Types Of Lesions Research Articles

Histopathological patterns of gastrointestinal lesions: Insights from a Tertiary Care Centre

Gastrointestinal (GI) lesions are a common clinical concern with significant implications for patient health, particularly in cases involving malignancies. Understanding the histopathological spectrum of these lesions is crucial for improving diagnosis and treatment strategies. This study aimed to investigate the histopathological spectrum of gastrointestinal lesions at a tertiary care center, focusing on the prevalence of different types of lesions and their distribution according to clinicopathological parameters. Methods: This cross-sectional study was conducted over a one-year period, from November 2022, to October 2023, at the Department of Pathology, Rohilkhand Medical College and Hospital, Bareilly, UP. A total of 100 patients with clinically suspected GI lesions were included. Biopsy specimens were collected and analyzed using standard histopathological techniques. The data were analyzed to determine the frequency of different types of GI lesions and their correlation with clinical features. Results: The study found that inflammatory lesions were the most prevalent, accounting for 57% of the cases. Malignant lesions were identified in 35% of the patients, with adenocarcinoma being the most common malignancy, especially in the colon, representing 57.14% of malignant cases. The small intestine was the most frequently affected anatomical site, involved in 33% of the cases, followed by the appendix at 22%. The majority of patients were middle-aged males, with a significant correlation between the type of lesion and gender. Conclusion: This study highlights the significant burden of gastrointestinal lesions, particularly inflammatory and malignant lesions, in the studied population. The findings underscore the importance of early detection and intervention to prevent the progression of these lesions, particularly in high-risk groups such as older males. Enhanced clinical management strategies are needed to address the substantial impact of GI pathologies on patient health.

Neuronal Intranuclear Inclusion Disease Presenting with Acute-Onset Dementia and Cortical Edema: A Case Report

BackgroundNeuronal Intranuclear Inclusion Disease (NIID) is a neurodegenerative disorder characterized by the formation of eosinophilic inclusions in the neurons, visceral and skin cells. The cause is associated with the GGC nucleotide repeat expansion in the NOTCH2NLC gene. The imaging hallmark of NIID is hyperintensities on diffusion-weighted imaging (DWI) at the corticomedullary junction. Clinical manifestations of NIID are highly heterogeneous. Here, we report a case of NIID presenting with acute-onset dementia and cortical edema.Case presentationWe describe an elderly male patient who presented with sudden dementia within a day. Considering the abrupt onset and the stroke history, we initially diagnosed vascular disease. However, further imaging revealed cortical edema in the temporo-parieto-occipital lobes. Blood and cerebrospinal fluid tests ruled out immunological, metabolic, infectious, or neoplastic etiologies. Genetic testing ultimately confirmed the diagnosis of NIID. Intravenous immunoglobulin (IVIG) therapy did not improve the patient’s symptoms; However, about 1 month after treatment, spontaneous improvement was observed. It is noteworthy that 22 months before the onset of cognitive impairment, the patient’s MRI for headaches already exhibited the typical imaging lesions of this disease in the cerebellum paravermal region.ConclusionPatients with encephalopathy syndrome exhibiting imaging features resembling mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome or Creutzfeldt-Jakob disease should consider the NIID as differential diagnosis. Chronic headaches and symmetric lesions in the cerebellar paravermal region on MRI may be noteworthy indicators of NIID during non-episodic phases.

Intracranial inoculation rapidly induces Nipah virus encephalitis in Syrian hamsters.

