Higher Number Of Lesions Research Articles

Resection versus resection with ablation: Analysis from the colorectal liver operative metastasis international collaborative.

Thermal ablation has recently become a key therapy for the treatment of colorectal liver metastasis (CLM). However, the role of ablation in combination with resection has not yet been firmly established. We hypothesize that in patients with CLM, those who undergo liver resection with ablation (RA) have similar outcomes compared with those who undergo liver resection only. We reviewed a multicenter international database of 906 surgical procedures for CLM from 5 high volume hepatobiliary surgical units. Patients undergoing RA (n = 63) were matched based on the number of lesions and tumor size using a 1:1 balanced propensity score analysis with those having resection only (n = 63). Our primary outcomes were overall survival (OS) and disease-free survival (DFS). The mean age of our cohort was 58 ± 11 years, with 43% females. With a median follow-up of 70.8 months, patients in the resection and RA group had a median OS of 45.1 and 54.8 months (p = 0.71), respectively. The median DFS was 22.7 and 14.2 months (p = 0.045), respectively. Using a multivariate Cox proportional hazards regression model, the treatment approach was not associated with OS (p = 0.94) or DFS (p = 0.059). A higher number of lesions is independently associated with worse DFS (hazard ratio: 1.12, p < 0.01). When there was disease recurrence, the region of recurrence was similar between the RA versus resection only groups (p = 0.27), but there was a shorter time to recurrence in the RA group (p = 0.002). For CLM, the treatment approach was not significantly associated with OS or DFS, while tumor biology likely played an important role. Prospective research on the quality and effectiveness of thermal ablation combined with hepatic resection is warranted.

The clinical characteristics and outcomes of the patients with pyogenic granuloma: A retrospective study of 144 patients

Aim: Pyogenic granuloma (PG), also known as lobular capillary hemangioma, is a benign, reactive vascular tumor. We aimed to evaluate the demographic and clinical characteristics, treatments received, and outcomes of patients followed up at our clinic with PG. Materials and Methods: We retrospectively evaluated all patients followed up at our clinic with PG in the last 4 years. Results: A total of 144 patients were included in our study. 73 (51%) of the patients were female and 71 (49%) were male. The mean age of the patients was 31.3±8.3 years. When we examined the PG locations in our patients, we observed that it was most commonly found in the arm/hand area (40%), on the face (29%), foot/leg area (19%), and on the trunk (8.3%). The highest number of lesions were respectively in the hand, foot nail edge, and lip locations. Out of the patients where the lesion side was specified, 63 had the lesion on the left while 20 had it on the right (p=0.001). 51% of our patients underwent excisional surgery. Other treatments applied to our patients, in order, were cryotherapy (15.3%), electrocauterization (8.3%), cauterization with silver nitrate, cryotherapy+electrocauterization, topical antibiotic and cryotherapy+timolol drop. When evaluating the outcomes of the patients, we learned from the notes dropped into the system at later controls that 73% had recovered. The remaining patients were lost to follow-up. When comparing the features of patients who were treated with non-excisional methods to those who underwent excision, we observed that there was a higher rate of patients younger than 12 years (p=0.023), a higher incidence of foot nail edge (p=0.016) and lip location (p=0.048), and a higher frequency of pregnancy in this group. Conclusion: PG is a vascular tumor of importance due to its potential for bleeding and ulceration and its chronic course if left untreated. Since there are malignant lesions in its differential diagnosis, we believe that surgical excision is a more appropriate treatment option when feasible. We think that the data we have obtained needs to be supported by more comprehensive, broader, and prospective studies.

A Multicenter Real-World Analysis (RWA) of Primary Cutaneous Anaplastic Large Cell Lymphoma (PCALCL) Treated in the Modern Era

