Maternal Hypothyroidism and Multiple Sclerosis: Disruption the Developing Neuroendocrine System

                                            http://austinpublishinggroup.com/multiple-sclerosis/

Maternal thyroid hormones have dynamic trophic actions during the perinatal development in particular the developing brain and myelination process. It is widely known that the appropriate myelinated growth, at postnatal day 25 in the rat, is responsible for protection and insulation of axons and is vital for the function of Central Nervous System (CNS), in particular the learning and memory function. Alternatively, there is a link between the hypothyroidism and the vulnerability of the CNS to inflammatory diseases by the thymus or spleen (cells of the immune system). In maternal hypothyroidism, the dysfunction in the thymic selection increases the accumulation of autoimmune T cells and the risk of autoimmune-inflammatory disorders in the offspring such as multiple sclerosis.

Multiple sclerosis is a long-lasting, neuroinflammatory demyelinating dysfunction of the CNS that mostly disturbs young adults. The etiology of multiple sclerosis might be due to a disturbance in the genetic process, immunological (autoimmune disorders), infectious, or environmental factors. Symptoms of multiple sclerosis during pregnancy are urinary insistence, fatigue, lower extremities paresthesias and gait difficulties. On the other hand, deficiency in the levels of maternal THs during the gestation can decrease the growth and differentiation of myelinated axons and cause permanent defects in the developing CNS including a mental retardation and cognitive disturbances. In mild-moderate iodine insufficiency, maternal and neonatal hypothyroxinemia, a low circulating free T4 with no change in free T3 or thyroid stimulating hormone (TSH), can disrupt the levels of nuclear Myelin Binding Protein (MBP) and increase the apoptosis causing a reduction in the cellular survival. More importantly, Wei et al. reported that hypothyroxinemia due to the maternal mild iodine decreases the expression of myelin-related proteins and delays the growth of neonatal myelination. Notably, a reduction in the levels of gestational THs can increase the severity of multiple sclerosis.

Maternal Hypothyroidism and Multiple Sclerosis: Disruption the Developing Neuroendocrine System

                                            http://austinpublishinggroup.com/multiple-sclerosis/

Maternalthyroid hormones (THs; 3,5,3’-triiodothyronine (T3) and thyroxin (T4)) have dynamic trophic actions during the perinatal development in particular the developing brain and myelination process. It is widely known that the appropriate myelinated growth, at postnatal day 25 in the rat, is responsible for protection and insulation of axons and is vital for the function of Central Nervous System (CNS), in particular the learning and memory function. Alternatively, there is a link between the hypothyroidism and the vulnerability of the CNS to inflammatory diseases by the thymus or spleen (cells of the immune system). In maternal hypothyroidism, the dysfunction in the thymic selection increases the accumulation of autoimmune T cells and the risk of autoimmune-inflammatory disorders in the offspring such as multiple sclerosis. Multiple sclerosis is a long-lasting, neuroinflammatory demyelinating dysfunction of the CNS that mostly disturbs young adults. The etiology of multiple sclerosis might be due to a disturbance in the genetic process, immunological (autoimmune disorders), infectious, or environmental factors. Symptoms of multiple sclerosis during pregnancy are urinary insistence, fatigue, lower extremities paresthesias and gait difficulties.

Onthe other hand, deficiency in the levels of maternal THs during the gestation can decrease the growth and differentiation of myelinated axons and cause permanent defects in the developing CNS including a mental retardation and cognitive disturbances. In mild-moderate iodine insufficiency, maternal and neonatal hypothyroxinemia, a low circulating free T4 with no change in free T3 or thyroid stimulating hormone (TSH), can disrupt the levels of nuclear Myelin Binding Protein (MBP) and increase the apoptosis causing a reduction in the cellular survival. More importantly, Wei et al. reported that hypothyroxinemia due to the maternal mild iodine decreases the expression of myelin-related proteins and delays the growth of neonatal myelination. Notably, a reduction in the levels of gestational THs can increase the severity of multiple sclerosis.

Entrepreneurship and its Genetic Basis

                                     http://austinpublishinggroup.com/molecular-cellular-biology/

Itis impossible to consider firms independent of people. Firms are managed by a group of people who try to achieve some results. It is easy to start home-based businesses because they are part time activities. In these kinds of tasks, you can do the task you want to do easily. If the task is more complex and labour-intensive, difficulties emerge. As the operational area if the firm expands, multiple licenses, permits, offers and forms need to be acquired from several governmental agencies. Therefore, an entrepreneur is an important part of the organization.

