RF Valenzuela*, E Duran-Sierra, M Canjirathinkal, B Amini, KE Torres, RS Benjamin, J Ma, WL Wang, KP Hwang, RJ Stafford, C Wu, AM Zarzour, AJ Bishop, S Lo, JE Madewell, R Kumar, WA Murphy Jr and CM Costelloe
Published on: 9th July, 2024
Purpose: This study aimed to determine the relevance of first- and high-order radiomic features derived from Diffusion-Weighted Imaging (DWI) and Apparent Diffusion Coefficient (ADC) maps for predicting treatment response in patients with Undifferentiated Pleomorphic Sarcoma (UPS).Methods: This retrospective study included 33 extremity UPS patients with pre-surgical DWI/ADC and surgical resection. Manual volumetric tumor segmentation was performed on DWI/ADC maps acquired at Baseline (BL), Post-Chemotherapy (PC), and Post-Radiation Therapy (PRT). The percentage of pathology-assessed treatment effect (PATE) in surgical specimens categorized patients into responders (R; PATE ≥ 90%; 16 patients), partial-responders (PR; 89% - 31% PATE; 10 patients), and non-responders (NR; PATE ≤ 30%; 7 patients). 107 radiomic features were extracted from BL, PC, and PRT ADC maps. Statistical analyses compared R vs. PR/NR.Results: Pseudo-progression at PC and universal stability at PRT were observed in R and PR/NR based on RECIST, WHO, and volumetric assessments. At PRT, responders displayed a 35% increase in ADC mean (p = 0.0034), a 136% decrease in skewness (p = 0.0001), and a 363% increase in the 90th percentile proportion (p = 0.0009). Comparing R vs. PR/NR at BL, statistically significant differences were observed in glrlm_highgraylevelrunemphasis (p = 0.0081), glrlm_shortrunhighgraylevelemphasis (p = 0.0138), gldm_highgraylevelemphasis (p = 0.0138), glcm_sumaverage (p = 0.0164), glcm_jointaverage (p = 0.0164), and glcm_autocorrelation (p = 0.0193). At PC, firstorder_meanabsolutedeviation (p = 0.0078), firstorder_interquartilerange (p = 0.0109), firstorder_variance (p = 0.0109), and firstorder_robustmeanabsolutedeviation (p = 0.0151) provided statistically significant differences.Conclusion: Observing a high post-therapeutic ADC mean, low skewness, and high 90th percentile proportion with respect to baseline is predictive of successfully treated UPS patients presenting > 90% PATE. Highly significant higher-order radiomic results include glrlm-highgraylevelrunemphasis (BL) and first-order-mean absolute deviation (PC).
Salam Jbeili, Mohamad Rima, Abdul Rahman Annous, Abdo Ibrahim Berro, Ziad Fajloun and Marc Karam*
Published on: 10th July, 2024
Introduction: Gentian Violet (GV) is a triphenylmethane industrial dye that is known for its antibacterial, antiviral, anti-helminthic, and anti-tumor effects. Although many studies focused on determining the biological and pharmacological applications of GV, its exact effect on the immune response has not been elucidated yet. Methods: In this study, we investigate the immunomodulatory effects of GV in BALB/c mice after intraperitoneal injection of the dye by assessing cytokines levels in the spleen. Results: Our data show that GV-treated mice have decreased levels of proinflammatory cytokines (IL-1β and TNF-α) and increased levels of anti-inflammatory cytokines (IL-4) in their spleens. In addition, IFN-γ which can modulate pro-inflammatory cytokine production was upregulated in GV-treated mice. Conclusion: Together, these findings suggest an anti-inflammatory activity of GV that warrants further studies investigating the potential of GV in immunotherapy.
Background: Sinonasal myxomas are exceptionally rare benign tumors in pediatric patients. This report presents the case of a 4-year-old boy diagnosed with a sinonasal myxoma extending into the right orbit.Case presentation: The patient’s clinical presentation included moderate-angle esotropia and ocular torticollis. Advanced imaging revealed an expansile lesion in the right posterior ethmoid cavity with orbital involvement. The differential diagnosis considered included malignancies such as rhabdomyosarcoma and lymphoma, as well as benign neoplasms and inflammatory changes. A biopsy confirmed the diagnosis of sinonasal myxoma. The patient underwent a wide local resection performed by a multidisciplinary team, leading to a confirmed histopathological diagnosis of sinonasal myxoma.Conclusion: This case highlights the diagnostic challenges and the importance of thorough clinical and radiologic evaluation in pediatric patients with unusual ocular symptoms. The report underscores the need for a multidisciplinary approach in managing rare neoplasms such as sinonasal myxomas.
