Sarcomatoid Squamous Cell Carcinoma Of The Vulva:A Case Report.

BACKGROUND: A sarcomatoid squamous cell carcinoma of the vul-va is a very rare malignancy of the female genital tract . It has been characterized as an aggressive disease typically associated with early development of local recurrences as well as distant metastases. CASE: A 77-year old woman presented to our hospital with an aggravated vulvar mass, complaining about pruritus and pain. The patient underwent a radical vulvectomy with bilateral inguinal lymph node dissection and bilateral pelvic lymph node sampling. The histo-pathologic examination was consistent with a sarcomatoid squamous cell carcinoma of the vulva with an identical microscopic and im-munohistochemical appearance. The FIGO stage was IB and further management was decided to be radiotherapy. CONCLUSION: A sarcomatoid squamous cell carcinoma is a rare entity with an aggressive biological behavior. To date, there have been only a few cases of the disease reported in the literature. Therefore a more systematic collection and closer study of such cases would be helpful for achieving an early diagnosis and more effective therapeutic strategies in the future.

Factors associated with HCV test uptake in heroin users entering substitution treatment in Greece.

OBJECTIVES: People who inject drugs (PWID) represent the main risk group for hepatitis C virus (HCV) infection in most middle and high-income countries. Testing PWID is considered as an important prevention measure. Identification of PWID characteristics associated with HCV testing may contribute to strategies targeting the containment of the HCV and HIV epidemics in Greece. METHODS: Anonymous behavioural data from 2747 heroin users were collected upon entry in 38 opioid substitution treatment (OST) clinics in Greece during the period 2013-2015. HCV test uptake was the dependent variable while covariates included sociodemographic and addiction-related variables, mostly derived from the EMCDDA treatment demand indicator protocol. RESULTS: Among 2299 cases with complete data on HCV testing, 83.5% reported any HCV testing uptake, with 61.2% reporting a recent test (< 12 months). In the multivariate analyses, any previous HCV testing uptake was associated with age ≥ 25 years, past drug treatment attempt, injecting or sniffing the primary substance, injection history ≥ 5 years, and syringe sharing earlier than the past 12 months. Past HCV test uptake was higher among those reporting full-time employment and 2-4 years injecting histories, and lower among residents of Athens. Recent testing was positively associated with female gender and polysubstance use. CONCLUSION: Any previous HCV testing uptake is high among PWID entering OST in Greece and is associated with older age, longer injecting histories and past drug-related treatment attempts. Efforts to prevent and mitigate the ongoing HCV test epidemic among PWID in Greece should combine treatment with scaling up of screening, targeting especially those younger than 25 years and at the beginning of their hazardous use.

Human immunodeficiency virus in injecting drug users in Europe following a reported increase of cases in Greece and Romania, 2011.

Greece and Romania reported an increased number of HIV cases among injecting drug users (IDUs) during 2011. Most European countries reported no changes in the rate of newly diagnosed cases of HIV or HIV prevalence in IDUs; however, six countries did report increases and several additional countries reported increases in injecting risk indicators or low coverage of prevention services. These indicate a potential risk for increased HIV transmission and future outbreaks unless adequate prevention is implemented.

Effect of age on pupillary light reflex: evaluation of pupil mobility for clinical practice and research.

PURPOSE: The aim of this study was to provide a data base for the measurement of various parameters of the pupil light reflex in normal subjects using a fast video pupillometry device (262 frames/sec). METHOD: One hundred healthy subjects took part in the study aged 44.31+/-18.11 years. Subjects were divided in two (2) groups according to age: 18-50 years of age (group 1) and 51-81 years of age (group 2). All subjects were examined between 09.00 and 15.00 and the re-test examination was repeated exactly 24 hours later. All variables showed satisfactory test-retest reliability (Pearson test-retest showed values over 0. 70 for all parameters besides Time for Maximum Constriction (T3. 0.62) and Recovery (R%: 0.57)). RESULTS: The Latency of pupil reaction to light (Ti) was not affected by Age. Baseline Pupil Radius (RI) after 2 min of dark adaptation was statistically smaller in the elderly group p < 0.001; Maximum Constriction Velocity (VCmax), Maximum Constriction Acceleration (ACmax) and Amplitude (AMP) were significantly smaller in the elderly group (p < 0.001) when compared to group 1. When all parameters were studied their correlation showed a statistical significant difference for R1, R2, VCmax, ACmax and AMP when related to Age. However when Age was taken into account through the use of partial correlation, the relation between R1, R2 and AMP remained unaltered, but the relations between R1 and VCmax and ACmax were dramatically reduced from -0.39 to -0.21 and from -0.45 to -0.09 respectively indicating that the relation observed between Ri and VCmax and ACmax was due mainly to the Age of the subjects. CONCLUSION: The results suggest that age influences Baseline Pupil Size, Maximum Constriction Velocity (VCmax) and Acceleration (ACmax), while the Latency of the light reflex remains unaltered.

Novel presenilin 1 mutations associated with early onset of dementia in a family with both early-onset and late-onset Alzheimer disease.

Two children of an adult with early-onset, autopsy-confirmed Alzheimer disease (AD) developed dementia in their late 20s and were subsequently found to have novel mutations in codon 434 of the presenilin 1 (PS1) gene on chromosome 14, a G-to-T substitution at nucleotide 1548 and a C-to-G substitution at nucleotide 1549. The younger of the 2 children had AD confirmed at postmortem examination. The disease course in these 3 individuals was characterized by cognitive and behavioral problems accompanied by myoclonus, seizures, and aphasia within 5 years after onset. Two grandparents had clinically diagnosed AD with stroke beginning at ages 78 and 66 years, but neither had a PS1 mutation. No other living family member was demented, nor did any other family member have the PS1 mutation. We conclude that the affected parent of the proband was a likely recent founder for these novel mutations in PS1. The family demonstrates the clinical and genetic heterogeneity of AD. Arch Neurol. 2000;57:1454-1457