scholarly journals Clinical and trichoscopic features in 18 cases of Folliculotropic Mycosis Fungoides with scalp involvement

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giuseppe Gallo ◽  
Alessandro Pileri ◽  
Michela Starace ◽  
Aurora Alessandrini ◽  
Alba Guglielmo ◽  
...  
Keyword(s):  
Mycosis Fungoides ◽  
Rare Variant ◽  
Point Of View ◽  
Differential Diagnoses ◽  
Disease Stage ◽  
Short Hair ◽  
Clinical Presentations ◽  
Number Of Patients ◽  
Clinical Point ◽  
Vellus Hairs

AbstractFolliculotropic Mycosis Fungoides (FMF) is a rare variant of Mycosis Fungoides involving the scalp leading to alopecia. The clinical and trichoscopic features in 18 patients were analyzed and compared with the reports in the literature. Gender, age, disease stage, site of onset were taken into consideration. Clinical and trichoscopic analyses were performed on each patient. From a clinical point of view, Folliculotropic Mycosis Fungoides lesions involving the scalp presented as generalized alopecia (27.8%) or patchy-plaque alopecia (72.2%). Trichoscopic analysis revealed six most frequent features: single hair (83.3%), dotted dilated vessels (77.8%), broken-dystrophic hairs (66.7%), vellus hairs (61.1%), spermatozoa-like pattern vessels (55.6%), and yellow dots (55.6%). Additional identified trichoscopic patterns were dilation of follicular openings, scales-crusts, purpuric dots, short hair with split-end, pigtail hairs, perifollicular hyperkeratosis, milky-white globules, black dots, white dots/lines and absence of follicular dots. These trichoscopic features were further correlated to clinical presentations and stage of the disease. The rarity of the disease is a limitation. The relatively high number of patients allowed to identify several clinical and trichoscopic patterns that could be featured as specific or highly suspicious for FMF in order to consider trichoscopy as a complementary diagnostic approach and improve the differential diagnoses between FMF and other scalp disorders.

Distinct Cytogenetic Aberrations during the Course of Mantle Cell Lymphoma (MCL).

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4638-4638
Author(s):  
Stephanos I. Papadhimitriou ◽  
Ageliki Davea ◽  
Ioanna Savvidou ◽  
George Paterakis ◽  
Helen Goumakou ◽  
...  
Keyword(s):  
Fusion Gene ◽  
Clonal Evolution ◽  
Point Of View ◽  
Lymphoma Cells ◽  
Cytogenetic Aberrations ◽  
Number Of Patients ◽  
Mantle Cell ◽  
Clinical Point ◽  
A Minor

Abstract BACKGROUND: Apart from t(11;14)(q13;q32), MCL is also characterized by other nonrandom cytogenetic findings. These additional aberrations are well studied at diagnosis and believed to represent clonal evolution during lymphomagenesis, but little is known about karyotypic changes during the course of the disease. METHODS: The study included 33 patients with MCL. In all cases, an interphase FISH assay was performed at diagnosis on lymphoma cells from peripheral blood, bone marrow or touch imprints of involved sites. Commercial probes were employed for the detection of t(11;14), +12, 13q−, and abnormalities of ATM, p53, p16, TEL, c-MYC and BCL6 genes. In 14 cases, the same FISH screening was repeated at least once (up to four times) during the course of the disease, at relapse or in the context of partial or no response. RESULTS: The most frequent additional findings at diagnosis were ATM deletion in 15 cases (45.5%) and 13q− in 12 cases (36.4%), followed by p16 deletion (3 cases; 1 homozygous), p53 deletion (2 cases), and +12, duplication of the CCND1/IGH fusion gene and BCL6 triplication, in one case each. 11 of the 14 cases studied at follow-up showed karyotypic evolution, with acquisition of p16 deletion (6 cases; 4 homozygous), TEL deletion (5 cases; 2 on the basis of monosomy 12), duplication of the CCND1/IGH fusion (3 cases), p53 deletion (2 cases), and c-MYC amplification (1 case). There was no case with acquisition of ATM deletion, 13q− or +12, but in two cases with 13q− in a minor subclone at diagnosis the aberration was estimated to involve the total of the lymphoma cells at relapse. Interestingly, new BCL6 aberrations were seen in 3 cases (triplication in one and amplification in the other two, including the case with gene triplication at diagnosis) and were detected at the third or the fourth repetition of the screening. The longest survival after detection of these aberrations was 3 months. CONCLUSIONS: Our data suggest that in most cases of MCL clonal evolution also occurs during the course of the disease, with the acquisition of multiple additional chromosomal lesions. Despite the small number of patients in our series, it seems that some of the aberrations (like ATM deletion or 13q−) are most commonly already present at diagnosis, while others (such as monosomy 12 and/or TEL deletion) appear more often or even exclusively on follow-up. From the clinical point of view, we found that the most informative finding is the overrepresentation of the BCL6 gene, apparently associated with aggressive behavior and perhaps the terminal stage of MCL.