Nipah virus (NiV) is a highly pathogenic Paramyxovirus associated with outbreaks in Malaysia, Bangladesh, and India with high mortality rates. NiV infection causes fatal respiratory and neurological disease. The majority of survivors suffer from long-term neurological sequelae or late onset and relapsed encephalitis. The pathogenesis of neurological disease is complex and has not been able to be studied in current animal models as they are skewed towards the development of lethal respiratory disease rather than neurological disease. Although NiV neurological disease can be observed in animal models, there is currently no model where the majority of animals consistently develop neurological disease. Here, we developed a new Syrian hamster (Mesocricetus auratus) model to mimic neurological disease in humans. Hamsters were inoculated intracranially in the cerebellomedullary cistern with different doses of NiV, strain Malaysia. Intracranial NiV inoculation in the cerebellomedullary cistern resulted in a rapid progression towards severe neurological disease requiring euthanasia. High Nipah viral loads were detected in the brains, and NiV spread from the CNS to the lungs. Histopathologic examination of the brain showed ischemic necrosis, often accompanied by marked edema and hemorrhage. NiV antigen was detected primarily in meninges and cerebellum, but rarely observed in brain parenchyma. These histological lesions were different from the typical lesions observed in NiV-infected humans. Thus, despite the consistent development of neurological disease, intracranial inoculation does not result in a model representative of NiV neurological disease.

Revolutionizing endometriosis treatment: automated surgical operation through artificial intelligence and robotic vision.

Clinical limitations due to poverty significantly impact the lives and health of many individuals globally. Nevertheless, this challenge can be addressed with modern technologies, particularly through robotics and artificial intelligence. This study aims to address these challenges using advanced technologies in robotic surgery and artificial intelligence, proposing a method to fully automate endometriosis robotic surgery with a focus on interpretability, accuracy, and reliability. A methodology for fully automatic endometriosis surgery is introduced. Given the complexity of endometriosis lesions detection, they are categorized by their anatomical location to improve system interpretability. Then, three ensemble U-Net frameworks are designed to detect and localize common types of endometriosis lesions intraoperatively. A cross-training approach is employed, exploring U-Net models with diverse neural architectures-such as ResNet50, ResNet101, VGG19, InceptionV3, MobileNet, and EfficientNetB7-to develop U-Net ensemble models for precise endometriosis lesions segmentation. A novel image augmentation technique is also introduced, enhancing the segmentation models' accuracy and reliability. Furthermore, two U-Net models are developed to localize the ovaries and uterus, mitigating unexpected noise and bolstering the method's accuracy and reliability. The image segmentation models, assessed using the Intersection over Union (IoU) metric, achieved outstanding results: 97.57% for ovarian, 96.35% for uterine, and 92.58% for peritoneal endometriosis. This study proposes a fully automatic method for some common types of endometriosis surgery, including ovarian endometriomas and superficial endometriosis. This method is centered around three ensemble U-Net frameworks and a noise reduction technique using two additional U-Nets for localizing the ovaries and uterus. This approach has the potential to significantly improve the accuracy and reliability of robotic surgeries, potentially reducing healthcare costs and improving outcomes for patients worldwide.

Immunohistochemical Localization of Fibroblast Activation Protein in Coronary Arteries with Different Forms of Atherosclerosis

Background: Fibroblast activation protein (FAP) is a cell surface glycoprotein expressed by myofibroblasts in areas of active tissue remodeling. It plays a potentially important role in cardiac remodeling, atherosclerotic plaque formation, and plaque rupture. Given the distinct pathophysiology and morphology of different forms of atherosclerosis, we analyzed FAP expression in human coronary vessels with no coronary artery disease, atherosclerotic plaques at different levels of progression, and other distinct forms of coronary disease in post bypass vein grafting and cardiac allograft vasculopathy after a heart transplant. Methods: Immunohistochemical staining with monoclonal F19 mouse anti-human FAP antibody was performed to identify FAP in human atherosclerotic plaques, coronary bypass atherosclerosis, and post-transplant arteriosclerosis. The presence and distribution of FAP in different types and stages of human atherosclerosis were compared. Results: There was no FAP staining in patients with no significant coronary disease. All different types of human atherosclerotic lesioning lesions showed the presence of FAP expression, with different staining patterns in advanced atherosclerotic plaque, vein graft atherosclerosis lesions, and arteriosclerosis after a heart transplant. Conclusions: These data suggest that FAP may be a potential diagnostic marker and target for interventions, not only in coronary atherosclerotic plaque, but also in other forms of coronary disease, which have distinct pathophysiologies and currently limited treatment options.

