Erratum: Brain tumours in the time of COVID-19: An online survey on patients' disease experience in one Italian region.

[This corrects the article DOI: 10.3389/fonc.2023.1002895.].

Bronchial carcinoid misdiagnosed as COVID pneumonia: a case report.

Bronchial carcinoid tumours are rare, slow-growing, malignant, Low-grade neuroendocrine tumours that arise from Enterochromaffin (Kulchitsky) cells and are usually detected typically as indolent and solitary tumours. Approximately 2% of all lung tumours are bronchial carcinoid tumours. Case presentation: The authors report a case of 55-years-old man who presented with a history of cough for 1 month and was initially diagnosed with a case of COVID-19. Then he was treated as a case of pneumonia as seen on high-resolution computed tomography. Later, contrast-enhanced computed tomography and bronchoscopy-guided biopsy were done which revealed a right lower lobe neuroendocrine tumour (carcinoid), which was successfully resected. Clinical discussion: The majority of typical carcinoids are located in the central airways leading to bronchial obstruction with recurrent pneumonia, chest pain, and wheezing. During the COVID-19 pandemic, lung cancer patients were at higher risk of being affected by COVID-19. This study emphasizes that early identification and differential diagnosis are extremely difficult in the absence of comprehensive study and workup as the clinical and imaging findings of COVID-19 may resemble lung cancer. Although hilar and mediastinal lymph nodes are the most common metastatic sites for typical carcinoids, most lymphadenopathies are caused by a reactive inflammatory reaction. Conclusion: Bronchial carcinoids are uncommon, malignant neuroendocrine tumours for which the only curative management is complete surgical resection. With full resection, the result of typical carcinoids with lymph node metastases is favourable.

The promise and challenge of spatial omics in dissecting tumour microenvironment and the role of AI.

Growing evidence supports the critical role of tumour microenvironment (TME) in tumour progression, metastases, and treatment response. However, the in-situ interplay among various TME components, particularly between immune and tumour cells, are largely unknown, hindering our understanding of how tumour progresses and responds to treatment. While mainstream single-cell omics techniques allow deep, single-cell phenotyping, they lack crucial spatial information for in-situ cell-cell interaction analysis. On the other hand, tissue-based approaches such as hematoxylin and eosin and chromogenic immunohistochemistry staining can preserve the spatial information of TME components but are limited by their low-content staining. High-content spatial profiling technologies, termed spatial omics, have greatly advanced in the past decades to overcome these limitations. These technologies continue to emerge to include more molecular features (RNAs and/or proteins) and to enhance spatial resolution, opening new opportunities for discovering novel biological knowledge, biomarkers, and therapeutic targets. These advancements also spur the need for novel computational methods to mine useful TME insights from the increasing data complexity confounded by high molecular features and spatial resolution. In this review, we present state-of-the-art spatial omics technologies, their applications, major strengths, and limitations as well as the role of artificial intelligence (AI) in TME studies.

The impact of COVID-19 on the indicators of the oncological service for breast cancer in Kazakhstan

