Perforated appendicitis due to fishbone.

Appendicitis is a common condition in daily clinical practice. Appendicitis due to foreign bodies is uncommon and may result from obstruction or perforation mechanism. We present a rare case of a 43-year-old male patient who was diagnosed with perforated appendicitis due to a fish bone by imaging studies and confirmed postoperatively.

Pelvic schwannoma in an adult male.

Schwannomas are benign nerve sheath tumors that are generally encapsulated and commonly detected in the head, neck, and mediastinal regions. Schwannomas localizing in the pelvis are extremely rare and tend to be asymptomatic initially due to slow growth rate. Schwannomas may be misdiagnosed as urologic or gynecologic tumors.

Radiation therapy for triple-negative breast cancer: emerging role of microRNAs as biomarkers and radiosensitivity modifiers. A systematic review.

Purpose: Radiation therapy (RT) for triple-negative breast cancer (TNBC) treatment is currently delivered in the adjuvant setting and is under investigation as a booster of neoadjuvant treatments. However, TNBC radioresistance remains an obstacle, so new biomarkers are needed to select patients for any integration of RT in the TNBC therapy sequence. MicroRNAs (miRs) are important regulators of gene expression, involved in cancer response to ionizing radiation (IR) and assessable by tumor tissue or liquid biopsy.

Uterine Arteriovenous Malformation: A Pictorial Review of Diagnosis and Management.

Uterine arteriovenous malformation (UAVM) is a rare condition and is classified as either congenital or acquired UAVM. Patients with UAVMs usually experience miscarriages or recurrent menorrhagia. Ultrasound is used for the initial estimation of UAVMs.

Balo's Concentric Sclerosis Mimicking Tumor on Magnetic Resonance Imaging in a Young Patient.

Balo's concentric sclerosis (BCS) is a rare demyelinating disease known as Multiple Sclerosis (MS) lesion type III. It is a disease of the white matter of the brain characterized by a round lesion with variable concentric myelinated and demyelinated layers, appearing as "onion bulb." We present a case of BCS and discuss the imaging findings and management strategies of this disease.

Intracranial Neurenteric Cyst in a Patient with Acute Unilateral Thalamic Infarction.

Unlabelled: Intracranial neurenteric cysts are rare congenital lesions that can be mistaken for other lesions. They may contain mucous or serous glands, smooth muscle, lymphoid tissue and components of connective tissue. We report a case of neurenteric cyst which was detected accidentally by diagnostic imaging in the context of a thalamus infarct in a 45-year-old woman.

Diffuse Pancreatic Carcinoma with Hepatic Metastases.

Pancreatic cancer is one of the seven leading causes of cancer death worldwide. Diffuse pancreatic carcinoma is very rare and underreported in the literature. Many advances have been made in the diagnosis and management of pancreatic cancer.

A Case of Arteriovenous Fistula After Kidney Trauma Mimicking Tumor.

Renal arteriovenous fistulas are rare complications of kidney injury that are usually caused by penetrating or blunt abdominal trauma, percutaneous or open biopsy, or surgery. We report a case of renal arteriovenous fistula after blunt abdominal trauma of a male patient who had traffic accidents. Computed tomography images show arteriovenous fistula lesion mimicking the tumor of the renal pelvis.

The focal hepatic hot spot sign with lung cancer in computed tomography.

The focal hepatic hot spot sign appears as an area of intense focal wedge-shaped enhancement of the quadrate lobe (segment IVa) of the liver in the arterial and venous phase. If this sign appears on enhanced computed tomography of the abdomen, obstruction of thoracic central venous must be considered, especially when clinical symptoms are unclear.

Pitfalls of Computed Tomography in the Coronavirus 2019 (COVID-19) Era: A New Perspective on Ground-Glass Opacities.

Aim To study ground-glass opacities (GGO) not only from the coronavirus 2019 (COVID-19) pneumonia" perspective but also as a radiological presentation of other pathologies with comparable features. Methods We enrolled 33 patients admitted to Policlinico Universitario G. B.

Cigarette smoking induces human CCR6Th17 lymphocytes senescence and VEGF-A secretion.

Chronic exposure to environmental pollutants is often associated with systemic inflammation. As such, cigarette smoking contributes to inflammation and lung diseases by inducing senescence of pulmonary cells such as pneumocytes, fibroblasts, and endothelial cells. Yet, how smoking worsens evolution of chronic inflammatory disorders associated with Th17 lymphocytes, such as rheumatoid arthritis, psoriasis, Crohn's disease, and multiple sclerosis, is largely unknown.

Human CCR6+ Th17 Lymphocytes Are Highly Sensitive to Radiation-Induced Senescence and Are a Potential Target for Prevention of Radiation-Induced Toxicity.

Purpose: This study addresses the sensitivity of different peripheral CD4 T-lymphocyte subsets to irradiation (IR) and identifies potential targets for the prevention or treatment of radiation-induced toxicity.

Methods: This study was performed on peripheral blood mononuclear cells or sorted peripheral memory lymphocytes of CCR6 mucosa-homing Th17/CCR6Th and regulatory T subtypes of healthy volunteers. Cells were irradiated with a 2 Gy with or without pharmacologic inhibitors of different signaling pathways.

Stroma in normal and cancer wound healing.

It is currently believed that stroma, the connective framework of biological tissues, plays a central role in normal wound healing and in cancer. In both these contexts, stromal cellular components such as activated fibroblasts interact with complex protein networks that include growth factors, structural protein or proteinases in order to initiate and sustain an extensive remodelling process. However, although this process is usually spatially and temporally self-limited, it is unregulated in the case of cancer and leads to uncontrolled cell proliferation and invasion within tissues, metastasis and therapeutic resistance.

