scholarly journals A Rare Case of Rectal Mixed Adeno-Neuroendocrine Carcinoma (MANEC) with Liver Metastasis

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S62-S63
Author(s):  
M Akkad Wattar ◽  
R Tarakji ◽  
W Bibars
Keyword(s):  
Liver Metastasis ◽  
Neuroendocrine Carcinoma ◽  
Immunohistochemical Staining ◽  
Chromogranin A ◽  
World Health ◽  
Malignant Neoplasms ◽  
Invasive Component ◽  
Health Organization ◽  
The Right ◽  
Immunohistochemical Studies

Abstract Introduction/Objective Mixed Adeno-Neuroendocrine Carcinoma (MANEC) is a rare subtype of colorectal cancer which was recognized and described by the world health organization (WHO) in 2010. It was defined as malignant neoplasms in which each component represents at least 30% of the lesion. In this abstract, we present a case of mixed adeno-neuroendocine carcinoma of the rectum with metastasis of the neuroendocrine component to the liver. We discuss the histomorphological and immunohistochemical features of this tumor. Methods/Case Report A 64-year-old male presented with abdominal pain in the right upper quadrant area. An abdominal CT scan showed multiple nodules in the liver as well as a mass lesion in the rectum. Liver needle core biopsy revealed infiltrating nests of atypical cells with marked pleomorphism, a variable amount of cytoplasm, and prominent nucleoli. Mitotic activity and necrosis were seen. By immunohistochemical staining, the tumor cells were negative for CK7 and CK20, positive for CD56, and partially positive for CDX2. Although glands formation was not seen; however, given the positivity of CDX2 as well as the colonic mass, mismatch protein analysis (MMR) was performed and it was intact. These findings were consistent with poorly differentiated high-grade neuroendocrine carcinoma. The rectal mass was excised through colonoscopy and revealed invasive carcinoma with morphology similar to that of the liver biopsy in addition to a vague glandular differentiation. Tubulovillous adenoma was also seen. On immunohistochemical staining, the invasive component was positive for CD56, synaptophysin, and chromogranin A, partially positive for CDX2, and negative for CK20, consistent with the neuroendocrine component. The adenoma was positive for CK20, and CDX2, and negative for CD56. Rare positivity was seen by synaptophysin and chromogranin A. The carcinoma and the adenoma were both positive for P53. The neuroendocrine carcinoma comprised 40-50% of the tumor. Results (if a Case Study enter NA) NA Conclusion Only a few cases of Mixed Adeno-Neuroendocrine Carcinoma (MANEC) were reported. We add a new case with liver metastasis. The systematic application of immunohistochemical studies aided in the recognition of each component of the neoplasm.

Mixed Adenocarcinomas of the Lung: Place in New Proposals in Classification, Mandatory for Target Therapy

2010 ◽  
Vol 134 (1) ◽  
pp. 55-65 ◽  
Author(s):  
Marco Chilosi ◽  
Bruno Murer
Keyword(s):  
Lung Cancer ◽  
Lung Adenocarcinoma ◽  
World Health Organization ◽  
Cell Biology ◽  
Small Cell ◽  
World Health ◽  
Malignant Neoplasms ◽  
New Classification ◽  
Therapeutic Decisions ◽  
Health Organization