Manufacturersproduce by deploying production factors. Production factors are the tools used by the manufacturers to produce goods and services demanded by society. Production factors can be categorized as labour (including entrepreneurship skills), capital and land. The fourth production factor that brings the three factors mentioned together and attempts to produce the goods and services demanded by the consumer by organizing these factors is called the entrepreneur. Entrepreneur is an important and scarce manufacturing factor as he takes on some risks while bringing related production factors together and undertakes some risks when making investment decisions. This entrepreneur is generally accepted as a dynamic manufacturing factor among these production factors and is considered different from labour in terms of administration or production, as it is the driving force of the organization. In order to accomplish the production activity an individual or individuals need to take the responsibilities that may emerge in the future. In this context, an entrepreneur is a strategic manufacturing factor that the economy cannot ignore. Organizations with large production cannot function without entrepreneurship. Clearly, entrepreneurship is a rare human resource when there is a general reluctance to take risks and lack of the skills necessary to coordinate the work.

Microbial Degradation of Phenol by an Application of Pseudomonas mendocina

                                           http://austinpublishinggroup.com/microbiology/

Duringthe last few decades, an array of foreign compounds has been introduced into the environment due to the revolution of industrial field. The accumulation of these compounds has resulted in environmental contamination and contributed too many deleterious effects on living systems. The need to remove these contaminations has led to the development of new technologies with different removal performance and cost levels. Traditionally waste waters were treated by Physico Chemical methods, but recently Microbial Degradation has been widely studied and used as a low-cost alternative and offering the possibility of complete mineralization of organic compounds. Studies on microbial means of treating Phenolic effluents date back at least two decades. The toxicity of Phenol has been widely documented and their disastrous effect towards human and environment is greatly concerned. Phenolics constitute 11 of the 126 chemicals that have been designated as priority by the United States Environmental Protection Agency.

Phenolin water and wastewater has been the major organic chemicals. and is associated with pulp mills, coal mines, gasoline, petrochemicals, wood preservation plants, pesticides, insecticides, herbicides, detergents, solvents, polymeric resin production, plastic rubber proofing, disinfectants, pharmaceuticals, metallurgical, explosives, textiles, dyes, the coffee industry, domestic waste, agricultural run-off, and chemical spills. The maximum Permissible limit of Phenolic compounds in leachates for safe disposal to inland surface water is 1mg/L. Phenol is currently removed by methods such as precipitation/coagulation, osmosis, ion-exchange, ultra filtration, electro dialysis, electrochemical degradation, floatation, etc., which are costly and inefficient. These current treatment methods often produce other toxic end products, requiring further processing.

Fractal Approaches to Image Analysis in Oncopathology

                                           http://austinpublishinggroup.com/medical-oncology/

Mandelbrot’sconcept of fractal geometry is a powerful approach in order to precisely characterize natural structures, structures that follow geometric laws not in common with the classic Euclidean rules. The term “fractal” is related to highly irregular shapes, with non-integer, or fractional, dimensions, and a property known as self-similarity. Unlike a smooth Euclidean line, a fractal line is irregular or wrinkly, it owns a non-integer dimension: values placed between 1 and 2 observing a 2D image. If we imagine observing this fractal line with the lens of a microscope with increasing power of magnification we look smaller wrinkles that resemble the wrinkles of the larger ones. Further magnification shows yet smaller wrinkles and so on.

Ina theoretical (mathematical) fractal that behavior is repeated toward the infinite, in a natural fractal this is only true for few scales, at least for two order of magnitude: the object presents subunits that resembles the larger scale structure, maintaining the same, shape, at least statistically, if observed at various magnification: a property named self-similarity, that give us an index called fractal dimension. Fractal dimension may be explained as a statistical index of complexity, able to characterize the space-filling capacity of a pattern. Fractal analysis has become in recent years very powerful to study many phenomena in astrophysics, economics, agriculture as well in biology and medicine.