Secondary medical prevention in patients with peripheral arterial disease - Prescriptions of vascular surgeons and medical doctors (angiologists) in a multidisciplinary vascular centre

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 145-152 ◽  
Author(s):  
Klein-Weigel ◽  
Gutsche-Petrak ◽  
Wolbergs ◽  
Köning ◽  
Flessenkamper
Keyword(s):  
Peripheral Arterial Disease ◽  
Oral Anticoagulants ◽  
Arterial Disease ◽  
Disease Stage ◽  
Channel Blockers ◽  
Medical Doctors ◽  
Vascular Surgeon ◽  
Medical Prevention ◽  
Number Of Patients ◽  
Peripheral Arterial

Background: We compared medical secondary prevention in patients with peripheral arterial disease stage II (Fontaine) located in the femoro-popliteal artery managed by vascular surgeons and medical doctors / angiologists in our multidisciplinary vascular center. Patients and methods: We retrospectively analyzed demission protocols of in-hospital treatments between 01.01.2007 and 20.06.2008. Results: We surveyed 264 patients (54.2 % women; mean age 67.52 ± 8.98 yrs), 179 (67.8 %) primarily treated by medical doctors / angiologists and 85 (32.2 %) primarily managed by vascular surgeons. Medical doctors / angiologists treated more women (n = 109) than men (n = 34), (p = 0.002) and documented smoking and diabetes mellitus more often (p < 0.001) than vascular surgeons. Besides, patients had similar cardiovascular risk profiles and concomitant diseases, vascular surgeons prescribed 5.47 ± 2.26 drugs, medical doctors / angiologists 6.37 ± 2.67 (p = 0.005). Overall, 239 (90.5 %) patients were on aspirin, 180 (68.2 %) on clopidogrel, and 18 (6.9 %) on oral anticoagulants. Significantly more patients treated by medical doctors / angiologists received clopidogrel (169 versus 11; p < 0.001), significantly more surgical patients received oral anticoagulants (11 versus 7; p = 0.016). The number of patients without prescriptions for any antithrombotic therapy was 6 (6.9 %) in patients treated by vascular surgeons and 0 (0 %) in patients managed by medical doctors / angiologists (p = 0.001). Prescription-rates of β-blockers, ACE-inhibitors, Angiotensin II-antangonists, calcium channel blockers, and diuretics were statistically not different between the two disciplines, but statins were prescribed significantly more often by medical doctors / angiologists (139 versus 49; p < 0001). With the exceptions of Clopidogrel (women > men) and diuretics (men > women) we observed no gender-specific prescriptions. Conclusions: We observed high prescriptions rates of secondary medical prevention in patients primarily treated by medical doctors / angiologists and vascular surgeons. We believe that this result is highly influenced by our multidisciplinary approach. Nevertheless, efforts have to be made to raise vascular surgeon’s awareness of statin use and complete prescription of antithrombotic and antiplatelet drugs.

scholarly journals Neonatal Birthmarks at the 4 Central Hospitals in Vientiane Capital, Lao PDR

2021 ◽  
Vol 8 ◽  
pp. 2333794X2199090
Author(s):  
Vilounna Sanaphay ◽  
Sourideth Sengchanh ◽  
Alongkone Phengsavanh ◽  
Anousavanh Sanaphay ◽  
Leelawadee Techasatian
Keyword(s):  
Sebaceous Gland ◽  
Neonatal Period ◽  
Lao Pdr ◽  
Skin Lesions ◽  
Medical Advice ◽  
Point Of View ◽  
Parental Anxiety ◽  
Skin Disorders ◽  
Clinical Point ◽  
Therapeutic Procedures

