaceuticals. One to ten hours prior to surgery, 0.1-0.2 ml (equivalent to 0.5-1 mCi) of Tc-99m-phytate was injected to the lesion under the guidance of ultrasonography. Then, the lesion was localized using a hand-held gamma probe, and excision of the lesion was performed according to its radioactivity signal. Data analysis was performed using SPSS, version 16. Results: Benign and malignant pathologic results were observed in 77 (81.9%) and 17(18.1%) of the patients, respectively, and the mean volume of the excised tissue was 26.29±27 mm³. 79 patients had a solitary lesion (84%), 55 in the left breast (58.5%) and 39 in superolateral quadrant (41.5%). The mean size of the lesions was 15.7 mm in diameter (ranging from 4 to 34 mm). Additionally, there was a need to secondary surgery in 3 (3.2%) patients and inappropriate localization in 6 (6.4%) patients (subcutaneous or intra-ductal spread of radiodrug). Conclusion: Combination of ultrasound- and radio-guided localization methods for localizing non-palpable breast lesions is a simple and acceptable method for localization with no significant complications. For radio-drug spread and subsequent excessive excised tissue volume, subcutaneous and intra-ductal lesions are not suitable indication for ROLL

The Role of Nuclear Medicine in The Diagnosis and Management of Solitary Pulmonary Nodules

  Solitary pulmonary nodule (SPN) is a frequent finding on the chest x-ray and computed tomography. Nuclear medicine techniques play an important role in the diagnosis and management of SPN. In the current review, we briefly will explain the different nuclear medicine modalities in this regard including positron emission tomography (PET) using 18-F-FDG, and 11-C-Methionine, and single photon emission computerized tomography (SPECT) using somatostatin receptor scintigraphy, 201-Thallium, and 99m-Tc-MIBI.