Objective: The demanding nature of oncological therapies may affect treatment motivation and adherence, leading to an increased risk of premature death. Exploring the interaction between depressive ...episodes and treatment adherence is essential, considering how depression may influence patients' willingness to continue treatment. This study aims to investigate the association between depressive episodes, low treatment adherence, and premature death in individuals with cancer. The study also assessed whether low adherence to therapy acted as a mediator in the relationship between depression and the risk of early death. Participants and Methods: This is a 9-month cohort study in which participants were enrolled in two Italian Oncology hospital units. The Patient Health Questionnaire (PHQ-9) was used for depression screening. Stratified analyses were conducted to explore the relationship between depression, low adherence, and premature death. Results: Out of 263 subjects, depressive episode frequency was 48.2% and low adherence was 9.9%. After 9 months, 13.7% had died. There was a significative association between experiencing a depressive episode (RR=2.14, 95% CI: 1.08-4.39) and low adherence (RR=2.2, 95% CI: 1.01-4.48) upon cohort entry and being deceased at month 9 of observation. The risk associated with depression was found to persist even after accounting for the level of adherence to therapy through standardization (MH-OR=3.11; 95% CI: 1.52-6.34). Conclusions: Individuals with cancer who experience a depressive episode or demonstrate low adherence to therapy are at risk for premature death. Early intervention targeting depressive symptoms and treatment adherence may improve oncological-related outcomes.
Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare new syndrome occurring after the ChAdOx1 nCoV-19 vaccine immunization. Patients with VITT are characterized by a variable clinical ...presentation, likewise also the outcome of these patients is very variable. Here we report the lung ultrastructural findings in the course of VITT of a 58-year-old male patient. Alveoli were mainly dilated, irregular in shape, and occupied by a reticular network of fibrin, while interalveolar septa appeared thickened. The proliferation of small capillaries gave rise to plexiform structures and pulmonary capillary hemangiomatosis-like features. Near the alveoli occupied by a dense fibrin network, the medium-sized arteries showed a modified wall and an intraluminal thrombus. This scenario looks quite similar to that found during COVID-19, where the lungs suffer from the attack of the antigen-antibodies complexes and the virus respectively. In both diseases, the final outcome is a severe inflammation, activation of the haemostatic system and fibrinolysis.
Celiac disease (CD) diagnosis can be extremely challenging in the case of atypical patterns. In this context, oral signs seem to play a decisive role in arousing suspicion of these forms of the ...disease. At the same time, the different expressions of the HLA-DQB1*02 allele apparently seem to facilitate the interpretation of signs and highlighted symptoms. The aim of this work was to verify whether it is possible to identify a correlation between the development of oral signs and different DQ2 haplotypes in celiac pediatric patients. 44 celiac patients with a medium age of 9.9 were studied. Oral examinations were performed in order to identify recurrent aphthous stomatitis (RAS) and dental enamel defects (DED). The diagnosis of DED resulted as being related to allele expression (P value = 0.042) while it was impossible to find a similar correlation with RAS. When both oral signs were considered, there was an increase in correlation with HLA-DQB1*02 expression (P value = 0.018). The obtained results identified both the fundamental role that dentists can play in early diagnosis of CD, as well as the possible role of HLA haplotype analysis in arousing suspicion of atypical forms of the disease.
Mycobacterium marinum is the causative agent of mycobacteriosis in wild and cultured fish and of atypical infection in humans. For the diagnosis of M. marinum, cultural and traditional polymerase ...chain reaction (PCR) methods are currently used. However, these protocols, although able to discriminate within Mycobacterium spp., have proved to be time-consuming or difficult to carry out. For this reason, the aim of this study was to obtain a rapid and specific diagnostic tool to quantify fish Mycobacterium spp. or to discriminate M. marinum from other mycobacteria. A primary PCR amplification with SYBR Green had a detection limit (dl) of 10²Mycobacterium DNA copies with a log-linear quantification range up to 10⁴ (R² = 0.99). The second PCR using FRET probes, flanking a region containing species specific nucleotide variations, was designed and validated with synthetic erp gene fragments corresponding to different mycobacterial species, different whole mycobacteria suspensions, experimentally infected fish tissues, tissues from experimentally infected fish, and samples of cultured fish. The results show that the FRET probes demonstrate a high specificity as the melting curve analysis allowed efficient discrimination of M. marinum from Mycobacterium chelonae, Mycobacterium fortuitum, Mycobacterium pseudoshottsii, Mycobacterium shottsii and Mycobacterium ulcerans. The kidney is the organ with the strongest detection signal and using fish tissues the method has a mean sensitivity of 50 DNA copies/PCR.