Introduction: The real-world outcomes in patients (pts) with PCALCL in the era of targeted therapies like Brentuximab Vedotin (BV) is not well defined due to lack of large multicenter studies. We conducted a multicenter retrospective RWA to assess patient and disease characteristics, treatment patterns, survival outcomes and impact of novel therapies in this rare type of cutaneous T cell lymphoma (CTCL). Methods: A total of 95 adult (≥18 years) pts from 8 academic institutions in the United States diagnosed from 2010-2022 were included in the analysis. The study was approved by the Institutional Review Boards at the respective sites. Demographic and disease factors were summarized by descriptive statistics. Overall survival (OS) was estimated by Kaplan-Meier method and compared using log rank method. Results: In our cohort, the median age at diagnosis was 63 (range 18-93) years. The majority of pts were male 60%, white 79%, and had good performance status (PS) ECOG 0-1 (93%). Median time from initial presentation to diagnosis was 1.8 (range 0-211) months. Most common initial skin presentation was tumor 46% (44/95), followed by plaques 27% (26/95) and patches 15% (14/95). No pt presented with erythroderma. Median size of the largest lesion was 2 (range 0.5-20) cm. 63% had early stage (IA-IIA) disease and 86% had &amp;lt;5 skin lesions at the time of initial diagnosis. Furthermore, palpable lymph node (LN) (10%) and elevated LDH (18%) were uncommon at diagnosis. Initial treatments include localized radiation 60%, surgical excision 21% and topical steroids 11%. A small subset of pts received systemic treatments like CHOP 13% (12/95), BV 8% (8/95) and oral methotrexate 7% (7/95) as frontline therapy. A proportion of pts received XRT with CHOP (6/12) and BV (2/8). The overall response rate (ORR) to initial therapy was 68% (65/95) with 61% achieving a CR and 17% had primary refractory disease (stable and progressive disease). Relapse rate after 1st line therapy was 52% (49/95). In our cohort a total of 22 pts received BV after frontline therapy, of which 19 were BV naïve and 3 were re-treated. At the time of last follow up, 27% of our cohort were still on treatment, 78% were alive and 21% were dead; only 3% of deaths were attributed to the lymphoma. The median OS was 128 months (95% CI: 78.4-NA) (Figure 1) with a median follow up of 42 (range 0.5-123.5) months. The 5-year OS was 77%. On univariate analysis, older age (≥65 vs &amp;lt;65 years) (median OS 78 vs 128 months; p=0.004) and higher number of lesions (5-10 vs &amp;lt;5) (mOS 34 vs 128 months; p=&amp;lt;0.0001) were significant associated with OS (Table 1). Type and size of the skin lesions, presence of palpable LN, elevated LDH, stage, and treatment modalities had no impact on OS. Results of multivariate analysis will be presented at the conference. Conclusion: In this large multicenter RWA of PCALCL, excellent long-term survival was observed following frontline therapies that were mostly skin directed. The use of systemic therapies including BV were infrequent even in relapsed disease. Older age and increased number of skin lesions were associated with poor OS.

Recursive Partitioning Model to Identify Early Progression in Patients with Extracranial Oligometastatic Colorectal Cancer Treated with Stereotactic Body Radiotherapy

<h3>Purpose/Objective(s)</h3> Metastases directed therapy of oligometastatic colorectal cancer (CRC) may confer long-term disease advantages. However, there is a paucity of data to predict optimal patient selection. Our hypothesis is that pretreatment factors can identify patients at higher risk of early progression after SBRT for CRC oligometastases. <h3>Materials/Methods</h3> An institutional cohort was reviewed to identify patients with extracranial oligometastatic (≤ 5 metastases) colorectal cancer who received SBRT to all metastases. Outcomes of interest were local failure (LF), overall survival (OS) and progression-free survival (PFS). Recursive partitioning analysis (RPA) was performed to identify "early progression", defined as those having a PFS event within 6 months of SBRT, from a training set consisting of 70% of the cohort. The remaining 30% were used in the validation analysis of the model. <h3>Results</h3> From January 2008 to May 2021, 254 patients were identified with 408 lesions irradiated. Median age was 75 years (IQR: 62-82), median follow-up was 30.5 months (IQR: 17.7-48.8), and median time from diagnosis of cancer to metastatic disease was 12.0 months (IQR: 0.2-26.1). The majority of patients had a single metastasis (n=167, 65.8%). The 12-, 24- and 36-month cumulative incidence of LF was 10.3%, 22.8% and 27.5%, respectively. On multivariable analysis (MVA), liver metastasis (vs. non-liver, HR 1.99, 95%CI: 1.32-3.00, p<0.01) and lower mean PTV dose BED₁₀ (HR: 1.01, 95%CI: 1.01-1.02, p<0.01) predicted for higher LF. Median OS was 51.1 months (95%CI: 46.2-56.3) and 12-, 24- and 36-month OS was 94.0%, 79.5% and 64.9%, respectively. On MVA, higher pre-SBRT CEA (HR: 1.21, 95%CI: 1.01-1.45, p=0.04) and larger PTV volume (HR: 1.61, 95%CI: 1.31-1.97, p<0.01) were significant predictors of worse OS. Median PFS was 11.8 months (95%CI: 9.9-13.7) and 6-, 12- and 24-month PFS was 73.2%, 49.2% and 30.4%, respectively. Of the 254 patients included, 68 (26.8%) had "early progression". The RPA model ranked the following variables in order of importance: presence or history of any liver metastases, pre-SBRT CEA and number of lesions treated at time of SBRT. Four terminal nodes (i.e., groups) were generated, classifying the probability of "early progression" with a training and validation receiver operating characteristic curve (AUC) of 0.72 and 0.71, respectively. The two groups at highest risk of early progression were: 1) history or presence of any liver metastases and with ≥2 lesions treated; and 2) history or presence of any liver metastases with 1 lesion treated at the time of SBRT, and pre-SBRT CEA ≥8 ng/mL. <h3>Conclusion</h3> History or presence of liver metastases, higher number of lesions, and higher CEA levels can aid in the identification of oligometastatic patients who progress soon after SBRT. Such patients can be considered for alternative treatment strategies.

