Alterations in plasma endocannabinoid concentrations among individuals with major depression treated with electroconvulsive therapy.

The role of the endocannabinoid system (ECS) in depression and suicidality has recently emerged. The purpose of the study was to identify changes in plasma endocannabinoid concentrations of several endocannabinoids and correlate them with depressive symptoms and suicidality in patients with severe major depression undergoing electroconvulsive therapy (ECT). The study included 17 patients that were evaluated in four visits at different stages of therapy. At each visit depression, anxiety and suicidality symptoms were assessed and blood samples collected. Several endocannabinoid concentrations increased following six sessions of ECT, as 2-AG (p < 0.05) and LEA (p < 0.01), and following twelve sessions of ECT, as 2-AG (p < 0.05), AEA (p < 0.05), LEA (p < 0.05) and DH-Gly (p < 0.05). Endocannabinoids also correlated with symptoms of depression, anxiety and suicidality at baseline and at the sixth ECT session. Finally, we found one endocannabinoid, l-Gly, that differentiated between remitted and not-remitted patients at the seventh and thirteenth ECT sessions (p < 0.05). Our findings suggest that depression is markedly related to imbalance of the endocannabinoid system, and further regulated by ECT. Plasma endocannabinoids could be promising biomarkers for detection of depression response and remission.

Eccrine Squamous Syringometaplasia Associated With Lichen Sclerosus et Atrophicus.

ABSTRACT: Eccrine squamous syringometaplasia (ESS) has been associated with several conditions including morphea, linear scleroderma, and burns. It is yet to be reported in lichen sclerosus et atrophicus (LSA). We describe a bullous LSA plaque on the forearm of a woman with pre-existing genital LSA and vitiligo. Besides the histopathological findings of bullous LSA, numerous small irregular squamoid structures were present in the mid and upper dermis always above the normal eccrine glands. The histopathology, periodic acid-Schiff stain, and positive immunostains for P63, low molecular weight keratins 8&18, epithelial membrane antigen, and carcinoembryonic antigen supported the diagnosis of ESS. The pathogenesis of ESS in LSA may be related to ischemia, inflammation, and fibrosis.

Attitudes of the Public to Receiving Medical Care during Emergencies through Remote Physician-Patient Communications.

Providing health services through remote communications for sub-acute health issues during emergencies may help reduce the burden of the health care system and increase availability of care. This study aimed to investigate the attitudes of the public towards receiving medical services and providing medical information through remote communication in times of emergencies. During the pandemic outbreak of the novel coronavirus (COVID-19), pandemic outbreak, 507 participants answered a structured online survey, rating their mean willingness to receive medical care and provide medical information, on a four-point Likert scale. Furthermore, demographic characteristics, social media use, and trust in data protection was collected. The mean willingness to receive medical services was 3.1 ± 0.6 and the mean willingness to provide medical information was 3.0 ± 0.7, with a strong significant correlation between the two (r = 0.76). The multiple regression model identified higher trust in data protection, level of education, and social media use as statistically significant predictors for a higher willingness to receive medical information while the first two predicted willingness to provide information. The findings suggest an overall positive attitude to receive medical care through remote communications.

Bartholin's gland hyperplasia in a young woman.

BACKGROUND: Tumors arising from the Bartholin's gland are very rare; the majority are benign. As most instances of swelling in the Bartholin's gland area represent a duct cyst, clinicians tend to perform incision and drainage, rather than excision of the tumor. CASE: A young woman with prolonged dyspareunia underwent total excision of the Bartholin's gland because it felt firm and irregular. Histological examination revealed a well-circumscribed lesion containing an increased number of acini with a preserved tubular/acinar ratio - findings were consistent with nodular hyperplasia. CONCLUSION: Bartholin's gland hyperplasia may be a cause of swelling in the gland area and dyspareunia. We recommend that whenever the gland feels firm or enlarged, total excision be considered, rather than drainage.

[Malignant teratocarcinosarcoma of the nose and paranasal sinuses].

Malignant teratocarcinosarcoma of the nasal cavity and the paranasal sinuses is a rare and invasive tumor. It is characterized by a mixture of mesenchymal and epithelial components, with cellular elements of a fetal nature. We describe in detail the first and only case in Israel of a patient with such a tumor. Only 40-50 such cases have been described in the medical literature. We have also reviewed the existing literature dealing with malignant teratocarcinosarcoma.