116 research outputs found
Primary pleuropulmonary synovial sarcoma with brain metastases in a paediatric patient: an unusual presentation
Primary lung neoplasms are rare in children. The most common primary lung malignancies in children are pleuropulmonary blastoma and carcinoid tumour. Synovial sarcoma (SS) accounts for approximately 1% of all childhood malignancies. In absolute terms, the SS of the lungs and pleura are extremely rare and pose a diagnostic difficulty. Soft tissue sarcomas usually have a high potential for metastases, however, metastasis to the brain is rare, even in widely disseminated disease, and it has been described only in 3 case reports previously. Primary pleuropulmonary SS with brain metastases is even rarer. Here we present a case of an 11-year-old boy who presented with respiratory complaints, viz. fever and cough for 20 days. Initial impression was lung abscess, however, on histopathological, immunohistochemical and molecular study, the disorder was diagnosed as synovial sarcoma. After a week from the first consult, the child developed neurological symptoms, viz., an episode of convulsion and gradually worsening power of the lower limb. Computed tomography scan and Magnetic Resonance Spectroscopy was suggestive of brain metastases. Given the rarity of primary lung neoplasms in children, clinical detection remains a challenge. Delayed diagnoses are common as respiratory symptoms may be attributed to inflammatory or infective processes. Primary pleuropulmonary synovial sarcoma is a rare tumour and it is not known to commonly metastasise to the brain. Though rare, primary pleuropulmonary SS should be considered an important differential among peadiatric primary lung neoplasms due to its potential for curability if detected early, and more aggressive metastatic pattern, e.g. brain metastases making early detection imperative.
Prospective cross sectional study on anatomical variation with special emphasis on critical anatomical landmark in patients undergoing multi detector computed tomography of paranasal sinuse
Introduction: Paranasal sinuses are best evaluated by multi-detector computed tomography. Evaluation of sphenoid sinus pneumatization, lamina papyracea, onodi cell, cribriform plate, types of optic canal and supraorbital pneumatisation are useful for evaluation of the surgical anatomy of paranasal sinuses for the radiologist which guides the surgeon to take a correct approach for surgery without major complications of crucial structures. CT is recently used as a investigation of choice in the assessment of the paranasal sinuses and surrounding structures.
Aims and Objective: To study the types of anatomical variation of paranasal sinuses and osteomeatal complex and clinical importance of these various of paranasal sinus on pre-operative computed tomography.
Materials and Methods: Over a period of 18 months, 104 patients referred for CT scan of PNS region G.K.General hospital were evaluated for the presence of normal variants of the paranasal region. Unenhanced CT of the PNS was performed for these patients in the coronal plane, complemented by axial views in selected cases.
Results: Out of 109 patients who fulfilled inclusion criteria were studied from that most common is type II cribriform plate found in 80.7% of patients, Presence of haller cells was noted in 11.01% of individuals. Most of the uncinate process was attached to lamina papyracea in 88.9% individuals. Onodi cell was identified among 41% patients. Depending on the pneumatization of the sphenoid sinus, type I course of optic nerve was most common. Sellar variety of sphenoid sinus was more common observed in 82.5% patients. Presence of supraorbital pneumatization was identified in 72.4% patients among total subjects.