Introduction. According to International Agency for Research on Cancer in 2040, about 3 million new cases of breast cancer (BC) are predicted and about 1 million women are expected to die from this pathology. The aim of the study to assess the impact of COVID-19 on the indicators of the oncological service for breast cancer in Kazakhstan. Material and research methods. The main method was a retrospective study using descriptive, analytical methods of biomedical statistics and data of the Ministry of Health of the Republic of Kazakhstan - form No.7 and 35 regarding BC (ICD 10 - C50) for 2011-2020. Results. For 2011-2020 42,376 new cases of BC and 12,914 deaths from this pathology were registered. The average annual crude incidence rate was 46.4+or-1.10/0000 (95%CI=44.3-48.5), and increased from 40.8+or-0.70/0000 (2011) to 51 .3+or-0.70/0000 in 2019 and then decrease to 44.2+or-0.70/0000 in 2020 (p<0.001). In dynamics, mortality rates tended to (p<0.001) decrease from 16.1+or-0.40/0000 (2009) to 11.9+or-0.40/0000 in 2019 and 11.5+or- 0.40/0000 in 2020, and the average annual crude mortality rate was 14.2+or-0.60/0000 (95%CI=13.1-15.3). Indicators of early diagnosis (stage I-II) improved from 73.4% (2011) to 86.9% in 2019, and decreased to 84.2% in 2020. Proportion of patients with stage III decreased (from 20.9% in 2011 to 8.4% in 2019 and to 10.0% in 2020) and stage IV (from 5.6% to 4.2% and 5.0%, respectively), i.e. neglect rates are declining. The indicators of morphological verification improved from 95.7% to 99.4% over the years. Conclusions. As a result of the analysis, an improvement in the indicators of morphological verification, early diagnosis, a decrease in the neglect and mortality rates were established. The trends in 2011-2019 differed significantly from the period from 2011-2020, which is due to the COVID-19 pandemic on the registration of BC.

Application of Convolutional Neural Network techniques to the classification of lung illnesses

The heterotypic perspective of cancer depicts solid tumors as ecosystems composed of aberrant epithelium tumor cells and a multitude of cell types together referred to as stromal cells. Macrophages, which are innate immune cells, are overrepresented in certain environments. Tumor-associated macrophages (TAMs) are macrophages found in the tumor microenvironment;they are derived from the blood's monocytes and are essential for tumor progression. TAMs acquiring tumorigenic qualities is dependent on a complicated interaction between TAMs and tumor cells. Using co-culture studies, we showed that tumor-derived secretory signals promote Tams' tumor-promoting characteristics, shaping up Tams' features in ways that are advantageous to the tumor. When model human monocytes (THP-1) were co-cultured with A549 cells, the A549 cells exhibited increased proliferation, migration, and invasiveness due to the secretion of tumor-promoting cytokines from the THP-1 cells. We showed that EDA-containing Fibronectin secreted by A549 cells reliably mediates the pro-inflammatory response of THP-1 monocytes in a paracrine manner. Ablation of such responses by the treatment of THP-1 cells with TLR-4 blocking antibody implicated Fibronectin-TLR4 axis in tumor-associated inflammation and suggests a paradigm wherein lung carcinoma cell derived EDA-containing Fibronectin drives a pro-inflammatory and pro-metastatic tumor microenvironment. Interestingly, autocrine proliferation, migration, and invasion were all boosted by EDA-containing Fibronectin secreted by A549 cells. Lastly, we demonstrated that the EDA in Fibronectin activates the epithelial-mesenchymal transition pathway in A549 cells, hence granting these cells the ability to metastasize. © 2023 IEEE.

Impact of SARS-CoV-2 immunization on a breast screening programme

BACKGROUND: A common secondary effect after SARS-CoV-2 immunization is an increased in size of the axillary lymph nodes ipsilateral to the vaccinated site. Eventually, an increased in size of the axillary lymph nodes may lead to a misinterpretation of the breast screening mammogram, performed in asymptomatic women between the age 50 to 69 years old for early breast cancer diagnosis. The aim of our research was to evaluate the impact of the vaccination for SARS-CoV-2 in the breast screening programmes in terms of recall rates and number of false positive results. As a secondary purpose we would analysed the protocols adopted by different breast screening units around the world after SARS-CoV-2 vaccination. METHODS: Observational and retrospective study analysing breast screening mammograms from a single Breast Cancer Screening Unit in Madrid. The mammograms of previously vaccinated women were analysed, reviewing the axillary lymph nodes and the re-call rate secondary to axillary lymphadenopathies. RESULTS: Four hundred and twenty three screening mammograms were performed in May 2021 in the University Hospital Ramon y Cajal in Madrid, which is part of the Breast Screening Programme in Madrid, Spain. None of the women previously vaccinated for SARS-CoV-2 were recalled for complementary studies due to an increased in the axillary lymph nodes. CONCLUSIONS: The protocol stablished by the Spanish Society of Breast Image that stands up for a routine breast screening mammogram after SARS-CoV-2 immunization, has no increase in the recall rate or increase in number of false positives.