A method for labelling lesions for machine learning and some new observations on osteochondrosis in computed tomographic scans of four pig joints

BackgroundOsteochondrosis is a major cause of leg weakness in pigs. Selection against osteochondrosis is currently based on manual scoring of computed tomographic (CT) scans for the presence of osteochondrosis manifesta lesions. It would be advantageous if osteochondrosis could be diagnosed automatically, through artificial intelligence methods using machine learning. The aim of this study was to describe a method for labelling articular osteochondrosis lesions in CT scans of four pig joints to guide development of future machine learning algorithms, and to report new observations made during the labelling process. The shoulder, elbow, stifle and hock joints were evaluated in CT scans of 201 pigs.ResultsSix thousand two hundred fifty osteochondrosis manifesta and cyst-like lesions were labelled in 201 pigs representing a total volume of 211,721.83 mm3. The per-joint prevalence of osteochondrosis ranged from 64.7% in the hock to 100% in the stifle joint. The lowest number of lesions was found in the hock joint at 208 lesions, and the highest number of lesions was found in the stifle joint at 4306 lesions. The mean volume per lesion ranged from 26.21 mm3 in the shoulder to 42.06 mm3 in the elbow joint. Pigs with the highest number of lesions had small lesions, whereas pigs with few lesions frequently had large lesions, that have the potential to become clinically significant. In the stifle joint, lesion number had a moderate negative correlation with mean lesion volume at r = − 0.54, p < 0.001.ConclusionsThe described labelling method is an important step towards developing a machine learning algorithm that will enable automated diagnosis of osteochondrosis manifesta and cyst-like lesions. Both lesion number and volume should be considered during breeding selection. The apparent inverse relationship between lesion number and volume warrants further investigation.

Investigation of CDH1 germline mutations in Turkish patients with Kaposi’s sarcoma

Abstract Objectives Kaposi’s sarcoma (KS) develops from the lining cells of blood or lymphatic vessels and may appear as red, purple, brown, or black lesions. E-cadherin, CDH1, is a cell adhesion molecule located on the surface of epithelial cells. CDH1 gene expression is downregulated in several cancers and is considered a tumor suppressor gene involved in epithelial-mesenchymal transition in carcinomas. Loss of CDH1 gene expression is observed in many carcinomas, mainly diffuse gastric carcinomas and lobular breast carcinomas, as well as skin tumors. This study investigates the CDH1 germline mutations in HIV-negative (Human Immunodeficiency) Virus KS patients in the Turkish population. Methods The study examined 25 peripheral blood mononuclear cells from KS patients using the Sanger sequencing technique. Results Sixteen exons of the CDH1 gene were sequenced, and a pathogenic functional germline mutation, HET c.2245C &gt; T, p.(Arg749Trp) rs776975632, NM _004360.5, was identified in a patient with a family history of gastric and breast cancer with a high number of lesions compared to other KS patients. Discussion: KS patients with a family history of cancer could be screened for CDH1 gene and cancer-related-gen variants in the future. Conclusions KS is a rare malignancy, and genetic analysis will benefit KS patients. Further studies are needed to describe better the variations detected in a large number of KS patients in this study.