Folasade Omobolanle Ajao*, Oluwatobi Olayiwola Yusuf, Damilola Ayodeji Balogun, Marcus Olaoye Iyedupe, Mariam Olayinka Adesola and George Adetomiwa Egunjobi
Published on: 29th August, 2024
Background: Linagliptin is an anti-diabetic drug that claims no adverse effects and treatment of gestational diabetes mellitus (GDM) demands a safe anti-diabetic medication. Therefore, this study investigates the anti-diabetic efficacy of linagliptin in an induced GDM.Materials and methods: Thirty-two matured female rats (100 - 200 g) were utilized. Sixteen non-pregnant/diabetic animals were fed with a normal diet and sixteen rats were fed with a high-fat (HFD), mated at the estrous stage in 2:1, and pregnancy was confirmed with a spermatozoa in a vaginal smear. The pregnant rats were intraperitoneally injected with a single dose (30 mg/kgb. wt)of streptozotocin (STZ) to induce GDM. The animals were grouped into 4 groups, 8 rats/groups. Group I: control; Group II: control + 10 mg/kgb.wt linagliptin; Group III: GDM; Group IV: GDM + 10 mg/kgb.wt linagliptin. The animals were sacrificed after 14 days of treatment. Blood samples were collected for biochemical parameters.Results: Fasting blood glucose (FBG) insulin, glycated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), malondialdehyde (MDA), interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-alpha (TNF-α) levels significant (p < 0.05) elevated in GDM rats, with significant reduction in high-density lipoprotein-cholesterol (HDL-C), catalase (CAT), superoxide dismutase (SOD) and reduced glutathione (GSH). Linagliptin administration significantly (p < 0.05) decreased the FBG, insulin, HbA1c, TC, TG, LDL-C, MDA, IL-6, IL-1β, and TNF-α and ameliorates the HDL-C, CAT, SOD, and GSH levels significantly.Conclusion: Linagliptin remarkably showed anti-hyperglycemic, anti-oxidative, and anti-inflammatory properties. Linagliptin could be a promising drug for hyperglycemia treatment during gestation.
Amália Cinthia Meneses do Rêgo and Irami Araújo-Filho*
Published on: 4th September, 2024
Background: The impact of COVID-19 and long-term COVID-19 on gastrointestinal neoplasms remains underexplored. The current review investigates the potential link between these conditions and the role of gut microbiota in mediating oncogenic processes. Dysbiosis, characterized by alterations in gut microbial composition, may exacerbate inflammation and immune dysregulation, contributing to cancer development.Methods: A comprehensive literature review was conducted using databases including PubMed, Scopus, Embase, SciELO, and Web of Science. Inclusion criteria encompassed studies published between 2020 and 2024 that explored the intersection of COVID-19, long-term COVID-19, and gastrointestinal cancers. The articles were critically appraised for quality and relevance, and data were synthesized to elucidate common mechanisms and outcomes.Results: The review identifies several mechanisms by which gut microbiota may influence cancer risk in COVID-19 patients. Persistent inflammation, oxidative stress, and immune dysfunction observed in Long COVID were associated with dysbiosis. Specific microbial metabolites, such as secondary bile and short-chain fatty acids, were implicated in promoting tumorigenesis. Comparative analysis of studies suggests that SARS-CoV-2-induced dysbiosis may heighten susceptibility to gastrointestinal cancers, particularly in patients with prolonged post-infection symptoms.Conclusion: The findings underscore the need for further research to clarify the role of gut microbiota in cancer development among COVID-19 patients. These mechanisms could inform preventative strategies and therapeutic interventions, particularly for those experiencing COVID. The review highlights gaps in current knowledge and advocates for longitudinal studies to assess the long-term effects of COVID-19 on gastrointestinal health.
Mehdi Marrak*, Yassine Ouanes, Mokhtar Bibi, Jihed Karmous, Kays Chaker and Yassine Nouira
Published on: 8th October, 2024
Usually affecting men in the sixth decade bladder cancer is generally revealed by hematuria or lower urinary tract symptoms. Cutaneous metastases are very rare in genitourinary tumors representing only 1.34% of cutaneous metastases of other neoplasms. The presence of cutaneous metastases is associated with a poor prognosis with a median survival of fewer than 12 months.We reported the case of a 65-year-old man current smoker who presented a cutaneous metastasis of urothelial bladder cancer confirmed after a cutaneous biopsy, palliative chemotherapy was initiated after multidisciplinary staff.