Antiviral and antibacterial potential of electrosprayed PVA/PLGA nanoparticles loaded with chlorogenic acid for the management of coronavirus and Pseudomonas aeruginosa lung infection.

Respiratory tract infections are a common cause of morbidity and mortality globally. The current paper aims to treat this respiratory disorder. Therefore, we elucidated the phytochemical profile of Euphorbia milii flowers and isolated chlorogenic acid (CGA) for the first time. The electrospraying technique was utilized to prepare CGA nanoparticles in polyvinyl alcohol (PVA)/PLGA polymeric matrix. Complete in vitro characterizations were performed to determine particle size, polydispersity index (PDI), zeta potential, loading efficiency (LE), scanning electron microscopy and in vitro release study. The optimum formula (F2) with a particle size (454.36 ± 36.74 nm), a surface charge (-4.56 ± 0.84 mV), % of LE (80.23 ± 5.74), an initial burst (29.46 ± 4.79) and % cumulative release (97.42 ± 4.72) were chosen for further activities. In the murine lung infection model, PVA/PLGA NPs loaded with CGA (F2) demonstrated in vivo antibacterial activity against Pseudomonas aeruginosa. Using a plaque assay, the in vitro antiviral activity was investigated. The F2 exhibited antiviral activity against coronavirus (HCoV-229E) and (Middle East respiratory syndrome coronavirus (MERS-CoV), NRCEHKU270). The IC50 of F2 against HCoV-229E and MERS-CoV was 170 ± 1.1 and 223 ± 0.88 µg/mL, respectively. The values of IC50 of F2 were significantly lower (p < .05) than that of free CGA. Therefore, the encapsulation of CGA into electrospray PVA/PLGA NPs would be a promising tool as an antimicrobial agent.

Impact of COVID-19 on breast cancer stage at discovery and time to treatment in Cote d'Or, France

State of the matterDue to the COVID-19 pandemic, and the resulting bottlenecks in the French healthcare system, the management of patients with COVID-19 has been prioritized over that of patients with other pathologies, in particular chronic diseases. The objective of this study was to investigate the impact of COVID-19 on the discovery stage of cancers diagnosed in an organized breast cancer screening program, as well as the impact on the time to supported. Material and methodsAll women aged 50 to 74 for whom cancer has been diagnosed in Cote d'Or as part of the national organized breast cancer screening program (first or second reading) from January 1, 2019 to December 31, 2020 have were included in this study. Using data from pathological anatomy laboratories, clinical centers, and the breast and gynecological cancer registry in Cote d'Or, France, we collected sociodemographic, clinical, and treatment data from all patients. We compared data from the year 2019 (pre-COVID) with that of the year 2020 (COVID). ResultsIn this study, we did not observe any change in the stage of discovery of the cancer at the time of diagnosis, nor any change in the therapeutic strategy. However, we observed a significant increase in infiltrated tumors, a decrease in in situ tumors, and the finding of larger clinical size of in situ tumors after the COVID pandemic. ConclusionWhile these results are reassuring, continued monitoring is needed to determine post-pandemic effects.

Network pharmacological mechanism of Runfei Ningshen Decoction in the treatment of insomnia caused by COVID-19

