Nasopharyngeal Lipoma: A Rare Presentation of a Common Lesion.

Lipomas are common slow-growing benign tumors composed of mature adipose tissue. They can grow in any location where fat is present. They are well encapsulated and are generally of little clinical concern. Lipomas are typically located in the subcutaneous fat of the neck and trunk. The presence of a lipoma in the nasopharynx is rare. These lesions may produce clinical symptoms or be found incidentally. Here, we present the case of a 34-year-old male who was found to have an incidental pharyngeal lipoma following a nasopharyngoscopy for unrelated tympanostomy tube placement. This case illustrates a rare presentation of an otherwise common lesion.

Serotonin mediates stress-like effects on responses to non-nociceptive stimuli in the medicinal leech Hirudo verbana.

Noxious stimuli can elicit stress in animals that produce a variety of adaptations including changes in responses to nociceptive and non-nociceptive sensory input. One example is stress-induced analgesia that may be mediated, in part, by the endocannabinoid system. However, endocannabinoids can also have pro-nociceptive effects. In this study, the effects of electroshock, one experimental approach for producing acute stress, were examined on responses to non-nociceptive mechanical stimuli and nociceptive thermal stimuli in the medicinal leech (Hirudo verbana). The electroshock stimuli did not alter the leeches' responses to nociceptive stimuli, but did cause sensitization to non-nociceptive stimuli, characterized by a reduction in response threshold. These experiments were repeated with drugs that either blocked synthesis of the endocannabinoid transmitter 2-arachidonoylglycerol (2-AG) or transient receptor potential vanilloid (TRPV) channel, which is known to act as an endocannabinoid receptor. Surprisingly, neither treatment had any effect on responses following electroshock. However, the electroshock stimuli reliably increased serotonin (5-hydroxytryptamine or 5HT) levels in the H. verbana CNS. Injection of 5HT mimicked the effects of the electroshocks, sensitizing responses to non-nociceptive stimuli and having no effect on responses to nociceptive stimuli. Injections of the 5HT receptor antagonist methysergide reduced the sensitization effect to non-nociceptive stimuli after electroshock treatment. These results indicate that electroshocks enhance response to non-nociceptive stimuli but do not alter responses to nociceptive stimuli. Furthermore, while 5HT appears to play a critical role in this shock-induced sensitizing effect, the endocannabinoid system seems to have no effect.

Advanced Stage Breast Cancer on Initial Presentation Following One Year Hiatus in Screening Mammography Due to COVID-19 Pandemic.

Breast cancer is the second most common cancer and second leading cause of cancer death affecting women in the U.S., behind only skin and lung cancers, respectively. Modern screening mammography methods have contributed, in part, to a 40 percent decrease in breast cancer mortality since it was introduced in 1976. Therefore, regular breast cancer screening is vital to women's health. The COVID-19 Pandemic posed many challenges to healthcare systems worldwide. One challenge was the discontinuation of routine screening tests. We present a female patient who consistently participated in annual screening mammography and was confirmed negative for malignancy between 2014 and 2019. She did not get her mammogram in 2020 due to the COVID-19 pandemic and was subsequently diagnosed with stage IIIB breast cancer when she resumed her screening mammogram in 2021. This case illustrates one of the consequences of delayed breast cancer screening.