Abstract Context.—Lung cancer is one of the most frequent and lethal malignant neoplasms, but knowledge regarding the molecular basis of its pathogenesis is far from complete due to the striking diversity of different forms. The current lung cancer classification (World Health Organization 2004) can efficiently distinguish clinically relevant major subtypes (small cell and non–small cell carcinomas), but its results are partly inadequate when facing prognostic and therapeutic decisions for non–small cell carcinomas, especially for the group of tumors classified as adenocarcinoma. Lung adenocarcinoma comprises a heterogeneous group of tumors characterized by diverse morphologic features and molecular pathogenesis. The category of mixed adenocarcinomas includes most adenocarcinomas (approximately 80%) and, according to World Health Organization criteria, is defined by the occurrence of a mixed array of different patterns (acinar, papillary, bronchioloalveolar, solid with mucin). The histologic recognition of mixed adenocarcinoma is subjective and cannot consistently discriminate between responders and nonresponders to new targeted therapies (eg, tyrosine kinase inhibitors). Diagnostic problems are mainly related to the poor reproducibility of histologic criteria, especially when applied in small biopsies and cytology, and to the difficulty in assigning each form to a precisely defined entity, as needed by updated therapeutic approaches. In this evolving scenario, pathologists face new challenging diagnostic roles that include not only the precise morphologic definition of carcinoma subtypes but also their molecular characterization. Objective.—To use a comprehensive critical analysis reconciling the overwhelming variety of biologic, morphologic, molecular, and clinical data to define new classification schemes for lung adenocarcinoma. Data Sources.—Scientific literature and personal data were used. Conclusions.—A new classification approach should redefine lung adenocarcinoma heterogeneity reconciling classic morphology, immunophenotypic and molecular features of neoplastic cells, and also relevant information provided by stem cell biology. This approach, which has been already successfully applied in World Health Organization classification of other tumors, could improve the recognition of new reproducible profiles for adenocarcinomas, more closely and reproducibly related to clinical features and response to specific therapies, limiting the use of “wastebasket” categories such as mixed adenocarcinoma.

Implementing the Sphere Project’s standards for patient’s healthcare rights in the disaster zone: The experience of the Israeli field hospital in post-quake Nepal

2021 ◽  
Vol 16 (1) ◽  
pp. 59-66
Author(s):  
Deganit Kobliner-Friedman, RN, MPH ◽  
Ofer Merin, MD ◽  
Eran Mashiach, MD ◽  
Reuven Kedar, MD ◽  
Shai Schul, MHA ◽  
...  
Keyword(s):  
Disaster Response ◽  
Sexual Exploitation ◽  
World Health ◽  
Field Hospital ◽  
Medical Teams ◽  
Health Organization ◽  
The Individual ◽  
The Right ◽  
Israel Defense Forces ◽  
Privacy And Confidentiality

Emergency medical teams (EMTs) encounter chaos upon arriving at the scene of a disaster. Rescue efforts are utilitarian and focus on providing the technical aspects of medical care in order to save the most lives at the expense of the individual. This often neglects the basic healthcare rights of the patient. The Sphere Project was initiated to develop universal humanitarian standards for disaster response.The increase in the number of EMTs led the World Health Organization (WHO) to organize standards for disaster response. In 2016, the WHO certified the Israel Defense Forces Field Hospital (IDF-FH) as the first to be awarded the highest level of accreditation (EMT-3). This paper presents the IDF-FH’s efforts to protect the patient’s healthcare rights in a disaster zone based on the Sphere Principles.These core Sphere Principles include the right to professional medical treatment; the right to dignity, privacy, and confidentiality; the right for information in an understandable language; the right to informed consent; the obligation to maintain private medical records; the obligation to adhere to universal ethical standards, to respect culture and custom and to care for vulnerable populations; the right to protection from sexual exploitation and violence; and the right to continued treatment.

scholarly journals Lebanon Cities’ Public Spaces

2018 ◽  
Vol 3 (1) ◽  
pp. 119-152 ◽  
Author(s):  
Maryam Nazzal ◽  
Samer Chinder
Keyword(s):  
Green Space ◽  
Public Spaces ◽  
World Health ◽  
Right To The City ◽  
Social Connections ◽  
Land Prices ◽  
The Social ◽  
Health Organization ◽  
The Right ◽  
The City