Objective: To study the mechanism of Runfei Ningshen Decoction in the treatment of insomnia caused by corona virus disease 2019(COVID-19) by using network pharmacology and molecular docking analysis. Methods: The chemical components and targets of Chinese medicinal materials of Runfei Ningshen Decoction in TCMSP, Batman, and CTD databases were searched. The relevant targets of novel coronavirus pneumonia and insomnia in Disgenet, GeneCards, CTD, and Malacards databases were searched. The component-target-disease network was established by using Cytoscape 3.2.1 software;The protein-protein intereation(PPI) network was constructed in string database. The common targets were enriched by using Cluster Profiler software package in R language software platform. The molecular docking of core targets related to insomnia caused by COVID-19 was carried out by using Discovery Studio 4.0 software. Results: 349 medicinal ingredients in Runfei Ningshen Decoction, 1 904 targets, 1 505 new coronavirus pneumonia-related targets, and 1 337 insomnia-related targets were collected. When the intersection of Venn diagrams were used, 404 common targets were obtained for the 2 diseases. 250 targets were intersected with the 2 diseases, and 33 core targets were screened out by the analysis of the interaction network between targets. Pathway enrichment analysis showed that Runfei Ningshen Decoction mainly acts on AKT1, INS, TP53, IL-6, key targets such as AKT1, INS, TP53, IL-6, JUN, CASP3, TNF, CAT, PTGS2 and CXCL8, which are involved in the important pathway processes such as human cytomegalovirus infection, fluid shear stress, and AGE-RAGE signaling pathways in complications of atherosclerosis and diabetes. The results of molecular docking showed that the core target has a high affinity with beta-sitosterol, 1-methoxy phaseolin, 3'-hydroxy-4'-O-methylglycyrrhizin, and anhydroicariin. The prescription treatment of insomnia caused by COVID-19 may be through the targets such as PTGS2, AR, PPARG, NOS2, HSP90 AA1 and so on. Conclusion: Runfei Ningshen Decoction can treat insomnia caused by COVID-19 by inhibiting IL-6 and TNF-a.

Evaluation of fetuin-A, CRP, and CRP/fetuin-A values in COVID-19 patients

Objectives: Fetuin-A, a glycoprotein with several functions, is also a negative acute phase reactant. The purpose of this study was to investigate levels of serum fetuin-A in coronavirus disease 2019 (COVID-19) patients, its association with disease severity, and whether it has superiority over C-reactive protein (CRP). Methods: The research comprised 56 individuals with COVID-19(+) and 30 healthy controls. The COVID-19(+) patient population was split into three subgroups: mild, moderate, and severe. All participants' serum concentrations of fetuin- A, tumor necrosis factor-alpha (TNF-a), and interleukin-6 (IL-6) were measured using ELISA commercial test kits. In addition, CRP and other biochemical values from biochemistry laboratory data were gathered, and the CRP/fetuin-A ratio was calculated. Results: The fetuin-A concentration of the COVID-19(+) patient group was shown to be statistically lower than that of the healthy control group. TNF-a and IL-6 levels were found to be significantly different in both groups. While fetuin-A had a higher area under the curve (AUC) value than CRP (0.875 and 0.800, respectively), CRP/fetuin-A had the strongest AUC (0.933). Conclusion: Low serum fetuin-A concentrations in COVID-19 patients suggest that fetuin-A is a negative acute phase reactant for severe acute respiratory syndrome coronavirus 2. Furthermore, fetuin-A alone and CRP/fetuin-A value are both contenders for being more remarkable markers than CRP.

COVID-related alteration in the balance between pro-and anti/inflammatory bioactive lipids and cytokines

COVID-19 caused by SARS-CoV-2 is an inflammatory condition involving mainly lungs, vascular endothelium, liver, heart, and brain with significant disturbances in the innate and adaptive immune responses. SARS-CoV-2 virus enters the cells by binding to ACE2 receptor that is present in many tissues. Despite the availability of effective vaccine(s) against SARS-CoV-2 and its variants current pandemic continues to cause significant morbidity and mortality The emergence of several mutant variants of SARS-CoV-2 is a major concern especially about the efficacy of current vaccines against these variants and other variants that are likely to emerge in the future. In this context, the observation that essential fatty acids (EFAs) such as linoleic acid (LA) and their metabolites can inactivate SARS-CoV-2, regulate inflammatory events and immune responses, and suppress inappropriate excess production of proinflammatory interleukin-6 (IL-6) and tumor necrosis factor-a (TNF-a), and bradykinin and thus, restore homeostasis is noteworthy. Of all the EFAs, LA and arachidonic acid (AA) are the most effective to inactivate SARS-CoV-2 and other similar viruses and prevent unwarranted inflammation, enhance wound healing by augmenting the production of anti-inflammatory bioactive lipids and cytokines. Since an imbalance between pro- and anti-inflammatory cytokine(s) and other molecules involved in inflammation and wound healing have a significant role in other serious diseases such as sepsis, ARDS (acute respiratory distress syndrome), ischemia-reperfusion injury and severe pneumonia(s), it remains to be seen whether administration of LA and AA and other fatty acids can prevent and suppress these life-threatening diseases in addition to COVID-19.

