Surgical treatment of non-tuberculous mycobacterial lymphadenitis in children: Our experience and a narrative review

Non-tuberculous mycobacterial lymphadenitis (NTML) accounts for about 95% of the cases of head-and-neck mycobacterial lymphadenitis, and its prevalence has been increasing in the Western world. The diagnostic work-up can be challenging, and differential diagnoses such as tuberculous and suppurative lymphadenitis need to be considered. It may, therefore, not be diagnosed until the disease is in a late stage, by which time it becomes locally destructive and is characterized by a chronically discharging sinus. The treatment options include a medical approach, a wait-and-see policy, and surgery, with the last being considered the treatment of choice despite the high risk of iatrogenic nerve lesions. The aim of this article is to provide an overview of pediatric, head-and-neck NTML based on the literature and our own experience, with particular emphasis on the impact and limitations of surgery.

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COVID-19 lung injury as a primer for immune checkpoint inhibitors (ICIs)-related pneumonia in a patient affected by squamous head and neck carcinoma treated with PD-L1 blockade: a case report

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-001870 ◽

2021 ◽

Vol 9 (2) ◽

pp. e001870

Author(s):

Angelo Dipasquale ◽

Pasquale Persico ◽

Elena Lorenzi ◽

Daoud Rahal ◽

Armando Santoro ◽

...

Keyword(s):

Lung Injury ◽

Head And Neck ◽

Checkpoint Inhibitors ◽

Experimental Therapy ◽

Common Mechanism ◽

Nasopharyngeal Swab ◽

Immune Mediated ◽

Diagnostic Work ◽

Work Up ◽

Diagnostic Work Up

By the beginning of the global pandemic, SARS-CoV-2 infection has dramatically impacted on oncology daily practice. In the current oncological landscape, where immunotherapy has revolutionized the treatment of several malignancies, distinguishing between COVID-19 and immune-mediated pneumonitis can be hard because of shared clinical, radiological and pathological features. Indeed, their common mechanism of aberrant inflammation could lead to a mutual and amplifying interaction.We describe the case of a 65–year-old patient affected by metastatic squamous head and neck cancer and candidate to an experimental therapy including an anti-PD-L1 agent. COVID-19 ground-glass opacities under resolution were an incidental finding during screening procedures and worsened after starting immunotherapy. The diagnostic work-up was consistent with ICIs-related pneumonia and it is conceivable that lung injury by SARS-CoV-2 has acted as an inflammatory primer for the development of the immune-related adverse event.Patients recovered from COVID-19 starting ICIs could be at greater risk of recall immune-mediated pneumonitis. Nasopharyngeal swab and chest CT scan are recommended before starting immunotherapy. The awareness of the phenomenon could allow an easier interpretation of radiological changes under treatment and a faster diagnostic work-up to resume ICIs. In the presence of clinical benefit, for asymptomatic ICIs-related pneumonia a watchful-waiting approach and immunotherapy prosecution are suggested.

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IMPROVED DIAGNOSTIC WORK-UP OF PATIENTS PRESENTING TO THE CARDIOLOGIST WITH SYMPTOMS OF SUSPECTED OBSTRUCTS CORONARY ARTERY DISEASE: GENDER SPECIFIC RESULTS FROM THE IMPACT (INVESTIGATION OF A MOLECULAR PERSONALIZED CORONARY GENE EXPRESSION TEST ON CARDIOLOGY PRACTICE PATTERN) TRIAL

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(13)61163-8 ◽

2013 ◽

Vol 61 (10) ◽

pp. E1163

Author(s):

John A. McPherson ◽

Kelly Davis ◽

May Yau ◽

Philip Beineke ◽

Mark Monane ◽

...

Keyword(s):

Gene Expression ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Practice Pattern ◽

Artery Disease ◽

Diagnostic Work ◽

The Impact ◽

Work Up ◽

Gender Specific ◽

Diagnostic Work Up

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Sleep disturbances in craniopharyngioma: a challenging diagnosis

Journal of Neurology ◽

10.1007/s00415-021-10794-1 ◽

2021 ◽

Author(s):

Ramona Cordani ◽

Marco Veneruso ◽

Flavia Napoli ◽

Claudia Milanaccio ◽

Antonio Verrico ◽

...