Протозоози в’єтнамських вислобрюхих свиней на півдні України

Goal. To find out the distribution and diversity of the simplest gastrointestinal tract in Vietnamese potbellied pigs by cage- and cage-exercise systems in the South of Ukraine. Methods. Methods used: clinical observation, coprological research. Cryptosporidia were studied by making a native smear according to the generally accepted method, staining of smears was performed by the method of Kester and Romanovsky-Gimza. Eimeriosis and isosporosis were established by studying faeces using the Fuleborn flotation method, as well as in the Kotelnikov–Khrenov modification. Balantidia was recognized on wet smears with Lugol’s solution (diluted from 1:5 to 1:100). Detection of blastocysts was performed by ethyl acetate-formalin concentration and direct microscopy. Results. In the south of Ukraine, protozoa in Vietnamese potbellied pigs are quite common, the causative agents of which are Isospora suis, Cryptosporidium spp., Eimeria suis, Balantidium coli, and Blastocystis spp. Piglets and weaners (8 months) — balantidiosis (24.1–33.4%) and blastocystosis (13.8–26.2%). Conclusions. Isospora suis (34.2%) and Eimeria suis (25.9%) had the highest number of lesions in Vietnamese potbellied pigs on homestead farms in the South of Ukraine, while at cage-growing affection with Isospora suis and Eimeria suis was less by 8.1 and 7.4%, respectively, and lesions of pigs with Balantidium coli and Blastocystis spp. were higher by 7.4 and 6.0%, respectively.

Clinical presentation of verruca vulgaris in HIV

Immunocompromised patients, including those with human immunodeficiency virus (HIV), have been observed to have verrucae that are more extensive and treatment-resistant compared to those in immunocompetent patients. However, there is a critical lack of data in the current literature on the characteristics of verruca vulgaris in individuals with HIV. This retrospective chart review included a cohort of HIV-positive individuals and a control group of immunocompetent individuals presenting to an outpatient, county hospital-based dermatology clinic for evaluation of verruca vulgaris between the years of 2016 and 2018. Clinical characteristics, including gender, age, last CD4 count, viral load, antiretroviral therapy adherence, and total number and location of lesions were recorded. A total of 66 patients (33 HIV-positive, 33 immunocompetent) were included in the study. HIV-positive status was significantly associated with a higher total number of lesions (42% of immunocompromised patients versus 21% of immunocompetent patients presented with four or more lesions, P=0.04) as well as location of lesions on the face, scalp, and neck (51.5% versus 9.1%, P&lt;0.001). HIV-positive status may be associated not only with a higher burden of verruca vulgaris lesions but also a higher number of lesions in locations at or above the neck.

Spectrum of Lesions in the Fallopian Tubes – A Histopathogical Study

Introduction: The Fallopian tubes are a pair of narrow tubular structures connecting the ovary and the uterus. It is usually the site of fertilization and plays a very important role in the fusion of the sperm and ovary and helps in movement of the fertilized zygote to the uterus. Even though being an organ of very small size the importance of the variety of lesions occurring in the fallopian tubes is often not considered. Biopsies of the fallopian tubes are taken to show the different lesions found in the tubes.&#x0D; Aim: The main aim of the study is to study the spectrum of lesions occurring in the fallopian tubes and correlation of these findings with its clinical parameters.&#x0D; Study Design: This is a retrospective descriptive study&#x0D; Place and Duration of Study: Department of Pathology, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Thandalam, Chennai between June 2019- December 2019.&#x0D; Methodology: A retrospective study of all the fallopian tube specimens sent for routine histopathological analysis over a period of 6 months was carried out. The different pathological lesions were observed from the relevant clinical data and the correlation with its clinical parameters was done.&#x0D; Results: A sample size of 77 specimens was collected among which the commonest age group which was found to have the highest number of lesions was between 26-30 years. This was found to be in correlation to the reproductive age group of women. The most common form of pathological lesion observed was ectopic pregnancy (about 46% of total pathological lesions), followed by Paratubal cysts (23%), Hydrosalpinx (15%) and Hematosalpinx (8%). Cystadenoma was the only benign tumor observed in this study and constituted 8% of the total pathological lesions.&#x0D; Conclusion: This study shows the importance of histopathological examination of all fallopian tube specimens with or without abnormal findings.