Polarization of peripheral blood macrophages and PBMCs TXNIP/NLRP3 mRNA changes in patients with hepatitis B virus acute-on-chronic liver failure

Objective: The aim of this study was to explore the polarization of peripheral blood macrophages and peripheral blood mononuclear lymphocyte (PBMC) thioredoxin-interacting protein (TXNIP)/nuc1eotide-binding oligo-merization domain-like receptor protein 3 (NLRP3) mRNA changes in patients with hepatitis B virus acute-on-chronic liver failure (HBV- ACLF). Methods 57 patients with HBV-ACLF and 43 patients with chronic hepatitis B (CHB) were enrolled in our hospital between June 2019 and June 2020, and the percentages of peripheral blood M1 and M2 macrophages were detected by flow cytometry. The PBMC TXNIP, NLRP3 and cysteine protease-l (caspase- 1) mRNA were assayed by real-time fluorescence quantification RT-PCR. Serum interleukin-6 (1L) -6, IL-10 and tumor necrosis factor-a (TNF-a) were detected by ELISA. Results: The percentage of M1 macrophages and M1/M2 cell ratio in patients with HBV-ACLF were (3.5..0.4) % and (1.2..0.2), significantly higher than [(2.1..0.2) % and (0.6..0.1), P < 0.05], while the percentage of M2 macrophages was (2.5..0.3) %, significantly lower than [(4.1..0.4) %, P < 0.05] in patients with CHB;serum IL-6 and TNF-a in patients with HBV- ACLF were (37.9..4.2) ng/L and (2.3..0.2) pg/mL, significantly higher than [(28.8..3.6) ng/L and (1.2..0.1) pg/mL, respectivley, P < 0.05], while serum IL-10 level was (1.410.2) pg/mL, significantly lower than [(2.9..0.3) pg/mL, P < 0.05] in patients with CHB;the PBMCs NLRP3, TXNIP and caspase-1 mRNA in patients with HBV-ACLF were (0.5..0.1), (0.7..0.1) and (1.2..0.1), all significantly lower than [(08..02), (1.0..01) and (1.6..0.2), respectively, P< 0.05] in patients with CHB;the percentage of PBMC M1 macrophages in 15 dead patients was (4.1..0.4) %, significantly higher than [(3.3..0.3) %, P < 0.05], while the percentage of M2 macrophages, PBMCS NLRP3 and TXNIP mRNA were (1.9..0.2) %, (0.2..0.1) and (0.4..0.1), significantly lower than [(2.7..0.3) %, (0.6..0.1) and (0.8..0.1), respectively, 3P < 0.05] in 42 survivals. Conclusion The peripheral blood macrophages are polarized in the pro-inflammatory direction and the down-regulation of TXNIP and NLRP3 mRNA might be related to immunosuppression in patients With HBV-ACLF.

Lesion-specific 3D-printed moulds for image-guided tissue multi-sampling of ovarian tumours: A prospective pilot study.