In Lebanon, the social connections are undeniable and crucial. However, meeting places remain private such as houses, restaurants, malls, and beach resorts. This is mainly due to the shortage of public spaces in Lebanon resulting from lack of planning, regulations and awareness around the right to the city and the importance of public spaces. In main cities where land prices are so expensive, common practice has prioritized the use of land in real estate development, thus trumping other uses such as public and communal spaces.In the late 1990s, Lebanon saw the emergence of malls, which have arguably acted as alternatives to public spaces. Malls, with their wealth of food courts, restaurants, cinemas, and play areas, have become the new downtown for a portion of the Lebanese population. They are also considered safe, which is another important factor.In 2015, the percentage of green spaces in Lebanon has decreased to less than 13%. While the World Health Organization (WHO) recommends a minimum of 9m2 of green space per capita (UN-HABITAT, 2016), Beirut has only 0.8m2.

scholarly journals THE HUMAN RIGHT TO HEALTH: A RETROSPECTIVE ANALYSIS AFTER 70 YEARS OF INTERNATIONAL RECOGNITION

2018 ◽  
pp. 24-42
Author(s):  
MARÍA DALLI
Keyword(s):  
Human Rights ◽  
Right To Health ◽  
World Health ◽  
Health Coverage ◽  
Human Right ◽  
The Sustainable Development ◽  
Cultural Rights ◽  
Health Organization ◽  
The Individual ◽  
The Right

In 1948, the General Assembly of the United Nations adopted the first international text recognising universal human rights for all; the Universal Declaration of Human Rights. Article 25 recognises the right to an adequate standard of living, which includes the right to health and medical care. On the occasion of the 70th anniversary of the Declaration, this article presents an overview of the main developments that have been made towards understanding the content and implications of the right to health, as well as an analysis of some specific advancements that aim to facilitate the enforcement thereof. These include: a) the implication of private entities as responsible for right to health obligations; b) the Universal Health Coverage goal, proposed by the World Health Organization and included as one of the Sustainable Development Goals; and c) the individual complaints mechanism introduced by the Optional Protocol to the International Covenant on Economic, Social and Cultural Rights (adopted on the 10th December 2008, 60 years after the UDHR).

Emergence of a High-Grade Sarcoma in a Recurrent Meningioma: Malignant Progression or Collision Tumor?

2011 ◽  
Vol 135 (7) ◽  
pp. 935-940
Author(s):  
Buge Oz ◽  
Melike Pekmezci ◽  
Reza Dashti ◽  
Kutlay Karaman ◽  
Cengiz Kuday ◽  
...  
Keyword(s):  
Malignant Transformation ◽  
Neurofibromatosis Type ◽  
Collision Tumor ◽  
World Health ◽  
Malignant Neoplasms ◽  
High Grade ◽  
Multiple Meningiomas ◽  
Short Period ◽  
High Grade Sarcoma ◽  
Health Organization

Abstract Anaplastic meningiomas that resemble sarcomas often reveal clues to their meningothelial differentiation or develop in a plausible setting that confirms their meningothelial origin. Malignant mesenchymal neoplasms without obvious evidence of meningothelial differentiation or origin are more likely to be true primary or metastatic sarcomas. Because of their clinical and biological differences, it is important to distinguish anaplastic meningioma from a sarcoma. We present a 67-year-old woman with multiple meningiomas, who developed a high-grade spindle cell tumor 6 months after the resection of a World Health Organization grade I meningioma. It was not clear whether this tumor represented a malignant transformation of meningioma or a primary sarcoma. Malignant transformation of a meningioma is exceptional within this short period and a coexisting sarcoma and meningioma are equally uncommon. Even though these malignant neoplasms are rare in general, they appear to be more prevalent in patients with multiple meningiomas including those with neurofibromatosis type 2.

scholarly journals Co-existence of gastric adenocarcinoma and neuroendocrine carcinoma: a rare entity