Trajectory of mean platelet volume changes after aneurysmal subarachnoid hemorrhage in patients with or without delayed cerebral ischemia

The morbidity of aneurysmal subarachnoid hemorrhage (aSAH) remains high, particularly because of secondary cerebral lesions that significantly aggravate the primary lesions. The main type of secondary lesions is delayed cerebral ischemia (DCI), in which platelets (PLT) appear to play a key role. Mean platelet volume (MPV) is an indirect marker of platelet activation. We aimed to determine the individual trajectories of MPV over time in patients with and without DCI during the course of aSAH. This is a single-center, retrospective, longitudinal analysis of individual trajectories of MPV over time, in a cohort of aSAH patients included in the Prospective, Observational Registry of Patient with Subarachnoid Hemorrhage in Neurocritical Care Unit (ProReSHA). A mixed-effects linear regression model was used to compare the trajectories of MPV and MPV/PLT ratio between patients who developed a DCI and those who did not. A total of 3634 MPV values were collected in 587 patients. The analysis of MPV as a function of DCI occurrence showed a significant difference in the trajectory over time between patients with DCI and those without, with an estimate of 0.02 (95%CI 0.01, 0.04, p = 0.009). The analysis of the MPV/PLT ratio as a function of DCI occurrence and other covariates showed a significant difference in the trajectory over time only for patients with a modified Fisher score less than 3, with an estimate of -0.59 (95%CI: -0.94, -0.23, p = 0.001). The individual trajectories of MPV over time differ between patients with DCI and those without. However, MPV values vary greatly over time and between patients. Thus it does not appear as a reliable biomarker for stratifying patients based on their specific risk of developing DCI. ClinicalTrials.gov identifier: (NCT02890004), registered in August 2016.

Chronic acid sphingomyelinase deficiency diagnosed in infancy/childhood in Polish patients: 2024 update.

Acid sphingomyelinase deficiency (ASMD) is an autosomal recessive lysosomal storage disease (LSD) associated with biallelic pathogenic variants in the sphingomyelin phosphodiesterase 1 (SMPD1) gene. The aim of this study was to provide the 2024 update on chronic visceral and neurovisceral ASMD diagnosed in the infancy/childhood in Polish patients. All the patients diagnosed in the pediatric age (0-18 years) with ASMD, both chronic neurovisceral and visceral type, and then systematically followed up, were enrolled into the study. A total number of 7 patients were enrolled into the study. Four patients were previously reported. Two patients were newly recognized with ASMD - 1 with chronic visceral and 1 with chronic neurovisceral ASMD. Splenomegaly was noted in all the patients while a mild liver enlargement was observed in 4 of 7 patients. All patients presented with decreased high-density lipoprotein cholesterol (HDL-C) and decreased serum 25-hydroxy-vitamin D concentration while almost all (6 of 7) with hypercholesterolemia. Cherry-red spot was observed in 5 of 7 patients, including 1 patient with neurovisceral type. Seven various SMPD1 gene variants were identified and missense variants were the most common types of genetic lesions, comprising 71% of all alleles. In all the screened patients, lyso-sphingomyelin (lyso-SM) in dried blood spot (DBS) was found elevated; however, the greater values were observed for patients with chronic neurovisceral type. Chronic acid sphingomyelinase deficiency (ASMD) is a slowly progressive disease. Pediatric ASMD is characterized by spleno-hepatomegaly, dyslipidemia (with decreased HDL-C as the most characteristic) and infiltrative (interstitial) lung disease. Both visceral and neurovisceral chronic ASMD patients could present with cherry-red spot. Both acid spingomyelinase activity and lyso-spingomyelin concentration in DBS should be regarded as a first-tier screening method into ASMD.

Congenital Pulmonary Airway Malformation Type II and Challenge in the decision-making process in developing countries-a case report

Congenital Pulmonary Airway Malformation (CPAM) is a congenital lung disease that can be present from prenatal to childhood. The overall incidence of CPAM is reported to be 1 in 10,000 to 1 in 35,000 births, making it the most common type of congenital lung lesion. This malformation results from the interruption of lung development during various stages of embryogenesis. This case report aims to illustrate the disease through ultrasound imaging, emphasize its characteristics, and discuss parental counseling and decision-making regarding the continuation of pregnancy. It is important to highlight the limitations of prenatal diagnostic precision in developing countries and the need for additional diagnostic tools to improve parental decision-making options.

