scholarly journals Histologic Findings in Surgical Pathology Specimens From Individuals Taking Masculinizing Hormone Therapy for the Purpose of Gender Transition: A Systematic Scoping Review

2021 ◽  
Author(s):  
Alicia R. Andrews ◽  
Archan Kakadekar ◽  
Dina N. Greene ◽  
Mahmoud A. Khalifa ◽  
Victor Santiago ◽  
...  
Keyword(s):  
Hormone Therapy ◽  
Case Reports ◽  
Transitional Cell ◽  
The Body ◽  
Surgical Pathology ◽  
Gender Transition ◽  
Ongoing Research ◽  
Ovid Medline ◽  
Histologic Changes ◽  
Transgender Men

Context.— Transgender men and transmasculine persons experience a discordance between the female sex they were assigned at birth and their gender. They may choose to take hormone therapy and/or undergo surgery to masculinize the body. Understanding the common (and less common) histologic changes present in patients taking masculinizing hormones will empower pathologists to better serve this unique patient population. Objective.— To summarize histologic findings in surgical pathology specimens from persons taking masculinizing hormones as a part of gender transition. Data Sources.— A systematic review of the OVID Medline and PubMed databases was performed to identify all studies describing histologic findings in surgical pathology specimens from transgender men from January 1946 to January 2021. Conclusions.— Publication in this area has markedly increased in the last 2 decades. However, most of the studies identified were descriptive and case reports describing changes seen in specimens removed as a part of masculinizing surgical procedures. Benign histologic findings include stromal hyalinization and epithelial atrophy in the breast, polycystic ovarian syndrome–like changes in the ovary, and transitional cell metaplasia in the cervix. The most commonly reported neoplastic finding was adenocarcinoma of the breast, with rare cases of ovarian, endometrial, cervical, vaginal, pituitary, pancreatic, and cardiovascular neoplasia also reported. Ongoing research in this area is needed to better characterize the histologic findings in persons taking masculinizing hormones to provide a deeper understanding of the effect of these treatments on different tissues and facilitate better patient management.

scholarly journals Histologic Findings in Surgical Pathology Specimens From Individuals Taking Feminizing Hormone Therapy for the Purpose of Gender Transition: A Systematic Scoping Review

2021 ◽  
Author(s):  
Alicia R. Andrews ◽  
Archan Kakadekar ◽  
Robert L. Schmidt ◽  
Paari Murugan ◽  
Dina N. Greene
Keyword(s):  
Hormone Therapy ◽  
Squamous Metaplasia ◽  
Germ Cell Tumors ◽  
Transgender Women ◽  
The Body ◽  
Surgical Pathology ◽  
Breast Adenocarcinoma ◽  
Future Research ◽  
Anal Squamous Cell Carcinoma ◽  
Organ Systems

Context.— Transgender women experience health disparities in all areas of medicine. Within surgical pathology, knowledge gaps relating to the concepts of transgender care exist. Medical transition for transgender women and transfeminine persons may involve hormone therapy and/or surgery to feminize the body. Understanding the common histologic changes in specimens from feminizing surgeries, as well as other specimens from patients on feminizing hormone therapy, will aid surgical pathologists in providing better care to this unique patient population. Objective.— To summarize histologic findings in surgical pathology specimens from transgender women taking feminizing hormones. Data Sources.— A systematic review of the OVID Medline and PubMed databases was performed to identify all studies describing histologic findings in surgical pathology specimens from transgender women from 1946 to 2019. Conclusions.— Much of the literature to date describing histologic findings in transgender women comes from the examination of genitourinary specimens removed during feminizing surgeries. Common benign changes associated with feminizing hormone therapy include the development of acini and lobules in the breast, testicular tubular changes, and squamous metaplasia of the prostate and urethra. Neoplastic cases include breast adenocarcinoma and fibroepithelial lesions, testicular germ cell tumors, prostatic adenocarcinoma, anal squamous cell carcinoma, pituitary adenomas, and meningiomas. Additional studies assessing the findings in other organ systems as well as population-based studies assessing rates of neoplasia are needed. However, future research relies on engagement within the surgical pathology community as well as collaboration with clinicians and patients to achieve optimal results.