Damage to black locust leaves (Robinia pseudoacacia L.) by the black locust gall midge (Obolodiplosis robiniae) (Haldeman, 1847) in the Włoszczowa-Jędrzejów Protected Landscape Area - research on strengthening and developing knowledge and awareness in environmental education

Abstract The prepared article by the team of authors aims to show research in the field of strengthening and developing knowledge and awareness from environmental education in the community of nature conservation services and the academic community. This paper is the result of research conducted in 2014–2015, in the Włoszczowa-Jędrzejów Protected Landscape Area, in the Świętokrzyskie Province. The material for the study was acacia robinia (Robinia pseudoacacia L.) leaves collected on two research areas, differentiated due to the influence of anthropogenic factors. As a result of the study, 5,000 black locust leaves were collected, 65% of which were found to be damaged. Research stands under the influence of strong anthropopressure were characterised by a higher number of lesions on leaves.

Risk factors for idiopathic myelitis at admission and predictors for late diagnostic change

Immune-mediated myelopathy (IMM) diagnosis is challenging, and its etiology may remain unclear despite extensive investigation. We evaluated diagnostic changes in IMM patients during follow-up. We included 80 patients, 61.3% female, with median follow-up time 62.5 months. Diagnoses at discharge were: 48.8% Multiple Sclerosis-IMM (MS-IMM), 32.5% I-IMM, 11.3% Neuromyelitis Optica Spectrum Disorders-IMM (NMOSD-IMM), 1.3% MOG encephalomyelitis (MOGAD), and 6.2% Others IMM (O-IMM). Twenty-two patients (27.5%) changed diagnosis (median 15.5 months): 68.8% MS-IMM, 12.5% NMOSD-IMM, 3.8% MOGAD, 10.0% I-IMM, and 5.0% O-IMM. Most patients that changed diagnosis were I-IMM. Predictive factors for diagnostic change in I-IMM were: autonomous gait (p = 0.029), lesions suggestive of MS (p = 0.039), higher number of lesions (p = 0.043), lesions length < 3 vertebral bodies (p = 0.033), cervical involvement (p = 0.038), and lower EDSS at admission (p = 0.013). Etiologic reclassifications in IMM are common, therefore patients require an appropriate follow-up time to increase diagnostic accuracy.

Radiofrequency Ablation for Movement Disorders: Risk Factors for Intracerebral Hemorrhage, a Retrospective Analysis.

One of the greatest concerns associated with radiofrequency ablation is intracerebral hemorrhage (ICH). However, the majority of previous studies have mainly evaluated Parkinson disease patients with ablation of the globus pallidus internus (GPi). To investigate the hemorrhagic risk associated with radiofrequency ablation using ventro-oral (Vo) nucleus, ventral intermediate (Vim) nucleus, GPi, and pallidothalamic tract. Radiofrequency ablations for movement disorders from 2012 to 2019 at our institution were retrospectively analyzed. Multivariate analyses were performed to evaluate associations between potential risk factors and ICH. A total of 558 patients underwent 721 stereotactic radiofrequency ablations for movement disorders. Among 558 patients, 356 had dystonia, 111 had essential tremor, and 51 had Parkinson disease. Among 721 procedures, the stereotactic targets used in this study were as follows: Vo: 230; Vim: 199; GPi: 172; pallidothalamic tract: 102; Vim/Vo: 18. ICH occurred in 37 patients (5.1%, 33 with dystonia and 4 with essential tremor). Symptomatic ICH developed in 3 Vo nuclei (1.3%), 3 Vim nuclei (1.5%), and 2 GPi (1.2%). Hypertension (odds ratio=2.69, P=.0013), higher number of lesions (odds ratio=1.23, P=.0221), and younger age (odds ratio=1.04, P=.0055) were significant risk factors for ICH associated with radiofrequency ablation. The present study revealed that younger age, higher number of lesions, and history of hypertension were independent risk factors for ICH associated with stereotactic radiofrequency ablation.

Clinical and macroscopic morphological features of canine tungiasis.