Background: High-Grade Serous Ovarian Carcinoma (HGSOC) is the most prevalent and lethal subtype of ovarian cancer, but has a paucity of clinically-actionable biomarkers due to high degrees of multi-level heterogeneity. Radiogenomics markers have the potential to improve prediction of patient outcome and treatment response, but require accurate multimodal spatial registration between radiological imaging and histopathological tissue samples. Previously published co-registration work has not taken into account the anatomical, biological and clinical diversity of ovarian tumours. Methods: In this work, we developed a research pathway and an automated computational pipeline to produce lesion-specific three-dimensional (3D) printed moulds based on preoperative cross-sectional CT or MRI of pelvic lesions. Moulds were designed to allow tumour slicing in the anatomical axial plane to facilitate detailed spatial correlation of imaging and tissue-derived data. Code and design adaptations were made following each pilot case through an iterative refinement process. Results: Five patients with confirmed or suspected HGSOC who underwent debulking surgery between April and December 2021 were included in this prospective study. Tumour moulds were designed and 3D-printed for seven pelvic lesions, covering a range of tumour volumes (7 to 133 cm3) and compositions (cystic and solid proportions). The pilot cases informed innovations to improve specimen and subsequent slice orientation, through the use of 3D-printed tumour replicas and incorporation of a slice orientation slit in the mould design, respectively. The overall research pathway was compatible with implementation within the clinically determined timeframe and treatment pathway for each case, involving multidisciplinary clinical professionals from Radiology, Surgery, Oncology and Histopathology Departments. Conclusions: We developed and refined a computational pipeline that can model lesion-specific 3D-printed moulds from preoperative imaging for a variety of pelvic tumours. This framework can be used to guide comprehensive multi-sampling of tumour resection specimens.

Evaluation of tumour necrosis factor alpha-stimulated gene-6 and fibroblast growth factor-2 levels in patients diagnosed with multi-system inflammatory syndrome in children.

Investigations are still ongoing about the pathophysiology of multi-system inflammatory syndrome in children, which can progress with serious morbidity and mortality after COVID-19 infection. In this study, we aimed to investigate whether fibroblast growth factor-2 and tumour necrosis factor alpha-stimulated gene-6 levels play a role in the diagnosis of the disease and on cardiac involvement. Twenty-three patients (11 girls, 12 boys) and 26 healthy controls (10 girls, 16 boys) were included in the study. The mean age of the patient and control group was 8.45 ± 2.43 and 10.73 ± 4.27 years, respectively. There was no difference between the fibroblast growth factor-2 and tumour necrosis factor alpha-stimulated gene-6 levels of the patient and control groups. When the patients with myocardial involvement in the patient group were compared with the patients without myocardial involvement in terms of fibroblast growth factor-2 and tumour necrosis factor alpha-stimulated gene-6 levels, no difference was found between these groups. The correlation of fibroblast growth factor-2 and tumour necrosis factor alpha-stimulated gene-6 levels with other laboratory parameters was investigated in the patient group. Fibroblast growth factor-2 was moderately inversely correlated with white blood cell count (r = -0.541, p = 0.008), absolute neutrophil count (r = -0.502, p = 0.015) and C-reactive protein (r = -0.528, p = 0.010). Fibroblast growth factor-2 was strongly inversely correlated with erythrocyte sedimentation rate (r = -0.694, p =<0.001). Our data show that fibroblast growth factor-2 and tumour necrosis factor alpha stimulated gene-6 do not provide sufficient information about diagnosis and cardiac involvement in multi-system inflammatory syndrome in children.

A case of disseminated intravascular coagulation following tumour lysis syndrome due to small cell carcinoma of the lung.

A 64-year-old man was diagnosed with small cell lung cancer (SCLC) with multiple bone and liver metastases and bone marrow metastases. Spontaneous tumour lysis syndrome (TLS) was observed before starting chemotherapy with carboplatin, etoposide, and atezolizumab. The tumour further collapsed, and the patient developed disseminated intravascular coagulation (DIC) on day 4 of chemotherapy. The patient was successfully treated with intravenous hydration and rasburicase for TLS and subcutaneous unfractionated heparin for DIC. A large amount of tissue factor may be released in TLS, which could induce DIC. However, to the best of our knowledge, this is the first report of DIC following TLS in a case of SCLC. DIC following TLS in SCLC is a rare but life-threatening oncologic complication. Therefore, clinicians should be aware of this possibility when treating patients with advanced SCLC.