Characterization of bone lesions and bone mineral density of roadkilled wild animals in the Brazilian semi-arid

Highways are one of the anthropogenic factors that have the greatest impact on terrestrial biodiversity. Barriers, depletion effects, and roads are the most common locations of wild animal roadkill, leading to biodiversity loss in wild vertebrates. However, the corpses of these animals can be used as opportunistic samples, an excellent source of information on topics such as population dynamics, which is one of the aims of road ecology. Nonetheless, there are only a few studies on injuries in roadkilled wild animals. Between 2018 and 2021, road monitoring was performed around three Federal Conservation Units in Brazil. Twenty-four animals, including birds, reptiles, and mammals, were collected. This study aims to characterize the lesions in wild animals that were roadkilled on roads in the Brazilian semi-arid region using necropsy and quantitative computed tomography (QCT). Also, the bone mineral density was measured using QCT and compared with the number of lesions and body condition score. Four types of bone lesions were found in 13 different bones, with an average of 3.25 lesions per bird and 3.75 lesions per reptile and mammal, with no statistical difference between the means (p > 0.05). Providing a database on the main injuries found in wild animals that are frequently roadkilled serves as an aid to wildlife rescue and rehabilitation professionals who contribute to the conservation of species. In addition, the data on road ecology serves as a basis for the implementation of mitigation measures against wildlife roadkills, also contributing to the conservation of species.

Concomitant Cervical and Anal Screening for Human Papilloma Virus (HPV): Worth the Effort or a Waste of Time?

This study represents a follow-up analysis of the AnusGynecology (ANGY) study. This prospective, cross-sectional, single-center study recruited women for concomitant cervical and anal screening of HPV genotypes and cytology during a single appointment. All women with findings of either HPV or any type of dysplastic lesions on anal smears were offered follow-up in a specialized high-resolution anoscopy (HRA) outpatient clinic, representing the study cohort for this follow-up study. Overall, 275 patients (mean age 42 ± 12) were included. Among them, 102 (37%) had cervical high-risk (HR) HPV. In total, HPV was (incidentally) revealed in 91 patients (33%) on anal smears, while any degree of anal squamous intraepithelial lesion (SIL) was found in 30 patients (11%), 6 if which were high-grade SIL (H-SIL). Furthermore, 10 out of 19 biopsies were positive (3 H-SIL lesions). Only half (48/91, 53%) of the women agreed to undergo the recommended specialized follow-up evaluation. Of them, 18 (38%) were diagnosed with dysplastic lesions (9 low grade (L-SIL) and 9 H-SIL, respectively) on biopsies, while the remaining visits revealed no abnormalities. Multivariable analysis revealed cervical HR-HPV infection (OR 4, 95% CI 2.2-7.5) and anal intercourse (OR 3.1, 95% CI 1.7-5.9) as independent risk factors for anal HR-HPV infection. Close follow-up of these women is hence strongly recommended.

