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Adrenal gland lesions span a range of entities from benign and malignant primary neoplasms to metastatic tumors. Fine-needle aspiration (FNA) provides a minimally invasive diagnostic tool to stage patients with known malignancy and procure material for molecular testing. This study characterizes the clinicopathologic associations of patients with adrenal gland FNA from 2 large hospitals.

FNAs were identified by query of electronic medical record from 2002-2019. Clinical and pathological information was collated and correlated with corresponding surgical diagnosis when available.

Of 139 cases, the majority (n = 127, 91%) were adequate computed tomography-guided FNAs and included the following diagnoses positive for malignancy (n = 77, 55%), negative for malignancy (n = 32, 23%), neoplastic cells present (n = 16, 12%), nondiagnostic (n = 12, 9%), atypical (n = 1, 1%), and suspicious for carcinoma (n = 1, 1%). The majority (94%, n = 72 of 77) of malignancies were metastatic tumors, most frequently carcinomed lesions represent metastases from primary lung carcinomas, but other primary sites including those below the diaphragm are part of the diagnostic differential. Adrenal metastasis was associated with a poor prognosis, with median survival of 8 months.Adoptively transferred T cell receptor (TCR)-transgenic T cells (TCR-T cells) are not restricted by cell surface expression of their targets and are therefore poised to become a main pillar of cellular cancer immunotherapies. Addressing clinical and laboratory data, we discuss emerging features for the efficient deployment of novel TCR-T therapies, such as selection of ideal TCRs targeting validated epitopes with well-characterized cancer cell expression and processing, enhancing TCR-T effector function, trafficking, expansion, persistence, and memory formation by strategic selection of substrate cells, and gene-engineering with synthetic co-stimulatory circuits. Overall, a better understanding of the relevant mechanisms of action and resistance will help prioritize the vast array of potential TCR-T optimizations for future clinical products.

Diaphragmatic rupture (DR) is an acquired diaphragmatic defect that can cause herniation of abdominal organs into the chest. It is usually a trauma-related lesion, but rarely it can occur spontaneously. Every DR with abdominal herniation should be considered a surgical emergency.

A 61-year-old male patient, with previous exposure to asbestos, was diagnosed of Stage Ib malignant pleural mesothelioma (MPM). He underwent neo-adjuvant chemotherapy (three cycle of cisplatin-pemetrexed combination) and a cytoreductive surgery with pleurectomy/decortication. Post-operative course was characterized by prolonged air-leakage (PAL). After three months, during a follow-up CT-scan, a spontaneous diaphragmatic rupture (SDR) with gastric herniation was detected and treated by a laparascopic diaphragmatic repair and suture.

Spontaneous diaphragmatic rupture (SDR) is an extremely rare injury of the diaphragm (less than 1% of all DR). In this case, potential predisposing factors for SDR could be presence of diaphragmatic "locus minoris resistentiae" due to thinning of the diaphragm and increase tissue fragility after neo-adjuvant chemotherapy and diaphragmatic pleural stripping; increased thoraco-abdominal pressure gradient due to PAL and residual pleural space. Thus, we confirmed the feasibility and safety of the laparoscopic approach.

We highlight the multifactor etiopathology, the challenging diagnosis and the importance of a prompt treatment of SDR.

We highlight the multifactor etiopathology, the challenging diagnosis and the importance of a prompt treatment of SDR.

Quality of life has been an increasingly reference measure in whole health impact of diseases and in septorhinoplasty evaluation as well. It is known that the decision for this elective surgical procedure requires the subjective perception of patients' complaints about their own health and life stage in association with the surgeon's aesthetic and functional perspective of each case.

To define the quality of life of candidates for septorhinoplasty using the World Health Organization quality of life questionnaire, WHOQOL-Brief, and the prevalence of other independent variables for this population.

A cross-sectional study using a sample of candidates for septorhinoplasty was performed. All patients responded to the WHOQOL-Brief during the pre-operative period. A normative population quality of life study was the reference for the sample size and means.

A total of 302 patients were included among the 322 eligible patients. Twenty patients did not complete the questionnaire correctly and were excluded froencourage a multidisciplinary approach for chronic symptoms when associated with nasal obstruction, sleep disorders and aesthetic complaints.

Lymph node metastasis is a well-known prognostic factor for laryngeal carcinoma. However, current nodal staging systems provide limited information regarding prognosis. Additional parameters should be considered to improve prognostic capacity.

To assess the prognostic values of metastatic lymph node number, ipsilateral/contralateral harvested lymph nodes, and lymph node ratio in patients undergoing surgical treatment of laryngeal squamous cell carcinoma.

Seventy-four patients diagnosed with laryngeal squamous cell carcinoma primarily managed surgically were included in this study. The patients' pathological and survival data were obtained from their medical records. The effects of harvested lymph nodes and lymph node ratio on disease-free survival, disease-specific survival, and overall survival were analyzed.

Ipsilateral, contralateral, and bilateral evaluations of harvested lymph nodes showed no significant associations with prognosis. Lymph node ratio was significantly associated with overall survival when evaluated bilaterally. Metastatic lymph node number showed more suitable stratification than TNM classification.