Use of Nanomaterials for Marine Bioremediation: A Perspective

                                  http://austinpublishinggroup.com/material-science-engineering/

One of the most challenging task of the 21^st Century is to develop new eco-friendly, sustainable and economically-sound technologies to clean up the environment from contaminants. In the last years, different physical, chemical and biological technologies have specifically focused on actions to protect and restore marine environment (sediment and/or water) from pollutants. Many of these technologies have played a central role in marine oil spill response contingency plans.

Bioremediation techniques have been proved to be a new an effective method for cleaning up residual pollutants in a variety of environments and a quite flexible management option to be implemented, also at a large scale, in marine ecosystem.

Stimulation of the growth of indigenous microorganisms (biostimulation) or inoculation of foreign oil-degrading bacteria (bioaugmentation) were recognized as effective measures for accelerating the detoxification of a polluted site with a minimal impact on the ecological system. Although bioremediation provides an excellent and flexible recovery strategy for different pollutants, it is poorly effective when dealing with high concentration of the pollutants and xenobiotics or refractory compounds, causing unsustainable treatment efficiencies and recovery time.

In this context the development of nanotechnology and the integration of the use of Nanomaterials (NMs) and Nanoparticles (NPs) can represent a promising innovation able to enhance the bioremediation action and to go beyond the actual limitations for in-situ or ex-situ applications. The combined approach appears to embrace a wider range of potential applications with reduced costs and increased control of undesired byproducts formation. Hazardous and radioactive waste depollution, groundwater and wastewater treatment, heavy metal and hydrocarbons contaminated sediments remediation are only few of the most known potential applications of Nanomaterials (NMs) in bioremediation processes.

LECT2 – A New Cause of Hepatic Amyloidosis

                                                     http://austinpublishinggroup.com/liver/

Amyloidosis is caused by an abnormal deposition and accumulation of insoluble protein fibrils in multiple organs, often leading to diverse clinical presentations, and possible organ failure. On Congo-Red staining, amyloid fibrils form characteristic beta-pleated sheets that typically show apple, green birefringence upon polarization under light microscopy. The kidney is the most common organ affected in systemic amyloidosis. The liver is involved less frequently than the kidney. In this editorial we present a recently discovered amyloid protein - LECT2 (leukocyte chemotactic factor 2) that has been documented to affect the kidney and the liver. Of more than 30 types of amyloid protein fibrils discovered thus far, LECT2 is one of the most recently described. It was initially reported to present with slowly progressive renal failure and nephrotic syndrome.

In the United States, LECT2 protein has been found to be especially prevalent among people of Hispanic ethnicity. In an autopsy series, LECT2 amyloid deposits were identified within the kidney in 3.1% of Hispanics, and could represent an important but under-recognized etiology of chronic kidney disease in this population. Two large case series focusing on renal amyloidosis identified LECT2 as the second and third most common form of renal amyloidosis respectively. LECT2 fibrils are found in the glomeruli, renal vessels, and interstitium. Other organs including the liver, spleen, adrenals, and lungs but not myocardium or brain have been reported to be involved with LECT-2 amyloid protein.

Bilateral Optic Nerve Infiltration as an Initial Site of Relapse of Acute Lymphoblastic Leukemia in Remission

                                                  http://austinpublishinggroup.com/leukemia/

CentralNervous System (CNS) relapse in Acute Lymphoblastic Leukemia (ALL) is in a phase where the incidence is expected to decrease due to advent of better systemic chemotherapy CNS prophylaxis via both chemo and radiotherapy, but the fact that the life span of patients have significantly increased compared to yester years contributes to increased incidence. Cases after complete systemic remission presenting with isolated bilateral optic nerve relapse is rarely reported.

An18 year old male, presented with fever 15 days, with swelling in neck both sides. Clinical examination showed multiple, palpable bilateral neck nodes, just palpable hepatomegaly. The hemogram showed elevated total count 18250, with 20% lymphoblasts. The bone marrow examination and flow cytometry confirmed a B-cell ALL. CSF cytology was negative at baseline. The patient was started on MCP 841 protocol, was in remission after induction. There were few episodes of febrile neutropenia during the course of treatment, but was uneventful. In the second Maintenance phase (M2), the patient presented to the OPD with c/o progressive dimness of vision since 1 week. There was no history of loss of consciousness, seizures, disorientation, headache, trauma to eye, diplopia or pain in the eyes. On examination the patient was conscious and oriented, vitals stable. The CNS examination was normal except the optic nerve. The ophthalmic examination is as follows: Left eye: Optic disc atrophy present, generalized oedema, Vascular sheath thickening and tortuosity, superficial flame shaped haemorrhage. Right eye: Vascular sheathing present, generalized oedema present, foveal reflexes dull, vitreous, macula and retinal vessels- normal.