During a 4-year (2007–2010) survey, the presence of Brucella suis infection in domestic pigs in Sardinia was investigated. Serum samples were collected from breeding pigs located on 108 commercial ...farms with documented reproductive problems and analysed using the Rose Bengal (RBT) and complement fixation (CFT) tests for screening and confirmation of Brucella, respectively. Of the 1251 serum samples analysed by RBT, 406 sera, originating from 36 farms, were positive for B. suis. CFT was positive in 292/748 sera analysed, confirming positivity in all 36 pig herds. Pigs with international complement fixation test units per ml (ICFTU/ml) values ⩾160 were slaughtered, and their organs collected for bacteriological examination and testing by polymerase chain reaction (PCR). Brucella spp. strains were isolated in culture from 13/502 organs analysed, and subsequently identified as B. suis biovar 2. PCR detected positivity to Brucella spp. in 19/285 organs analysed. These results confirm the presence and emergence of B. suis infection in domestic pigs in Sardinia.
Objective: To report 2 cases of patients with oral lichen planus (OLP), with involvement of the cheeks, with reduced mouth opening, successfully treated with a single radiofrequency session. Cases ...Presentation: A 55-year-old and 56-year-old female patients with OLP and trismus were treated with a handpiece that works with a frequency comprised between 500 kHz and 1 MHz. Parameters used were: first case – biostimulation with application of monopolar capacitive technique software muscle hypotonia, at the power of 29%, for 10 minutes; biostimulation with bipolar resistive technique software contractures power 20%, 10 minutes. Second case –biostimulation with application of monopolar capacitive technique software muscle hypotonia, at the power of 17%, for 10 minutes; biostimulation with bipolar resistive technique software contractures power 20%, 10 minutes. Results: Patients increased the mouth opening respectively of 6 mm and 8 mm and pain disappeared. Conclusions: The use of radiofrequency in the treatment of trismus associated with potentially malignant diseases could be a safe and effective tool, although further studies are needed to confirm these preliminary data.
Objective: This paper deals with oral leukoplakia, a potential oral malignant disorder that often increases in malignancy due to an associated infection supported by the fungus Candida albicans. The ...work is aimed at describing this dual condition through a literature review and an unusual clinical case treated with Photodynamic Therapy. Materials and Methods: We used PubMed as a research engine in order to detect the most recent papers (2014-2023) written in English. Our main goal was to obtain more information about oral leukoplakia, its colonization by C. albicans and its rate of malignant transformation. We also searched the database in order to evaluate the efficacy of Photodynamic therapy against Candida infections. Case Presentation: The case presentation refers to a 37-year-old man with a diagnosis of tongue leukoplakia with a co-infection of C. albicans, treated with Photodynamic Therapy instead of conventional antifungal drugs. Results: The literature review was based on a total of 17939 articles, which were reduced to only 25 after setting the inclusion and exclusion criteria in several steps. Oral leukoplakia is an idiopathic condition that can be considered a precancerous lesion; its co-infection with C. albicans increases the chances of its malignant transformation. Photodynamic therapy is a new approach in terms of non-conventional therapies, and there is growing evidence that it can be used in the treatment of oral diseases, too. Conclusions: We eradicated the presence of C. albicans strains on our patient’s leukoplakia by using a mixture of photo-activated curcumin and H2O2, decreasing the chances of malignant transformation of our patient’s lesion, who is still undergoing a six-month control protocol.
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