Conclusion: The presence of anatomical variants does not indicate a predisposition to sinus pathology but these variations may predispose patients to increased risk of intraoperative complication
Knowledge of and Attitudes Toward Clinical Depression Among Health Providers in Gujarat, India
Background: Clinical depression is a major leading cause of morbidity and mortality but it is oftentimes overlooked and undertreated. The negative perception and lack of understanding of this condition prevents millions of people from seeking appropriate and on-time medical help, leading to distress and increased burden for affected people and their families. The implementation of public education campaigns and training of non-psychiatric health professionals on mental health and clinical depression has been neglected in several countries, including India, which is the second most populous country in the world with a population of more than 1.2 billion people, almost one-fifth of the world's population. Objective: This study sought to explore the knowledge and attitudes toward the diagnosis and treatment of clinical depression in nonpsychiatric health care providers in Vadodara, Gujarat, India. Methods: A cross-sectional survey was conducted over a 4-week period In Gujarat, India among resident physicians and community health workers about their knowledge and views on clinical depression. Findings: We found considerable stigma and misinformation about depression especially among health care workers in India. Most of the community health workers had a great deal of difficulty when defining clinical depression, and a large majority said that they never heard about depression or its definition and although the overwhelming majority of respondents did not believe that clinical depression results from a punishment from God (82% disagreed or strongly disagreed with this belief) or evil spirits (77.5%), a much smaller proportion disagreed with the assertions that depression was either solely due to difficult circumstances (38.2%) or that sufferers only had themselves to blame (47.2%). Meanwhile, only 32.6% disagreed with the position that clinical depression is a sign of weakness and 39.4% disagreed with the statement that suicide was a sign of weakness. Conclusions: Our findings underscore the considerable public health priority facing India’s policymakers and planners to better educate more non-psychiatric physicians and community health workers to identify, understand, and respond to early signs of mental illnesses, especially clinical depression
Sol-gel synthesis, characterization of ZnO thin films on different substrates, and bandgap calculation by the Tauc plot method
The sol-gel spin coating method was used for the preparation of the Zinc Oxide which was coated over polymer, transparent, and glass translucent substrates and characterized with the help of a UV-Vis Spectroscope. The wavelength bandgap of those samples was found to be 296nm, 310.5nm, and 330nm respectively. The actual band gap of ZnO is 388nm. Similarly, their optical bandgap energy calculated by the Tauc Plot method were 3.641eV, 3.385eV, and 3.495 eV respectively. The transparent polymer slide has the lowest wavelength bandgap and the translucent glass slide has the highest. Further, the bandgap’s value differs from its actual value to the difference in the absorption process due to the presence of the substrate. These results suggest that the choice of substrate can significantly impact the optical properties and performance of the zinc oxide thin film. This result can be applied in developing and optimizing zinc oxide thin films for various purposes, such as in solar cells, sensors, and optoelectronics. By carefully selecting the substrate, it may be possible to tailor the bandgap energy and other optical properties of the thin film to better suit the specific application
Sol-gel synthesis, characterization of ZnO thin films on different substrates, and bandgap calculation by the Tauc plot method
The sol-gel spin coating method was used for the preparation of the Zinc Oxide which was coated over polymer, transparent, and glass translucent substrates and characterized with the help of a UV-Vis Spectroscope. The wavelength bandgap of those samples was found to be 296nm, 310.5nm, and 330nm respectively. The actual band gap of ZnO is 388nm. Similarly, their optical bandgap energy calculated by the Tauc Plot method were 3.641eV, 3.385eV, and 3.495 eV respectively. The transparent polymer slide has the lowest wavelength bandgap and the translucent glass slide has the highest. Further, the bandgap’s value differs from its actual value to the difference in the absorption process due to the presence of the substrate. These results suggest that the choice of substrate can significantly impact the optical properties and performance of the zinc oxide thin film. This result can be applied in developing and optimizing zinc oxide thin films for various purposes, such as in solar cells, sensors, and optoelectronics. By carefully selecting the substrate, it may be possible to tailor the bandgap energy and other optical properties of the thin film to better suit the specific application
Pierwotny maziówczak opłucnej i płuca z przerzutami do mózgu u dziecka: nietypowe objawy