2017 ◽  
Vol 7 (2) ◽  
pp. 1221-1223 ◽  
Author(s):  
Nirajan Mainali ◽  
Niraj Nepal ◽  
Prabesh Kumar Choudhary ◽  
Amrita Sinha ◽  
Saroj Rajbanshi ◽  
...  
Keyword(s):  
Neuroendocrine Carcinoma ◽  
Partial Gastrectomy ◽  
Endoscopic Biopsy ◽  
World Health ◽  
Neuroendocrine Neoplasms ◽  
World Health Organization Classification ◽  
Well Differentiated ◽  
Health Organization ◽  
Histopathology Examination

A mixed adenoneuroendocrine carcinoma is a tumor composed of both adenocarcinoma and neuroendocrine carcinoma components, with each comprising  at least one-third of the lesion, as defined by the World Health Organization classification of neuroendocrine neoplasms in 2010.. A 67-years-old male was admitted to the hospital with symptoms suggesting gastric cancer. Histopathology examination from endoscopic biopsy revealed adenocarcinoma. Later partial gastrectomy specimen examination the lesion show presence of well differentiated adenocarcinoma along with neuro endocrine carcinoma.

Right diagnosis, right treatment: SAFER PRACTICES

2019 ◽  
Vol 1 (7) ◽  
pp. 356-360 ◽  
Author(s):  
Paul Silverston
Keyword(s):  
Clinical Practice ◽  
Health Professionals ◽  
Diagnostic Errors ◽  
Integrated Approach ◽  
Diagnostic Error ◽  
World Health ◽  
Formal Training ◽  
The World ◽  
Health Organization ◽  
The Right

Choosing the right treatment for the patient requires that the right diagnosis is made first. In primary and ambulatory care, however, diagnostic errors are both common and commonly preventable. The World Health Organization has recommended that all health professionals should receive formal training in the principles of diagnostic reasoning and the causes of diagnostic error, and that strategies and interventions to reduce the risk of diagnostic error should be used in clinical practice. This article describes a mnemonic checklist, SAFER PRACTICES, which can be used in an integrated approach to the prevention and detection of diagnostic errors that starts in the classroom and continues through to the consulting room.

scholarly journals Everything counts in sending the right message: science-based messaging implications from the 2020 WHO guidelines on physical activity and sedentary behaviour

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Michelle L. Segar ◽  
Marta M. Marques ◽  
Antonio L. Palmeira ◽  
Anthony D. Okely
Keyword(s):  
Physical Activity ◽  
Sedentary Behaviour ◽  
Psychological Needs ◽  
World Health ◽  
Behavioural Science ◽  
Aerobic Activity ◽  
New Guidelines ◽  
Health Organization ◽  
The Right ◽  
Country Specific

Abstract The World Health Organization (WHO) released the 2020 global guidelines on physical activity and sedentary behaviour. The new guidelines contain a significant change from the 2010 guidelines on physical activity for adults and older adults that has important implications for next-generation physical activity messaging: The removal of the need for aerobic activity to occur in bouts of at least 10 min duration. This change in the guidelines provides an opportunity to communicate in new ways that align with behavioural science, permitting physical activity communicators and promoters to better support people’s psychological needs, motivation, and ability to fit healthy levels of physical activity into their lives. The frames and messages we use to communicate about the guidelines matter because they influence whether activity is perceived as relevant, meaningful, and feasible – or not. When developing new physical activity communications there are some overarching principles, based on behavioural science, to keep in mind. Using established theory, this commentary aims to support the creation of more strategic frames and messages for increasing the value and integration of physical activity into daily living. Country-specific physical activity campaigns using these ideas will be discussed.

scholarly journals Lipomatous tumours in adrenal gland: WHO updates and clinical implications

2017 ◽  
Vol 24 (3) ◽  
pp. R65-R79 ◽  
Author(s):  
Alfred King-yin Lam
Keyword(s):  
Adrenal Gland ◽  
Age Distribution ◽  
World Health ◽  
Adrenal Myelolipoma ◽  
Adrenal Tumours ◽  
Endocrine Organs ◽  
Lipomatous Tumour ◽  
Health Organization ◽  
The Right