Linezolid Induced Skin Reactions in a Multi Drug Resistant Infective Endocarditis Patient: A Rare Case

2020 ◽  
Vol 15 (3) ◽  
pp. 222-226 ◽  
Author(s):  
Asha K. Rajan ◽  
Ananth Kashyap ◽  
Manik Chhabra ◽  
Muhammed Rashid
Keyword(s):  
Case Report ◽  
Infective Endocarditis ◽  
Rare Case ◽  
Case Reports ◽  
Multidrug Resistant ◽  
The Body ◽  
Prior History ◽  
Skin Reactions ◽  
Rare Case Report ◽  
Multiple Drugs

Rationale: Linezolid (LNZ) induced Cutaneous Adverse Drug Reactions (CADRs) have rare atypical presentation. Till date, there are very few published case reports on LNZ induced CADRs among the multidrug-resistant patients suffering from Infective Endocarditis (MDR IE). Here, we present a rare case report of LNZ induced CARs in a MDR IE patient. Case report: A 24-year-old female patient was admitted to the hospital with chief complaints of fever (101°C) associated with rigors, chills, and shortness of breath (grade IV) for the past 4 days. She was diagnosed with MDR IE, having a prior history of rheumatic heart disease. She was prescribed LNZ 600mg IV BD for MDR IE, against Staphylococcus coagulase-negative. The patient experienced flares of cutaneous reactions with multiple hyper-pigmented maculopapular lesions all over the body after one week of LNZ therapy. Upon causality assessment, she was found to be suffering from LNZ induced CADRs. LNZ dose was tapered gradually and discontinued. The patient was prescribed corticosteroids along with other supportive care. Her reactions completely subsided and infection got controlled following 1 month of therapy. Conclusion: Healthcare professionals should be vigilant for rare CADRs, while monitoring the patients on LNZ therapy especially in MDR patients as they are exposed to multiple drugs. Moreover, strengthened spontaneous reporting is required for better quantification.

scholarly journals Cutaneous Leishmaniasis in a Bangladeshi Adult: A Case Report

2015 ◽  
Vol 25 (2) ◽  
pp. 78-80
Author(s):  
Abdur Rahim ◽  
Md Moniruzzan ◽  
Rashedul Hassan ◽  
Monira Sarmin ◽  
Md Abdullah Yusuf ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Plasma Cells ◽  
Case Reports ◽  
Ring Finger ◽  
Clinical History ◽  
The Body ◽  
Nasal Bridge ◽  
Cutaneous Tuberculosis ◽  
Exposed Part ◽  
Ulcerative Lesions

Cutaneous leishmaniasis is rare in Bangladesh although very few case reports are seen since last few years. But Visceral Leishmaniasis (kala azar) and PKDL are common in this region. In country like ours where tuberculosis and leprosy are more prevalent Cutaneous Leishmaniasis is very likely to be mistreated as Cutaneous tuberculosis especially lupus vulgaris or leprosy. Cases of Cutaneous Leishmaniasis (CL) are usually imported to Bangladesh from other endemic countries. A patient from an endemic area of Cutaneous Leishmaniasis, a non-healing nodulo-ulcerative lesion on exposed part of the body, dermal infiltration with lymphocytes, histiocytes and plasma cells and demonstration of intracellular parasites in lesional skin establish the diagnosis of Cutaneous Leishmaniasis. We present a case of Cutaneous Leishmaniasis in a Bangladeshi adult working in Saudi Arabia for more than 15 years. He presented with multiple ulcerative lesions on nasal bridge, right ear lobule and dorsum of right ring finger. The patient’s clinical history, morphology of the lesions and laboratory analysis were consistent with Cutaneous Leishmaniasis, a rare entity for Bangladesh.Bangladesh J Medicine Jul 2014; 25 (2) : 78-80

Mutagenicity, Metabolism, and DNA Interactions of Urethane

1990 ◽  
Vol 6 (1) ◽  
pp. 71-108 ◽  
Author(s):  
Rene E. Sotomayor ◽  
Thomas F.X. Collins
Keyword(s):  
Molecular Mechanisms ◽  
Case Reports ◽  
The Body ◽  
Alcoholic Beverages ◽  
Fermented Foods ◽  
X Rays ◽  
Spermatogenic Cells ◽  
Dna Interactions ◽  
Specific Locus ◽  
Vinyl Carbamate

