Quality of Life in Hematologic Malignancy in the Eastern Mediterranean Region: A Systematic Review.

Health-related quality of life (HRQoL) indicates patients' overall health and is an essential aspect of cancer care. Although multiple studies have addressed the various aspects of HRQoL in cancer patients, few studies have investigated HRQoL in hematologic malignancy patients in the Eastern Mediterranean region (EMR). This review conducted an electronic search using OVID-Medline to identify HRQoL-related articles involving hematologic malignancy patients in the EMR. Eight studies met the inclusion criteria. Two studies validated translated QoL psychometric instruments, three were observational studies, and three were interventional studies. Except for the validation studies, all studies discussed HRQoL in leukemia patients. Our review highlighted a scarcity in the number of studies focusing on patients with hematological malignancies in this region. The included studies demonstrated the negative impact of hematological malignancies and therapies on patients' HRQoL. In addition, the studies displayed the association between physical symptoms and QoL of cancer patients, necessitating the importance of addressing these symptoms. The studies were limited by publication year, the number of patients, geographical locations, and disease entities. Future studies in this area are encouraged to help understand factors affecting HRQoL in the EMR region and ways to improve it. Consequently, further research is needed to establish translated and validated QoL assessment instruments that target patients in the EMR using the most common tools including the Short-Form 36-item Health Survey and the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire.

Novel Inflammatory-Nutritional Biomarkers as Predictors of Histological Activity in Crohn's Disease.

BACKGROUND: There has increasingly been an interest in histological remission as a therapeutic endpoint in inflammatory bowel disease. The aim of this study was to evaluate the utility of a variety of inflammatory - nutritional markers for predicting histological disease activity in patients diagnosed with Crohn's disease. METHODS: Patients with Crohn's disease that had requisite endoscopic, pathological, and laboratory data were retrospectively enrolled in the study. Relevant clinical, laboratory, endoscopic, and pathological data were abstracted. The neutrophil:lymphocyte ratio (NLR), lymphocyte:monocyte ratio (LMR), platelet:lymphocyte ratio (PLR), red blood cell distribution width (RDW), modified Glasgow Prognostic score (mGPS), Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk index (GNRI), CRP/Albumin ratio (CAR), Iron:Ferritin ratio (Fe:F) and the Systemic immune inflammation index (SII) were calculated. The cohort was stratified by presence of histological disease on colonoscopy, and groups were compared with appropriate statistical methods. RESULTS: When comparing patients without histological disease to those with disease, there was a statistically significant difference in CAR (2.9 ± 1.5 vs. 4.2 ± 2, p = 0.001), RDW (13.4 ± 1.3 vs. 14.5 ± 1.8, p = 0.008), PNI (52.4 ± 6.2 vs. 47.4 ± 9.3, p = 0.03), and mGPS (0.2 ± 0.4 vs. 0.6 ± 0.7, p = 0.01). For predicting histological activity, ROC analyses indicated an optimal cutoff of 0.3 for CAR (AUC 0.8, PPV 90.5%), 13.5 for RDW (AUC 0.7, PPV 84.1), 86.1 for PNI (AUC 0.7, PPV 86.1) and > 0 for mGPS (AUC 0.6, PPV 85.2%). The NLR, LMR, PLR, GNRI, Fe: F, and SII did not meet statistical significance (p = 0.4, 0.08, 0.2, 0.5, 0.6, and 0.3, respectively). CONCLUSIONS: We report on ten biomarkers, many of them never studied in Crohn's disease, which can help in predicting the presence of active histological disease. Larger prospective studies are needed to investigate the utility of these biomarkers alone and in combination.

Gastric Ulcer as Presentation of HIV-Associated Kaposi Sarcoma and Resolution With HAART Therapy.

Kaposi sarcoma (KS) is a neoplasm of endothelium-derived cells that are associated with human herpesvirus 8 infection. In the setting of HIV, extensive disease typically necessitates highly active antiretroviral therapy in conjunction with chemotherapy. We report a patient who presented with gastrointestinal symptoms and was found to have KS presenting only as cratered gastric ulcers. The patient declined chemotherapy and was treated with highly active antiretroviral therapy alone and had complete resolution of KS on endoscopy and imaging up to 3 years later.

Pure Testicular Choriocarcinoma with Dermatological, Brain, and Gastrointestinal Metastases.

Testicular choriocarcinoma is a non-seminomatous germ cell tumor (NSGCT) and is the rarest of all testicular cancers. Nearly all choriocarcinomas can be classified as either pure choriocarcinoma or as a component of a mixed germ cell tumor. Pure testicular choriocarcinoma is extremely aggressive and metastasizes early and extensively. We present a case of testicular cancer that metastasized to the skin, gastrointestinal tract, and brain, and discuss the case in light of the available literature.

Sertraline-Induced Acute Eosinophilic Pneumonia.

BACKGROUND: Acute Eosinophilic Pneumonia (AEP) is a rare, potentially fatal disease often characterized by a short febrile illness, hypoxemic respiratory failure, diffuse pulmonary opacities and evidence of pulmonary eosinophilia. AEP can be idiopathic, but has documented associations with multiple drugs. CASE REPORT: We present the first case highlighting Sertraline specifically as a cause of drug-induced AEP in the English literature.