Diffuse Idiopathic Skeletal Hyperostosis (DISH) and non small cell lung cancer: case presentation and review of the literature

Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier’s disease, is a systemic non inflammatory disease of unknown cause. It is characterized by the presence of osteophytes due to calcification and ossification of spinal ligaments and entheses. Moreover, diffuse idiopathic skeletal hyperostosis has been associated with a variety of metabolic disorders. However, to the best of our knowledge no association with non small cell lung cancer (NSCLC) has been reported so far. In the present study we report a case of a patient with NSCLC and DISH.Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier’s disease, is a systemic non inflammatory disease of unknown cause. It is characterized by the presence of osteophytes due to calcification and ossification of spinal ligaments and entheses. Moreover, diffuse idiopathic skeletal hyperostosis has been associated with a variety of metabolic disorders. However, to the best of our knowledge no association with non small cell lung cancer (NSCLC) has been reported so far. In the present study we report a case of a patient with NSCLC and DISH

Unilateral hypertransparency on chest radiograph: the congenital Poland Syndrome

  Unilateral hypertransparent hemithorax requires a particular diagnostic approach as it can be the result of diverse pulmonary diseases, including pneumothorax, large pulmonary embolus, unilateral large bullae, mucous plag, airway obstruction and contralateral pleural effusion. Congenital syndromes with chest wall abnormalities, are rare, but often underdiagnosed causes. Poland Syndrome consists of such a rare, congenital anomaly and is characterized by the absence of the pectoralis major muscle and upper limb ipsilateral abnormalities. We present a case of a patient with acute exacerbation of chronic obstructive pulmonary disease (COPD) and a unilateral hypertransparency on chest radiology, attributed to the underlying Poland Syndrome.  

Jednostronnie jasne płuco na radiogramie klatki piersiowej — wrodzony zespół Polanda

Zwiększenie przejrzystości jednego płuca wymaga wdrożenia szczególnych procedur diagnostycznych, ponieważ przyczyną takiego stanu może być wiele różnorodnych chorób układu oddechowego, włączając odmę opłucnową, masywny zator płucny, duży jednostronny pęcherz rozedmowy, czop śluzowy, zamknięcie dużego oskrzela oraz płyn w przeciwległej jamie opłucnowej. Wrodzone zaburzenia budowy ściany klatki piersiowej należą do rzadkich, choć często niezdiagnozowanych przyczyn. Zespół Polanda należy do takich rzadkich wrodzonych anomalii i polega na niewykształceniu mięśnia piersiowego większego i nieprawidłowościach budowy kończyny górnej po tej samej stronie. W pracy przedstawiono przypadek chorego z zaostrzeniem przewlekłej obturacyjnej choroby płuc (POChP) i obrazem jednostronnie jasnego płuca na radiogramie klatki piersiowej, spowodowanym zespołem Polanda.Zwiększenie przejrzystości jednego płuca wymaga wdrożenia szczególnych procedur diagnostycznych, ponieważ przyczyną takiego stanu może być wiele różnorodnych chorób układu oddechowego, włączając odmę opłucnową, masywny zator płucny, duży jednostronny pęcherz rozedmowy, czop śluzowy, zamknięcie dużego oskrzela oraz płyn w przeciwległej jamie opłucnowej. Wrodzone zaburzenia budowy ściany klatki piersiowej należą do rzadkich, choć często niezdiagnozowanych przyczyn. Zespół Polanda należy do takich rzadkich wrodzonych anomalii i polega na niewykształceniu mięśnia piersiowego większego i nieprawidłowościach budowy kończyny górnej po tej samej stronie. W pracy przedstawiono przypadek chorego z zaostrzeniem przewlekłej obturacyjnej choroby płuc (POChP) i obrazem jednostronnie jasnego płuca na radiogramie klatki piersiowej, spowodowanym zespołem Polanda

Co-evolution, opportunity seeking and institutional change: Entrepreneurship and the Indian telecommunications industry 1923-2009

"This is an Author's Original Manuscript of an article submitted for consideration in Business History [copyright Taylor & Francis]; Business History is available online at http://www.tandfonline.com/." 10.1080/00076791.2012.687538In this paper, we demonstrate the importance for entrepreneurship of historical contexts and processes, and the co-evolution of institutions, practices, discourses and cultural norms. Drawing on discourse and institutional theories, we develop a model of the entrepreneurial field, and apply this in analysing the rise to global prominence of the Indian telecommunications industry. We draw on entrepreneurial life histories to show how various discourses and discursive processes ultimately worked to generate change and the creation of new business opportunities. We propose that entrepreneurship involves more than individual acts of business creation, but also implies collective endeavours to shape the future direction of the entrepreneurial field

Multilocus variable number of tandem repeat analysis reveals multiple introductions in Spain of Xanthomonas arboricola pv. Pruni, the causal agent of bacterial spot disease of stone fruits and almond

Xanthomonas arboricola pv. pruni is the causal agent of the bacterial spot disease of stone fruits, almond and some ornamental Prunus species. In Spain it was first detected in 2002 and since then, several outbreaks have occurred in different regions affecting mainly Japanese plum, peach and almond, both in commercial orchards and nurseries. As the origin of the introduction(s) was unknown, we have assessed the genetic diversity of 239 X. arboricola pv. pruni strains collected from 11 Spanish provinces from 2002 to 2013 and 25 reference strains from international collections. We have developed an optimized multilocus variable number of tandem repeat analysis (MLVA) scheme targeting 18 microsatellites and five minisatellites. A high discriminatory power was achieved since almost 50% of the Spanish strains were distinguishable, confirming the usefulness of this genotyping technique at small spatio-temporal scales. Spanish strains grouped in 18 genetic clusters (conservatively delineated so that each cluster contained haplotype networks linked by up to quadruple-locus variations). Furthermore, pairwise comparisons among populations from different provinces showed a strong genetic differentiation. Our results suggest multiple introductions of this pathogen in Spain and redistribution through contaminated nursery propagative plant material