Adrenal lipomatous tumour is a group of adrenal tumours with a significant component of adipose tissue. According to the current World Health Organization (WHO) classification of tumours of endocrine organs, adrenal myelolipoma is the only entity amongst the group of tumours being described. In the literature, other more recently documented adrenal lipomatous tumours included 24 lipomas, 32 teratomas and 16 angiomyolipomas. Rare fatty tumours of the adrenal gland comprised liposarcoma, hibernoma, adrenocortical tumours with fat component and rare adrenal tumours with fat component. Myelolipoma comprises approximately 3% of primary adrenal tumour. It is noted more commonly in females and in the right adrenal gland. Approximately 40 bilateral myelolipomas were reported. The tumour is most frequently recorded in patients between fifth and seventh decades of life. Adrenal lipomas are often seen in males and in the right adrenal gland. They were commonly noted in patients in the sixth decade of life. The diagnosis could only be possible on examination of the surgically removed specimen. Adrenal teratomas were more common in females and with a bimodal age distribution. Slightly over 60% of the patients with adrenal teratoma are symptomatic. Adrenal angiomyolipomas were often symptomatic, more common in females and in the fifth decades of life. To conclude, adrenal lipomatous tumour is uncommon. They are often benign and non-functional. It is important to recognize the features of this group of lipomatous tumours in the adrenal gland as they are being detected on increasing incidence as a result of the wide-spread use of modern imaging modalities.

scholarly journals COVID-19 Knowledge Resource Categorization and Tracking: A Conceptual Framework (Preprint)

2021 ◽  
Author(s):  
Muhammad Afzal ◽  
Maqbool Hussain ◽  
Jamil Hussain ◽  
Sungyoung Lee
Keyword(s):  
Conceptual Framework ◽  
Level Structure ◽  
Global Scale ◽  
Information Resources ◽  
World Health ◽  
Infrastructure Development ◽  
Knowledge Resources ◽  
Health Organization ◽  
The Right ◽  
Resource Categorization

BACKGROUND Declaring the COVID-19 disease a global pandemic by the World Health Organization (WHO), it gained momentum as every day passed, and private and government sectors of different countries pushed funding towards research in various capacities. A great portion of efforts is devoted to information technology and service infrastructure development, including research to develop intelligent models and techniques for alerts, monitoring, early diagnosis, prevention, and other relevant services. As a result, tons of information resource have been created in the global space and are available for use. However, there is lack of a defined structure to organize these resources into categories or classes based on the nature as well the origin of data. OBJECTIVE This study aims to organize COVID-19 information resources into a well-defined structure to facilitate easy identification of a resource, tracing information workflows, and a guide for contextual dashboards design and development. METHODS A sequence of action research was performed that involve a review of COVID-19 efforts and initiatives on a global scale during the year 2020. Data is collected according to a defined structure of primary, secondary, and tertiary categories. Various descriptive statistical analysis techniques were employed to get insights of the data to help in developing a conceptual framework underlining the organization of resources and interactions among different resources. RESULTS In this paper, we present a three-level structure of resource categorization that provides a gateway to access the global initiatives with enriched metadata, assists users in tracing the workflow of tertiary, secondary, and primary resources with relationships among various fragments of information. The results comprise mapping initiatives at the tertiary level to secondary and then to the primary level to reach the firsthand resource of data, research, and trials. CONCLUSIONS Adopting the proposed three-level structure enables a consistent organization and management of existing COVID-19 knowledge resources and provides a roadmap for classifying the futuristic resources. This study is one of the earliest studies to introduce an organized structure and demonstrate the placement of COVID-19 resources at the right place. By implementing the proposed framework according to the stated guidelines, this study facilitates the development of applications such as interactive dashboards to facilitate the contextual identification and tracking of interdependent COVID-19 information resources.

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