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Purpose@#Locally advanced rectal cancer (LARC) is managed by chemoradiotherapy (CRT), followed by surgery. Herein we reported patients with metastases during or after CRT. @*Methods@#Data of patients with LARC who received CRT from 2008 to 2017 were reviewed. Patients with metastases after CRT were included. Those with metastatic tumors at the initial diagnosis were excluded. @*Results@#Fourteen patients (1.3%) of 1,092 who received CRT presented with metastases. Magnetic resonance circumferential resection margin (mrCRM) and mesorectal lymph nodes (LNs) were positive in 12 patients (85.7%). Meanwhile, magnetic resonance extramural vascular invasion (mrEMVI) was positive in 10 patients (71.4%). Magnetic resonance tumor regression grade (mrTRG) 4 and mrTRG5 was detected in 5 and 1 patient respectively. Ten patients (71.4%) underwent combined surgery and 3 (21.4%) received palliative chemotherapy. @*Conclusion@#Patients with metastases after CRT showed a higher rate of positive mrCRM, mrEMVI, mesorectal LNs, and poor tumor response. Further studies with a large number of patients are necessary for better survival outcomes in LARC.
RESUMO
Purpose@#Locally advanced rectal cancer (LARC) is managed by chemoradiotherapy (CRT), followed by surgery. Herein we reported patients with metastases during or after CRT. @*Methods@#Data of patients with LARC who received CRT from 2008 to 2017 were reviewed. Patients with metastases after CRT were included. Those with metastatic tumors at the initial diagnosis were excluded. @*Results@#Fourteen patients (1.3%) of 1,092 who received CRT presented with metastases. Magnetic resonance circumferential resection margin (mrCRM) and mesorectal lymph nodes (LNs) were positive in 12 patients (85.7%). Meanwhile, magnetic resonance extramural vascular invasion (mrEMVI) was positive in 10 patients (71.4%). Magnetic resonance tumor regression grade (mrTRG) 4 and mrTRG5 was detected in 5 and 1 patient respectively. Ten patients (71.4%) underwent combined surgery and 3 (21.4%) received palliative chemotherapy. @*Conclusion@#Patients with metastases after CRT showed a higher rate of positive mrCRM, mrEMVI, mesorectal LNs, and poor tumor response. Further studies with a large number of patients are necessary for better survival outcomes in LARC.
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Mixed hepatitis C virus (HCV) genotype infection is emerging with improved methods of detection. It is commonly seen in hemodialysis patients and intravenous drug users due to repeated HCV exposure and absence of protective immunity, and can contribute to treatment failure. Direct-acting antiviral regimens have been extensively studied in patients with different individual HCV genotypes; however, there are no reported data on their use in patients with mixed HCV genotype. We present a case of mixed HCV genotype 1a and 2 infection in a decompensated cirrhotic patient treated successfully with sofosbuvir, ledipasvir, and ribavirin.
RESUMO
Objective: To determine the prevalence of Cysticercus tenuicollis (C. tenuicollis) metacestodes in five oryx species kept in Al Ain Zoo animal collection. Methods: This study was based on a retrospective analysis of post-mortem records covering a four year period (July 2010 to July 2014). Results: A total of 213 individual animals were recorded dead during the four year period (July 2010 to July 2014). Out of this, 12 (5.6%) were recorded with C. tenuicollis. More females (8) than males (4) were recorded to have C. tenuicollis, although this was not statistically significant (P = 0.373. 7). Conclusions: This study shows that, Arabian oryx, beisa oryx, fringe-eared oryx, gemsbok and scimitar-horned oryx are susceptible to C. tenuicollis. Based on the epidemiology and the life cycle of this parasite, it is possible that these captive animals ingested the parasite through contaminated feed which could have happened in the pasture land or stray dogs and wild canidae (e.g. fox) visited the zoo contaminating the oryx feed. Stray dogs and wild canidae should be prevented from visiting pasture land and a captive animal facility.