Newborn skin disorders are quite common and happen to occur during the neonatal period. Most of the birthmarks are transient; however, worried parents often seek medical advice from their child’s physician regarding skin lesions. Thus, it is important to differentiate the skin lesions from pathologic ones to avoid unnecessary diagnostic or therapeutic procedures. This is the first published study in Lao neonates that carried out the data from 4 central hospitals in Vientiane Capital, Lao PDR from September 2019 to February 2020. Among 500 neonates, Sebaceous gland hyperplasia (53%), Mongolian patches (46.6%), and Erythema toxicum neonatorum (30%) were the 3 most common cutaneous conditions found in the Lao newborns. From a clinical point of view, these findings are often a source of parental anxiety and medical concern for inexperienced clinicians.

A Dutchman in London: reflections of a hospital chief executive from the Netherlands in the NHS

BMJ Leader ◽  
2021 ◽  
pp. leader-2021-000509
Author(s):  
Marcel Levi
Keyword(s):  
Health Care ◽  
The Netherlands ◽  
Health Care Professionals ◽  
Chief Executive ◽  
Point Of View ◽  
British Society ◽  
The Public ◽  
Interesting Insight ◽  
Clinical Point ◽  
High Level

BackgroundThe NHS is a fascinating health care system and is enjoying a lot of support from all layers of British society. However, it is clear that the system has excellent features but also areas that can be improved.Story of selfA number of years as a chief executive in one of London’s largest hospital has brought me a wealth of impressions, experiences, and understanding about working in the NHS. Contrasting those to my previous experience as chief executive in Amsterdam (The Netherlands) provides an interesting insight.ObservationsVery strong features of the NHS are the high level of health care professionals, the focus on quality and safety, and involvement of patients and the public. However, the NHS can significantly improve by addressing the lack of clinical professionals in the lead, curtailing ever increasing bureaucracy, and reducing its peculiar preference for outsourcing even the most crucial activities to private parties. The frequent inability to swiftly and successfully complete goal-directed negotiations as well as the large but from a clinical point of view irrelevant private sector are areas of sustained bewilderment. Lastly, the drive for innovation and transformation as well as the level of biomedical research in the NHS and supported by the British universities is fascinating and outstanding.

scholarly journals Hyperpigmented mycosis fungoides: a rare variant

2013 ◽  
Vol 15 ◽  
Author(s):  
Meryem Soughi ◽  
Fatima Zahra Mernissi
Keyword(s):  
Mycosis Fungoides ◽  
Rare Variant

scholarly journals Alterações dimensionais em pastas de óxido de zinco/eugenol: um novo método para sua mensuração

2021 ◽  
pp. 39-55
Author(s):  
Léo Werner Süffert ◽  
Ennio Pessôa
Keyword(s):  
Standard Deviation ◽  
Personal Information ◽  
High Variability ◽  
Point Of View ◽  
New Method ◽  
Extensive Review ◽  
Review Of The Literature ◽  
Dimensional Changes ◽  
Impression Materials ◽  
Clinical Point

After an extensive review of the literature, regarding zinc.oxide/eugenol impression pastes, we selected 20 of the most representatives as our references. Trough personal information of several of the investigators it was discovered that dimensional changes of theese materials is one of the most difficult properties to be measured. A new method was developed to measure dimensional changes ot 4 (four) of the most widely used zinc.oxide/eugenol impression materials in Brazil. The results, presented through several graphs and tables showed that dimensional changes varied from 0,003%, values which may probably be considered negligible from a clinical point of view. We noticed, however, high values for standard deviation and variance which indicate the high variability within the experiments. Those values were not found when we used the same method with mercaptan and silicone impression materials, in which the measurement of dimensional changes was highly reproducible. One hypothesis (which we intend to investigate in a later research) is that, during storage, a sedimentation could occur, of the components of greater density! Consequently ther might result a change in composition, independent of the method used to establishe the proportion of the two pastes, be it by wheight or measurement of lenght, which could be the cause of variability of the composition of each mixture!