Urethane, a known animal carcinogen, has been the subject of intensive research efforts spanning 40 years. Recent concerns have focused on the presence of urethane in a variety of fermented foods and alcoholic beverages, although no epidemiological studies or human case reports have been published. Much information is available about the mutagenesis, metabolism, and DNA interactions of urethane in experimental systems. Urethane is generally not mutagenic in bacteria although in some instances it acts as a weak mutagen. Urethane is not mutagenic in Neurospora but is weakly mutagenic in Saccharomyces. Drosophila appear to be the only organisms that consistently give positive mutagenic results with urethane, but its mutagenicity is weak and in many cases shows no clear dose dependence. Urethane is a good clastogen in mammalian somatic cells in vivo, but it shows variable results with cells in vitro. It efficiently induces sister chromatid exchanges in a variety of cells. Mammalian spermatogenic cells are insensitive to the induction of specific locus and dominant lethal mutations by urethane. Mutational synergism has been reported to occur between ethyl methanesulfonate and urethane when administered two generations apart, and some investigators have suggested possible synergism for cancer-causing mutations in mice exposed to X-rays and urethane one generation apart. These studies are controversial and have not been confirmed. Studies on the induction of cancer-causing dominant mutations by urethane are at variance with results from extensive studies with the specific locus test in mice. Urethane studies with the unscheduled DNA synthesis assay in mouse spermatogenic cells and with the sperm abnormality test have given negative results. Urethane is rapidly and evenly distributed in the body. The rate of elimination of urethane from plasma is a saturable process and varies according to the strain and age of the animal. Recent studies have concentrated on the effect of ethanol on urethane metabolism. At concentrations similar to those in wine, ethanol inhibits the tissue distribution of urethane in mice. These results are important because they suggest a lower carcinogenic/mutagenic risk than expected from exposure to urethane in alcoholic beverages. Although research on the metabolic activation of urethane has been extensive, no conclusive results have been obtained about its active metabolite, at one time thought to be N-hydroxyurethane. More recently, it has been postulated that urethane is actived to vinyl carbamate and that this metabolite is capable of reacting with DNA. Vinyl carbamate is more carcinogenic and more mutagenic than the parental compound, but despite intensive efforts it has not been identified as a metabolite in animals treated with urethane. Urethane binding to DNA appears to correlate well with tissue susceptibility to cancer. Various studies have attempted to elucidate the molecular nature of the bound molecule and the binding site. Some results have indicated the formation of a single DNA adduct, 7-(2-oxoethyl)guanine. This adduct may isomerize to O6,7-(1'-hydroxyethano)guanine, which might be more mutagenic than the 2-oxoethyl adduct; however, this possibility seems unlikely. Despite extensive research, urethane's metabolism and molecular mechanisms of mutation are still not clearly understood.

scholarly journals Causes of Allergies and Diagnosis and Treatment

2015 ◽  
Vol 9 (5) ◽  
pp. 18-24 ◽  
Author(s):  
Saman Aiubi ◽  
Nasroallah Moradi Kor ◽  
Omid Lakzaie Azar ◽  
Fatemeh Asadi Rahmani ◽  
Zeinab Hajian Berenjestanaki ◽  
...  
Keyword(s):  
Food Allergy ◽  
Systematic Reviews ◽  
The Body ◽  
Food Allergies ◽  
Current Time ◽  
Assessment Scores ◽  
Trigger Time ◽  
Ovid Medline ◽  
Overview Of Systematic Reviews ◽  
Time Of Year

Allergies are diseases of the immune system that cause an overreaction to substances called "allergens." Allergies are grouped by the kind of trigger, time of year or where symptoms appear on the body: indoor and outdoor allergies (also called "hay fever," "seasonal," "perennial" or "nasal" allergies), food allergies, latex allergies, insect allergies, skin allergies and eye allergies. People who have allergies can live healthy and active lives. The search strategy has been devised on ovid medline and then adapted for the other databases (see Additional file 1 for full search strategies). In all cases the databases will be searched from 1 January 2000 to 30 September 2012, and limited to Europe based on the definition provided by the Organization for Economic Cooperation and Development (OECD).The resulting quality assessment scores are given alongside other study parameters in three tables. We assessed the systematic reviews based on the type of intervention or subject assessed for the prevention of food allergy or food sensitization. In this overview of systematic reviews concerning the etiology and prevention of food allergy, we identified 14 eligible publications. This systematic review will provide the most up to date estimates of the frequency of food allergy in Europe. Given the presumed increase in IgE mediated food allergy in the recent past, there is much interest in identifying the causes of food allergy and primary preventive strategies. These advances are creating the opportunities for novel therapies for food allergy. However, at the current time, the only treatment is avoidance.DOI: http://dx.doi.org/10.3126/ijls.v9i5.12701

scholarly journals Amoxicillin Induced Steven Johnson’s Syndrome: A Case Report

2020 ◽  
Vol 10 (4-s) ◽  
pp. 220-222
Author(s):  
R Mahendra Kumar ◽  
Sanatkumar Nyamagoud ◽  
Krishna Deshpande ◽  
Ankitha Kotian
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Case Reports ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
Hypersensitivity Reactions ◽  
Johnson Syndrome ◽  
Oral Consumption ◽  
Life Threatening