Induction of Apoptosis in Human Lung Cancer Cells (A-549) by a Novel Nutrient Mixture via Upregulation of Caspase Enzymes

                               http://austinpublishinggroup.com/lung-cancer-research/

Worldwide,lung cancer is the most common cause of death from cancer and the incidence of lung cancer continues to increase. Although cigarette and tobacco smoking substantially increase the risk of developing lung cancer, the lifetime chance of developing lung cancer for a male is 1 in 15 and for females, the risk is slightly lower, 1 in 17. According to 2018 estimates of the American Cancer Society the 234,030 people may get a diagnosis of lung cancer in the United States and it may account for approximately 154,050 deaths. Small Cell Lung Cancer (SCLC) and Non Small Cell Lung Cancer (NSCLC) are the two major categories of lung cancer.

Only16% of the lung cancer cases are diagnosed at early stage. Most of the diagnoses occur when the cancer has already metastasized. More than 50% of patients die within one year of being diagnosed. Despite scientific advances surgery, chemotherapy, and radiation are still main modalities of treatment for lung cancer. Yet, both SCLS and NSCLC have poor prognosis with a 5-year survival rate of metastasized lung cancer has not improved more than 4% over several decades. There is therefore an urgent need to change the direction in cancer research and develop new, original and safer approaches.

being used as important treatment methods of cancers, due to their antitumor actions including induction of apoptosis. We have developed strategies to inhibit cancer development and its spread using a unique combination of naturally occurring nutrients. The antitumor Nutrient Mixture (NM) combination containing lysine, proline, ascorbic acid, and green tea extract has demonstrated anti-carcinogenic activity against a number of cancer cell lines.

Effects of Early Endocrine Disruptor Exposures (Faulty Hormonal Imprinting) on Immunity

                                            http://austinpublishinggroup.com/austin-immunology/

Endocrinedisruptors are (mainly steroid-) hormone-like molecules, which binding to the hormone receptors disturb the endocrine functions, causing troubles (diseases) in human adults. Perinatally (in fetal, neonatal, and early postnatal period), the developing immune system is touched by them, causing faulty hormonal imprinting, consequently late and life-long failures of immunity. In addition to the perinatal period there are other critical periods, as weaning and adolescence, in which faulty immune-imprinting can be provoked and this are also taking place in continously dividing and differentiating cells during the whole life however, the perinatal period has the determining role. Thephysiological hormonal imprinting is specific however, the faulty imprinting can be overlapping to not related hormones. Stressors can execute faulty imprinting-like effects by mobilizing stress hormones. The broad spectrum of faulty imprinting causing factors (endocrine disruptors) makes unavoidable the meeting with them. The alterations, caused by the endocrine disruptors are epigenetically inherited, so it can be supposed that the present state of human immunity had been formed by earlyer (natural) endocrine disruptors as e.g phytoestrogens, aromatic hydrocarbons, metals etc. “Endocrine disruptors” are a new category, but endocrine disruption has been present and influenced the development of the immune system since millions of years. However, the disruptors’ number and amount enormously increasing, so the future changes in the immune system caused by man-made endocrine disruptors must be attended. At present these changes seem to be harmful however, the chance for positive changes (transformation of human endocrine system) could be -after long time- possible. It is also worth to study the faulty hormonal imprinting effect of endocrine disruptors, as they seem responsible for numerous immune alterations (consequently diseases) manifested in adult age.

TheEndocrine Disuptors (EDs) are such molecules of our environment, which are similar to hormones (first of all steroid hormones) or can influence the effect of these hormones, by binding to the hormone-specific receptors or disturbing the transmission process betwen the receptor-hormone complex and the response by the cell. EDs can act to the endocrine system at any time of life however, the consequences are different, depending on the developmental period. From this point of view, the early stages of development seem to be rather critical, as in this periods (late prenatal, early postnatal, named perinatal) the further fate of the endocrine system (consequently the organs and systems regulated by it) is determined by hormonal imprinting.

