Primary Clear Cell Chondrosarcoma of the Spine: A Case Report of a Rare Entity and a Review of the Literature

Chondrosarcoma is the third most common primary malignant bone tumor after osteosarcoma and Ewing's sarcoma. Clear cell chondrosarcoma is a rare subtype variant of chondrosarcoma, most commonly encountered in the proximal part of the femur or humerus. Vertebral involvement is exceedingly rare and shows a predilection for the thoracic spine. We report the case of a woman with clear cell chondrosarcoma of the thoracic spine, which has been surgically excised, and review the pertinent literature (PubMed). Although it has a reasonably benign biological behavior, clear cell chondrosarcoma needs to be treated as a malignancy. The best treatment for spinal chondrosarcoma is surgery. It should be promptly and adequately resected. Gross-total resection should be the ultimate surgical goal. Radiation therapy should also be considered, especially in the case of subtotal resection or inoperable lesions. In conclusion, it is important to keep in mind this entity in the differential diagnosis of spinal tumors, in order to optimize treatment planning. With adequate treatment, local recurrence rates as low as 20% can be achieved

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Case Report Primary Clear Cell Chondrosarcoma of the Spine: A Case Report of a Rare Entity and a Review of the Literature

Chondrosarcoma is the third most common primary malignant bone tumor after osteosarcoma and Ewing's sarcoma. Clear cell chondrosarcoma is a rare subtype variant of chondrosarcoma, most commonly encountered in the proximal part of the femur or humerus. Vertebral involvement is exceedingly rare and shows a predilection for the thoracic spine. We report the case of a woman with clear cell chondrosarcoma of the thoracic spine, which has been surgically excised, and review the pertinent literature (PubMed). Although it has a reasonably benign biological behavior, clear cell chondrosarcoma needs to be treated as a malignancy. The best treatment for spinal chondrosarcoma is surgery. It should be promptly and adequately resected. Gross-total resection should be the ultimate surgical goal. Radiation therapy should also be considered, especially in the case of subtotal resection or inoperable lesions. In conclusion, it is important to keep in mind this entity in the differential diagnosis of spinal tumors, in order to optimize treatment planning. With adequate treatment, local recurrence rates as low as 20% can be achieved

Systemic inflammatory response after laparoscopic and conventional colectomy for cancer: a matched case-control study

Studies dealing with laparoscopic colectomy for cancer have reached conflicting results in regards to various inflammatory cytokines. Most of them have not examined potential differences with the open procedures at later postoperative days, when the immunologic advantage of laparoscopic surgery would be more demanding to demonstrate (for earlier administration of adjuvant treatment). The aim of this work is to detect differences of proinflammatory cytokines between conventional and laparoscopic colectomy for cancer. 30 patients who underwent laparoscopic colectomy were age, sex, and preoperative stage-matched with 30 patients treated by open surgery. C-reactive protein (CRP), interleukin (IL)-1, -6, and -8, and interferon (IFN)-gamma serum levels were measured preoperatively, at 24 h, and at the 7th postoperative day (POD). CRP and IL-6 postoperative values (24 h and 7th POD) were significantly higher than baseline for both groups (p = 0.001), but the respective values at the 7th POD were less than at 24 h (p = 0.001). IL-1 and -8 levels did not show any differences between assessment timepoints. A higher IFN-gamma measurement was demonstrated at 24 h compared with baseline for the laparoscopic group only (p = 0.03). This difference was not maintained at the 7th POD. IFN-gamma levels at 24 h and the 7th POD were significantly less for the open compared with the laparoscopic group of patients (p = 0.001). No correlation was revealed between measured serum values and age, sex, tumor location, or stage. This matched case-control study verifies the already reported lack of differences regarding IL-1. Controversy still exists on likely IL-6 differences. The inadequately studied IL-8 does not seem to play an important role in immunologic differences. The immunologically beneficial IFN-gamma, produced by the principal effectors of cell-mediated immunity Th1 cells, seems to have a more active presence following laparoscopic colectomy, potentially contributing to an immunologic “advantage” by counteracting “harmful” cytokines, such as IL-1

An Integrated Toolbox for the Engagement of Citizens in the Monitoring of Water Ecosystems

The monitoring of water ecosystems requires consistent and accurate sensor measurements, usually provided from traditional in-situ environmental monitoring systems. Such infrastructure, however, is expensive, hard to maintain and available only in limited areas that had been affected by extreme phenomena and require continuous monitoring. Due to climate change, the monitoring of larger areas and extended water ecosystems is imperative, raising the question of whether this monitoring can be disengaged from the in-situ monitoring systems. Due to climate change and extreme weather phenomena, more citizens are affected by environmental issues and become aware of the need to contribute to their monitoring. As a result, they are willing to offer their time to support the collection of scientific data. Collecting such data from volunteers, with no technical knowledge and while using low-cost equipment such as smart phones and portable sensors, raises the question of data quality and consistency. We present here a novel integrated toolbox that can support the organization of crowd-sourcing activities, ensure the engagement of the participants, the data collection in a consistent way, enforce extensive data quality controls and provide to local authorities and scientists access to the collected information in a uniform way, through widely accepted standards