Stevens-Johnson syndrome (SJS) is a very rare, potentially fatal skin reaction that is typically the result of reaction to the drug. In particular, SJS is characterized by extensive skin and mucous membrane lesions (i.e. mouth, nose, esophagus, anus, and genitalia), epidermis detachment, and acute skin blisters. In 95 % of case reports, drugs were found to be an important cause for the development of SJS. This story is a case of A 42 year old male hospitalized with rashes all over the body and fever, after oral consumption of Amoxicillin drug for sore throat. This case study discusses the possibility that serious hypersensitivity reactions with Amoxicillin can rarely occur and can be extremely harmful and life-threatening Menacing. Keywords: Toxic Epidermal Necrolysis, Stevens Johnson Syndrome, Adverse drug reaction, Nikolsky’s sign

scholarly journals Hemophagocytic Lymphohistiocytosis Syndrome As Presenting Sign For Acute Monocytic Leukaemia- A Case Report.

2020 ◽  
Vol 7 (08) ◽  
pp. 4918-4924
Author(s):  
Gal Sahaf Levin ◽  
Gida Ayada ◽  
Moshe Yeshurun ◽  
Oleg Rogach ◽  
Shaul Lev
Keyword(s):  
Acute Myeloid Leukemia ◽  
Organ Failure ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Myeloid Leukemia ◽  
Case Reports ◽  
Transitional Cell ◽  
Interleukin 2 ◽  
Clinical Manifestations ◽  
Multi Organ Failure ◽  
Acute Myeloid

Background: Hemophagocytic lymphohistiocytosis (HLH) is a rare aggressive syndrome of excessive immune activation. Clinical manifestations of this syndrome mimic various other clinical conditions making the diagnosis harder to achieve. These manifestations are believed to be a result of cytokine storm which leads, eventually, to a multi-organ failure and eventually death. The latter two might be prevented if HLH was diagnosed early. HLH is classified into primary consist of monogenic disorders and secondary occurs as a complication in various settings such as infection, autoimmune disease, and malignancy. In hematologic malignancies, HLH is classically associated with specific entities, mainly, lymphoma or induced by treatment-related infections. Acute myeloid leukemia, on the other hand, is less common trigger with only few case reports.   Case presentation: An 83-years-old, 5 years free of transitional cell man, presented with unstable atrial fibrillation was intubated and shortly after that he developed a multi-organ failure. Bicytopenia and a high level of ferritin aroused a clinical suspicion of HLH syndrome. Further evaluation revealed high levels of soluble interleukin 2 receptors and no activity of natural killers cells. A bone marrow was performed and it did not show phagocytosis, however, acute myeloid leukemia (AML) was diagnosed. AML was suggested to be associated with chemotherapy that our patient received 5 years earlier.   Conclusion: Hemophagocytic lymphohistiocytosis can be present as a multi-organ failure requiring a high index of suspicion. Chemotherapy related-AML can be a trigger for HLH. 

scholarly journals A review of medical marijuana for the treatment of posttraumatic stress disorder: Real symptom re-leaf or just high hopes?

2018 ◽  
Vol 8 (2) ◽  
pp. 86-94 ◽  
Author(s):  
Ilona Shishko ◽  
Rosana Oliveira ◽  
Troy A. Moore ◽  
Kenneth Almeida
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Chart Review ◽  
Stress Disorder ◽  
Case Reports ◽  
Retrospective Chart Review ◽  
Current Evidence ◽  
Ptsd Symptoms ◽  
Ovid Medline ◽  
Current Medication

