Unusual clear cell variant of epithelioid mesothelioma

Clear cell mesothelioma is an extremely rare neoplasm of the pleura, which can easily be mistaken for a metastasis of clear cell carcinoma to the pleura. We report here the histochemical, immunohistochemical, and ultrastructural aspects of a new case of clear cell pleural mesothelioma in a 52-year-old man with no known asbestos exposure. He was admitted to the hospital for recurrent pleural effusion, which was negative for neoplastic cells at the cytologic examination. A partial decortication of the right pleura was performed. The morphologic, immunohistochemical, and ultrastructural features reported for this case are consistent with the diagnosis of clear cell mesothelioma. The differential diagnosis and immunohistochemical features in comparison with other clear cell neoplasms are discussed

Complete intraperitoneal displacement of a double J stent: a first case.

OBJECTIVES: Ureteral double-J stents are known to migrate proximally and distally within the urinary tract, while perforation and stent displacement are uncommon. Possible mechanisms of displacement are either original malpositioning with ureteral perforation or subsequent fistula and erosion of the excretory system, due to infection or long permanence of the device. We present the unique case of complete intraperitoneal stent migration in a 59-year-old caucasian male without evidence of urinary fistula at the moment of diagnosis, so far an unreported complication. MATERIALS AND METHODS: Eight months after the placement of a double-J stent for lower right ureteral stricture at a district hospital, the patient came at our observation for urosepsis and hydro-uretero-nephrosis. A CT scan demonstrated intraperitoneal migration of the stent outside the urinary tract. Cystoscopy failed to visualize the lower extremity of the stent, a percutaneous nephrostomy was placed to drain the urinary system and the stent was removed through a small abdominal incision on the right lower quadrant. RESULTS: In our case we presume that during the positioning manoeuvre the guide wire perforated simultaneously the lower ureteral wall and the pelvic peritoneum, and that once the upper end of the stent was coiled, the lower extremity was also attracted intraperitoneally. The lack of pain due to the spinal lesion concurred to this unusual complication. CONCLUSIONS: We must be aware that ureteral double J stents may be found displaced even inside the peritoneal cavity, and that the use of retrograde pyelography during placement is of paramount importance to exclude misplacement of an apparently normally coiled upper extremity of the stent

CT colonography followed by elective surgery in patients with acute diverticulitis : a radiological-pathological correlation study

Purpose: To perform a radiologic-pathologic correlation analysis of sigmoid colon in patients undergoing pre-operative CT Colonography (CTC) after an episode of acute diverticulitis (AD). Methods: Fifty-nine consecutive patients (31/28 M/F; 58 \ub1 13 years) underwent CTC 55 \ub1 18 days after AD, 8 \ub1 4 weeks before surgery. Thirty-seven patients (63%) underwent conventional abdominal CT at time of AD. An experienced blinded radiologist retrospectively analyzed all images: disease severity was graded according to the Ambrosetti classification on conventional CT and according to the diverticular disease severity score (DDSS) on CTC. A GI pathologist performed a dedicated analysis, evaluating the presence of acute and chronic inflammation, and fibrosis, using 0\u20133 point scale for each variable. Results: Of 59 patients, 41 (69%) had at least one previous AD episode; twenty-six patients (44%) had a complicated AD. DDSS was mild-moderate in 34/59 (58%), and severe in 25/59 (42%). All patients had chronic inflammation, while 90% had low-to-severe fibrosis. Patients with moderate/severe fibrosis were older than those with no/mild fibrosis (61 \ub1 13 versus 54 \ub1 13). We found a significant correlation between DDSS and chronic inflammation (p = 0.004), as well as DDSS and fibrosis (p = 0.005). Furthermore, fibrosis was correlated with complicated acute diverticulitis (p = 0.0.27), and with age (p = 0.067). At multivariate analysis, complicated diverticulitis was the best predictor of fibrosis (odds ratio 4.4). Patient age and DDSS were other independent predictors. Conclusion: DDSS-based assessment on preoperative CTC was a good predictor of chronic colonic inflammation and fibrosis. In addition, the presence of complicated diverticulitis on CT during the acute episode was most predictive of fibrosis

Innovative Interprofessional Collaboration: Addressing the Need for Education for Health Center Workers around Patients\u27 Sexual Orientation and Gender Identity (SOGI)