Clinical features of vascular cognitive impairment

Vascular cognitive impairment (VCI) can occur in cerebrovascular disease of varying degree of severity, which requires further investigation.Objective: to identify specific features of attention deficit and executive function (EF) impairment in VCI and to determine the relationship between cognitive, neurological and radiological signs of the disease.Material and methods. The study involved 80 patients (51 with VCI – the main group and 29 healthy volunteers – the control group). All participants underwent clinical and neuropsychological examination and MRI of the brain. VCI was diagnosed according to 2014 VASCOG criteria. The neuropsychological examination included an assessment of the general cognitive function (MoCA test, MMSE); general EF (FAB, EXIT-25); episodic memory (12-word memory test and Benton Visual Retention Test); semantic memory (categorical association method); initiation and productivity of cognitive activity (literal associations); attention [TMT-A, Symbol-Digit Modalities Test (SDMT)]; cognitive flexibility (TMT-B); cognitive control (Stroop test).Results. As a result of the study, three subgroups of patients with VCI were identified: 1) predominantly attention deficit (AD); 2) AD and significant decrease in cognitive flexibility (CFD); 3) AD in combination with a significant cognitive control deficiency (CCD). The TMT-A and SDMT tests were significantly worse in all subgroups of VCI compared to the control group, with the worst SDMT score in subgroup 2. Subgroup 2 also had the longest time to complete the TMT-B test. Subgroup 3 was characterized by the worst Stroop test results, and uncontrolled arterial hypertension was more common in this group. Gait disturbances were significantly more frequent in subgroup 2, and increased reflexes of oral automatism and grasp reflex were observed in subgroup 3. White matter hyperintensity (WMH) was more pronounced in subgroup 2, and lacunar infarcts (LI) were more frequent in subgroup 3. Prevalence of LI and severity of WMH were lowest in subgroup 1.Conclusion. The main features of VCI are attention deficit and EF impairment, characteristics of EF disorders depend on the severity and type of vascular lesions of the brain. Progression of WMH is associated with more pronounced CFD and an increase in the number of LI is associated with CCD. There is a correlation between CFD and gait disturbances and between CCD and lack of primitive reflexes inhibition.

Challenges in Teledermoscopy Diagnostic Outcome Studies: Scoping Review of Heterogeneous Study Characteristics.

Teledermoscopy has demonstrated benefits such as decreased costs and enhanced access to dermatology care for skin cancer detection. However, the heterogeneity among teledermoscopy studies hinders the systematic reviews' synopsis of diagnostic outcomes, impeding trust and adoption in general practice and limiting overall health care benefits. This study aims to improve understanding and standardization of teledermoscopy diagnostic studies, by identifying and categorizing study characteristics contributing to heterogeneity. Subsequently, the variability and consistency of these characteristics were assessed. A review of systematic reviews regarding the diagnostic outcomes of teledermoscopy was performed to discern reported study characteristics contributing to heterogeneity. These characteristics were thematically grouped into 3 domains (population, index test, and reference standard), forming a data extraction framework. A scoping review on teledermoscopy diagnostic outcomes studies was performed, guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. Data pertaining to study characteristics from included studies were extracted and analyzed through descriptive content analysis. Systematic reviews' reference lists validated the scoping review query. The literature search yielded 4 systematic reviews, revealing 15 heterogeneous studies across the population, index test, and reference standard domains. The scoping review identified 49 studies, with 27 overlapping with the systematic reviews. Population characteristics varied, with one-third (16/49, 33%) of studies reporting fewer than 100 samples; most studies (41/49, 84%) reported on the type of lesion, and most (20/49, 41%) teledermoscopy consultations took place in secondary care. One-fifth (11/49, 22%) did not describe inclusion or exclusion criteria, or the criteria varied highly. Index test characteristics showed differences in clinical expertise, profession, and training in dermatoscopic photography, and 59% (29/49) did not report on 1 or more index test characteristics. Image quality and clinical information reporting likewise varied. Reference standard characteristics involved teledermatologists' assessment, but 16 studies did not report teledermatologists' experience levels. Most studies (26/49, 53%) used histopathology as a gold standard. The heterogeneity in the population, index tests, and reference standard domains across teledermoscopy diagnostic outcome studies underscores the need for standardized reporting. This hinders the synopsis of teledermoscopy diagnostic outcomes in systematic reviews and limits the integration of research results into practice. Adopting a (tailored) STARD (Standards for Reporting Diagnostic Accuracy Studies) checklist for teledermoscopy diagnostic outcome studies is recommended to enhance the consistency and comparability of outcomes. We suggest performing a Delphi study to gather consensus on the tailored STARD guideline.