Tungiasis is a public health problem in endemic resource-poor communities, where dogs are important reservoirs of Tunga spp., contributing significantly to the process of transmission of this zoonosis. In order to optimize the diagnosis of canine tungiasis, macroscopic morphological characteristics and clinical signs of the lesions were investigated, based on the inspection of 40 dogs infested by T. penetrans from an endemic rural community in northeastern Brazil. Of the 1546 lesions found in these dogs, including all stages of development of the parasite, 89.1% (1378) were located on the paw pads. Dogs aged up to 5years had the greatest number of lesions. Dark pigmentation and hyperkeratosis of the paw pads made it difficult to identify the lesions. Among all the clinical signs observed were hyperemia (38; 95%), pain (32; 80%), fissure (11; 27.5%), onychogryphosis (29; 72.5%), cluster of lesions (26; 65%), hyperkeratosis (25; 62.5%), lameness (15; 37.5%), and fissure (11; 27.5%). Ectopic lesions were found especially in the nipples (64; 4.1%) and abdomen (51; 3.3%). The maximum diameter of the stage III neosomes was 6mm. Dogs with a higher number of lesions had a higher degree of hyperkeratosis. Age over 1year was associated with a higher rate of dispersion of the parasite in the environment (p = 0.04). The identification of the initial stages of tungiasis can guarantee a more effective control of the disease in dogs, which will mainly depend on the treatment of adult animals and the application of continuous preventive actions based on One Health in these communities.

Juvenile ossifying fibroma of the maxillofacial region: analysis of clinico-pathological features and management.

Background The diagnosis and management of juvenile ossifying fibroma (JOF) remains a highly debated topic with paucity of studies with long-term follow-up, hence the aim of this study was to report on the clinico-pathological features and management of these neoplasms.Material and Methods A retrospective analysis was performed on all histopathologically confirmed JOF presenting at two tertiary hospitals in Cape Town, South Africa over a period of 39 years. Clinical, demographic, histopathological and radiological features were analyzed. Surgical methods were documented and a minimum post-operative follow-up of 12 months was a prerequisite.Results Seventeen patients met the inclusion criteria and were included in this study. Overall, the ages of patients ranged from 3–31 years (mean= 13 years) with male to female ratio of 1.8:1. The ages of patients diagnosed with Trabecular JOF were significantly younger than patients with Psammomatoid JOF (P = 0.01). The majority of patients presented with marked swelling (88.2%). Interestingly, most neoplasms occurred in the mandible (76.5%) with all Psammomatoid JOF uncharacteristically occurring in the mandible. There was only one case of Trabecular JOF occurring in the sinonasal area. Most neoplasms appeared as unilocular (76.5%) and well-defined (82.4%) with mixed radio-density (70.6%) on radiographs and computed tomography. Curettage with peripheral ostectomy was shown to be the least invasive method with an accepTable recurrence rate (10%). Six lesions underwent resection without any recurrences however caused high morbidity to these young patients.Conclusions The high number of lesions occurring in the mandible for both variants of JOF demonstrates that site should not be a major determining factor in the diagnosis of JOF. Moreover, curettage with peripheral ostectomy should be used as the first line of management to minimize morbidity to the patient and that resection should be reserved for large and recurrent lesions. Key words:Juvenile ossifying fibroma, juvenile trabecular ossifying fibroma, juvenile psammomatoid ossifying fibroma, fibro-osseous lesions, maxillofacial region, multi-centre study.

The role of conidia in the dispersal of Ascochyta rabiei

Ascochyta rabiei asexual spores (conidia) were assumed to spread over short distances (~10 m) in a combination of rain and strong wind. The potential distance of conidial spread was investigated in three rainfall and three sprinkler irrigation events. Chickpea trap plants were distributed at the distances of 0, 10, 25, 50 and 75 m from infected chickpea plots before scheduled irrigation and forecast rainfall events. Trap plants were transferred to a controlled temperature room (20 °C) for 48 h (100% humidity) after being exposed in the field for 2–6 days for rainfall events, and for 1 day for irrigation events. After a 48 h incubation period, trap plants were transferred to a glasshouse (20 °C) to allow lesion development. Lesions on all plant parts were counted after 2 weeks, which gave an estimate of the number of conidia released and the distance travelled. Trap plants at all distances were infected in all sprinkler irrigation and rainfall events. The highest number of lesions on trap plants were recorded closest to the infected plots –the numbers decreased as the distance from the infected plots increased. There was a significant (p < 0.05) relationship between the amount of rainfall and the number of lesions recorded. A generalised additive model was developed that efficiently described spatial patterns of conidial spread. With further development, the model can be used to predict the spread of A. rabiei. This is the first systematic study to show that conidia distribute A. rabiei over longer distances than previously reported.

