Bilateral Basal Cell Adenocarcinoma of the Parotid Gland: In a Recipient of Kidney Transplant

We report a rare case of bilateral basal cell adenocarcinoma (BcAC) of the parotid gland in a male patient 30 years after kidney transplantation and continuous administration of immunosuppressive therapy. BcAC is a salivary gland malignancy first recognized as a distinct neoplastic entity in WHO classification of salivary gland tumours in 1991. Over 90% of BcACs are detected in the parotid gland. The most important differential diagnosis is basal cell adenoma. Infiltrative growth is the distinguishing feature of BcAC. Administration of immunosuppressive medication to this patient for three decades may have contributed to development of this rare neoplasia. To our knowledge, similar cases of BcAC have not been reported previously

Increased MIB-1 expression in salivary gland pleomorphic adenoma that recurs and undergoes malignant transformation

Correction: Volume12, Issue1 Article Number10828 DOI: 10.1038/s41598-022-15267-7The objective of this retrospective study was to explore possible changes in histopathological features and expression of cyclin D1 and MIB-1 in salivary gland pleomorphic adenoma (PA) that recur or undergo malignant transformation. Knowledge of these characteristics might help to guide the management of these rare tumors. The histopathology and immunohistochemical staining characteristics of such tumors were analyzed in a cohort of 65 patients constituting three different groups of tumors: PA, recurrent pleomorphic adenoma (RPA) and carcinoma ex PA (CxPA). The RPAs were divided into two subgroups: primary PA that were known to recur later (PA-prim) and recurrent tumors appearing after a primary tumor (PA-rec). RPAs and CxPAs were compared with PAs without recurrence, which served as a control group. In our study, CxPA and PA-rec, but not PA-prim, showed increased MIB-1 expression compared with the control group. Neither cyclin D1 expression nor any histopathological features showed any association in statistical analyses. CxPA showed increased mitotic activity, squamous metaplasia, and nuclear atypia. Tumor multifocality was more frequent in PA-rec and CxPA. The different MIB-1 expression in CxPA and PA-rec in comparison to PA-prim suggests that the changes in expression could develop after the primary tumor.Peer reviewe

The presence of herpesviruses in malignant but not in benign or recurrent pleomorphic adenomas

Peer reviewe

Increased MIB-1 expression in salivary gland pleomorphic adenoma that recurs and undergoes malignant transformation

The objective of this retrospective study was to explore possible changes in histopathological features and expression of cyclin D1 and MIB-1 in salivary gland pleomorphic adenoma (PA) that recur or undergo malignant transformation. Knowledge of these characteristics might help to guide the management of these rare tumors. The histopathology and immunohistochemical staining characteristics of such tumors were analyzed in a cohort of 65 patients constituting three different groups of tumors: PA, recurrent pleomorphic adenoma (RPA) and carcinoma ex PA (CxPA). The RPAs were divided into two subgroups: primary PA that were known to recur later (PA-prim) and recurrent tumors appearing after a primary tumor (PA-rec). RPAs and CxPAs were compared with PAs without recurrence, which served as a control group. In our study, CxPA and PA-rec, but not PA-prim, showed increased MIB-1 expression compared with the control group. Neither cyclin D1 expression nor any histopathological features showed any association in statistical analyses. CxPA showed increased mitotic activity, squamous metaplasia, and nuclear atypia. Tumor multifocality was more frequent in PA-rec and CxPA. The different MIB-1 expression in CxPA and PA-rec in comparison to PA-prim suggests that the changes in expression could develop after the primary tumor

Robottiavusteinen kirurgia nielusyövän hoidossa

HALO-katsaus•Ha­vain­noivien vertai­lu­tut­ki­musten ja klii­nisen koke­muksen perus­teella tran­so­raa­linen robot­ti­ki­rurgia vai­kuttaa lupaa­valta mene­tel­mältä vali­koi­duissa poti­las­ryh­missä, mut­ta tutki­mus­näyttö vaikut­ta­vuu­desta ja turval­li­suu­desta on toistai­seksi puutteel­lista ja heikko­laa­tuista

Prenatal Diagnosis Improves the Postnatal Cardiac Function in a Population-Based Cohort of Infants with Hypoplastic Left Heart Syndrome

Background: Prenatal diagnosis of hypoplastic left heart syndrome (HLHS) enables planning of perinatal care and is known to be associated with more stable preoperative hemodynamics. The impact on postnatal myocardial function is poorly known. The aim of this study was to determine the impact of prenatal diagnosis of HLHS on postnatal myocardial function.Methods: A consecutively encountered cohort of 66 infants with HLHS born between 2003 and 2010 in Finland was retrospectively reviewed. Twenty-five infants had prenatal diagnoses. Postnatal global and segmental right ventricular fractional area change, strain rate, and myocardial velocity were analyzed from the apical four-chamber view using Velocity Vector Imaging. Preoperative hemodynamic status and end-organ damagemeasurements were the lowest arterial pH, highest lactate, alanine aminotransferase, and creatinine. Early mortality was studied until 30 days after Norwood procedure.Results: Prenatally diagnosed infants had better cardiac function (fractional area change, 27.9 &plusmn; 7.4% vs 21.1 &plusmn; 6.3%, P = .0004; strain rate, 1.1 &plusmn; 0.6/1.3 &plusmn; 1.0 vs 0.7 &plusmn; 0.2/0.7 &plusmn; 0.3 1/sec, P = .004/.003; myocardial velocity, 1.6 &plusmn; 0.6/2.0 &plusmn; 1.1 vs 1.3 &plusmn; 0.4/1.4 &plusmn; 0.4 cm/sec, P = .0035/.0009). Mechanical dyssynchrony was similar in both groups (P &gt; .30). Infants diagnosed prenatally had less acidosis (pH = 7.30 vs 7.25, P = .005) and end-organ dysfunction (alanine aminotransferase, 33 &plusmn; 38 vs 139 &plusmn; 174 U/L, P = .0001;creatinine, 78 &plusmn; 18 vs 81 &plusmn; 44 mmol/L, P = .05). No deaths occurred among the prenatally diagnosed infants, but four deaths were recorded among postnatally diagnosed infants (P = .15).Conclusions: A prenatal diagnosis of HLHS is associated with improved postnatal right ventricular function, reduced metabolic acidosis, and end-organ dysfunction. (J Am Soc Echocardiogr 2013;26:1073-9.)Keywords: Hypoplastic left heart syndrome, Prenatal diagnosis, Cardiac function, Velocity Vector Imaging<br /