A convolutional neural network-based system for identifying neuroendocrine neoplasm and multiple types of lesions in the pancreas via endoscopic ultrasound (with videos)

Background and aimsEndoscopic ultrasound (EUS) is sensitive in detecting pancreatic neuroendocrine neoplasm (pNEN). However, the endoscopic diagnosis of pNEN is operator-dependent and time-consuming since pNEN mimics normal pancreas and other pancreatic lesions. We intended to develop a convolutional neural network (CNN)-based system named iEUS for identifying pNEN and multiple types of pancreatic lesions via EUS. MethodsRetrospective data of 12,200 EUS images obtained from pNEN and non-pNEN pancreatic lesions, including pancreatic ductal adenocarcinoma (PDAC), autoimmune pancreatitis (AIP), and pancreatic cystic neoplasm (PCN), were used to develop iEUS. It was composed of a two-category (pNEN/ non-pNEN pancreatic lesion) classification model (CNN1) and a four-category (pNEN/ PDAC/ AIP/ PCN) classification model (CNN2). Videos from consecutive patients were prospectively collected for a human-iEUS contest to evaluate the performance of iEUS. ResultsA total of 573 patients were enrolled in this study. In the human-iEUS contest containing 203 videos, CNN1 and CNN2 showed an accuracy of 84.2% and 88.2% for diagnosing pNEN, respectively, which were significantly higher than that of novices (75.4%) and comparable with intermediate endosonographers (85.5%) and experts (85.5%). In addition, CNN2 showed an accuracy of 86.2%, 97.0%, and 97.0% for diagnosing PDAC, AIP, and PCN, respectively. With the assistance of iEUS, the sensitivity of endosonographers at all three levels in diagnosing pNEN has significantly improved (64.6% vs. 44.8%, 87.5% vs. 71.9%, 74.0% vs. 57.6%, respectively). ConclusionsThe iEUS precisely diagnosed pNEN and other confusing pancreatic lesions, thus could assist endosonographers in achieving more accessible and accurate endoscopic diagnoses via EUS.

Oral Manifestations in Paraneoplastic Syndromes: ASystematic Review and Meta-Analysis.

This study examined the prevalence of oral signs and symptoms in paraneoplastic syndromes. A systematic search on oral paraneoplastic syndromes was conducted in MEDLINE/PubMed, Ovid, and Scopus databases from inception to April 1, 2024. Risk of bias was evaluated using the MURAD or Quality in Prognosis Studies tools, and a random-effects meta-analysis was performed. Evidence quality was rated using the GRADE approach. The study sample comprised 811 participants from 487 studies. Oral manifestations predominantly affected patients with paraneoplastic pemphigus, mucous membrane pemphigoid, and acanthosis nigricans. Palate is the most frequently affected site (18.2%; 95% confidence interval [CI] 14.7-21.9), while erosion was the most common lesion type (83.3%; 95% CI 72.2-92.0) associated with the underlying malignancy. The prevalence of death in people with paraneoplastic syndromes was 50.9% (95% CI 39.9-61.7), while the prevalence of remission after neoplasm treatment was 63.4% (95% CI 49.9-76.0). GRADE assessment revealed uniformly low to very low certainty for all outcomes studied. Further research is needed to understand the mechanisms behind these oral manifestations, which is crucial for earlier paraneoplastic syndrome diagnosis and optimal patient management. PROSPERO number: CRD42022328921.

Cytological Evaluation of Palpable Non-Neoplastic Breast Lesions among Women attended from Rural Community of Bangladesh: A Retrospective Cross-Sectional Study

Background: Non-neoplastic palpable breast disease is one of the most common disorders from which women suffer throughout the world. The use of fine-needle aspiration cytology (FNAC) method has proven to be quick, simple and cost-effective with minimum risk of complications in the evaluation of breast lumps. Objective: This study was planned to find out the common causes of various types of non-neoplastic breast lesions of female at different ages through fine needle aspiration cytology. Methodology: The retrospective cross-sectional study was carried out in the Department of Pathology at Monno Medical College& Hospital, Manikganj, Bangladesh. It lasted 2 years 6 months from July 1, 2019 to December 31, 2021. This study examined all breast lumps found in female patients. For data analysis, the patient's age and FNAC report were recorded. Aspirates were done using 5ml/10ml syringe and 23-gauge needle. Smears were stained with Papanicolaou stain. Results: The study included total 349 female patients with breast lesion. Among these, non-neoplastic lesions were 183(52.44%) cases and neoplastic lesions were 166(47.56%) cases. Among the lesions, 105(30.08%) cases were in fibrocystic changes; 28(8.02%) cases were in non-suppurative mastitis; 24(6.87%) cases were in suppurative mastitis (abscess), 14(4.01%) cases were in granulomatous mastitis. About 45(42.88%) cases of Fibrocystic changes, 13(44.84%) cases of non-suppurative mastitis and 9(37.5%) cases of Suppurative mastitis (abscess) were in the age group 21 to 30 years, 21 to 30 years and 41 to 50 years respectively. Conclusion: Fibrocystic changes are the commonest lesion in this study. Journal of Monno Medical College June, 2024; 10 (1):07-12

