Recurrent malignant solitary fibrous tumor of the scalp: a case report and literature review

Solitary fibrous tumor (SFT) is a rare type of mesenchymal neoplasm that first was discovered in the pleura but can also affect the peritoneum, lungs, mediastinum, and skin. Cutaneous malignant SFT is an extremely rare tumor that resembles dermatofibrosacoma protuberance (DFSP) histologically and immunohistochemically. Herein, we describe a case of malignant SFT that presented as a recurrent mass on the scalp. The first lesion was totally excised one year before recurrence and was diagnosed as a DFSP based on the histopathology and cluster of differentiation 34 immunostaining positivity. Re-examination of the previously examined specimen was considered. Activator of transcription 6 positivity was also detected in the tissue, confirming the diagnosis of a recurrent malignant SFT rather than DFSP. There was no evidence of recurrence, locoregional, or distant metastases at six months after lesion removal with a safety margin.

The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study / 소아과

BACKGROUND: Ventilator dependency constitutes a major problem in the intensive care setting. Malnutrition is considered a major determinant of extubation failure, however, attention has been attracted to modulating carbon dioxide production through decreasing carbohydrate loading and increasing the percent of fat in enteral feeds. The detected interrelation between substrate oxidation and ventilation outcome became the base of several research to determine the appropriate composition of the nonprotein calories of diet in ventilated patients. PURPOSE: We aimed to assess the effect of high-fat dietary modification and nutritional status on ventilatory and final outcomes of pediatric intensive care. METHODS: Fifty-one ventilated children (1 month to 12 years of age) with pulmonary disease who could be enterally fed, in the Cairo University Pediatric intensive care unit, were divided into 2 groups: group A included 25 patients who received isocaloric high-fat, low-carbohydrate diet; group B included 26 patients who received standard isocaloric diet. Comprehensive nutritional assessment was done for all patients. RESULTS: Group A had a significant reduction in carbon dioxide tension, but no similar reduction in the duration or level of ventilatory support. Assisted minute ventilation was predicted by weight-for-age and caloric intake rather than the type of diet. Poor nutritional status was associated with higher mortality and lower extubation rates. Mild hypertriglyceridemia and some gastrointestinal intolerance were significant in group A, with no impact on the adequacy of energy or protein delivery. CONCLUSION: The high-fat enteral feeding protocol may contribute to reducing carbon dioxide tension, with mild hypertriglyceridemia and negligible gastrointestinal intolerance as potential adverse effects. Optimization of nutritional status rather than dietary modification may improve ventilatory and survival outcomes in critically ill-ventilated children.

Role of pet/ct in assessment of colorectal carcinoma

Background: colorectal cancer is the second most common cause of cancer in women [9.2% of diagnoses] and the third most common in men [10.0%], it is the fourth most common cause of cancer death after lung, stomach, and liver cancer

Aim of the Work: the goal of this study was to elucidate the role of 18F-FDG PETCT in evaluation of colorectal cancer

Patients and Methods: twenty five patients with histopathologically proven colorectal primary malignancy were evaluated for suspected local recurrence and metastasis. No age predilection and both sexes were included, clinical history, image follow-up, tumor markers, and pathological reports were reviewed for gold standard

Results: the final diagnosis of distant metastasis and/or local recurrence in post-therapeutic cancer colon was evident in 70% of our patient population with PET/CT sensitivity of 95.6%, specificity of 91.4%, [NPV] of 88.9%, [PPV] of 96.7%, and diagnostic efficacy of 94.4% and CT sensitivity of 62.6%, specificity of 48.6, [NPV] of 33.3% [PPV] of 76.0%, and diagnostic efficacy of 58%

Conclusion: PET/CT is a better method to evaluate post-therapeutic colorectal cancer patients

Prognostic significance of hepatic veins waveforms study by doppler ultrasonography in cirrhotic patients with portal hypertension

Doppler Ultrasonographic [U/S] waveform changes in the hepatic veins can be found in chronic parenchymal liver disease, especially in the late stages. In this prospective study, 150 Egyptian bilharzial cirrhotic patients with portal hypertension but without hepatocellular carcinoma [HCC] in addition to 20 age and sex matched apparently healthy control were studied. Diagnosis was confirmed with liver biopsy in 121 patients [those with prolonged prothrombin time 3 seconds more than control and platelet count less than 90000 per mm were excluded]. Doppler wave form patterns in patients were classified into 4 types: [I, II, III and IV], while we found that all the control group was of type I Doppler waveform Prognostic value of the hepatic veins waveforms together with clinical and biochemical parameters were evaluated with their relation to the outcome of our patients. Out of 150 of our patients 112 were male and 38 were females, their ages ranged between 29-65 years [with mean +/- SD = 47.08 +/- 7.70 years]. All were experienced variceal bleeding. Most of the patients [130] were HCV positive. By the end of the follow up period [18 months] 23 [15:3%] patients have died, all due to liver cell failure. A univariate analysis that followed by a multivariate one showed that flat Doppler waveform [type IV] changes in the right hepatic vein with the following characteristics of patients [rebleeding varices, presence of encephalopathy, increase s.billrubin and decrease prothrombin%] were independently related to survival. Doppler U/S study [which is a non-invasive maneuver] of the right hepatic vein has improved the prognostic accuracy in patients with cirrhosis and portal hypertension. Moreover type IV [flat waveform with fluttering] was associated with bad prognosis and poor survival