Lunapower6697

Objective Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, many studies have described the quantitative peripheral blood findings seen in COVID-19 patients. However, morphologic changes have been described by only a few studies. We report morphologic and quantitative changes in peripheral blood of COVID-19 patients. Design We reviewed electronic medical records, complete blood counts, and peripheral blood smears of 20 patients who were COVID-19 positive by reverse transcriptase-polymerase chain reaction (RT-PCR), from March 1, 2020, through May 31, 2020. The peripheral blood smears of all 20 patients were retrieved and morphological features of white blood cells, red blood cells, and platelets were reviewed and documented. Appropriate pictures were taken. Results Of the 20 patients reviewed, 13 were males and seven were females. The average age of the patients was 65.1 years. The most common quantitative hematologic abnormalities noted on complete blood count (CBC) were anemia followed by neutrophilia, neutrophilic left shift, and lymphopenia. The most significant morphologic changes noted were neutrophils with clumped chromatin, multiple abnormal nuclear shapes, pseudo-Pelger-Huet deformity, and smudged neutrophils. Lymphocytes showed abundant blue cytoplasm and/or lymphoplasmacytoid morphology and monocytes were activated with abnormal shapes and vacuolization. Platelets were adequate in number in the majority of patients and platelet clumping was the most significant finding noted. The red blood cells were normocytic and normochromic with few nucleated red blood cells and coarse basophilic stippling. Conclusion Our study identifies and describes significant morphologic changes in the peripheral blood cells of COVID-19 patients. An understanding of these morphologic changes in addition to established hematologic parameters can aid in the diagnosis of COVID-19 and serial CBC and peripheral smear review may help with management decisions in COVID-19 patients.Background When researching female patients with breast or ovarian neoplasms, our research will sensitize oncologists to the prevalence of biliary tract cancers such that early cancers are not overlooked. Depending on different inherited, environmental, and iatrogenic risk factors, patients diagnosed with cancer have a risk of harboring another de novo malignancy. The additional primary identification of late has increased mainly due to progress in both diagnosis and treatment modalities, improvement in life expectancy, and understanding. Methods This is a descriptive study of retrospectively collected data from health records over 15 months, of patients who had biliary tract cancer and incidentally detected coexisting second non-biliary malignancy, from July 2018 to September 2019 at a tertiary care hospital. Details such as age, sex, smoking history, family history, occupation, body mass index (BMI), the organ involved, levels of tumor markers, treatment, and outcome were recorded. Results Six consecutive patients with biliary tract cancer presented during this duration and incidentally detected the second primary was ovarian cancer in three (50%) patients, breast carcinoma in two (33%) patients, and urinary bladder carcinoma in the remaining one patient (17%). The median age at diagnosis was 52.5 years with a range of 40-65 years. All patients were females (100%), non-smokers, homemaker, and without any history of cancer in family members. Only two patients who had a resectable disease were alive at one year's follow-up. Conclusion The mechanisms of carcinogenesis in multiple primary malignancies are mainly genetic, epigenetics, and immunological. Prognosis, as well as the intent of treatment, depends on the respective stages of the two malignancies. In our study, most of the patients were in an advanced stage that demanded palliative care.Objective To determine if differences exist in the timing of cleft palate repair with respect to sex, race, income, and geographical location within the United States. Design Retrospective cross-sectional study using the Kids' Inpatient Database (KID) from 1997 to 2009. Setting Inpatient. Patients Children with cleft palate with or without cleft lip undergoing inpatient cleft palate repair. Main outcome measures Age at the time of palatoplasty (in months) by sex, race, income quartile, and geographic location. Results A total of 7,218 children with cleft palate underwent repair at a mean age of 12.1 months (95% CI 12.0-12.3). Females underwent palatoplasty at an older age (13.6 months) than males (13.2 months), a difference of 0.47 months (SE 0.19, p=0.015). White children underwent surgery at an earlier age (12.1 months) than Black (12.9 months) (difference 0.73 months, SE 0.37, p=0.045), Hispanic (12.7 months) (difference 0.57 months, SE 0.25, p=0.025), and Asian children (15.7 months) (difference 3.60 months, SE 0.49, p less then 0.0001). Asian children were also found to undergo repair later than Hispanic (difference 3.03 months, SE 0.51, p less then 0.0001) and Black (difference 2.87 months, SE 0.59, p less then 0.0001) children. Patients born into the highest income brackets were repaired 0.75 months earlier than those in the lowest bracket (SE 0.26, p=0.005). Patients in the Midwest underwent palatoplasty later (14.3 months) than in the Northeast (12.9 months) (difference 1.36 months, SE 0.31, p less then 0.0001), South (13.2 months) (difference 1.05 months, SE 0.36, p=0.004), and West (13.2 months) (difference 1.09 months, SE 0.32, p=0.0007). Conclusions After controlling for confounding factors, our results suggest that in recent history, Black, Hispanic, and Asian children with cleft palate were repaired later than their White counterparts. In addition, children of affluent families were repaired earliest, and economically disadvantaged children were repaired later than their peers.Breast cancer management includes a combination of surgery, radiation therapy, and chemotherapy. While this management has proven effective, it is not perfect. click here To expand the umbrella of management to resistant breast cancer tumors, researchers have explored the idea of sphingosine kinase (SphK) and sphingosine-1-phosphate (S1P) as a potential target for treatment. In this article, we review the mechanism of the sphingosine kinase/sphingosine-1-phosphate (SphK/S1P) axis along with its effect on the tumor microenvironment (TME) and compounds that have been studied inhibiting the SphK/S1P axis. We searched for relevant articles in the last five years in Medline and PubMed Central. Inclusion criteria, exclusion criteria, and quality checklists were applied to identify the most relevant articles. We compiled the information that has been summarized in the respective tables and figures provided in this review. The metabolism of sphingolipids was summarized, followed by the SphK/S1P upregulation in breast cancer cells.