Melanoma of anal canal

Melanomas are primarily tumours of the skin, but rarely occur at other sites like retina and anal canal. Anorectal melanoma is an uncommon condition associated with a very poor prognosis. The patient usually presents with per rectal bleed or mass. These are often misdiagnosed on presentation. Diagnosis is confirmed by biopsy. Treatment is abdominoperineal resection or wide local excision if tumour free margins can be obtained. We present a case of a 60 years old female who presented to the outpatient department with per rectal mass and bleed since 4 to 5 months and was diagnosed with melanoma anal canal on biopsy. CT scan abdomen and pelvis was done. Patient underwent abdominoperineal resection as wide local excision with sphincter saving was not possible due to the location and extent of tumour as seen on CT scan. Patient had an uneventful recovery after the procedure.

Rectal cancer and chemoradiation in Iraq: systematic review and meta-analysis / Câncer retal e quimiorradioterapia no Iraque: revisão sistemática e metanálise

Abstract Background: Rectal cancer is one of the most common malignant tumors of gastrointestinal tract. Combining chemotherapy with radiotherapy has a sound effect on its management. Objectives: Assessment the patterns of characterizations of rectal cancer. Evaluation of the efficacy, and long-term survival of pre-/ postoperative chemoradiation. Collecting all eligible evidence articles and summarize the results. Methods: By this systematic review and meta-analysis study, we include data of chemoradiation of rectal cancer articles from 2015 until 2019. The research was carried out at Baghdad Medical City oncology centers. Accordance with the PRISMA guidelines, and the Newcastle-Ottawa Scale used. Results: Starting with gender distribution as M:F ratio of 0.94:1.06. Regarding the age, recorded mean ± SD of 48.7 ± 14.2 years. Rectosigmoid represented the most common site as 50(49.5%), and adenocarcinoma was common histopathology as 76(75.2%) of patients, with localized stage in 50(49.5%). The moderate differentiation was most grade as 65(64.4%). The distant from anal verge mostly seen was 5-10 cm in 59(58.4%). The pulmonary was commonest site of metastasis in 11(10.9%). Most patients undergo APR operation, which has done in 41(40.6%). Adjuvant chemoradiation received by 40(39.6%) patients, whereas neoadjuvant chemoradiation gave to 25 patients. A total of 2609 articles from 12 databases met our search strategies. The highest Newcastle-Ottawa score (8) demonstrated in three studies, and median score (7) calculated in five studies. Conclusions: The incidence belonged to 5th and 6th decade of life. Rectosigmoid represented the most common site. Mostly, the 5-10 cm distant of tumor from anal verge was common finding. The pulmonary was most site of metastasis. We concluded the formulation of a novel point that survival benefit found in many pre or postoperative chemoradiation trials in rectal cancer.

Resumo Introdução: O câncer retal é um dos tumores malignos mais comuns do trato gastrointestinal. A combinação de quimioterapia e radioterapia em seu tratamento é eficaz. Objetivos: Avaliar os padrões de caracterização do câncer retal. Avaliar a eficácia e sobrevida a longo prazo em pacientes submetidos a quimiorradioterapia pré- ou pós-operatória. Coletar todos os artigos de evidências qualificados e resumir os resultados. Métodos: Esta revisão sistemática e metanálise incluiu dados de ensaios clínicos randomizados por cluster de 2015 até 2019. A pesquisa foi realizada nos centros de oncologia do Baghdad Medical City. As diretrizes PRISMA e a escala de Newcastle-Ottawa foram utilizadas para avaliar os estudos. Resultados: Quanto à distribuição por sexo, observou-se uma relação homem:mulher de 0,94:1,06. Em relação à idade, a média ± DP foi de 48,7 ± 14,2 anos. O retossigmoide fpo o local mais comum em 50 pacientes (49,5%); a histopatologia mais comum foi adenocarcinoma, observada em 76 pacientes (75,2%), com estágio localizado em 50 (49,5%). Diferenciação moderada foi observada em 65 pacientes (64,4%). A distância da borda anal variou entre 5 e 10 cm em 59 pacientes (58,4%). O pulmão foi o local mais comum de metástase, sendo observado em 11 pacientes (10,9%). A maioria dos pacientes (41 [40,6%]) foi submetida à ressecção abdominoperineal. Um total de 40 pacientes (39,6%) foram submetidos a quimiorradioterapia adjuvante e 25, a quimiorradioterapia neoadjuvante. Na revisão da literatura, foram encontrados 2.609 artigos que atendiam aos critérios de pesquisa utilizados em 12 bancos de dados. Três estudos atingiram o escore máximo na escala de Newcastle-Ottawa (8); cinco estudos atingiram o escore mediano (7). Conclusões: No presente estudo, a maior incidência de câncer retal foi observada entre a quinta e sexta décadas de vida. O retossigmoide foi o sítio tumoral mais comum. A maioria dos tumores estava localizado entre 5 a 10 cm de distância da margem anal. O pulmão foi o local mais importante de metástase. No presente estudo, quimiorradioterapia pré- ou pós-operatória estava relacionada a uma maior sobrevida em casos de câncer retal.