Prognostic markers for overall survival and outcome to LuPSMA radionuclide treatment in patients with metastatic castration-resistant prostate cancer.

5548 Background: The aim of this international multicenter retrospective analysis was to identify prognostic markers for the clinical outcome in late-stage mCRPC patients treated with 177Lutetium-prostate-specific membrane antigen (LuPSMA) radionuclide treatment. Methods: Patients with progressive mCRPC treated with LuPSMA at six centers in Germany, USA, and Australia were considered for inclusion. Eligible patients had 24 predefined, pretherapeutic covariates (demographics, prior mCRPC treatments, and PSMA PET/CT derived parameters) and survival data available. Endpoints included overall survival (OS) and PSA progression-free survival (PSA-PFS). Covariates were tested using univariate and mulitvariate proportional hazards regression Cox models. Results: 267/414 (64%) patients met inclusion criteria and were analyzed. 113 patients participated in clinical trials (ACTRN12615000912583, NCT03042312), while 154 were enrolled in compassionate-access programs. After a median follow-up of 22.5 months, median OS was 13.0 months (95%CI 11.6-14.4); 83% of the patients died. Median PSA-PFS was 4.0 months (95%CI 3.2-4.7). In the multivariate analysis, factors associated with shorter OS were: shorter time since diagnosis of prostate cancer (HR=2.04; p=0.002), lower number of prior systemic therapies (≤3; HR=1.56; p=0.006), prior exposure to chemotherapy (HR=1.42; p=0.05), lower hemoglobin levels (HR=1.13; p=0.002), higher number of lesions (≥20: HR=1.53; p=0.009), multiple sites of metastases (bone/LN only vs. bone + LN; HR=1.39; p=0.03) and visceral involvement (M1c) (HR=1.45; p=0.01). Factors associated with longer PSA-PFS were: longer time since diagnosis of prostate cancer (HR=0.44; p&lt;0.001), higher hemoglobin levels (HR=0.32; p=0.03), presence of pelvic lymph nodes (LN) metastasis (N1) (HR=0.68; p=0.01), no distant lymph node metastases (M1a) (HR=0.66; p=0.01), no skeleton involvement (HR=0.44; p=0.01), no visceral metastases (M1c) (HR=0.51; p&lt;0.001), higher PSMA-positive tumor volume (HR=0.87; p=0.04), and higher SUVmean (HR=0.94; p=0.002). Conclusions: This retrospective analysis identified prognostic factors for survival and treatment response to LuPSMA. Along with the conventional risk factors in mCRPC, PSMA PET/CT can be a useful tool for stratifying patients and guide patient’s selection for LuPSMA radionuclide treatment.

Clinical Presentation and Response to Therapy in Children with Cutaneous Leishmaniasis.

Cutaneous leishmaniasis (CL) caused by Leishmania braziliensis occurs predominantly in adult males. Herein, we compare the clinical presentation and the response to antimony therapy of CL in children versus adults. Participants included 571 patients with CL; of these, 129 were children (age ≤ 12 years). Cure was defined as the complete healing of ulcer in the absence of raised borders at day 90 after initiation of therapy. Failure was defined by the presence of an active ulcer or a scar with elevated borders at day 90. In comparison with adults, children had shorter duration of illness, more lesions in the head, and smaller ulcers. Risk factors for therapeutic failure were younger age, shorter duration of disease, higher number of lesions, and larger size of the biggest ulcer. When age was categorized in ≤ 12-year-olds (children versus adults), it predicted therapeutic failure with statistical significance at day 60 but not at day 90. In conclusion, our data indicate that there are significant differences in the clinical presentation of CL between children and adults. Physicians caring for children with CL should be aware that lesions may take longer to heal and remain alert for the possibility of higher odds of therapeutic failure in this group.