COVID-19 Vaccination Safety Profiles in Patients With Solid Tumour Cancers: A Systematic Review.

Vaccination has become an essential means of protection for solid tumour patients against coronavirus disease 2019 (COVID-19). In this systematic review, we sought to identify common safety profiles of the COVID-19 vaccine in patients with solid tumours. A search of Web of Science, PubMed, EMBASE and Cochrane was conducted for studies in English full-text that reported side-effect data experienced by patients with cancer who were at least 12 years old with solid tumours or a recent history of solid tumours after receiving either one or multiple doses of the COVID-19 vaccination. Study quality was assessed with the Newcastle Ottawa Scale criteria. Acceptable study types were retrospective and prospective cohorts, retrospective and prospective observational studies, observational analyses and case series; systematic reviews, meta-analyses and case reports were excluded. Among local/injection site symptoms, the most commonly reported were injection site pain and ipsilateral axillary/clavicular lymphadenopathy, whereas the most commonly reported systemic effects were fatigue/malaise, musculoskeletal symptoms and headache. Most side-effects reported were characterised as mild to moderate. A thorough evaluation of the randomised controlled trials for each featured vaccine led to the conclusion that in the USA and abroad, the safety profile seen in patients with solid tumours is comparable with that seen in the general public.

Characteristics of vasculogenic mimicry and tumour to endothelial transdifferentiation in human glioblastoma: a systematic review.

BACKGROUND: Glioblastoma, the most common primary malignant brain tumour in adults, is a highly vascular tumour characterised by abnormal angiogenesis. Additional mechanisms of tumour vascularisation have also been reported in glioblastoma, including the formation of tumour cell-derived vessels by vasculogenic mimicry (VM) or the transdifferentiation of tumour cells to endothelial cells. VM and endothelial transdifferentiation have frequently been reported as distinct processes, however, the use of both terms to describe a single process of vascularisation also occurs. Some overlapping characteristics have also been reported when identifying each process. We therefore aimed to determine the markers consistently attributed to VM and endothelial transdifferentiation in the glioblastoma literature. METHODS: Ovid MEDLINE and Ovid Embase were searched for studies published between January 1999 and July 2021 that assessed VM or tumour to endothelial transdifferentiation in human glioblastoma. The online systematic review tool Covidence was used for screening and data extraction. Extracted data included type of tumour-derived vasculature reported, methods and techniques used, and markers investigated. Studies were grouped based on type of vasculature reported for further assessment. RESULTS: One hundred and thirteen of the 419 unique records identified were included for analysis. VM was reported in 64/113 studies, while tumour to endothelial transdifferentiation was reported in 16/113 studies. The remaining studies used both terms to describe a single process, did not define the process that occurred, or concluded that neither VM nor endothelial transdifferentiation occurred. Absence of CD34 and/or CD31 in vascular structures was the most common indicator of VM, while expression of CD34 and/or CD31, in addition to various other endothelial, stem cell or tumour cell markers, indicated tumour to endothelial transdifferentiation. CONCLUSION: Cells derived from tumour to endothelial transdifferentiation express typical endothelial markers including CD34 and CD31, while tumour cells contributing to VM lack CD34 and CD31 expression. Additional tumour markers are required to identify transdifferentiation in glioblastoma tissue, and this process requires further characterisation.

Transurethral resection of bladder tumour (TURBT) as a day-case: A real-world practice and patients' perspective from a district general hospital (DGH).