The presence of herpesviruses in malignant but not in benign or recurrent pleomorphic adenomas

Background: The etiology of salivary gland tumors is mainly unknown. The anatomical location of the salivary glands, with the mucosal pathway to the oral cavity and its rich microbiome, raises the question of potential viral background.Objective: This study focuses on the potential presence of herpes-, polyoma- and parvoviruses in pleomorphic adenoma (PA), recurrent pleomorphic adenoma (RPA) and carcinoma ex pleomorphic adenoma (CaxPA).Methods: Thirty different viruses were analyzed by PCR-based assays in 68 formalin-fixed paraffin-embedded salivary gland tumors (25 PA, 31 RPA and 12 CaxPA).Results: Virus DNA was detected altogether in 19/68 (28%) tumor samples. Human herpesviruses 6B and 7 (HHV-6B and HHV-7) and Epstein-Barr virus (EBV) were frequently and almost exclusively found in CaxPA (5/12, 7/12, and 3/12, respectively). Within the 7 CaxPA that were virus-positive, 3 samples contained 3, and 1 sample even 4, different viruses. Infrequent viral positivity was shown for parvovirus B19 and cutavirus, as well as Merkel cell and Malawi polyomaviruses.Conclusions: Our unexpected finding of herpesvirus DNA almost exclusively in CaxPA tissues deserves further in-depth studies.</p

Huumeiden ja päihdyttävien lääkkeiden käyttäjä sairaanhoitajan vastaanotolla : Ylä-Savon SOTE ky:n ajanvarausvastaanoton sairaanhoitajien kokemuksia tunnistamisesta ja varhaisesta puuttumisesta

Päihteidenkäyttö aiheuttaa runsaasti painetta erilaisten terveydenhuollon palveluiden suuntaan, sillä päihteidenkäyttöön liittyvää hoidontarvetta ilmenee jokaisessa yksikössä sen osaamisalasta riippumatta. Hoitoalan ammattilaisten velvollisuutena on toimia potilasta tai asiakasta tukien ja auttaen havaitessaan päihteidenkäyttöä, sillä päihteiden aiheuttamat haitat niin yksilön kuin yhteiskunnan näkökulmasta ovat mittavat. Puheeksiottaminen on tärkeää, sillä merkittävimpänä päihteidenkäyttöön liittyvänä tiedon lähteenä ja tunnistamisen mahdollistajana on asiakkaan ja hoitajan välille syntyvä luottamuksellinen hoitosuhde sekä sen sisältämä, avoimuuteen perustuva dialogi. Suomalainen päihdekulttuuri on vielä hyvin alkoholikeskeinen ja Suomessa käytetyistä päihteistä yleisin on alkoholi. Tämän vuoksi päivittäisen potilastyöskentelyn myötä alkoholin aiheuttamat vieroitusoireet ja sairastavuus ovat monelle sairaanhoitajalle tuttuja ilmiöitä. Sen sijaan huumausaineiden suhteen saattaa olla, että sairaanhoitaja ei ole vielä kertaakaan työssään kohdannut huumeita käyttävää asiakasta. Tämän opinnäytetyön tarkoituksena on selvittää sairaanhoitajien kokemuksia huumausaineita ja lääkkeitä huumaavassa tarkoituksessa käyttävän asiakkaan tunnistamisesta ja varhaisesta puuttumisesta. Opinnäytetyön tilaajana oli Ylä-Savon SOTE kuntayhtymä. Tutkimuksessa haastateltiin neljää ajanvarausvastaanottotoiminnassa työskentelevää sairaanhoitajaa. Tutkimuksessa kävi ilmi, että epäily asiakkaan päihteiden käytöstä tai päihtymystilasta heräsi käyttäytymisen ja yleisen olemuksen perusteella. Vastaajat kertoivat kohtaavansa huumausaineita käyttävän asiakkaan samalla tavalla, kuin kenet tahansa muunkin vastaanotolle saapuvan. Varhainen puuttuminen koettiin tärkeänä, mutta ajanpuute haasteena. Opinnäytetyössä ilmeni, että täsmätietoa huumeista ja niiden vaikutuksista kaivattiin lisää. Opinnäytetyöstä saatuja tuloksia ei voida hyödyntää valtakunnallisesti, mutta tulosten avulla Ylä-Savon SOTE kuntayhtymä voi pohtia esimerkiksi vastaanottotoiminnan täydennyskoulutuksen suunnittelua huumeidenkäyttöön liittyvän tietoisuuden lisäämiseksi ja varhaisen puuttumisen tehostamiseksi