Keyword(s):

Sleep Disturbances ◽

Neuropsychological Functioning ◽

Sella Turcica ◽

Hypothalamic Region ◽

Spatial Disorientation ◽

Cystic Tumors ◽

Diagnostic Work ◽

The Impact ◽

Work Up ◽

Diagnostic Work Up

AbstractCraniopharyngiomas are rare solid or mixed solid and cystic tumors that arise from Rathke’s pouch remnants along the pituitary-hypothalamic axis, from the sella turcica to the brain third ventricle. Both the tumor and its treatment can lead to significant neurological and endocrinological complications. Due to the essential role of the hypothalamus in the complex neurophysiologic process of sleep, tumors involving the hypothalamic area may be responsible for disturbances in sleep–wake regulation with alterations in the circadian rhythm, sleep fragmentation, and increased daytime sleepiness. We report two cases of patients with craniopharyngioma, who came to our attention due to the occurrence of episodes characterized by psychomotor slowing and afinalistic limb movements, temporal and spatial disorientation, psychomotor agitation, and oneiric stupor like episodes. A comprehensive clinical data collection and a targeted diagnostic work-up led to a diagnosis of severe sleep disorder characterized by hypersomnia, altered sleep–wake rhythm, and sleep-related breathing disorder. In addition, the polysomnography revealed peculiar alterations in the sleep structure. The diagnostic work-up lead to an accurate differential diagnosis between epileptic seizures and episodes expressions of sleep disturbances. These clinical features can be challenging to diagnose and can lead to misdiagnosis and inappropriate treatment. Diagnosis of sleep disorders is crucial, considering the impact of sleep on general health, cognition, and neuropsychological functioning. These findings support the need to incorporate a comprehensive sleep evaluation in childhood brain tumor involving the suprasellar/hypothalamic region.

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Faculty Opinions recommendation of Handling an Isolated Malleus Handle Fracture: Current Diagnostic Work-up and Treatment Options.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718879660.793501429 ◽

2014 ◽

Author(s):

Robert Vincent ◽

Nina Mistry

Keyword(s):

Treatment Options ◽

Diagnostic Work ◽

Work Up ◽

Diagnostic Work Up

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Risk of depression following prostate cancer work-up: A nationwide study.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.5061 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 5061-5061

Author(s):

Anne Sofie Friberg ◽

Klaus Brasso ◽

Elisabeth Wreford Andersen ◽

Signe Benzon Larsen ◽

John Thomas Helgstrand ◽

...

Keyword(s):

Prostate Cancer ◽

Cumulative Incidence ◽

Treatment Modalities ◽

Income Quintile ◽

Increased Risk ◽

Diagnostic Work ◽

The Impact ◽

Work Up ◽

Diagnostic Work Up

5061 Background: Little is known about the psychological impact of undergoing evaluation for prostate cancer (PCa). We investigated the risk of developing a depression following PCa work-up with benign and malignant findings, respectively, compared with cancer-free men. Methods: A nationwide cohort of men who underwent prostate needle biopsies in Denmark from 1997–2011 was identified through the Danish Prostate Cancer Registry. Primary outcome was indication of moderate to severe depression defined as hospital contact for depression or first redemption of a prescribed antidepressant. For comparison, we selected a minimum of five age-matched cancer-free men per man who had undergone PCa specific diagnostic work-up. We excluded men with other cancer, major psychiatric disorder or use of antidepressants up to three years before study entry. Information on outcome and covariates (age, period, cohabitation status, income quintile and comorbidity) were retrieved from National Danish registries. We illustrated the risk of depression by cumulative incidence functions. Data were analyzed using Cox models adjusted for possible confounders. Results: We identified 54,766 men who underwent work-up including transrectal biopsies of the prostate, among these, 21,419 biopsy sets were benign and 33,347 men were diagnosed with PCa. We found an increasing cumulative incidence of depression in all groups. However, men diagnosed with PCa had a significantly higher risk throughout up to 18 years of follow-up. The adjusted hazard ratio (HR) of depression in men diagnosed with PCa was increased throughout follow-up with the highest risk in the two years following diagnosis (HR 2.77, 95% CI 2.66–2.87). After undergoing biopsies, men with benign results had an increased risk of depression (HR 1.22, 95% CI 1.14–1.31) in the first two years compared with cancer-free men; hereafter, we found no difference. Conclusions: We found an increased risk of depression in men following diagnostic work-up for PCa compared with a matched background population. In men diagnosed with PCa, the risk remained increased throughout the study period. Future studies are needed to further analyze the impact of stage and treatment modalities.

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