Pattern of histopathological lesions in lung autopsy

Background: A large number of pathologic conditions involve the lung parenchyma like inflammatory, neoplastic and others. The lungs are also involved in almost all terminal events of cardiovascular disease. Autopsy is an important and most useful way to find out the condition of internal organs and to evaluate any localized lesions or systemic disease and hence determine cause of death. Aims and objectives of study are to identify the histopathological spectrum of lung disease. To find out frequency of various lung pathologies in respect to age and sex.Methods: This study was retrospective and done on 649 cases of medico legal autopsies. The tissue specimens were fixed and processed. Routine paraffin sectioning was done followed by Hematoxylene and eosin (H and E) staining. Special stains were done whenever required. Relevant clinical and postmortem findings, gross and microscopic examination findings were recorded.Results: After thorough histopathological examinations, of total 649 cases, various pulmonary lesions were identified in 348(53.6%) cases while in 301(46.4%) cases no significant pathology was seen. Most commonly affected age group was 30-49 years 43.1% followed by age group of >60years 17.8%. Majority of diseased were male 285 (81.9%). Most common lung pathology found was Edema and congestion in 93 cases (26.72%), chronic venous congestion in 92 cases (26.44%) pneumonia in 65 cases (18.68%) followed by Tuberculosis/Tuberculous pneumonia in 29 cases (8.3%).Conclusions: In our population, the present study reveals that infectious disease are still the most common cause of mortality, despite recent advances in diagnostic technology, the autopsy has remained an important complementary tool for identifying and understanding pathology of disease.

Evaluation of peripheral lymphadenopathy by fine needle aspiration cytology: a one year study at tertiary centre

Background: Lymphadenopathy is common presenting features in various non-neoplastic and neoplastic lesions. Fine needle aspiration cytology (FNAC) is simple, quick, inexpensive and minimally invasive technique that can be used as an outpatient procedure to diagnose them. The present study was undertaken to assess the various causes of lymphadenopathy through FNAC, and to see the distribution of lesions with respect to age and gender. To assess the diagnostic accuracy of lymph node fine needle aspiration (FNA) cytology in various non-neoplastic and neoplastic conditions.Methods: Total 555 cases of the lymph node FNAC were studied from January 2014 to December 2014 in Cytopathology department of Government Medical College, Surat .The cytomorphologic features seen in the aspirates were analyzed and correlated with their etiology.Results: In this study 555 cases of cervical lymphadenopathy were analysed. The age of the patients ranged from 5 months to 90 years of which 60.2% were males and 39.8% were females. Maximum numbers of cases 147(26.4%) were in the age group of 21- 30 years. The most common lesion encountered was tuberculous lymphadenitis 44.8% followed by metastatic tumors 31.3%, reactive lymph node 16.7%, acute lymphadenitis 5.4% and lymphoma 1.8%. Male showed predominance of metastatic carcinoma and lymphoma while chronic reactive hyperplasia and tuberculous lymphadenitis were equally distributed in both male & female.Conclusions: FNAC is safe, rapid and cost effective method in establishing the diagnosis in large number of cases of lymphadenopathy. It can differentiate a neoplastic from a non-neoplastic process and therefore influence patient management preventing patient from being subjected to unnecessary surgery

Autophagy gene haploinsufficiency drives chromosome instability, increases migration, and promotes early ovarian tumors.

Autophagy, particularly with BECN1, has paradoxically been highlighted as tumor promoting in Ras-driven cancers, but potentially tumor suppressing in breast and ovarian cancers. However, studying the specific role of BECN1 at the genetic level is complicated due to its genomic proximity to BRCA1 on both human (chromosome 17) and murine (chromosome 11) genomes. In human breast and ovarian cancers, the monoallelic deletion of these genes is often co-occurring. To investigate the potential tumor suppressor roles of two of the most commonly deleted autophagy genes in ovarian cancer, BECN1 and MAP1LC3B were knocked-down in atypical (BECN1+/+ and MAP1LC3B+/+) ovarian cancer cells. Ultra-performance liquid chromatography mass-spectrometry metabolomics revealed reduced levels of acetyl-CoA which corresponded with elevated levels of glycerophospholipids and sphingolipids. Migration rates of ovarian cancer cells were increased upon autophagy gene knockdown. Genomic instability was increased, resulting in copy-number alteration patterns which mimicked high grade serous ovarian cancer. We further investigated the causal role of Becn1 haploinsufficiency for oncogenesis in a MISIIR SV40 large T antigen driven spontaneous ovarian cancer mouse model. Tumors were evident earlier among the Becn1+/- mice, and this correlated with an increase in copy-number alterations per chromosome in the Becn1+/- tumors. The results support monoallelic loss of BECN1 as permissive for tumor initiation and potentiating for genomic instability in ovarian cancer