Conventional Treatment Integrated with Chinese Herbal Medicine Improves the Survival of Patients with Advanced Non-Small Cell Lung Cancer

                                 http://austinpublishinggroup.com/austin-internal-medicine/

Lungcancer is the leading cause of all cancer deaths in the world, whether in developed or developing countries. The diagnosis and treatment of lung cancer have made significant progress recently, however, the 5-year survival rate remains less than 15%. According to a statistical analysis of cancer deaths in 2016 by the Ministry of Health and Welfare (MOHW) in Taiwan, the number of lung cancer deaths increased 5.7-foldover the prior three decades; meanwhile, lung cancer had the highest mortality rate for ten consecutive years, accounting for 25.4% of cancer deaths in 2016. It is generally believed that the particularly highly invasive nature of lung cancer cells is responsible for the high mortality rate of lung cancer, with nearly 90% of patient’s dying with metastasis. Meanwhile.

despiteadvances in treatment modalities, the overall 5-year survival rate of lung cancer patients has increased by only 4% (from 12% to 16%) over the past four decades. Lung cancer may be subdivided into two categories: small cell lung cancer and Non-Small Cell Lung Cancer (NSCLC), accounting for approximately 13% and 87% of all lung cancers, respectively. NSCLC can further be divided into three major cell types: adenocarcinoma, squamous cell carcinoma, and large cell carcinoma, of which adenocarcinoma has the highest proportion, accounting for approximately 55% of incidence.

Estimation of Submarine Groundwater Discharge into the Indian River Lagoon

                                                      http://austinpublishinggroup.com/irrigation/

A calibrated and validated finite difference numerical model was used to estimate the spatial and temporal distribution of the Meteoric Groundwater Discharge (MGWD) and Submarine Groundwater Discharge (SGD) into a coasted estuary known as the Indian River Lagoon (IRL) at two transects. Specifically, this paper describes the methodology used to determine: a) the quantity of MGWD originating from the mainland and the barrier island, b) the spatial distribution of the SGD into the IRL, c) the groundwater salinity and hydraulic head distribution below the IRL, and d) the regional flow directions of the MGWD and the Oceanic Groundwater Discharge (OGWD) in a vertical plane below the transects. It was found that a brackish transition zone, in which groundwater salinity varies from freshwater salinity to lagoon water salinity, exists in the surficial aquifer, below the IRL, at both the Palm Bay and Titusville transects. The daily SGD flow into the IRL for each month ranged from 1.77 to 2.10 m³/d, and from 0.37 to 0.42 m³/d, per meter of lagoon shoreline, at the Palm Bay and Titusville transects, respectively. These numbers are close to the 0.45 m³/d per meter of lagoon shoreline MGWD, through a 22 m outflow face, estimated by at the Eau Gallie transect. The mainland produced 98% of the MGWD at the Palm Bay transect and 86% of the MGWD at the Titusville transect. The estimated annual MGWD were 9.0 % and 1.6 % of the annual rainfall at the Palm Bay and Titusville transects. These numbers are reasonable given the impervious character of the watersheds that discharge into the IRL at these transects. The MGWD can occur at distances of several kilometers from the groundwater divide and up to a kilometer away from the IRL shoreline, and can affect the brackish water salt concentration below the IRL. Also, it is possible that, below the lagoon, zones of meteoric ground water may occur below the brackish water at depths of 20 to 30 m as in the case of the Palm Bay transect. The MGWD appears to be the primary source of SGD into the IRL at the study transects, as no ocean water enters the lagoon, and there is virtually no tidal influence at any of the transects which implies that the reversed estuarine water discharge (REWD) is also negligible.

Idiopathic and Autoimmune Diseases

                                        http://austinpublishinggroup.com/immune-research/

In our homeopathic practice we regularly come across a patients having some idiopathic or autoimmune diseases as these diseases has no treatment in allopathy.