INTRODUCTION: Day-case transurethral resection of bladder tumour (TURBT) is currently only performed in 18% cases across the United Kingdom. To determine 30-day readmission rate and morbidity after day-case TURBT in a district general hospital (DGH) and to report patient demographics, quality of TURBT and early recurrence rate as well as patient feedback after day-case TURBT. METHODS: A retrospective audit of day-case TURBTs over a 3-year pre-COVID19 (2017-20) was performed. We only included patients who underwent a TURBT and excluded any cystoscopy and biopsy or fulguration. A day-case TURBT pathway is in place in this centre. Feedback was obtained using hospital patient feedback forms. RESULTS: We included 77 patients who underwent TURBT in the day-case theatre, of these 5 patients required in-patient stay after the surgery. Of the remaining 72 discharged on the same day, 8 were re-admitted (11%) for Clavien-Dindo I complications. The readmission/failed discharge group had a higher rate of older patients, with higher ASA scores and longer operative times, however resection quality and tumour characteristics were not different from the day-case TURBTs. All patients reported an overall positive experience (good or very good). CONCLUSIONS: In the first of its kind audit reporting patient feedback after day-case TURBT, the data obtained can provide us and other centres adopting day-case TURBTs guidance to employ better patient selection to reduce readmission rates. Hence, day-case TURBT can be a feasible option in appropriately selected patients, with a suitable pathway in place.

Brain tumours in the time of COVID-19: An online survey on patients' disease experience in one Italian region.

Background: Since the outbreak, in 2019, of COVID-19, the world has experienced marked changes in daily habits, partly reflecting the exceptional social restrictions and health measures adopted to contain the disease. All these measures significantly affected not only peoples's daily lives and psychological well-being but also the possibility for the healthcare system to function properly. In this setting, brain tumour patients were at risk due to their higher physical and mental fragility and their need for regular care. The aim of the present study was to assess, using a self-reported online questionnaire, the patients's perceptions regarding their disease experience. Materials and methods: We developed an online anonymous self-report survey to assess patients's disease experience during the pandemic. We investigated the impact of the COVID-19 pandemic on patients's cancer care schedules, their psychological distress and emotions felt during the pandemic, their levels of worry about COVID-19, and their oncological conditions. Results: 107 patients answered our survey, most of them suffering from a glioma. Less than one-third of the sample had their appointments cancelled, delayed or converted into online visits due to the pandemic. Of the patients who answered the survey, 95% declared they were satisfied with their Institute's oncological management. The feelings reported most often were peacefulness or anxiety/worry; the majority of the sample reported high levels of loneliness, which tended to increase with age, whilst the psychological distress was correlated with age and with having a recurrence of the disease. Half of the sample declared severe worry about their oncological condition, in particular subjects with a recurrence or who were receiving adjuvant therapies. Patients with recurrence tended to worry more about the possibility of contracting COVID-19, and its effects. Conclusion: Our findings illustrate how fragile and in need of care patients with a brain tumour may be, especially those with more severe clinical conditions. These data may help boost healthcare professionals's knowledge about brain tumour patients's needs and fears, so as to be able to offer them a better hospital experience and improve their clinical management, while possibly also reducing the psychological burden on patients and their families.

AGIHO guideline on evidence-based management of COVID-19 in cancer patients: 2022 update on vaccination, pharmacological prophylaxis and therapy in light of the omicron variants.

The novel coronavirus SARS-CoV-2 and the associated infectious disease COVID-19 pose a significant challenge to healthcare systems worldwide. Patients with cancer have been identified as a high-risk population for severe infections, rendering prophylaxis and treatment strategies for these patients particularly important. Rapidly evolving clinical research, resulting in the recent advent of various vaccines and therapeutic agents against COVID-19, offers new options to improve care and protection of cancer patients. However, ongoing epidemiological changes and rise of new virus variants require repeated revisions and adaptations of prophylaxis and treatment strategies to meet these new challenges. Therefore, this guideline provides an update on evidence-based recommendations with regard to vaccination, pharmacological prophylaxis and treatment of COVID-19 in cancer patients in light of the currently dominant omicron variants. It was developed by an expert panel of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO) based on a critical review of the most recent available data.