scholarly journals Addressing adenomyosis: Implications beyond we actually know

2019 ◽  
Vol 8 (9) ◽  
pp. 3644
Author(s):  
Ganesh Kumar ◽  
Purnima Pachori
Keyword(s):  
Recurrent Pregnancy Loss ◽  
Imaging Techniques ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Age Group ◽  
Adherent Placenta ◽  
Clinical Presentations ◽  
Number Of Patients ◽  
Retrospective Comparative Study ◽  
Clinical Records

Background: Hysterectomy is one of the commonest gynecological surgeries being performed in India for various pelvic pathologies like fibroid uterus, endometrial hyperplasia, dysfunctional uterine bleeding, etc. But pre-operative diagnosis of adenomyosis and making it an indication for hysterectomy is not as common as pathologists find it in histo-pathology of hysterectomized specimens. The aim of the study was to study the frequency of adenomyosis in comparison to leiomyoma as a uterine pathology in hysterectomized specimens and correlate them clinically.Methods: A retrospective comparative study was carried out on 1646 hysterectomy specimens, during January 2014 to December 2016, which showed either adenomyosis or leiomyoma or both. Clinical records of these cases were retrieved and histo-pathology was correlated to clinical presentations and pre-operative ultrasonography.Results: Of the 1646 specimens taken for comparision between adenomyosis and leiomyoma, 49% showed only adenomyosis, 37% only leiomyoma and 14% had dual pathology showing findings of both. The peri-menopausal age group (45-54 years) accounted for the maximum number of patients undergoing hysterectomy (37.12%). But adenomyosis was found maximum in 35 - 44 years age group (38.04%). The clinical presentations for these two pathologies were similar and maximum patients presented with abnormal uterine bleeding and pelvic pain. Ultrasonography was able to diagnose only 32% cases of adenomyosis pre-operatively whereas this figure was 87% for fibroids.Conclusions: Adenomyosis and leiomyoma both account for the most frequent findings in hysterectomy specimens. Fibroids are easily diagnosed pre-operatively, but adenomyosis needs to be diagnosed pre-operatively by high index of clinical suspicion and imaging techniques. Adenomyosis is not just a disease of middle age, it needs to be addressed for infertility, recurrent pregnancy loss (RPL), bad obstetric history, IVF failures and adherent placenta as well.

scholarly journals Conditional Survival and Cure of Patients With Colon or Rectal Cancer: A Population-Based Study

2020 ◽  
Vol 18 (9) ◽  
pp. 1230-1237 ◽  
Author(s):  
Seyed M. Qaderi ◽  
Paul W. Dickman ◽  
Johannes H.W. de Wilt ◽  
Rob H.A. Verhoeven
Keyword(s):  
Rectal Cancer ◽  
Colon Cancer ◽  
Population Based ◽  
Stage I ◽  
Stage Iii ◽  
Disease Stage ◽  
Conditional Survival ◽  
Population Based Study ◽  
Pathologic Stage ◽  
Number Of Patients

Background: The increasing number of colorectal cancer (CRC) survivors need survival estimates that account for the time already survived. The aim of this population-based study was to determine conditional survival, cure proportions, and time-to-cure (TTC) of patients with colon or rectal cancer. Materials and Methods: All patients with pathologic stage I–III CRC treated with endoscopy or surgery, diagnosed and registered in the Netherlands Cancer Registry between 1995 and 2016, and aged 18 to 99 years were included. Conditional survival was calculated for those diagnosed before and after 2007. Cure proportions were calculated using flexible parametric models. Results: A total of 175,384 patients with pathologic stage I (25%), II (38%), or III disease (37%) were included. Conditional 5-year survival of patients with stage I, II, and III colon cancer having survived 5 years was 98%, 94%, and 92%, respectively. For patients with stage I–III rectal cancer, this was 96%, 89%, and 85%, respectively. Statistical cure in patients with colon cancer was reached directly after diagnosis (stage I) to 6 years (stage III) after diagnosis depending on age, sex, and disease stage. Patients with rectal cancer reached cure 0.5 years after diagnosis (stage I) to 9 years after diagnosis (stage III). In 1995, approximately 42% to 46% of patients with stage III colon or rectal cancer, respectively, were considered cured, whereas in 2016 this percentage increased to 73% to 78%, respectively. Conclusions: The number of patients with CRC reaching cure has increased substantially over the years. This study’s results provide valuable insights into trends of CRC patient survival and are important for patients, clinicians, and policymakers.

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