Omaima Taie*, Najlaa Taie, Yassine Eddich and Hassan Chtata
Published on: 24th October, 2024
Pseudotumoral calcinosis (CPT) is a condition characterized by the deposition of calcium phosphate crystals in the periarticular tissues, forming large calcified masses. Although the pathophysiology of CPT is not fully understood, an increase in the calcium-phosphate product beyond the precipitation threshold and severe hyperparathyroidism appear to play a significant role. Treatment remains controversial, with surgical excision often recommended. We report a case of CPT in a 74-year-old diabetic patient undergoing chronic hemodialysis who experienced progressively worsening pain in the left hip for six months, along with mobility difficulties. A CT scan revealed a calcified mass on the posterior thigh, likely explaining the electric shock-like pain, as well as compression of the superficial femoral artery causing decubitus pain resembling critical limb ischemia. The biological assessment showed elevated calcium-phosphate levels and hyperparathyroidism. Surgical excision is not indicated due to the mass’s proximity to vascular and nerve structures. This case highlights the diagnostic and therapeutic challenges of CPT, emphasizing the need for iterative angioplasties, considering that this condition is rare in chronic hemodialysis patients with calcified periarticular masses.
M Lamrani*, K Lakhdar, S Sardaoui, Y Alami, F Tijami, H Hachi, Z El-Hanchi and A Baydada
Published on: 11th November, 2024
Fibrothecal tumors of the ovary are rare neoplasms, comprising less than 4% of all ovarian tumors and primarily affecting post-menopausal women. These benign tumors arise from the stromal tissue of the ovary and may produce hormones, particularly estrogen. Their diagnosis presents considerable challenges, frequently leading to misclassification as malignant ovarian tumors or uterine myomas. This report describes the case of a 59-year-old woman who presented with abdominal distension and pelvic pain. Clinical examination revealed a large, lobulated mass and imaging studies classified the right ovarian mass as ORADS 4. An exploratory laparotomy confirmed the absence of metastasis, resulting in total hysterectomy, bilateral adnexectomy, and omentectomy. The anatomopathological analysis identified the latero-ovarian mass as a fibrothecoma. Generally, fibrothecal tumors are benign with a favorable prognosis following surgical intervention. Common symptoms include pelvic pain and abdominal distension, and diagnosis typically relies on imaging techniques such as ultrasound and CT, with definitive confirmation achieved through histopathological examination. Given their potential to mimic malignant ovarian cancer, accurate diagnosis is critical and necessitates a multidisciplinary approach.
The present study aimed to analyze Cholinesterase (CE) levels in cord blood from preeclamptic women and to evaluate cholinesterase status in patients with osteosarcoma. Serum cholinesterase levels were assessed in 30 cases of osteosarcoma and 30 controls suffering from musculoskeletal pain. Additionally, maternal and cord blood samples were collected from 25 women with preeclampsia and compared with those from 25 normotensive pregnant women and 25 normal, healthy controls. The results indicated that serum cholinesterase levels were significantly lower in osteosarcoma patients (Group I) compared to those with musculoskeletal pain (Group II, p < 0.05). Similarly, cholinesterase levels were reduced in the maternal blood of women with preeclampsia when compared to normotensive controls. Cord blood cholinesterase levels were lower in the infants of normotensive mothers, with levels reaching 88.65% of the maternal levels. Furthermore, cord blood cholinesterase levels were significantly lower in preeclamptic women compared to normotensive pregnant women. When comparing cholinesterase levels to those of normal controls, it was observed that CE levels were significantly elevated in both normotensive and preeclamptic women. The findings of low serum cholinesterase levels in this study suggest that cholinesterase secreted by osteoblasts is utilized in bone formation and tumorigenesis. Additionally, the decrease in cholinesterase levels associated with preeclampsia may be linked to the loss of muscarinic cholinergic receptors that occur in this condition.
Jeremy Hassoun, Aurélie Bornand, Alexis Ricoeur, Giulia Magini, Nicolas Goossens and Laurent Spahr*
Published on: 19th December, 2024
Visualizing a nodule in the liver parenchyma of a patient with chronic liver disease raises the suspicion of hepatic malignancy. We report here the case of a 63-year-old female with primary biliary cholangitis (PBC) in whom a hepatic pseudolymphoma (HPL) was incidentally detected. This fairly rare lesion mimics primary liver cancer, has no specific radiological features, and requires histology for a definite diagnosis. This tumor-like lymphoid liver proliferation has been reported in clinical situations with immune-mediated inflammation including PBC. It can be observed in many organs but very rarely in the liver. The diagnosis of HPL should be considered when detecting a liver nodule in a patient with this particular chronic cholestatic liver disease.
