Review reveals potential predictors of long-term distress after cancer diagnosis

A new review of published studies indicates that distress and neuroticism at or within 3 months of cancer diagnosis may predict emotional distress at least 12 months later. In the Psycho-Oncology analysis, there was no consistent evidence that...

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Larval infestation of chronic ischaemic leg ulcer

Description

Several cases of obligatory wound myiasis have been reported in the medical literature.1–3 For a long time, such infestation was perceived as a complication of poor quality wound care in patients with chronic ulcers. There are only three cases of wound myiasis reported in the literature. Demirel et al reported on a 68-year-old male patient with larvae infestations of diabetic wound that were discovered during surgical debridement.3 Another two cases of traumatic larval infestation associated with Bowen carcinoma and with chronic leg ulcer were reported.3 Up to date, there is no report of chronic ulcer with massive larvae infestation as in this patient.

Figure 1 with video capture (video 1) demonstrates a massive larvae infestation of severe chronic ischaemic ulcer in a 60-year-old homeless male patient with HIV, who presented with unilateral leg pain without systemic or...

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Bilateral haemorrhagic basal ganglia infarction associated with early-onset group B streptococcus meningitis

A 2-day-old infant presented with poor feeding and grunting. Investigations revealed a raised C reactive protein of 164. Full septic screen was done, which subsequently confirmed a diagnosis of group B streptococcus meningitis. Baby was apyrexial and haemodynamically stable. There were no obvious neurological manifestations, and a routine cranial ultrasound scan was done, which revealed echogenic changes in the basal ganglia and thalami. MRI brain showed extensive haemorrhagic infarction within the lentiform and caudate nuclei with involvement of both posterior limbs of the internal capsule. This was followed by triventricular hydrocephalus needing shunt procedure. The clinical course was complicated by infantile spasms, which were treated with vigabatrin and steroids and subsequent global developmental delay and cerebral palsy.

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Hepatic amyloidosis: a cause of rapidly progressive jaundice

Description

An 83-year-old man presented with an acute history of weight loss and jaundice. He had a history of type 2 diabetes mellitus and hypertension. He consumed 30 units of alcohol per week.

The patient was cachectic and jaundiced with non-tender hepatomegaly and no evidence of chronic liver disease. There was evidence of hypoalbuminaemia (albumin 25 g/L, reference 34–51 g/L), hyperbilirubinaemia (bilirubin 188 μmol/L, reference <22 μmol/L) and a raised alkaline phosphatase (629 IU/L, reference 35–105 IU/L). Full blood count, coagulation tests and the remaining liver function tests were normal. An estimated Glomerular filtration rate (eGFR) was 71 mL/min/1.73 m². Autoantibodies and immunoglobulins were normal. Hepatitis viral serology was negative. Serum light chain measurements revealed kappa chain concentration of 13.3 (reference 3.3–19.4 mg/L) and lambda chain concentration of 28.5 (reference 5.7–26.6 mg/L) with a ratio of 0.47 (reference 0.26–1.75). A CT abdomen revealed hepatomegaly and ascites. He subsequently had a liver biopsy (figures 1–3

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Sclerosing microcystic adenocarcinoma of the tongue: a report of two further cases and review of the literature.

Publication date: Available online 9 January 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): A. Wood, B.I. Conn
We present two further cases of sclerosing microcystic adenocarcinoma occurring in the tongue of two female patients; one aged 68 years old and the other 49 years old. Histopathologically, both tumours were characterized by a diffusely infiltrative lesion consisting of small cuboidal cells arranged in discrete, dispersed cords, isolated tubules and bilayered strands with intervening microcystic lumina set in a sclerotic background. Both lesions showed striking neurotopism with perineural and intraneural infiltration. Extensive invasion of adjacent skeletal muscle was also observed. The tumour cells showed diffuse staining with antibodies to CK7. A dual population of ductal and myoepithelial cells was identified, with antibodies to CAM5.2 & CK5/6 decorating the inner epithelial layer and antibodies to p63, p40 and S100 staining the outer myoepithelial cell layer. The Ki-67 proliferation index in both cases was <5%. An initial diagnosis of adenocarcinoma NOS of salivary gland origin was made on both incisional biopsies with a possible metastatic origin, particularly from breast, also raised. A local minor salivary gland origin was confirmed after staging investigations and surgical resection. Both patients were treated by surgery alone and remain well five years and one year and two months post treatment respectively.



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Analysis of the evolution of gross alpha and gross beta activities in airborne samples in Valencia (Spain)

Publication date: March 2018
Source:Journal of Environmental Radioactivity, Volume 183
Author(s): Marina Sáez-Muñoz, María del Carmen Bas, Josefina Ortiz, Sebastián Martorell
Gross alpha (Aα) and gross beta activities (Aβ) were measured weekly in the airborne of the Universitat Politècnica de Valencia campus (in the east of Spain) during the period 2009–2015 (7 years). The geometric mean values of weekly Aα and Aβ were 0.53·10⁻⁴ Bq m⁻³ and 5.77·10⁻⁴ Bq m⁻³, respectively; with an average ratio Aα/Aβ of 0.097. This study highlights the heterogeneity of gross alpha and gross beta activities depending on the different periods of the year. Data show seasonal variations with the highest activity in summer months and the lowest one in winter months. Several atmospheric factors were considered in order to explain this intra-annual variation (wind speed, temperature, relative humidity, precipitations, dust content and prevailing wind directions). Multiple Linear Regression Analysis were performed in order to obtain information on significant atmospheric factors that affect gross α and gross β variability, which could be useful in identifying meteorological or atmospheric changes that could cause deviations in gross α and gross β activity depending on the seasons considered. Models obtained explain more than 60% of variability for global data, and also for winter and spring-autumn months. However, more research is needed to explain gross α and gross β variability in summer months, because the atmospheric factors considered in the MLR explain less than 35% of variability.



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Sclerosing microcystic adenocarcinoma of the tongue: a report of two further cases and review of the literature.

We present two further cases of sclerosing microcystic adenocarcinoma occurring in the tongue of two female patients; one aged 68 years old and the other 49 years old. Histopathologically, both tumours were characterized by a diffusely infiltrative lesion consisting of small cuboidal cells arranged in discrete, dispersed cords, isolated tubules and bilayered strands with intervening microcystic lumina set in a sclerotic background. Both lesions showed striking neurotopism with perineural and intraneural infiltration.

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