A small-molecule PI3Kα activator for cardioprotection and neuroregeneration

Harnessing the potential beneficial effects of kinase signalling through the generation of direct kinase activators remains an underexplored area of drug development1,2,3,4,5. This also applies to the PI3K signalling pathway, which has been extensively targeted by inhibitors for conditions with PI3K overactivation, such as cancer and immune dysregulation. Here we report the discovery of UCL-TRO-1938 (referred to as 1938 hereon), a small-molecule activator of the PI3Kα isoform, a crucial effector of growth factor signalling. 1938 allosterically activates PI3Kα through a distinct mechanism by enhancing multiple steps of the PI3Kα catalytic cycle and causes both local and global conformational changes in the PI3Kα structure. This compound is selective for PI3Kα over other PI3K isoforms and multiple protein and lipid kinases. It transiently activates PI3K signalling in all rodent and human cells tested, resulting in cellular responses such as proliferation and neurite outgrowth. In rodent models, acute treatment with 1938 provides cardioprotection from ischaemia–reperfusion injury and, after local administration, enhances nerve regeneration following nerve crush. This study identifies a chemical tool to directly probe the PI3Kα signalling pathway and a new approach to modulate PI3K activity, widening the therapeutic potential of targeting these enzymes through short-term activation for tissue protection and regeneration. Our findings illustrate the potential of activating kinases for therapeutic benefit, a currently largely untapped area of drug development

Laboratory-Confirmed COVID-19 Among Adults Hospitalized with COVID-19–Like Illness with Infection-Induced or mRNA Vaccine-Induced SARS-CoV-2 Immunity — Nine States, January–September 2021

What is already known about this topic? Previous infection with SARS-CoV-2 or COVID-19 vaccination can provide immunity and protection against subsequent SARS-CoV-2 infection and illness. What is added by this report? Among COVID-19–like illness hospitalizations among adults aged ≥18 years whose previous infection or vaccination occurred 90–179 days earlier, the adjusted odds of laboratory-confirmed COVID-19 among unvaccinated adults with previous SARS-CoV-2 infection were 5.49-fold higher than the odds among fully vaccinated recipients of an mRNA COVID-19 vaccine who had no previous documented infection (95% confidence interval = 2.75–10.99). What are the implications for public health practice? All eligible persons should be vaccinated against COVID-19 as soon as possible, including unvaccinated persons previously infected with SARS-CoV-2

Effectiveness of 2-Dose Vaccination with mRNA COVID-19 Vaccines Against COVID-19–Associated Hospitalizations Among Immunocompromised Adults — Nine States, January–September 2021

What is already known about this topic? Studies suggest that immunocompromised persons who receive COVID-19 vaccination might not develop high neutralizing antibody titers or be as protected against severe COVID-19 outcomes as are immunocompetent persons. What is added by this report? Effectiveness of mRNA vaccination against laboratory-confirmed COVID-19–associated hospitalization was lower (77%) among immunocompromised adults than among immunocompetent adults (90%). Vaccine effectiveness varied considerably among immunocompromised patient subgroups. What are the implications for public health practice? Immunocompromised persons benefit from COVID-19 mRNA vaccination but are less protected from severe COVID-19 outcomes than are immunocompetent persons. Immunocompromised persons receiving mRNA COVID-19 vaccines should receive 3 doses and a booster, consistent with CDC recommendations, practice nonpharmaceutical interventions, and, if infected, be monitored closely and considered early for proven therapies that can prevent severe outcomes

