Integrated Analysis of Clinical and Microbiome Risk Factors Associated with the Development of Oral Candidiasis during Cancer Chemotherapy.

Oral candidiasis is a common side effect of cancer chemotherapy. To better understand predisposing factors, we followed forty-five subjects who received 5-fluorouracil- or doxorubicin-based treatment, during one chemotherapy cycle. Subjects were evaluated at baseline, prior to the first infusion, and at three additional visits within a two-week window. We assessed the demographic, medical and oral health parameters, neutrophil surveillance, and characterized the salivary bacteriome and mycobiome communities through amplicon high throughput sequencing. Twenty percent of all subjects developed oral candidiasis. Using multivariate statistics, we identified smoking, amount of dental plaque, low bacteriome and mycobiome alpha-diversity, and the proportions of specific bacterial and fungal taxa as baseline predictors of oral candidiasis development during the treatment cycle. All subjects who developed oral candidiasis had baseline microbiome communities dominated by Candida and enriched in aciduric bacteria. Longitudinally, oral candidiasis was associated with a decrease in salivary flow prior to lesion development, and occurred simultaneously or before oral mucositis. Candidiasis was also longitudinally associated with a decrease in peripheral neutrophils but increased the neutrophil killing capacity of Candida albicans. Oral candidiasis was not found to be associated with mycobiome structure shifts during the cycle but was the result of an increase in Candida load, with C. albicans and Candida dubliniensis being the most abundant species comprising the salivary mycobiome of the affected subjects. In conclusion, we identified a set of clinical and microbiome baseline factors associated with susceptibility to oral candidiasis, which might be useful tools in identifying at risk individuals, prior to chemotherapy

Radiofrequency ablation of lymphoma

Percutaneous minimally invasive radiofrequency (RF) ablation has not been described for lymphoma. This image-guided modality is presented in 3 different settings for the treatment of refractory lymphoma. The first patient received RF ablation for the curative treatment of a solitary residual hepatic mass following rituximab-based chemotherapy for a posttransplantation lymphoproliferative disorder (PTLD) and is disease-free 4 years later. The second patient received RF ablation for successful palliation of progressive follicular lymphoma adjacent to the bladder wall following chemotherapy and maximum radiation. The third patient received RF ablation for prevention of airway obstruction from progressive diffuse large B-cell lymphoma of the right neck following chemotherapy and maximum radiation. RF ablation may be clinically beneficial and should be considered for the treatment of local lymphoma that is refractory or not amenable to standard approaches

Urethral duct invasion in female urethral melanoma

Primary melanoma of the genitourinary tract represents ≤1% of all melanomas and is a highly aggressive malignancy, usually presenting at an advanced stage. Primary urethral melanomas are often amelanotic, leading to difficulties in early clinical diagnosis and biopsy delays. Herein, we present the clinical follow-up and histopathology of two female patients with microscopic invasion of the urethral ducts, not illustrated by previous reports. This finding, verified by appropriate immunohistochemical markers, can be a useful clue in diagnosing amelanotic melanoma of the genitourinary tract. The pathology reporting for urethral melanoma should include the depth of invasion, mitotic index, the status of resection margins, perineural invasion and lymphatic invasion since they will likely have a bearing on the tumor's biological behavior. Herein, we report two female patients with urethral melanoma exhibiting urethral duct invasion. Moreover, we discuss pertinent histopathological and immunohistochemical features, along with oncogene mutational typing that may aid in confirming the diagnosis and identifying molecular target(s)

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Not AvailableBiofilm formation is an important virulence determinant of Staphylococcus aureus which is a major etiological agent of bovine mastitis. Here, 132 bovine mastitis-associated S. aureus were subjected to biofilm production, antimicrobial susceptibility, and the detection of ica, bap, agr and blaZ genes. It was found that 33.3% of the isolates produced biofilm. The number of isolates resistant to individual antibiotics increased by 1.2- to 7.0-fold when growing in biofilm versus planktonic mode of growth, and the spectrum of antibiotics as well as the number of isolates resistant to various antibiotics increased with the increase in the density of the biofilm. However, there was no correlation between the strength of biofilm and the extent of antibiotic resistance. When evaluated for the presence of genes reported to be associated with biofilm formation, bap gene was detected in a significant number (12.9%) of the isolates.Not Availabl

Genomic characterization of an esthesioneuroblastoma with spinal metastases: illustrative case.

BACKGROUND: Esthesioneuroblastoma (ENB) is a rare neoplasm of the sinonasal tract. Currently, the optimal treatment includes maximal resection combined with radiotherapy and/or chemotherapy. Although ENBs often recur and have an aggressive clinical course, spinal metastases are extremely rare and the underlying molecular mechanisms are poorly understood. OBSERVATIONS: Here, the authors describe a 50-year-old male with an aggressive ENB, initially treated with resection and chemotherapy/radiation, who developed multiple thoracic and lumbar spinal metastases. The authors performed targeted exome sequencing on both the resected primary tumor and biopsied spinal metastases, which revealed 12 total variants of unknown clinical significance in genes associated with the PI3K/AKT/mTOR pathway, chromatin remodeling, DNA repair, and cell proliferation. Six of these variants were restricted to the metastatic lesion and included missense mutations with predicted functional effects in GRM3, DNMT3B, PLCG2, and SPEN. LESSONS: This report discusses the potential impact of these variants on tumor progression and metastasis, as well as the implications for identifying potential new biomarkers and therapies