Recurrent Villous Adenoma with High-Grade Dysplasia Arising in a Urethral Diverticulum

Villous adenomas of the urinary tract are an uncommon, well-recognized entity, described in different locations. However, the occurrence of this lesion in the female urethral diverticulum is very unusual. We present the first case of a recurrent villous adenoma with high-grade dysplasia unassociated with adenocarcinoma, arising from a urethral diverticulum. A 75-year-old African-American female presented with urethral prolapse complaining of mild voiding difficulty, stress incontinence, and mild spotting of blood. Histological examination revealed a papillary lesion with finger-like processes lined by pseudostratified columnar epithelium with abundant goblet cells. There were focal areas with stratification to the luminal surface and loss of nuclear polarity and atypical mitoses, interpreted as villous adenoma with high-grade dysplasia. The lesion recurred at one year without evidence of malignant transformation. We also present a brief literature review of urothelial villous adenomas

CD163 versus CD68 in tumor associated macrophages of classical hodgkin lymphoma

Classical Hodgkin lymphoma (CHL) is a B-cell lymphoproliferative disorder with a relatively good prognosis. A small but significant percentage of patients, however, will respond poorly to therapy. A recent gene expression profiling study has identified a macrophage signature which has been correlated with primary treatment failure, and immunohistochemical tissue microarray for CD68 was shown to reflect the gene signature as a potentially clinically useful marker to predict adverse prognosis

تجربیات مدیران پرستاری در اپیدمی کووید-19 در یکی از بیمارستان های تهران: یک مطالعه کیفی

Background and Objectives: With the prevalence of Covid-19 and the involvement of many countries, nurses as a large segment of the medical staff on the front lines of the disease, have the most contact with patients and rich resources of experience, while caring for patients from attendance hours. The hospital is until his discharge or death. Accordingly, the purpose of this study was to investigate the experiences of nursing managers at the time of the onset of the Covid-19 epidemic in one of the leading hospitals in the reception and treatment of Covid-19 patients. Methods and Materials: This was a qualitative study with a conventional content analysis method. The study population in this study consisted of nursing managers including head nurses and supervisors who were active in the Covid ward in relation to Covid-19 patients. Results: Data were collected and analyzed from 15 participants, including 12 females and 3 males. The results showed that the challenges that nursing managers, including head nurses and supervisors, presented as the experiences of Covid-19 time include the three main categories of physical and mental issues, health literacy, and barriers to patient service. Conclusion: By properly implementing health measures through access to adequate resources including medical and pharmaceutical equipment, efficient manpower, and financial interactions, the challenges raised in the experiences of nursing managers can be overcome. How to cite this article: Jebelli B, Zarineh S, Varahram M, Esmaili SH, Ghazanchaei E. Experiences of Nursing Managers in the Covid-19 Epidemic in a Tehran Hospital: A Qualitative Study. Irtiqa Imini Pishgiri Masdumiyat. 2022;10(2):97-107.سابقه و هدف:  با شیوع کووید-19 و درگیری بسیاری از کشورها، پرستاران به عنوان قشر بزرگی از کادر درمان در خط مقدم مقابله با این بیماری، بیشترین ارتباط را با بیماران داشته و منابع غنی از تجربیات، در زمان مراقبت از بیماران از ساعات حضور در بیمارستان تا ترخیص و یا مرگ وی می باشند. هدف از این مطالعه بررسی تجربیات مدیران پرستاری در زمان شروع اپیدمی کووید-19 در یکی از بیمارستان های پیشگام در پذیرش و درمان بیماران کووید-19 بود. روش بررسی: مطالعه کیفی با روش تحلیل محتوای قراردادی بود. جامعه مورد مطالعه در این پژوهش از مدیران پرستاری شامل سرپرستاران و سوپروایزران بود که در ارتباط با بیماران کووید-19 مشغول به فعالیت در بخش کووید بودند. نتایج: از طریق جمع آوری و آنالیز داده ها از 15 شرکت کننده شامل 12 زن و 3 مرد انجام گرفت. نتایج نشان داد چالش هایی که مدیران پرستاری شامل سرپرستاران و سوپروایزران به عنوان تجربیات زمان کووید-19 مطرح نمودند شامل سه طبقه اصلی مسایل جسمی روانی، سواد سلامت و موانع ارائه خدمت به بیماران می باشد. نتیجه گیری: با اجرای صحیح اقدامات بهداشتی از طریق دسترسی به منابع کافی شامل تجهیزات پزشکی و دارویی، نیروی انسانی کارآمد و تعاملات مالی می توان بر چالش های مطرح شده در تجریبات مدیران پرستاری فائق آمد. How to cite this article: Jebelli B, Zarineh S, Varahram M, Esmaili SH, Ghazanchaei E. Experiences of Nursing Managers in the Covid-19 Epidemic in a Tehran Hospital: A Qualitative Study. Irtiqa Imini Pishgiri Masdumiyat. 2022;10(2):97-107

Smooth Muscle Tumor Originating in the Pleura: A Case Report and Updated Literature Review

Smooth muscle tumors (SMTs) of the pleura are exceptionally rare. At present and to the best of these authors’ knowledge, there are only 17 cases reported in the literature. We describe a case of a 51-year-old woman who complained of left sided pleuritic chest pain. Further, computed tomography (CT) revealed a left sided localized pleural-based mass involving the 9th rib. She underwent an interventional radiology guided percutaneous core biopsy of the lesion, which disclosed a “Smooth Muscle Tumor of Undetermined Malignant Potential (SMT-UMP).” A video-assisted thoracoscopic surgery (VATS) was performed for diagnosis and treatment purposes. Resections of the pleural-based mass and 9th rib were performed. SMT-UMP was the definitive diagnosis

Idiopathic Hypertrophic Pyloric Stenosis in an Adult, a Potential Mimic of Gastric Carcinoma

Primary or idiopathic hypertrophy of the pyloric muscle (IHPM) is a rare entity with uncertain pathogenesis which both clinically and pathologically mimics gastric cancer. We present a rare late-occurring case of IHPM in a 71-year-old Caucasian man with no apparent predisposing factor. Imaging studies demonstrated gastric distension with air fluid levels and no evidence of extrinsic compression. At upper endoscopy, massive gastric distension and no evidence of any ulcer or other mucosal defects were observed. Microscopically, marked hypertrophy of muscularis mucosa with smooth muscle cells arranged in whorls and fascicles was present which gradually transitioned to normal areas. The muscle fibers stained with smooth muscle actin and trichrome stain highlighted fibrosis between the muscle fibers. Although uncommon, IHPM can clinically and histologically mimic other proliferations in the gastric wall, such as gastrointestinal stromal tumor or a spindle cell neoplasm. The recent advances in understanding the pathogenesis of IHPM are discussed.Peer Reviewe