The expression of apoptosis associated protein 3 and nuclear factor 3 of activated T-cell in the tissue of epithelial ovarian tumors and its correlation with clinicopathological features / 中国基层医药

Objective To investigate the expressions of apoptosis associated protein 3 (APR3) and nuclear factor 3 of activated T-cell (NFAT3) in the tissue of epithelial ovarian tumors and its correlation with the clinicopathological features.Methods 92 patients with epithelial ovarian tumor were collected,23 cases with malignant tumor,24 cases with borderline tumor,45 cases with benign tumor.The expressions of APR3 and NFAT3 were detected by immunohistochemical methods,and the differences of different types of epithelial ovarian tumor were compared.The correlation of the expressions of APR3 and NFAT3 with the clinicopathological features of epithelial ovarian tumor was analyzed.The correlation of the expressions of APR3 with the expressions of NFAT3 in epithelial ovarian tumor was analyzed.Results The positive expression rate of APR3 in patients with malignant epithelial ovarian tumors (78.26％) was significantly higher than borderline tumors (41.67 ％) and benign tumors (22.22 ％),the differences were statistically significant (x2 =5.864,7.632,all P ＜ 0.05).The expression of APR3 in patients with malignant epithelial ovarian tumors was significantly correlated with differentiation,clinical stage,lymph node and abdominal organs metastasis and ascites (x2 =7.425,7.262,8.421,5.031,all P ＜ 0.05).The positive expression rate of NFAT3 in patients with malignant epithelial ovarian tumors (56.52％) was significantly higher than borderline tumors (29.17％) and benign tumors(17.78％),the differences were statistically significant (x2 =6.829,7.547,all P ＜0.05).The expression of NFAT3 in patients with malignant epithelial ovarian tumors was significantly correlated with differentiation,clinical stage,lymph node and abdominal organs metastasis (x2 =5.253,6.367,8.021,all P ＜ 0.05).The expressions of APR3 and NFAT3 in patients with malignant epithelial ovarian tumors were positively correlated (r =0.032,P ＜ 0.05).Conclusion The expressions of APR3 and NFAT3 in the tissue of malignant epithelial ovarian tumor obviously increase,are significantly correlated with differentiation,clinical stage,lymph node and abdominal organs metastasis and are positively correlated,and it may be correlated with the development and progression of malignant epithelial ovarian tumor.

Anti-Influenza Activity of Betulinic Acid from Zizyphus jujuba on Influenza A/PR/8 Virus

Betulinic acid, a pentacyclic triterpene isolated from Jujube tree (Zizyphus jujuba Mill), has been known for a wide range of biological and medicinal properties such as antibacterial, antimalarial, anti-inflammatory, antihelmintic, antinociceptive, and anticancer activities. In the study, we investigated the antiviral activity on influenza A/PR/8 virus infected A549 human lung adenocarcinoma epithelial cell line and C57BL/6 mice. Betulinic acid showed the anti-influenza viral activity at a concentration of 50 muM without a significant cytotoxicity in influenza A/PR/8 virus infected A549 cells. Also, betulinic acid significantly attenuated pulmonary pathology including increased necrosis, numbers of inflammatory cells and pulmonary edema induced by influenza A/PR/8 virus infection compared with vehicle- or oseltamivir-treated mice in vivo model. The down-regulation of IFN-gamma level, which is critical for innate and adaptive immunity in viral infection, after treating of betulinic acid in mouse lung. Based on the obtained results, it is suggested that betulinic acid can be the potential therapeutic agent for virus infection via anti-inflammatory activity.

Nutrition Support Methods in Elderly Patients

Nutrition support methods in the elderly is not easy, but similar as young adult. Elderly patients are at increased risk of partial or complete loss of independence due to acute and/or chronic disease and often of concomitant protein caloric malnutrition. The type of artificial nutrition to use will depend on the current illness and the previous health record. Because enteral feeding is less expensive and aggressive, enteral feeding should be used whenever possible, leaving parenteral nutrition for specific situations where enteral feeding should not be used.