Metastatic lymph node number and bilateral lymph node ratio parameters should be taken into consideration to improve the prognostic capacity of TNM.

Metastatic lymph node number and bilateral lymph node ratio parameters should be taken into consideration to improve the prognostic capacity of TNM.

Presence of multimorbidity can affect prognosis, treatment, and outcomes of individuals with cancer. selleck compound However, the prevalence and factors associated with multimorbidity among older late-stage melanoma is not well studied. We estimated the prevalence of any type of pre-existing multimorbidity (autoimmune disorder (AD), physical health conditions (PHC), and mental health conditions (MHC)) among older adults with late-stage melanoma in the United States. We further examined the association of patient-level factors to multimorbidity in late-stage melanoma.

We derived data on older fee-for-service Medicare beneficiaries (age≥66years) diagnosed with late-stage melanoma between 2011 and 2015 (N=4,519) from the linked Surveillance, Epidemiology, and End Results cancer registry and Medicare claims. We defined multimorbidity as the prevalence of two or more chronic conditions prior to the diagnosis of melanoma. We used unadjusted and adjusted logistic regressions to examine the association of patient-level factors tstematic approaches to optimizing care of older patients with late-stage melanoma and multimorbidity.

To report the practice of orthokeratology (OK) in Algeria and to investigate the visual outcomes, safety and subjective responses with this technique in myopes.

A retrospective chart review of 48 participants using OK lenses since January 2010 were included in the study. Lenses were selected and fitted according to the manufacturer's recommendations using their respective software and the number of lenses required for a successful fit was recorded. Visual acuity (VA) in logMAR units and biomicroscopic findings were recorded for each visit. Subjective ratings was determined with analogue rating scale was filled in by the investigator, the participants were divided into Group 1 (> 4.00D) and Group 2 (< 3.75D) myopic groups for analysis.

First lens fitting success rate of 64.58%. There was also a significant difference between the BCVA at baseline and VA at Day 1 (P < 0.05), and no significant difference at Day 7, Day 30 and the final visit (P = 0.51, P = 0.93, P = 0.62, respectively), for Group 2. There was a significant difference between the BCVA at baseline and VA at Day 1, 7, 30 and the final visit (P < 0.05), for Group 1. the patients of the second group were happier but the results from the survey were not statistically significant (P = 0.10), no serious complication was reported.

the technique was efficient and safe as we didn't have any serious complication, with a high success rate for first lens fitting.

the technique was efficient and safe as we didn't have any serious complication, with a high success rate for first lens fitting.

Radial fracture accounts for 1% of fractures in children. It is potentially serious, and treatment is controversial. Several studies assessed prognostic factors, only one of which used exclusive intramedullary nailing, despite this being the gold standard.

Open surgery provides poor functional results in radial neck fracture.

All patients undergoing reduction and internal fixation of radial neck fracture between 2005 and 2015 were analysed. Inclusion criteria comprised Jeffery type 1 fracture with open growth plate, complete file, and ≥1 year's follow-up. Treatment systematically comprised Métaizeau intramedullary nailing, with crossover to open reduction only in case of failure. link2 Good results were defined as full range of motion and pain-free elbow.

Fifty-six patients were included 33 girls, 23 boys; mean age, 9 years. On the Judet classification modified by Métaizeau, 4 fractures were grade 2, 29 grade 3, 15 grade 4A and 8 grade 4B. Closed reduction was performed in 48 cases, including 8 with the help of percutaneous leverage effect. Eight required a surgical approach. Twenty-three showed postoperative reduction defect. At a mean 74 months' follow-up, at a mean age of 15 years, 37 patients had reached full skeletal maturity. Sixteen had poor results. Open reduction was associated with poor outcome (p<0.01). Age, initial epiphyseal tilt, associated lesions, immobilisation time, time to nail removal and residual tilt after reduction did not significantly affect outcome (p-values>0.05). link3 Percutaneous leverage effect had no impact on the quality of results (p=1).

Open reduction is to be avoided in radial neck fracture. A prospective study is needed to assess remodelling potential according to age.

IV, retrospective study.

IV, retrospective study.

The use of continuous positive airway pressure (CPAP) applied early after birth improves several outcomes when compared with intubation and invasive mechanical ventilation. "Early CPAP" protocols vary in relation to the pressure level, type of interface used, and studied sample.

This study compared intubation rate, exogenous surfactant use, and hospitalization length (among other variables) prior to and after adopting an "early CPAP" protocol in preterm infants with gestational age between 28 and 32 weeks, using intermediate pressures and short binasal prongs.

This was a retrospective study conducted in a public university hospital in Brazil. All preterm infants with gestational age between 28 and 32 weeks were included in the study. The newborns born between January 2011 and December 2012, prior to the protocol being implemented, were considered the historical control group, and those born after implementation, between February 2013 and August 2014 were considered the intervention group.

The participants in both groups had similar baseline characteristics (p > 0.

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