Negar Ostadsharif, Alireza Firouzfar, Parto Nasri and Behnam Sanei*
Published on: 6th January, 2025
Extrahepatic biliary neuroendocrine tumors (EBNETs) are a rare group of neoplasms with varying characteristics, with 223 cases documented since their discovery. In this case report, an EBNET is described as a result of vague abdominal pain and significantly elevated liver function tests in a 41-year-old woman who presented with vague abdominal pain and elevated liver function tests. Despite the challenges faced in preoperative diagnosis, including the need to differentiate from cholangiocarcinoma, surgical intervention was successful. Due to the tumor’s complex nature, meticulous dissection and reconstruction were required, leading to crucial insights into surgical management. In addition to highlighting the rarity of EBNETs, this case emphasizes the importance of early detection and customized surgical approaches.
Post-transplant malignancy is one of the contentious and feared consequences of Solid Organ Transplantation (SOT), which might detrimentally alter the outcome of transplantation. Risk factors are manifold, principally related to a suppressed immune system with intercurrent immunosuppressant medications commonly used in the context of SOT. Opportunistic viral infections encountered in SOT are crucial promoters of mitogenic proliferation in several common tumors. Lastly, immune suppressant therapy might trigger mitogenic changes directly.In this paper, we are discussing post-SOT malignancies, elaborating on the different phases of its pathogenesis, and elucidating on the different aspects that linger in its risk factors, preventive strategies, and management.
Gizem Kavak, Mehmet Ali Nahit Şendur, Dilek Kösehan, Ayşen Aydin, Mehmet Ferat Kiran and Yildiz Güney*
Published on: 27th January, 2025
Anaplastic Pleomorphic Xanthoastrocytoma is a very rare tumor of the Central Nervous System (CNS). BRAFV600E mutation is a common mutation in pleomorphic xanthoastrocytoma. We present a 52-year-old male patient who underwent total resection due to a temporal lobe mass. The primary tumor in the temporal lobe was given postoperative radiotherapy. During follow-up, genetically and histologically proven metastasis was detected in the paraspinal region. The adjuvant RT was given to metastasis after surgery. The patient, who used the combination of dabrafenib and trametinib after recurrence, is being monitored in remission.
Luca Damiani*, Giuseppe Argenziano, Andrea Ronchi, Francesca Pagliuca, Emma Carraturo, Vincenzo Piccolo and Gabriella Brancaccio
Published on: 31st January, 2025
Verrucous carcinoma is a rare, slow-growing squamous cell carcinoma that can occur in acral regions, including the plantar surface, being named carcinoma cuniculatum. The tumor presents as a well-demarcated, exudative lesion, resembling benign conditions like warts or infections. In this case, a verrucous lesion on the left plantar surface initially appeared to be non-malignant, with multiple incisional biopsies showing only inflammation. A final excisional biopsy of a large part of it confirmed the initial suspicion of malignancy, prompting complete excision and appropriate management. This case underscores the importance of performing wide and deep biopsies for early diagnosis and timely treatment of a suspected verrucous carcinoma.
Ali Mohammed Ali Elimam*, Isam Mohamed Babbiker, Reem Mohammed Elhaj Farah, Ayat Salih Abbas and Omer Mohamed Abubeker Sayed
Published on: 8th April, 2025
Mucinous cystadenoma constitutes 15% of epithelial ovarian tumors. In resource limited setting they may reach huge size as there is no regular medical checkup. This case series highlights these aspects along with diagnostic and surgical considerations.
Meningiomas, classical extra-axial dural-based tumors of the meninges, have well-documented classical imaging features and signs on CT and MRI. Most meningiomas are classical lesions with prompt diagnosis on imaging and generally exhibit benign outcomes with slow growth patterns. The latest WHO classification of tumors in 2021 has classified 15 subtypes of meningiomas, and while classical meningiomas are WHO Grade 1 tumors, grading between varying subtypes varies between WHO Grades 1 and 3. The microcystic meningioma is a rare and atypical subtype of meningioma that has been sparsely documented in literature. In this case report, we revisit this rare subtype of meningioma with a brief review of literature.
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