Pattern of histopathological lesions in lung autopsy

Background: A large number of pathologic conditions involve the lung parenchyma like inflammatory, neoplastic and others. The lungs are also involved in almost all terminal events of cardiovascular disease. Autopsy is an important and most useful way to find out the condition of internal organs and to evaluate any localized lesions or systemic disease and hence determine cause of death. Aims and objectives of study are to identify the histopathological spectrum of lung disease. To find out frequency of various lung pathologies in respect to age and sex.Methods: This study was retrospective and done on 649 cases of medico legal autopsies. The tissue specimens were fixed and processed. Routine paraffin sectioning was done followed by Hematoxylene and eosin (H and E) staining. Special stains were done whenever required. Relevant clinical and postmortem findings, gross and microscopic examination findings were recorded.Results: After thorough histopathological examinations, of total 649 cases, various pulmonary lesions were identified in 348(53.6%) cases while in 301(46.4%) cases no significant pathology was seen. Most commonly affected age group was 30-49 years 43.1% followed by age group of >60years 17.8%. Majority of diseased were male 285 (81.9%). Most common lung pathology found was Edema and congestion in 93 cases (26.72%), chronic venous congestion in 92 cases (26.44%) pneumonia in 65 cases (18.68%) followed by Tuberculosis/Tuberculous pneumonia in 29 cases (8.3%).Conclusions: In our population, the present study reveals that infectious disease are still the most common cause of mortality, despite recent advances in diagnostic technology, the autopsy has remained an important complementary tool for identifying and understanding pathology of disease.

Evaluation of peripheral lymphadenopathy by fine needle aspiration cytology: a one year study at tertiary centre

Background: Lymphadenopathy is common presenting features in various non-neoplastic and neoplastic lesions. Fine needle aspiration cytology (FNAC) is simple, quick, inexpensive and minimally invasive technique that can be used as an outpatient procedure to diagnose them. The present study was undertaken to assess the various causes of lymphadenopathy through FNAC, and to see the distribution of lesions with respect to age and gender. To assess the diagnostic accuracy of lymph node fine needle aspiration (FNA) cytology in various non-neoplastic and neoplastic conditions.Methods: Total 555 cases of the lymph node FNAC were studied from January 2014 to December 2014 in Cytopathology department of Government Medical College, Surat .The cytomorphologic features seen in the aspirates were analyzed and correlated with their etiology.Results: In this study 555 cases of cervical lymphadenopathy were analysed. The age of the patients ranged from 5 months to 90 years of which 60.2% were males and 39.8% were females. Maximum numbers of cases 147(26.4%) were in the age group of 21- 30 years. The most common lesion encountered was tuberculous lymphadenitis 44.8% followed by metastatic tumors 31.3%, reactive lymph node 16.7%, acute lymphadenitis 5.4% and lymphoma 1.8%. Male showed predominance of metastatic carcinoma and lymphoma while chronic reactive hyperplasia and tuberculous lymphadenitis were equally distributed in both male & female.Conclusions: FNAC is safe, rapid and cost effective method in establishing the diagnosis in large number of cases of lymphadenopathy. It can differentiate a neoplastic from a non-neoplastic process and therefore influence patient management preventing patient from being subjected to unnecessary surgery

Study of obstetric and perinatal outcome of twin pregnancy

Background: Multifetal pregnancy constitutes a significant portion of high-risk pregnancies. This is due to the increasing obstetric and perinatal morbidity and mortality rates associated with it. Maternal and perinatal outcome of twin pregnancies has been evaluated in this study.Methods: Total 30 patients with twin pregnancy and having gestational age more than 28 weeks were included in this observational study.Results: Incidence of twins in the study was found to be 2%. Twin pregnancies were more common in multiparous women aged between 20 and 30 years. Most common foetal presentation was vertex- vertex presentation. Most common maternal complication was preterm labour seen in 67% women, followed by anaemia seen in 50% women. Most of the women were delivered by caesarean section (63.3%). Most common perinatal complication was birth hypoxia (41.6%). Other perinatal complications were jaundice, septicemia, intrauterine growth restriction. 71% of the neonates had birth weight less than 2.5 kg. Perinatal mortality was found to be 11.6%.Conclusions: Twin pregnancies are high risk pregnancies associated with higher obstetric and perinatal morbidity. Perinatal morbidity was more common for the second coming twin. Regular antenatal visits, planned delivery and better NICU facilities can help combat these complications. A team of skilled obstetricians and pediatricians along with a multidisciplinary approach is essential for the effective management of twin pregnancies