Morphological and Clinical Aspects of Pott's Disease in Ancient Human Remains: A Scoping Review.

The present study is a scoping review of the literature on Pott's disease in ancient human remains. Comprehending the origin and history of Pott's disease is relevant to assessing this pathological condition from an evolutionary perspective. Tuberculosis (TB) is an ancient pulmonary disease that remains the leading cause of death from a single infectious agent, rating above HIV/AIDS. The disease typically affects the lungs but can also target other anatomical sites. Of those, the most common and characteristic are the skeletal changes involving the spine, such as in Pott's disease. Spinal tuberculosis accounts for approximately half of all cases of musculoskeletal tuberculosis. It can lead to loss of function in the lower limbs due to damage to the spinal column. Nevertheless, its origin and evolution are still not fully understood and need further investigation. The authors investigated the published studies on Pott's disease in ancient human remains, intending to survey the literature, map the evidence and identify gaps and future perspectives on TB in paleopathology. The search strategy was conducted between September 2021 and March 2023 using keywords including the terms "Pott disease" OR "tuberculosis" AND "skeletal remains" in PubMed Biomed Central, Scopus, and Google Scholar search engines and biomedical databases. Five hundred and three records were initially identified, and 66 studies were finally included and assessed for qualitative analysis. Finally, the included records were analyzed in terms of non-narrative data, including the type of publication, country of excavation, dating of the sample, the number of human remains, and their details. Furthermore, the type of bone lesion was indicated as well as the diagnostic method if detailed. Among articles identified, most were classified as original articles, and were published between 2011 and 2020. Close to 77% of the records reported excavation in Europe and the Near middle east. Included studies considered a total of 3388 human remains, mostly excavated in archaeological sites and necropolis. Interestingly, the reported prevalence was higher among young males and adults. Although most of the findings are consistent with the literature, since the majority of the human remains were from Europe and the Near Middle East, more research is necessary in other sectors of the world. The suggestion of a male predominance needs to be confirmed and questions about the possible pathognomic role of rib lesions as well Serpes endocranica symmetrica (SES) represent further areas of research that need to be explored.

A conservative treatment of an involved molar tooth associated with dentigerous cyst: a case report and literature review

BackgroundDentigerous cysts (DCs) are among the most frequently odontogenic cysts in young and middle-aged individuals. Marsupialization and enucleation are the main treatment options in clinical practice. However, there are few reports on preserving molars severely involved by the cyst.Case presentationA 35-year-old male patient with a large odontogenic cyst that was successfully treated using a multidisciplinary approach. The patient’s chief complaint was discomfort during mastication in the lower left molar region for a month. Clinical examination revealed that teeth 36 and 37 were intact without pain upon percussion, while tooth 38 was unerupted. The radiology examination illustrated a typical well-defined oval radiolucent lesion surrounding the crown of unerupted tooth 38, extending to the distal root of tooth 37. The treatment was divided into two parts: removal of the cyst and the impacted third molar, followed by filling with collagen bone particles; and preserving the tooth 37 via hemisection, root canal treatment and crown restoration. Pathological examination indicated a dentigerous cyst. After 18 months of treatment, the bone defect completely recovered and tooth 37 functioned well following the hemisection.ConclusionsHemisection effectively preserves the cyst-associated molars and maintains oral function. This article underscores the significance of collaboration among various departments in the treatment of odontogenic cysts, ultimately aiming to achieve minimally invasive and functional surgery.