Pierwotny nowotwór płuc rzadko występuje u dzieci. Najczęściej spotykane pierwotne złośliwe nowotwory płuc u dzieci to blastoma opłucnej i płuc oraz rakowiak. Maziówczak stanowi około 1% wszystkich nowotworów złośliwych występujących u dzieci. Maziówczak opłucnej i płuca jest zjawiskiem rzadkim i trudnym do rozpoznania. Mięsaki tkanek miękkich zazwyczaj posiadają dużą skłonność do przerzutów, jednak przerzuty do mózgu występują sporadycznie, nawet w zaawansowanych postaciach rozsianej choroby. Taki przebieg choroby został przedstawiony zaledwie w 3 opisach przypadków. Pierwotny maziówczak opłucnej i płuc z przerzutami do mózgu jest jeszcze rzadziej spotykany. W niniejszej pracy przedstawiono przypadek 11-letniego chłopca, u którego pojawiły się gorączka i trwający od 20 dni kaszel. Początkowo sądzono, że przyczyną jest ropień płuc, lecz po wykonaniu badań histopatologicznego, immunohistochemicznego i molekularnego rozpoznano maziówczaka. Po upływie tygodnia od pierwszej wizyty u dziecka pojawiły się objawy neurologiczne, tj. drgawki i stopniowo postępujące osłabienie siły kończyny dolnej. Wyniki tomografii komputerowej i rezonansu magnetycznego wskazywały na istnienie przerzutów do mózgu. Biorąc pod uwagę rzadkość występowania nowotworów płuc u dzieci, rozpoznanie kliniczne choroby pozostaje prawdziwym wyzwaniem. Często zdarza się, że rozpoznanie jest opóźnione, ponieważ objawy ze strony układu oddechowego mogą być przypisywane stanom zapalnym lub chorobom zakaźnym. Pierwotny maziówczak płuc i opłucnej występuje rzadko i sporadycznie wywołuje przerzuty do mózgu. Powinien być jednak brany pod uwagę przy rozpoznaniu różnicowym pierwotnych nowotworów płuc u dzieci, ponieważ przy wczesnym rozpoznaniu może być uleczalny, zaś w przypadku agresywnego przebiegu z przerzutami na przykład do mózgu, wczesne rozpoznanie jest szczególnie ważne.Pierwotny nowotwór płuc rzadko występuje u dzieci. Najczęściej spotykane pierwotne złośliwe nowotwory płuc u dzieci to blastoma opłucnej i płuc oraz rakowiak. Maziówczak stanowi około 1% wszystkich nowotworów złośliwych występujących u dzieci. Maziówczak opłucnej i płuca jest zjawiskiem rzadkim i trudnym do rozpoznania. Mięsaki tkanek miękkich zazwyczaj posiadają dużą skłonność do przerzutów, jednak przerzuty do mózgu występują sporadycznie, nawet w zaawansowanych postaciach rozsianej choroby. Taki przebieg choroby został przedstawiony zaledwie w 3 opisach przypadków. Pierwotny maziówczak opłucnej i płuc z przerzutami do mózgu jest jeszcze rzadziej spotykany. W niniejszej pracy przedstawiono przypadek 11-letniego chłopca, u którego pojawiły się gorączka i trwający od 20 dni kaszel. Początkowo sądzono, że przyczyną jest ropień płuc, lecz po wykonaniu badań histopatologicznego, immunohistochemicznego i molekularnego rozpoznano maziówczaka. Po upływie tygodnia od pierwszej wizyty u dziecka pojawiły się objawy neurologiczne, tj. drgawki i stopniowo postępujące osłabienie siły kończyny dolnej. Wyniki tomografii komputerowej i rezonansu magnetycznego wskazywały na istnienie przerzutów do mózgu. Biorąc pod uwagę rzadkość występowania nowotworów płuc u dzieci, rozpoznanie kliniczne choroby pozostaje prawdziwym wyzwaniem. Często zdarza się, że rozpoznanie jest opóźnione, ponieważ objawy ze strony układu oddechowego mogą być przypisywane stanom zapalnym lub chorobom zakaźnym. Pierwotny maziówczak płuc i opłucnej występuje rzadko i sporadycznie wywołuje przerzuty do mózgu. Powinien być jednak brany pod uwagę przy rozpoznaniu różnicowym pierwotnych nowotworów płuc u dzieci, ponieważ przy wczesnym rozpoznaniu może być uleczalny, zaś w przypadku agresywnego przebiegu z przerzutami na przykład do mózgu, wczesne rozpoznanie jest szczególnie ważne
Molecular modeling and ADMET predictions of flavonoids as prospective aromatase inhibitors
192-200With the advent of a myriad of treatment possibilities for breast cancer, enzyme inhibition turns out to be the prevailing strategy for inhibiting estrogen biosynthesis. Aromatization of ring A of androstenedione, testosterone and 16-hydroxytestosterone results in increased estrogen level, which embraces the risk for breast cancer. In this present research, we have targeted human placental aromatase complexed with HDDG046 (PDB ID: 4GL7) for its inhibition by several inhibitors of flavonoid derivatives and further screening those molecules for ADMET properties for assessing its credibility for acceptance in successive steps of drug discovery. Novel flavonoid derivative molecules have been designed using Maestro 10.4, based on the literature review. Further, their molecular modeling studies have been performed against the imported target PDB ID: 4GL7 using the GLIDE platform and have been subjected to ADMET assessment using the QikProp and pkCSM program. From all the series exposed to molecular modeling; 2K, 4K, 6K, 8W and 10K molecules have been subjected to ADMET study based on their interaction profile. Successively screening of these molecules led to selection of 8W molecule for further validation by pkCSM. The results obtained have been compared with the reported molecule HDDG046 which presents substantially positive outcomes for 8W in terms of CaCo2 permeability, water solubility, P- glycoprotein; hERG I, II and CYP interactions, hepatotoxicity, LD50 value and so forth. Juxtaposing the results of all the designed molecules under study, we have established that these prospective molecules especially 8W of flavonoid derivatives have the potency to inhibit the target under study, which can be useful in the treatment of breast cancer. This has been estimated based on the in silico approaches performed using Molecular Modeling which utilizes the integral function of Molecular Mechanics and Quantum Mechanics. In addition, the ADMET predictions validate their integrity for being the lead molecules in drug discovery stages in the near future
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A Phase II Basket Trial of Dual Anti-CTLA-4 and Anti-PD-1 Blockade in Rare Tumors (DART SWOG 1609) in Patients with Nonpancreatic Neuroendocrine Tumors.