Rozsiana samoistna hiperostoza szkieletu (DISH) u chorego na niedrobnokomórkowego raka płuca — opis przypadku i przegląd piśmiennictwa

Rozsiana samoistna hiperostoza szkieletu (DISH), zwana także chorobą Forestiera, jest chorobą ogólnoustrojową, niezapalną, o nieznanej przyczynie. Charakteryzuje się tworzeniem osteofitów na skutek wapnienia i kostnienia więzadeł i przyczepów ścięgnistych. Rozsiana samoistna hiperostoza szkieletu jest ponadto kojarzona z wieloma zaburzeniami metabolicznymi. O ile jednak wiadomo, nie raportowano dotychczas jej związku z niedrobnokomórkowym rakiem płuc (NSCLC). W niniejszej pracy przedstawiono przypadek chorego na NSCLC i DISH.Rozsiana samoistna hiperostoza szkieletu (DISH), zwana także chorobą Forestiera, jest chorobą ogólnoustrojową, niezapalną, o nieznanej przyczynie. Charakteryzuje się tworzeniem osteofitów na skutek wapnienia i kostnienia więzadeł i przyczepów ścięgnistych. Rozsiana samoistna hiperostoza szkieletu jest ponadto kojarzona z wieloma zaburzeniami metabolicznymi. O ile jednak wiadomo, nie raportowano dotychczas jej związku z niedrobnokomórkowym rakiem płuc (NSCLC). W niniejszej pracy przedstawiono przypadek chorego na NSCLC i DISH

Sleep apnea as a comorbidity in obese psoriasis patients: a cross-sectional study. Do psoriasis characteristics and metabolic parameters play a role?

Background Psoriasis is associated with a variety of comorbidities such as obesity and cardiovascular disease. Objective In a cross-sectional study, we explored whether obstructive sleep apnea and hypopnea syndrome (OSAHS) is associated with psoriasis characteristics and metabolic parameters. Methods Thirty-five patients with chronic plaque psoriasis underwent a nocturnal polysomnography study and were analysed for Apnoea-Hypopnoea Index to assess OSAHS severity and Framigham score to predict the absolute risk of coronary artery disease at 10years. The association of OSAHS with psoriasis was examined according to psoriasis characteristics (PASI and DLQI scores, disease duration and previous use of systemic treatments), metabolic parameters (Body Mass Index - BMI, waist to hip ratio - WHR, lipid profile) and other comorbidities (obesity, hypertension, arthritis and cardiovascular disease). Results There was no correlation between psoriasis characteristics and OSAHS. Psoriasis patients with OSAHS presented more frequent snoring and lower sleep quality compared with those without OSAHS. In univariate analyses, OSAHS was associated with increased BMI and hypertension in psoriasis patients. In multivariable logistic regression models, there was statistically significant evidence that only BMI and hypertension were associated with increased risk of OSAHS, adjusting for psoriasis characteristics, age and gender. Presence of metabolic syndrome, WHR, and smoking were not significant risk factors for OSAHS. In subgroup analyses, OSAHS correlated with duration of psoriasis (>8years) in women (P=0.021) and with Framigham score in men (P=0.035). Conclusion OSAHS may be a comorbidity in obese psoriasis patients with hypertension. Treatment with continuous positive airway pressure and weight loss interventions should be initiated

Sputum carcinoembryonic antigen, neuron-specific enolase and cytokeratin fragment 19 levels in lung cancer diagnosis

Objective: The aim of the present study was to examine the impact of sputum carcinoembryonic antigen (CEA), neuron-specific enolase (NSE) and cytokeratin fragment 19 (CYFRA 21-1) levels in lung cancer diagnosis and to compare the diagnostic usefulness of sputum assays with that of serum assays. Methodology: Forty-seven patients with lung cancer and 62 with benign lung disease were studied. Tumour marker levels in sputum (sp.) and serum (ser) were measured by immunoradiometric assays. Results: Sputum and serum tumour marker levels were significantly higher in lung cancer than in benign disease. When the specificity was 95%, the sensitivity was 57%, 43%, 36%, 30%, 28% and 19%, for spCEA, serCYFRA 21-1, spCYFRA 21-1, serCEA, serNSE, and spNSE, respectively. Bayesian analysis showed that the best predictive values correspond to spCEA and serCYFRA 21-1. The maximum overall gain was obtained in pretest probability of 0.35 for both spCEA and serCYFRA 21-1, with predictive values of 84% and 80% for spCEA and serCYFRA 21-1, respectively. Conclusion: Sputum turnout marker levels were no more useful than the serum levels in lung cancer diagnosis. SpCEA offered the best predictive values but these were still not sufficiently satisfactory for spCEA to be proposed for routine use

Pulmonary hemorrhage in patients receiving anti-platelets- a case series and a suggested therapeutic algorithm

Antiplatelet therapy including aspirin and thienopyridine agents (such as clopidogrel, prasugrel and ticagrelor) are often used in patients with coronary disease. Pulmonary hemorrhage due to antiplatelet therapy although very rare, when excessive, is a life-threatening event. So far, there is lack of specific guidelines for the management of these patients. We report a case series of 5 patients receiving antiplatelet therapy who were admitted to the hospital due to pulmonary hemorrhage related to antiplatelet therapy. We also propose an algorithm on the management of these patients taking into consideration the balance between thrombotic and bleeding risk and the severity of the hemorrhage