P379 Surveillance with chromoendoscopy to detect new dysplasia in inflammatory bowel disease

Abstract Background Inflammatory Bowel Disease patients (IBD) are in a higher risk of colorectal cancer (CRC) than the general population. Studies show that surveillance with chromoendoscopy (CE) is useful for prevention as it detects a higher number of dysplastic lesions, allowing their endoscopic resection and therefore preventing CRC. We aimed to assess our endoscopic results in IBD patients with previous diagnose of dysplasia. Methods We performed a retrospective data collection from IBD patients who have had dysplastic lesions in screening chromoendoscopy, performed in our hospital from January 2013 to June 2019. Demographic and clinical data at basal time were collected, as well as endoscopic and histological findings in basal chromoendoscopy and in the first follow-up Results 353 chromoendoscopies were performed in our Endoscopy Unit in this period and 50 patients showed dysplastic lesions. 14 (28%) of them had already had dysplasia in previous colonoscopies, which were performed with white light and aleatory biopsies. Basal characteristics are shown in the following table. In the initial chromoendoscopy, an average of 2.57 dysplastic lesions with an average size of 7.59 mm was detected. 70.8% were flat lesions (0-IIa/0-IIb Paris classification) and 53% were located distal to the splenic flexure. 85.7% were tubular adenomas low-grade dysplasia (LGD), 2 cases of high-grade dysplasia (HGD), one serrated polyp and one adenocarcinoma. Twenty-nine follow-up chromoendoscopy have been performed and new dysplasia lesions were found in 41.37% (average of 1.86 lesions, median 8 mm). 55.6% of the lesions were tubular adenomas LGD and 11.1% serrated adenomas LGD. Our analysis shows that patients with new lesions in the second chromoendoscopy had had worse bowel preparation on the first one (7.5 vs. 8.9, p = 0,006). We also found that these patients with new lesions had more flat lesions than sessile ones (70.6% Paris IIa, 23.5% IIb, 5.9% Is, p &amp;lt; 0,005). Conclusion Surveillance with chromoendoscopy in IBD patients with previous dysplastic lesions detects new dysplasia in 28% of them and LGD is the most frequent histology. In our sample, finding flat lesions or worse bowel cleaning in the first chromoendoscopy predicts having a higher number of lesions on the follow-up.

High Levels of Anti-GM-CSF Antibodies in Deep Infiltrating Endometriosis.

Endometriosis is a chronic hormono-dependent inflammatory gynecological disease. Endometriosis can be subdivided into three forms: superficial peritoneal implants, endometrioma, and deep infiltrating endometriosis (DIE). Inflammation is a typical feature of endometriosis with overproduction of prostaglandins, chemokines, and cytokines, like granulocyte-macrophage colony-stimulating factor (GM-CSF). GM-CSF is a hematopoietic growth factor and immune modulator which belongs to the group of cytokines that actively participate in inflammatory reactions. GM-CSF autoantibodies (Ab) are described in inflammatory diseases such as Crohn disease and ulcerative colitis where high concentrations of anti-GM-CSF Ab are correlated with severity, complications, and relapses. We have evaluated the presence of anti-GM-CSF Ab in the serum of 106 patients with endometriosis and 92 controls using a home-made enzyme-linked immunosorbent assay (ELISA) and correlated the results with the form and severity of the disease. We found that anti-GM-CSF Ab level is significantly increased in the sera of patients with endometriosis compared to controls and is associated with the severity of the disease especially in patients with deep endometriosis (p < 0.0001) with the highest number of lesions (p = 0.0034), including digestive involvement (p = 0.0041). We also found a correlation between these levels of anti-GM-CSF Ab and the number of lesions in DIE patients (r = 0.913). In this way, searching anti-GM-CSF Ab in endometriosis patient sera could be of value for patient follow-up and put further insight into the role of inflammation and of GM-CSF in endometriosis pathogenesis.

Abattoir study of genital diseases of female Black Bengal goats

Pathological investigation of genital diseases in Black Bengal goats (Capra hircus) was done using slaughterhouse materials. A total of 256 female genitalia were collected from slaughterhouses of Kishoreganj district of Bangladesh during October 2016 to December 2018. The gross pathological changes were recorded and tissues from the affected organs were collected for histopathology. A total of 56 (21.9%) female genitalia showed one or more of the 84 different pathological changes. The prevalence of reproductive diseases increased with age: the highest number of lesions (34) was recorded in animals aged 19-24 months. The uterus showed the highest number of pathological lesions (44) followed by ovary (31), fallopian tube (5), cervix (2) and vagina (2). Major pathological changes were luteal cyst (7.4%), endometritis (6.3%) and pyometra (7.0%). The Bangladesh Veterinarian (2019) 36(1 - 2): 8-19