Targeting Both Autophagy and Immunotherapy in Breast Cancer Treatment

As clinical efforts towards breast-conserving therapy and prolonging survival of those with metastatic breast cancer increase, innovative approaches with the use of biologics are on the rise. Two areas of current focus are cancer immunotherapy and autophagy, both of which have been well-studied independently but have recently been shown to have intertwining roles in cancer. An increased understanding of their interactions could provide new insights that result in novel diagnostic, prognostic, and therapeutic strategies. In this breast cancer-focused review, we explore the interactions between autophagy and two clinically relevant immune checkpoint pathways; the programmed cell death-1 receptor with its ligand (PD-L1)/PD-1 and the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4)/CD80 and CD86 (B7-1 and B7-2). Furthermore, we discuss emerging preclinical and clinical data supporting targeting both immunotherapy and autophagy pathway manipulation as a promising approach in the treatment of breast cancer

Raw Data TRAIL.xlsx

Cp raw data from real time RT-PCR experiments are included in this excel file<br

Standardized Delineation of Endocardial Boundaries in Three-Dimensional Left Ventricular Echocardiograms

International audienceBackground: Three-dimensional (3D) echocardiography is fundamental for left ventricular (LV) assessment. The aim of this study was to determine discrepancies in 3D LV endocardial tracings and suggest tracing guidance.Methods: Forty-five 3D LV echocardiographic data sets were traced by three experienced operators, from different centers, according to predefined guidelines. The 3D meshes were compared with one another, and the endocardial areas of discrepancies were identified. A discussion and retracing protocol was used to reduce discrepancies. For each data set, an average 3D mesh was produced (reference mesh). Subsequently, four novice operators, divided into two groups, traced 20 of the data sets. Two operators followed the tracing protocol and two did not.Results: The intraclass correlation coefficients among the three experienced operators for end-diastolic volume, end-systolic volume, and ejection fraction were 0.952, 0.955, and 0.932. The absolute distances between tracings were 1.11 ± 0.45 mm. The highest tracing discrepancies were at the apical cap and anterior and anterolateral walls in end-diastole and end-systole and also at the basal anteroseptum in end-systole. Agreement with the reference meshes was better for the novice operators who followed the guidance (10.9 ± 17.3 mL, 10.2 ± 14.7 mL, and −2.2 ± 4.1% for end-diastolic volume, end-systolic volume, and ejection fraction) compared with those who did not (16.3 ± 16.4 mL, 17.0 ± 16.0 mL, and −4.2 ± 4.1%, respectively).Conclusions: Comparing 3D LV tracings, the endocardial areas that are the most difficult to delineate were identified. The suggested protocol for LV tracing resulted in very good agreement among operators. The reference 3D meshes are available for online testing and ranking of LV tracing algorithms

Alterations of the 70 kDa heat shock protein (HSP70) and sequestosome-1 (p62) in women with breast cancer

Peripheral blood mononuclear cells (PBMCs) respond to altered physiological conditions to alleviate the threat. Production of the 70 kDa heat shock protein (HSP70) is up-regulated to protect proteins from degradation. Sequestosome-1 (p62) binds to altered proteins and the p62-protein complex is degraded by autophagy. P62 is also a regulator of intracellular kinase activity and cell differentiation. We hypothesized that the PBMC response to a malignant breast mass involves elevated production of HSP70 and a decrease in intracellular p62. In this study 46 women had their breast mass excised. PBMCs were isolated and intracellular levels of HSP70 and p62 were quantitated by ELISA. Differences between women with a benign or malignant breast mass were determined. A breast malignancy was diagnosed in 38 women (82.6%) while 8 had a benign lesion. Mean intracellular HSP70 levels were 79.3 ng/ml in PBMCs from women with a malignant lesion as opposed to 44.2 ng/ml in controls (p = 0.04). The mean PBMC p62 level was 2.3 ng/ml in women with a benign breast lesion as opposed to 0.6 ng/ml in those with breast cancer (p &lt; 0.001). Mean p62 levels were lowest in women with invasive carcinoma and a positive lymph node biopsy when compared to those with in-situ carcinoma or absence of lymphadenopathy, respectively. Intracellular HSP70 and p62 levels in PBMCs differ between women with a malignant or benign breast lesion. These measurements may be of value in the preoperative triage of women with a breast mass