In such a patients before starting to a treatment we take their complete history, family history, previous diseases and treatments taken. from this history we used to regularly observe that these patients are having some disease which is also running through their families and these are get suppressed by some anti inflammatory drugs, steroids, or for skin disease by strong external application ointments initially. for example some patients come to us with some chronic diseases either some idiopathic or autoimmune disease is having history of eczema which is also running through his family got suppressed by antihistamine, steroid ointments. Then these patient after some days present with severe life threatening diseases of vital organ in body to these they usually named as idiopathic or autoimmune diseases. these are Rheumatoid arthritis, idiopathic thrombocytopenic purpura, insulin resistance diabetes etc.

In these patients we prescribe a drug which is very similar to the behavioral, genetic, constitutional make up of patient. This leads to the reappearance of old ailments of previous diseases like itching, burning, eruptions on skin and as these eruptions flares up on the skin patients suffering get more and better. Similar to the suppression skin diseases allergies there is increased use of hormones in treatment of some specific diseases or even excessive and unnecessary use of drugs like HCG in natural phenomenon like pregnancy will definitely going to affect hormone mediated immunity too.

Malakoplakia of the Vulva Following Lung Transplantation

                                           http://austinpublishinggroup.com/invitro-fertilization/

A67-year-old woman with a past medical history of interstitial lung disease, status post bilateral lung transplant, presented with persistent painful bilateral labial lesions, which first appeared three months post-transplant. The lesions were biopsied and initially diagnosed as an abscess. Additional lesions developed and cultures grew Escherichia coli; however, despite treatment with multiple antibiotics and tapering of immunosuppressive agents, the lesions never resolved. A subsequent pelvic exam revealed three to five erythematous papules on bilateral labia measuring up to 4 mm in greatest dimension without spontaneous drainage. The patient underwent complete excision of all vulvar lesions and the specimens were received in surgical pathology.

Microscopicexamination revealed a nodular proliferation of sheets of histiocytes occupying the dermis with admixed lymphocytes and neutrophils, underlying an unremarkable epidermis. Numerous targetoid, basophilic Michaelis-Gutmann bodies were conspicuously seen within the proliferation, highlighted by von Kossa and periodic-acid Schiff stains. Special stains for infectious organisms were negative. A diagnosis of malakoplakia of the vulva was made.

Ethmoid-Nasal Phosphaturic Mesenchymal Tumour

                                         http://austinpublishinggroup.com/infectious-diseases/

Male patient, 53 years old, had been showing nasal obstruction for six months, otitis treated with inhaled antibiotics and crenotherapy with no results. He also reported paresthesia on left hard palate. He underwent rhinoscopy with optical fibres showing evidence of a neoformation of the right nasal concha, basis right of the nasal cavity with subtotal occlusion of the right posterior nasal aperture which impeded to see the Eustachian tube orifice. A CT with contrast medium confirmed the presence of a neoformation with partial involvement of the right pterygopalatine fossa, delimited by a confining bone. As the neoformation was located, the patient underwent an endoscopic transnasal surgical removal of the neoformation. Thehistological result initially showed the neoformation as a pleomorphic adenoma of the right nasal cavity. After a revision of the slides in another centre a phosphaturic mesenchymal tumour was diagnosed, due to the histological polymorphism characterized by hyalinization with microcystic spaces and a prevalence of chondroid and myxochondroid pattern. Later, the patient underwent a revision of the surgery with enlargement of the surgical margins and with a completely negative histological result for the disease. Moreover the concentration of calcium, phosphatemia and phosphaturia excluded Tumour-Induced Osteomalacia (TIO). Today, after 8 months since the second surgery, the patient appears to be free from the disease.