Direct immunofluorescence in bullous disorders: A mini-review

Background: Immunofluorescence microscopy is an invaluable tool for different lesions in dermatopathology. These lesions include bullous lesions, vasculitis, and connective tissue disorders/systemic lupus erythematosus. In this review, we take a look at bullous disorders. Some of these diagnoses are not possible on routine histopathology alone and require immunofluorescence for confirmation. Different diseases can be diagnosed according to the immunoglobulins/complements, sites of deposition (dermo-epidermal / intercellular spaces / dermal), and their patterns (linear, granular). Knowing the exact type of lesion can help guide treatment accordingly.

MRI-only breast cancers are less aggressive than cancers identifiable on conventional imaging

BackgroundMagnetic resonance imaging (MRI) has a superior sensitivity for the diagnosis of breast cancer, leading to lesions primarily detected by MRI. Some of these lesions cannot be identified by targeted second-look ultrasound (SLUS) examinations and are thus referred to as MRI-only lesions. We hypothesize that biologically more aggressive cancers lead to more distinct tissue damage improving visibility on SLUS. ObjectiveTo investigate whether there are differences in cancer subtypes between MRI-only and SLUS-detected malignant lesions. MethodsThis retrospective single-center observational study evaluated 435 patients who received breast MRI examinations between January 2017 and December 2022, with at least one lesion primarily detected on MRI and histologically confirmed as malignant. Demographic characteristics, lesion type (mass or non-mass), MRI-assessed lesion size (mm), histological diagnosis, stage, immunohistochemical analysis (ER, PR, HER-2, Ki-67), and lymph node status were assessed and compared between MRI-only and SLUS-detected. ResultsAmong 435 patients (mean age of 57.4 ± 13.3), 34.02 % (n = 148) were in the MRI-only group, while the remaining 65.98 % (n = 287) were identified by SLUS. MRI-only cases were significantly smaller in size (10 mm vs 20 mm), mostly staged as T1 (66.9 %) and showed features associated with less biological aggressiveness (higher pure ductal carcinoma in situ rates: 30.4 % vs 5.2 %; lower Ki-67, median values: 10 vs 20) compared to SLUS-detected cases (P < 0.001). SLUS-detected cancers had higher ratios of microscopic (4.9 % vs 3.4 %) and macroscopic axillary metastasis (26.8 % vs 7.4 %) compared to MRI-only lesions (P < 0.001). ConclusionMRI-only lesions presented histologically and immunohistochemically with less aggressive patterns compared to those detected via SLUS.Clinic Impact: Our data provide evidence that MRI-only lesions are biologically less aggressive and of lower stage, offering the potential of earlier treatment chance since they are visible on MRI before becoming more aggressive and destructive.

Amodiaquine ameliorates stress-induced premature cellular senescence via promoting SIRT1-mediated HR repair

DNA damage is considered to be a potentially unifying driver of ageing, and the stalling of DNA damage repair accelerates the cellular senescence. However, augmenting DNA repair has remained a great challenge due to the intricate repair mechanisms specific for multiple types of lesions. Herein, we miniaturized our modified detecting system for homologous recombination (HR) into a 96-well-based platform and performed a high-throughput chemical screen for FDA-approved drugs. We uncovered that amodiaquine could significantly augment HR repair at the noncytotoxic concentration. Further experiments demonstrated that amodiaquine remarkably suppressed stress-induced premature cellular senescence (SIPS), as evidenced by senescence-associated beta-galactosidase (SA-β-gal) staining or senescence‐related markers p21WAF1 and p16ink4a, and the expression of several cytokines. Mechanistic studies revealed that the stimulation of HR repair by amodiaquine might be mostly attributable to the promotion of SIRT1 at the transcriptional level. Additionally, SIRT1 depletion abolished the amodiaquine‐mediated effects on DNA repair and cellular senescence, indicating that amodiaquine delayed the onset of SIPS via a SIRT1-dependent pathway. Taken together, this experimental approach paved the way for the identification of compounds that augment HR activity, which could help to underscore the therapeutic potential of targeting DNA repair for treating aging-related diseases.