PurposeImmune checkpoint blockade has improved outcomes across tumor types; little is known about the efficacy of these agents in rare tumors. We report the results of the (nonpancreatic) neuroendocrine neoplasm cohort of SWOG S1609 dual anti-CTLA-4 and anti-PD-1 blockade in rare tumors (DART).Patients and methodsWe performed a prospective, open-label, multicenter phase II clinical trial of ipilimumab plus nivolumab across multiple rare tumor cohorts, with the (nonpancreatic) neuroendocrine cohort reported here. Response assessment by grade was not prespecified. The primary endpoint was overall response rate [ORR; RECIST v1.1; complete response (CR) and partial response (PR)]; secondary endpoints included progression-free survival (PFS), overall survival (OS), stable disease >6 months, and toxicity.ResultsThirty-two eligible patients received therapy; 18 (56%) had high-grade disease. Most common primary sites were gastrointestinal (47%; N = 15) and lung (19%; N = 6). The overall ORR was 25% [95% confidence interval (CI) 13-64%; CR, 3%, N = 1; PR, 22%, N = 7]. Patients with high-grade neuroendocrine carcinoma had an ORR of 44% (8/18 patients) versus 0% in low/intermediate grade tumors (0/14 patients; P = 0.004). The 6-month PFS was 31% (95% CI, 19%-52%); median OS was 11 months (95% CI, 6-∞). The most common toxicities were hypothyroidism (31%), fatigue (28%), and nausea (28%), with alanine aminotransferase elevation (9%) as the most common grade 3/4 immune-related adverse event, and no grade 5 events.ConclusionsIpilimumab plus nivolumab demonstrated a 44% ORR in patients with nonpancreatic high-grade neuroendocrine carcinoma, with 0% ORR in low/intermediate grade disease
The ACT-ONE trial, a multicentre, randomised, double-blind, placebo-controlled, dose-finding study of the anabolic/catabolic transforming agent, MT-102 in subjects with cachexia related to stage III and IV non-small cell lung cancer and colorectal cancer: study design
Aims Cachexia, the wasting disorder associated with a wide
range of serious illnesses including cancer, is a major cause of morbidity and mortality. There is currently no widely approved therapeutic agent for treating or preventing
cancer-associated cachexia. Colorectal cancer and nonsmall
cell lung cancer have relatively high incidences of cachexia, approximately 28% and 34%, respectively.
Neurohormonal overactivity has been implicated in the
genesis and progression of cachexia and beta receptor
antagonism has been proposed as a potential therapy.
MT-102, a novel anabolic/catabolic transforming agent,
has a multi-functional effect upon three potential pharmacological targets in cancer cachexia, namely reduced
catabolism through non-selective β-blockade, reduced
fatigue, and thermogenesis through central 5-HT1a
antagonism and increased anabolism through partial β-2
receptor agonism.
Methods At least 132 male and female patients, aged
between 25 and 80 years with a confirmed diagnosis of
late-stage non-small cell lung cancer or colorectal cancer,
with cachexia will be randomised to either one of the two
MT-102 doses or placebo in a 3:1:2 ratio (MT-102
10 mg BD−1/MT-102 2.5 mg BD/placebo). Patients will
continue on study treatment for maximally 16 weeks. The
primary endpoint, to be analysed by assigned treatment
group, will be body weight change over 16 weeks. For this
endpoint, the study has 85% power (0.05% significance
level) to detect per 4-week period a mean change of −0.8 kg
in the placebo group and 0 kg in the high-dose MT-102
arm. The first patient was randomised in February 2011 and
patient recruitment is expected to continue until mid-2012.
Perspective The ACT-ONE trial is designed to test whether
the anabolic/catabolic transforming agent MT-102 will
positively impact on the rate of change of body weight in
cancer cachexia, thereby evaluating a novel therapeutic
strategy in this hitherto poorly treatable condition. A
separate ACT-TWO trial will recruit patients who complete
the ACT-ONE trial and remain on randomised double-blind
medication. Participants in ACT-TWO will be followed for
an additional period with a separate primary endpoint
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