ETM PMTs are extremely rare. The diagnose is usually late due to the presence of osteomalacia or to symptoms linked to a local invasion. Patients affected by paraneoplastic syndrome can show nonspecific bone pain, muscular weakness and pathological fractures. PMT doesn’t show to have any link with sex and emerges to affect a very ample range of patients, from the age of 3 to 73. 95% of PMTs were observed in bones and only 5% in craniofacial districts. Among these about 50% of tumours were found in the sinonasal tract. In our revision it was observed that 20 cases of PMT reported in literature involve the sinonasal tract, while the rest of them involve other ETM tracts, as mandible, mouth, pharynx, larynx, thyroid and temporal bone. From a histological point of view PMT is characterized by spindle-shaped or stellar cells in a myxochondroid or myxoid matrix with calcification. Osteocytes in PMT are responsible for osteomalacia through the production of Fibroblast Grow Factor 23 (FGF23), which inhibits the transport of the sodium phosphate renal tubules leading to a phosphaturia and a consequent bone demineralization. PMT is mostly suspected when a not familial hypophosphatemia is present. Diagnostic workup must take into consideration the patient’s history, an objective systemic exam and a search for localizations in arms and legs and ETM. An otorhinolaryngologist who finds himself in front of a histological PMT must investigate a possible osteomalacia, as most cases see the presence of a paraneoplastic syndrome, and exclude the involvement of the bones. In the series displayed in chart 1 it is possible to observe that only 6 patients didn’t present TIO. In an extensive revision carried out by Folpe et al. on 109 mesenchymal tumours on the extremities, only 3 cases didn’t present TIO. The first line treatment is surgical resection with ample margins, which leads to a normalization of phosphatemia and phosphaturia with an improvement of the mineralization of bones. The persistence of metabolic alterations after surgical resection is predictive of an incomplete surgical resection or a relapse. Surgery appears to be the best choice also for the rare malignant manifestations of PMT, while adjuvant chemotherapeutic treatments haven’t been established, yet, due to the small amount of cases.

The Risk Criteries of Central Nervous System Involvement and the Management of its Treatment in Patients with Langerhans Cell Histiocytosis

                                       http://austinpublishinggroup.com/austin-hematology/

Langerhans Cell Histiocytosis (LCH) is a rare disease of monocytic-macrophage system and it is characterized by reactive clonal proliferation and accumulation of pathologic dendritic cells. Therefore, LCH was suggested recently to be a neoplastic disease and BRAF-V600E mutation is seen 60% of patients with LCH. LCH affects various organs such as bone, lungs, skin, liver, spleen, lymph nodes and Central Nervous System (CNS). LCH CNS disease can be divided into two groups. One is focal mass lesions; other is lesions associated with progressive neurodegeneration. Focal, space-occupying mass lesions are localised in meninges, choroid plexus and brain parenchyma which may contain CD1a+ LCH cells, lymphocytes and macrophages with histology similar to extra cranial lesions. The most common involvement sites are the hypothalamic pituitary region which is leading to anterior and posterior pituitary involvement that results DI, growth hormone deficiency and thyroid function abnormalities. 

The other neurological findings of LCH are progressive neurodegeneration (ND-LCH) which is characterized by progressive radio logical and clinical abnormalities. The ND-CNS-LCH occurs mostly in children, but rarely in adult LCH patients. There are two stages in ND-CNS-LCH: an early neurologically symptom-free stage characterized by MRI abnormalities alone and a second stage that includes prominent neurological symptoms Typical T2-weighted MRI findings are the increased symmetrical MRI signal in the dentate nucleus of the cerebellum, basal ganglia, plexus choroideus and pons. LCH – associated abnormal clinical findings such as ataxia, tremor, abnormal cerebellar tests are characterized by absence of CD1a+ histiocytes, an inflammatory collection of CD8+ lymphocytes with neuronal and axonal degeneration and extensive demyelination, Purkinje cell loss, gliosis that is explained as ‘paraneo plastic phenomena’.

LCH patients known to have an increased risk for CNS complications have craniofacial involvement at the time of diagnosis (single skull lesions of the orbit, temporal, mastoid, sphenoid and ethmoid bones), Multi System (MS) involvements such as bone marrow, lung, liver and bone marrow involvements, children below the age of 2, carrying BRAF-V600E mutation in CD207+ cells, treatment-resistant cases to prednisolone plus in blastin therapy for 6 months and those patients with multisystem disease (with or without detectable BRAF-V600E mutation). LCH spread to CNS would be hematogeneous or lymphatic routes. Sometimes, CNS manifestations occur even in the absence of detectable disease elsewhere in the body. 

Magnitude of Hepatitis B Virus among Barbers in Addis Ababa, Ethiopia

                                                 http://austinpublishinggroup.com/austin-hepatology/

Viralhepatitis is a major health problem worldwide. Hepatitis B virus (HBV) is of the greatest concern due to its burden of illness and death. WHO and the U.S Centers for Disease Control (CDC) estimate that over 500 million people are currently living with chronic viral hepatitis and globally around 2 billion people have been infected with hepatitis B virus with around 1 million people die every year due to complications of hepatitis B, including cirrhosis and liver cancer. HBV can cause both acute and chronic diseases. Hepatitis B virus is 50-100 times more infectious than human immunodeficiency virus (HIV) and 10 times more infectious than hepatitis C virus (HCV) and an infectious dose is so low that a contaminated razor or blade can easily transmit the infection.