Abstract Introduction: The incidence of posttraumatic stress disorder (PTSD) is common within the population and even more so among veterans. Current medication treatment is limited primarily to antidepressants. Such medicines have shown to produce low remission rates and may require 9 patients to be treated for 1 to have a response. Aside from the Veterans Affairs/Department of Defense guidelines, other guidelines do not recommend pharmacotherapy as a first-line option, particularly in the veteran population. Marijuana has been evaluated as an alternative and novel treatment option with 16 states legalizing its use for PTSD. Methods: A systematic search was conducted to evaluate the evidence for the use of marijuana for PTSD. Studies for the review were included based on a literature search from Ovid MEDLINE and Google Scholar. Results: Five studies were identified that evaluated the use of marijuana for PTSD. One trial was conducted in Israel and actively used marijuana. Three studies did not use marijuana in the treatment arm but instead evaluated the effects postuse. A retrospective chart review from New Mexico relied on patients to recall their change in PTSD symptoms when using marijuana. Three studies concluded there might be a benefit, but two discouraged its use. Although the two negative studies show a statistical difference in worse PTSD outcomes, clinical significance is unclear. Discussion: Conflicting data exist for the use of marijuana for PTSD; however, current evidence is limited to anecdotal experiences, case reports, and observational studies, making it difficult to make clinical recommendations.

Alternating Hemiplegia of Childhood, neurological comorbidities, intrafamilial variability: case-reports and literature review.

2021 ◽  
Author(s):  
Piero Pavone ◽  
Xena Giada Pappalardo ◽  
Naira Mustafa ◽  
Sung Yoon Cho ◽  
Dong Kyu Jin ◽  
...  
Keyword(s):  
Literature Review ◽  
Developmental Delay ◽  
Age Of Onset ◽  
Case Reports ◽  
Epileptic Seizures ◽  
The Body ◽  
Motor Dysfunction ◽  
Missense Mutations ◽  
Alternating Hemiplegia Of Childhood ◽  
Novel Variant

Abstract BACKGROUND Alternating Hemiplegia of Childhood (AHC) is an uncommon and complex disorder characterized by age of onset before 18 months, recurrent hemiplegia of one or either sides of the body or quadriplegia. Neurological comorbidities observed in two couples of AHC affected children are here reported together with data drawn by literature review. Results of genetic analysis obtained in the probands are also discussed. Developmental delay, epilepsy, tonic or dystonic spells, nystagmus and autonomic manifestations are frequently reported. AHC is mainly caused by mutations in ATP1A3 gene, and to a lesser extent in ATP1A2 gene.CASE PRESENTATION Clinical and genetic findings of a couple of twins and a couple of siblings affected by AHC from two different Italian families were deeply examined. Intrafamilial clinical variability was shown in the present cases. A pathogenic variant rs606231437 in ATP1A3 gene was detected in twins. For the affected siblings of family 2, the genetic results showed that the older brother and the healthy father shared a novel variant of GRIN2A (c.3175T>A) gene, and two missense mutations in SCNIB (rs150721582) and KCNQ2 (rs771211103) genes. In the younger brother was found only the GRIN2A variant.CONCLUSIONS Developmental delay, epileptic seizures and motor dysfunction are features frequently associated to paroxysmal hemiplegic attacks. Hemiplegic episode is only a sign even if the most remarkable of several neurological comorbidities in AHC carriers. The comparison of molecular analysis among the four probands brings out how the genetic framework is not recurrent, but may result from an unexpected greater genetic heterogeneity.

Principles of Cancer Treatment

2019 ◽  
Author(s):  
Samantha J. Baker ◽  
J. Bart Rose
Keyword(s):  
Hormone Therapy ◽  
Systemic Chemotherapy ◽  
Local Treatment ◽  
Local Environment ◽  
The Body ◽  
Isolation Techniques ◽  
Treatment Plans ◽  
Systemic Side Effects ◽  
Locoregional Therapies ◽  
Key Words Biopsy

Surgeons often play a pivotal role in the treatment plans for cancer patients, especially when the plan of action includes resection. Locoregional therapies have the advantage of treating the tumor and its local environment while minimizing systemic effects. Other examples of local treatment include radiotherapy and chemotherapy delivered with isolation techniques. In contrast, systemic chemotherapy, systemic radiation, hormone therapy, and immunotherapy are administered throughout the body. Systemic therapy is most useful in treating disease distant to the site of origin but can be limited by systemic side effects. This chapter explores each of these treatment arms in more detail and provides examples of when such options may be deployed. This review contains 1 figure, 2 tables, and 67 references. Key Words: Biopsy, Cancer, Chemotherapy, Directed therapy, Hormone therapy, Immunotherapy, Lymph nodes, Proton therapy, Radiation therapy, Staging

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