A Wake-Up Call for Routine Morbidity and Mortality Review Meeting Procedures as Part of a Quality Governance Programs in Radiation Therapy Departments: Results of the PROUST Survey.

Purpose: Morbidity and mortality review (MMR) meetings in radiation therapy (RT) departments aim to monitor radiation-induced toxicities and identify potential factors that may be correlated with their development and severity, particularly treatment planning errors. The aims of the Prospective Registration of Morbidity and Mortality, Individual Radiosensitivity and Radiation Technique (PROUST) survey were to make an inventory of existing MMR procedures and to describe their procedures.

Methods And Materials: The link to the web-based questionnaire of the PROUST survey was sent to 351 radiation oncologists working at 172 centers.

Ionizing radiation-induced cellular senescence promotes tissue fibrosis after radiotherapy. A review.

Ionizing radiation-exposure induces a variety of cellular reactions, such as senescence and apoptosis. Senescence is a permanent arrest state of the cell division, which can be beneficial or detrimental for normal tissue via an inflammatory response and senescence-associated secretion phenotype. Damage to healthy cells and their microenvironment is considered as an important source of early and late complications with an increased risk of morbidity in patients after radiotherapy (RT).

Parametric Dose Standardization for Optimizing Two-Agent Combinations in a Phase I-II Trial with Ordinal Outcomes.

A Bayesian model and design are described for a phase I-II trial to jointly optimise the doses of a targeted agent and a chemotherapy agent for solid tumors. A challenge in designing the trial was that both the efficacy and toxicity outcomes were defined as four-level ordinal variables. To reflect possibly complex joint effects of the two doses on each of the two outcomes, for each marginal distribution a generalised continuation ratio model was assumed, with each agent's dose parametrically standardised in the linear term.

Phase I/II study of the hypoxia-activated prodrug PR104 in refractory/relapsed acute myeloid leukemia and acute lymphoblastic leukemia.

We previously demonstrated vast expansion of hypoxic areas in the leukemic microenvironment and provided a rationale for using hypoxia-activated prodrugs. PR104 is a phosphate ester that is rapidly hydrolyzed in vivo to the corresponding alcohol PR-104A and further reduced to the amine and hydroxyl-amine nitrogen mustards that induce DNA cross-linking in hypoxic cells under low oxygen concentrations. In this phase I/II study, patients with relapsed/refractory acute myeloid leukemia (n=40) after 1 or 2 prior treatments or acute lymphoblastic leukemia (n=10) after any number of prior treatments received PR104; dose ranged from 1.

Optimizing Sedative Dose in Preterm Infants Undergoing Treatment for Respiratory Distress Syndrome.

The Intubation-Surfactant-Extubation (INSURE) procedure is used worldwide to treat pre-term newborn infants suffering from respiratory distress syndrome, which is caused by an insufficient amount of the chemical surfactant in the lungs. With INSURE, the infant is intubated, surfactant is administered via the tube to the trachea, and at completion the infant is extubated. This improves the infant's ability to breathe and thus decreases the risk of long term neurological or motor disabilities.

Effective sample size for computing prior hyperparameters in Bayesian phase I-II dose-finding.

Background: The efficacy-toxicity trade-off based design is a practical Bayesian phase I-II dose-finding methodology. Because the design's performance is very sensitive to prior hyperparameters and the shape of the target trade-off contour, specifying these two design elements properly is essential.

Purpose: The goals are to provide a method that uses elicited mean outcome probabilities to derive a prior that is neither overly informative nor overly disperse, and practical guidelines for specifying the target trade-off contour.

HIV knowledge and risks among Vietnamese men who have sex with men travelling abroad.

Rapid economic and social development in Vietnam has resulted in increased opportunities for travel and new potential routes of HIV transmission. We conducted a cross-sectional study examining demographics, knowledge, and sexual risk behaviour amongst 100 Vietnamese men who have sex with men who traveled abroad in the previous 12 months. Men who have sex with men surveyed were mostly university-educated, single, and under 30.

Using joint utilities of the times to response and toxicity to adaptively optimize schedule-dose regimes.

A Bayesian two-stage phase I-II design is proposed for optimizing administration schedule and dose of an experimental agent based on the times to response and toxicity in the case where schedules are non-nested and qualitatively different. Sequentially adaptive decisions are based on the joint utility of the two event times. A utility function is constructed by partitioning the two-dimensional positive real quadrant of possible event time pairs into rectangles, eliciting a numerical utility for each rectangle, and fitting a smooth parametric function to the elicited values.

Adaptive randomization to improve utility-based dose-finding with bivariate ordinal outcomes.

A sequentially outcome-adaptive Bayesian design is proposed for choosing the dose of an experimental therapy based on elicited utilities of a bivariate ordinal (toxicity, efficacy) outcome. Subject to posterior acceptability criteria to control the risk of severe toxicity and exclude unpromising doses, patients are randomized adaptively among the doses having posterior mean utilities near the maximum. The utility increment used to define near-optimality is nonincreasing with sample size.

A Hybrid Geometric Phase II/III Clinical Trial Design based on Treatment Failure Time and Toxicity.

The problem of comparing several experimental treatments to a standard arises frequently in medical research. Various multi-stage randomized phase II/III designs have been proposed that select one or more promising experimental treatments and compare them to the standard while controlling overall Type I and Type II error rates. This paper addresses phase II/III settings where the joint goals are to increase the average time to treatment failure and control the probability of toxicity while accounting for patient heterogeneity.