Thehepatitis B virus can survive in the environment for at least 7 days. During this time, the virus can still cause infection if it enters the body of a person who is not protected by the vaccine. It can also spread by percutaneous or mucosal exposure to infected blood and various body fluids, as well as through saliva, menstrual, vaginal, and seminal fluids. Infection in adulthood leads to chronic hepatitis in less than 5% of cases. In addition, infection can occur during medical, surgical and dental procedures, through tattooing, or through the use of razors and similar objects that are contaminated with infected blood or during barbershop shaving.

Razorsharing and shaves from the barbers have been identified as an important risk factors for blood-borne viruses spread as several investigations carried out all over the world demonstrate this facts. In many parts of Africa and Asia, the widespread cultural practice of shaving at a shop or roadside barber is an underestimated route of blood-borne viral disease transmission. For barbers, the use of blades and razors is part of their occupation, which can expose them to blood of customers while shaving and hair cutting. This exposure can put them at risk of many blood-borne diseases including viral hepatitis.

Surgery Following Failure of Repeated Chemotherapy for Squamous Cell Carcinoma of the Tongue can be Fatal and Futile

                                    http://austinpublishinggroup.com/head-neck-oncology/

SquamousCell Carcinoma of the Oral Cavity (OSCC) has a strong presence in this part of the world – with the 2012 GLOBOCAN estimates reporting the highest age-standardized rate, with respect to the world population, in the World Health Organization (WHO) South-East Asia region (6.0 per 100,000). OSCC is known to carry high mortality and morbidity, with various cohorts having described five-year Overall Survival (OS) between 36.1% to 62.5%, and complications rates ranging from 47% to 62%. The tongue is the most common subsite in OSCC.

Surgery has been established as the treatment of choice in OSCC, with chemotherapy and radiotherapy largely being used in the adjuvant setting for patients with specific risk features, and in the palliative setting for patients with recurrent or unresectable disease. Multidisciplinary care is imperative for ensuring favorable outcomes. Nevertheless, some patients seek alternative non-surgical treatment in the primary setting due to concerns of surgical morbidity and its impact on essential functions of eating, drinking, chewing, swallowing, and speaking.

While it is understandable that concerns arising from potential surgical morbidity may deter patients from accepting treatment upfront, non-surgical treatment in the primary setting for resectable OSCC has been associated with poorer outcomes. There is little published data on the outcomes of patients who avoid surgery and instead undergo multiple cycles of non-surgical treatment for OSCC.

The Most Common Cause of Sudden Cardiac Death in Athletes: Hypertrophic Cardiomyopathy-Associated Genes and Mutations

                                   http://austinpublishinggroup.com/austin-hypertension/

SuddenCardiac Death (SCD) is natural and unexpected death from cardiac causes, heralded by abrupt loss of consciousness within 1hour of the onset of an acute change in cardiovascular status. It is difficult to estimate the incidence of SCD but cardiovascular diseases are responsible for approximately 17 million deaths every year in the world, approximately 25% of which are SCD. Several factors like age, race, gender and heredity influence the incidence of SCD. The risk of SCD is higher in men than in women and it increases with age due to the higher prevalence of Coronary Artery Disease (CAD) in older age. Cardiac diseases associated with SCD differ in young vs. older individuals. In the young, there is a predominance of channelopathies and cardiomyopathies, myocarditis and substance abuse, while in older populations, chronic degenerative diseases predominate.

Causes of SCD are numerous: atherosclerotic coronary artery disease, nonatherosclerotic coronary abnormalities, ventricular hypertrophy of myocardium including hypertrophic cardiomyopathy, myocardial diseases and heart failure, congenital heart diseases and diseases of cardiac valves, electrophysiological abnormalities of cardiac conduction system (eg: Wolff Parkinson White Syndrome, Brugada Syndrome, long QT interval syndromes) and miscellaneous causes including extreme physical activity, blunt chest trauma(commotio cordis) and aortic dissection.