Significance of Acute Phase Reactants (APR) Score for the Early Detection of Neonatal Bacterial Infection

PURPOSE: We performed acute phase reactants (APR) test to evaluate as an appropriate screening test for the early detection of neonatal bacterial infection. METHODS: We selected 174 neonates and divided into two groups; sepsis group and well-baby group. We performed APR test. RESULTS: There are no significant difference in total leukocyte count, immature to mature rentrophil ratio, toxic granules, and platelet count between two groups. Number over two and one point of APR score in group I were significantly high compared to group II. Over two point and one point of APR score in neonatal infection had sensitivity of 58.7% and 92.3%, respectively the specificity of 95.7% and 70.0%, respectively Twenty-four cases of three point and 37 cases of two point of APR score were proved neonatal sepsis. Twenty-eight cases of over two point of APR score were positive in blood culture. CONCLUSION: APR score could be regarded as an useful test method for early detection of neonatal bacterial infection.

Predictive Values of APR Test for Neonatal Infection

PURPOSE: The study has been done to evaluate the significance of APR test predictive of neonatal infection. METHODS: A study was made on 76 cases of clinically infeected neonates who had been admitted at the NICU of Chungnam National Unoversity Hospital during the period from January, 1996 to July, 1996 in order to know the significance of APR test predictive of neonatal infection. RESULTS: 1)The APR test Of Control group (20 cases) shows negative results on 19 cases (95%) and positive result on 1 case (5%). 2) The APR test of Patient group (76 cases) shows negative results on 17 cases (22.3%) and positive results on 49 cases (77.7%). Of cases with positive result, one points were on 23 cases (30.5%), two points were 25 cases (32.8%), three points were on 11 cases (14.4%) and More than one point were of 59 cases. The sensitivity of APR test, WBC count and CRP is 77.7%, 35% and 62.496, respectivitly. As above result, APR test has a high sensitivity. 3) APR positive values are not significantly different between those of premature and fullterm patients. 4) APR values are more significant than WBC count or CRP value to predict the neonatal infection. 5) The APR test is rnore useful for prognostic correlation than other index. CONCLUSION: APR test is very sensitive and significantly useful predictive of neonatal infection.

Predictive Factors and Its Usefulness in Early Diagnosis of Neonatal Sepsis

PURPOSE: Early diagnosis of neonatal sepsis is very difficult because of no specific clinical and laboratory findings. It also takes at least 48 hours of incubation period to isolate the organism by culture study. So several laboratory tests have been evaluated for their usefulness in rapid detection of the neonatal sepsis. Those are evaluated either singly or in combination with a defined scoring system include leukocyte count with differential count, platelet count, C-reactive protein level, erythrocyte sedimentation rate, haptoglobin level, fibronectin level, leukocyte alkaline phosphatase and so on. But no single test or combination with others has proved superior to the leukocyte count and differential count as a reliable indirect indicator of neonatal bacterial infection. We performed this study to determine the appropriate screening test for early detection of neonatal sepsis. METHODS: During the period of May 1991 through April 1997, we selected 200 neonates who were admitted to the neonatal intensive care unit of Kon-Kuk University Medical Center Seoul Hospital. All of the cases were retrospectively evaluated and divided two groups; sepsis group-88 neonates who were confirmed by blood cultures, and control group-112 neonates who had no evidence of neonatal bacterial infection. RESULTS: The results were as follows; 1) The sex ratio of male to female was 1.5:1 in the sepsis group and showed significant difference between two groups (P or = 24hrs) (14.5%) meconiurn staining (6.8%), asphyxia (Apgar score 0.05). The acute phase reactants (APR) score above two (37/88) and positive C-reactive protein (51/88) in the sepsis group were regarded as significantly high compared to the control group. 5) In the cases with APR score above two including positive C-reactive protein and abnormal total leukocyte count, sensitivity was 17.0%, specificity 97.3% positive predictive predictive value 83.3%, and negative predictive value 60.0%. CONCLUSIONS: The higher frequency of neonatal sepsis was proved in the cases of APR score above two including positive C-reactive protein. In the cases with abnormal total leukocyte count and APR score above two including positive C-resctive protein, the specificity was 97.3% and the positive predictive value was 83.8%. So APR score above two including positive C-reactive protein and abnormal total leukocyte count could be regarded as an useful test method for early detection of neonatal sepsis.

Clinical application of APR score in the detection of neonatal infections; comparison of fullterm and premature

No abstract available.

The diagnostic significance of APR score in early detection of neonatal bacterial infection

No abstract available.