BACKGROUND: University of Rhode Island (URI) students in a graduate-level course, Interdisciplinary Teamwork in Health and Human Services, collaborated with a local health provider, Wood River Health Services (WRHS), to create training materials for its staff on the topic of sexual orientation/gender identity (SOGI). WRHS is a federally-funded, comprehensive community health center located in a rural area of Rhode Island. It provides medical, dental, and mental health services. WRHS had been advised to enhance its attention to issues related to SOGI. OBJECTIVES The aims for this project were: 1. Assess needs and priorities of WRHS staff around knowledge and attitudes about SOGI and health care; 2. Create a training tool for staf fto enable them to facilitate patient comfort in disclosing SOGI-related information that would assist them in addressing individual needs of patients; 3. Provide students an opportunity to effectively learn and practice interprofessionally. METHODS The students--representing three different health fields (Occupational Therapy, Human Development and Family Studies, and Pharmacy)--researched SOGI issues related to their fields. Students met with WRHS staff to develop a clear understanding of the center’s barriers to adequately provide care to LGBTQ+ patients. They conducted a survey to assess staff attitudes and knowledge about SOGI terminology, health disparities, and the importance of a welcoming environment that informed the development of a training presentation. Staf can complete it at their convenience, and it can be used as part of onboarding new staff. Retrospective pre/post-tests were administered to students and WRHS staff. CONCLUSION Informational presentations are a useful tool for agencies looking to build capacity and comfort among staff around SOGI. Additionally, providing students with opportunities to learn with, from, and about each other is a critical component of health professions education.https://jdc.jefferson.edu/sexandgenderhealth/1020/thumbnail.jp

Plastic changes in the spinal cord in motor neuron disease.

In the present paper, we analyze the cell number within lamina X at the end stage of disease in a G93A mouse model of ALS; the effects induced by lithium; the stem-cell like phenotype of lamina X cells during ALS; the differentiation of these cells towards either a glial or neuronal phenotype. In summary we found that G93A mouse model of ALS produces an increase in lamina X cells which is further augmented by lithium administration. In the absence of lithium these nestin positive stem-like cells preferentially differentiate into glia (GFAP positive), while in the presence of lithium these cells differentiate towards a neuronlike phenotype (III-tubulin, NeuN, and calbindin-D28K positive). These effects of lithium are observed concomitantly with attenuation in disease progression and are reminiscent of neurogenetic effects induced by lithiumin the subependymal ventricular zone of the hippocampus

Suitability of nanoparticles to face benzo(A)pyrene-induced genetic and chromosomal damage in m. galloprovincialis. an in vitro approach

Benzo(a)pyrene (B(a)P) is a well-known genotoxic agent, the removal of which from environmental matrices is mandatory, necessitating the application of cleaning strategies that are harmless to human and environmental health. The potential application of nanoparticles (NPs) in the remediation of polluted environments is of increasing interest. Here, specifically designed NPs were selected as being non-genotoxic and able to interact with B(a)P, in order to address the genetic and chromosomal damage it produces. A newly formulated pure anatase nano-titanium (nano-TiO2), a commercial mixture of rutile and anatase, and carbon black-derived hydrophilic NPs (HNP) were applied. Once it had been ascertained that the NPs selected for the work did not induce genotoxicity, marine mussel gill biopsies were exposed in vitro to B(a)P (2 µg/mL), alone and in combination with the selected NPs (50 µg/mL nano-TiO2, 10 µg/mL HNP). DNA primary reversible damage was evaluated by means of the Comet assay. Chromosomal persistent damage was assessed on the basis of micronuclei frequency and nuclear abnormalities by means of the Micronucleus-Cytome assay. Transmission Electron Microscopy (TEM) was performed to investigate the mechanism of action exerted by NPs. Pure Anatase n-TiO2 was found to be the most suitable for our purpose, as it is cyto-and genotoxicity free and able to reduce the genetic and chromosomal damage associated with exposure to B(a)P

A rare case of transmural endometriosis in primary adenocarcinoma of the rectum

Intestinal endometriosis of the rectum and sigmoid colon, occurring in up to 34% of pelvic endometriosis, mimics a wide number of conditions that are difficult to differentiate from inflammatory or malignant diseases. Herein we report the first case of transmural endometriosis concomitant with advanced primary rectal adenocarcinoma, presenting with obstructive symptoms. Correct diagnosis based on morphological identification and immunohistochemical characterization of the two entities is crucial for treatment